MentalHealth4Muslims

Obsessive Compulsive Disorder and Scrupulosity in Islam

Dr. Nafisa Sekandari and Sr. Hosai Mojaddidi — Sun, 08 Jan 2012 20:56:54 +0000

“He who has health has hope, and he who has hope has everything.” – Arabian Proverb

Wikipedia defines scrupulosity as a psychological disorder “characterized by pathological guilt about moral or religious issues. It is personally distressing, objectively dysfunctional, and often accompanied by significant impairment in social functioning”.

Religious practice and devotion are not necessarily the cause of scrupulosity. Scrupulosity is considered a form of Obsessive-Compulsive Disorder (OCD). OCD can occur in different forms. There are a variety of different types of obsessions and compulsions. The nature of intensity of these symptoms may vary over time. In some cases, aggressive, sexual and religious obsessions can occur together in the same individual.

The obsessions in OCD are the recurrent thoughts or impulses that make an individual anxious (such as the fear of germs in public places making one sick). Despite an individual’s efforts to control and suppress the obsessive thoughts, the obsessions persist. The thoughts often feel intrusive and disturbing despite the individual’s awareness of the thoughts being produced in their own mind. Obsessions can include fear of harming someone, becoming contaminated, and/or doing something embarrassing.

Compulsions, however, are repetitive behaviors or mental acts the person feels driven to perform. These acts are often with ritualistic rigidity aimed to prevent the anxiety connected with the obsessions. These actions may include the urge to wash, count, check, or repeat phrases to oneself.

OCD appears to be a biologically based disorder with severe psychological consequences. According to the OCD foundation about 1 in 100 adults – or between 2 to 3 million adults in the United States have OCD. The OCD foundation also estimates at least 1 in 200 – or 500,000 – kids and teens that have OCD in the United States. OCD statistics is assumed that up to 2.5 percent of the world population is affected obsessive-compulsive disorder. Some compulsive symptoms are detected in approximately eight percent of population.

People suffering from OCD also end up suffering from depression, a lack of self-esteem and self confidence, very weak willpower, relationship problems, and social withdrawal.

How Scrupulosity differs from devout faith and practice

According to the hadith “Abu Huraira (may God be pleased with him) reported the Prophet (peace be upon him) said: “The religion of Islam is easy, and whoever makes the religion a rigour, it will overpower him. So, follow a middle course (in worship); if you can’t do this, do something near to it and give glad tidings and seek help (of Allah) in the morning and at dusk and some part of the night” [al Bukhari]. Scrupulosity is when the individual is overpowered by their devotion and practice of their faith. The scrupulous individual will focus excessively on a few specific rules and rituals while neglecting other aspects of the religion. It often involves mistakenly thinking that innocent or unavoidable things are sin and so feeling needlessly guilty. When scrupulosity turns to obsessive thoughts, it can generate upsetting, uncontrollable blasphemous thoughts or images about God, or exalting the devil.

Just as some people with OCD feel compelled to keep checking locks or washing their hands, others might feel compelled to obsess over blasphemous thoughts that they hate or to keep doubting their salvation. Due to the doubting nature of scrupulosity, it has been also been called “pathological doubt”. OCD sufferers will take a simple act of locking a door, switching off the oven, or seeking Allah’s forgiveness, and then worry abnormally over whether they did it correctly. They feel driven to keep seeking assurance far beyond what is rational.

Scrupulosity is considered a hidden disease due to the fact that it can fill people with such false guilt that many are unlikely to admit to it, while others have no idea that they have an unhealthy sense of guilt and so suppose there is nothing wrong with them.

In Islam, such unwanted thoughts are called wasawis (plural of waswasah), which are whispered into the minds and hearts of people by Shaitan (Satan). These wasawis play a significant role in many mental disorders that involve anxiety and cognitive distortions. Although wasawis can affect individuals regardless of age, sex, faith, or creed, the nature, content, severity, and influence of these thoughts varies in individuals. For some, they only cause mild anxiety and worry, while others are more severely affected to the point of becoming spiritually, mentally, emotionally, psychologically, and socially paralyzed. Recurring thoughts about catching germs, being unclean, and questioning one’s faith appear to be the most common form of OCD amongst Muslim men and women but those suffering from scrupulosity, the unwanted thoughts tend to be more debilitating.

In the process of wasawis, Shaitan doesn’t care about the thoughts and doubts he sets buzzing around in our heads. Shaitan knows we will not be judged for the thoughts he has implanted in our heads because they are his thoughts, not ours. It is an impossible task to stop unwanted thoughts from coming in our minds. While we are busy battling unwanted thoughts from our mind, Shaitan accomplishes his goal of distracting us from the essential teachings of Islam. The goal of every Muslim should be to strengthen our faith and connection to Allah and not waste time avoiding certain thoughts or feelings.

Shaitan will try and distract us from his real schemes and instead focuses our attention on past sins instead of present forgiveness. Shaitan will also try and trick us into becoming so preoccupied with needlessly worrying about dishonoring God with words that we do not even mean, that we don’t notice that we are dishonoring God by not believing the extent of His love and forgiveness, even towards those of us who feel certain we are the worst sinners ever to walk this planet. No matter how terrible the words or images that invade our mind are, we are not “sinning”. Shaitan will also try and entice us to fear Quranic verses that apply only to people who until their dying day stubbornly refuse to repent from their deliberate sin/backsliding and refuse to seek forgiveness. Shaitan’s hope is that we become so alarmed by the few words in the verses that do not apply to us that we lose sight of the enormous number of joyous verses that do apply – those promising salvation to everyone who repents and believes in Allah and His messenger. Shaitan’s dirty trick is to put despicable thoughts in our mind and then blame us or Allah for it. Allah isn’t fooled into blaming us for Shaitan’s trickery and we shouldn’t be fooled either. Just like we can’t stop Shaitan from being Shaitan, we can’t stop thoughts of temptation from popping into our thoughts. All we can do is stop ourselves from being deceived by the thoughts.

All in all, Obsessive Compulsive Disorder is an anxiety disorder. It is fear/anxiety that keeps us hounded by doubts, guilt feelings or unwanted thoughts that keep repeating in our minds. It is the very nature of deceiving spirits to foster and exploit fear for their evil purposes, and their highest goal is to fool us into losing faith in our religion.

Treatment of Scrupulosity

Like other forms of OCD, scrupulosity responds to medication and cognitive-behavioral therapy (CBT). About 60%–80% of patients show some degree of response to treatment. The neurotransmitter serotonin appears to be involved in the pathology of OCD. Medications that boost the level of serotonin in the brain such as SSRI’s (e.g. clomipramine, fluoxetine, sertraline, paroxetine, fluvoxamine, and citalopram) are the most effective in treating OCD.

Cognitive-Behavioral therapy (CBT), specifically Exposure and Response Prevention (ERP) has been successfully used for the treatment of OCD. ERP focuses on the fact that compulsions provide only a temporary reduction of the anxiety produced by obsessions. The only way to experience more permanent relief is to habituate (get used to) the anxiety caused by the obsession, without performing the compulsion. The key factor of ERP is habituation. While this type of therapy typically causes some short-term anxiety, this facilitates long-term reduction in obsessive and compulsive symptoms. Facing the negative, unwanted thoughts will create anxiety. It is highly unpleasant, but they must disregard their fears in order to benefit from treatment. Facing their anxiety is an unavoidably unpleasant experience, but they must continually force themselves to stay close to God, even though their fears of rejection and divine displeasure are immense. As the person with scrupulosity begins to face his/her fears, he/she may experience a temporary increase in anxiety but with continued support and medication, the anxiety will decrease and symptoms will improve

When overwhelmed by unwanted thoughts:

Keep in mind, first and foremost, Allah (swt) has prescribed a balanced approach to Islam and reassured us His mercy and forgiveness are ever so near. So if fear, anxiety, or condemnation comes upon us, it is not from God. It is simply a dirty trick of Shaitan trying to get us to take our eyes off the infinite saving power of Allah (swt).
When unwanted thoughts or fears hit, do your best not to let the attack distress you. Let it wash over you, keeping as calm and unconcerned as you can. The thoughts or images won’t hurt you, and God does not accuse you. Allah (swt) knows best, even better than you do, that these thoughts are not yours. Temptation usually takes the form of thoughts being satanically placed on our minds, and temptation is not sin.
When you reach the point where you don’t react to the unwanted thoughts of doubt, oppressive guilt feelings, and spiritually repulsive thoughts, the attacks themselves will lessen. Psychological fact: Anxiety is a driving force behind Obsessive Compulsive Disorder so if you are not anxious about the thoughts, you’ll notice a significant reduction in the attacks. Spiritual fact: When Shaitan is thoroughly convinced that he can no longer use such things as unwanted thoughts to annoy you, or undermine your faith, he will eventually begin to tire of that approach and only try it now and again, just to check that you have not reverted to being concerned by such attacks.
We give pleasure and power to Shaitan when we fall into his trap of supposing that his plan is to get us to think or feel wrong things. Shaitan’s main goal is to get us distracted so he can ambush us.
Shaitan’s evil scheme is not to entice us to think or feel anti-God things but to fool us into denying the saving power of Allah (swt) by us forgetting Allah’s power to continually forgive every person who repents and puts faith in him.

Daily Exercises:

When unwanted thoughts creep in your mind, catch them and write them down. Right below the thought, challenge the thought by asking if that is a true thought. Is it 100% true about you? Below that write down,
“it’s just a thought”.
Practice daily affirmations such as “I’m doing the best that I can”, “My thoughts are just thoughts and only have power over me if I give them power and I choose not to empower these unwanted thoughts”, “I put my trust and faith in Allah’s mercy and forgiveness”. The affirmations might not feel true for you but repeating them daily will help you replace the negative thoughts with the positive affirmations, thereby lessening the power of the negative unwanted thoughts.
Practice deep breathing exercises and repeat to yourself “I am safe and with Allah’s blessings, Shaitan can’t hurt me”.
Actively get involved in a deeply engrossing activity that you enjoy such as exercising (yoga, running, biking, etc.) or playing a board game where you are not focused on the negative thoughts.
Force yourself to smile. This simple act will automatically make you feel happier and relax. Your mind is incapable of having a good and bad thought at the same time. When you smile, you force your mind to focus on the positive rather than the negative.
Work with a mental health professional to address the symptoms of scrupulosity. Past traumas (like sexual/physical abuse) and unsavory conduct and lifestyles of the past that may be responsible for severe guilt leading to OCD, must be dealt with in therapy with a trained mental health professional.

Overall, relaxation, daily practice, education, medication, and cognitive behavior therapy can be combined to treat OCD and Scrupulosity.

Coordination Between Islamic Leaders and Mental Health Professionals

It is often useful for mental health practioners and religious leaders to work together in raising awareness and educating the community about Scrupulosity. The religious leader can help the community members distinguish legitimate concerns about faith and guilt from stereotyped religious obsessions. If an individual is compulsively repeating a ritual until it is perfect, the Imams may need to give individuals special permission to perform a ritual in a less than perfect manner. This can lead to freedom from excessive guilt and stereotyped religious obsessions. Ultimately, the individual is freed to experience a richer life in his or her family and faith community.

6 Things NOT to Say to Someone Who is Divorced

Dr. Nafisa Sekandari and Sr. Hosai Mojaddidi — Wed, 09 Nov 2011 16:29:05 +0000

By Amal Killawi and Zarinah Nadir

Divorce is never easy.

Divorce is often a time of monumental hardship and change. Many people do not know how to convey their sentiments when learning about a divorce. Comments are usually well-intentioned, but can be grossly misplaced. In honor of our brothers and sisters who have experienced marriage dissolution or are currently in the process, we present a list of the top 6 things not to say to divorcees. These statements are based on real-life experiences shared with us.

1. “Are you sure?”

Unless this question is posed by close family and friends or persons involved in the mediation process, it is highly inappropriate, offensive, and intrusive. If people were unsure of their decision, they would not have shared the news with others. Additionally, for some people, divorce may not have been their choice or decision to make. People are likely to be under a great deal of emotional stress, and asking them about the uncertainty of their decision is disrespectful of their journey before separation.

2. “How long were you married?” And upon finding out it was a relatively short period – “Oh, well, at least it was short.”

Marriage duration is not an accurate indicator of the value of the relationship, the length of the healing process, or the legitimacy of the marital experience. Whether the marriage lasted for 5 months or 5 years, it is important to acknowledge the significance of this loss. The end of a marriage often also symbolizes the end of the dreams, aspirations, and life plans of the couple. Additionally, it is important to realize that regardless of the duration, some people may have suffered through distressing trials in their marriage. The last few months could have been a living nightmare.

3. “I saw it coming all along.”

Since when has “I told you so” ever been a sensitive comment? Unfortunately, some people use these opportunities to reveal their intuitiveness about a person’s marital problems. Although they may consider it to be a statement of reassurance – that one should not be upset because the relationship seemed destined for divorce anyways – it is just plain rude and insensitive.

4. “Who filed for divorce? Did you go to court? What did you get? Who has custody?”

For Muslims in the United States, divorce is often both a civil and religious process. These processes can be lengthy and draining emotionally and financially. Practice caution when asking questions about the divorce process. Take the lead from the divorcee before entering into a conversation. If the person doesn’t share, don’t probe. These are personal questions and may still be contentious.

5. “But you were such a perfect couple!”

Or any variation of this such as, “But he is such a nice brother!” or “She’s such a religious sister masha’Allah!” There’s no such thing as a perfect couple or a perfect person. It is important to remember that people’s public personas can be very different behind closed doors. No matter how well we think we know others, there is nothing comparable to living with another person in a marital relationship. Statements that pass judgment should be avoided because the reality is we do not know.

6. “May you get remarried soon!”

Not everyone who has experienced a divorce appreciates a du`a’ (prayer) for a speedy remarriage. While prayers are important for a person going through hardship, keep in mind that certain prayers expressed during this time may not always be appropriate. Some people do not wish to re-marry for some time. Additionally, some divorces are as a result of traumatic experiences such as domestic abuse or infidelity, and divorcees may very well be fearful of re-experiencing this trauma in a future marriage. It’s better to focus your du`a’ on helping them to adjust and move on, instead of praying for another marriage!

So then, what is appropriate etiquette?

Follow their lead. Recognize that some people may want to talk, while others do not. Respect their preference.
Express empathy. Say, “I’m sorry about your divorce. How are you doing?”
Offer support and encouragement. Simply saying, “Please know that I’m here if you need anything” can go a long way.
Stay silent. If you don’t know what to say, silence is golden and acceptable.
Be sensitive to their needs. Make them feel included despite their change in marital status.
Honor their journey. Grief is generally a part of the healing process as people learn to adjust to life after separation.

Remember, you may encounter someone at any stage in that process. By practicing sincerity and utilizing common courtesy, we can be more mindful in our interactions with people undergoing a time of reflection and change.

Reposted with permission from the authors and originally posted on http://www.suhaibwebb.com/relationships/marriage-family/spouse/6-things-not-to-say-to-someone-who-is-divorced/

The Impact of 9/11 on the Mental Health of Muslims: 10 Years Later

Dr. Nafisa Sekandari and Sr. Hosai Mojaddidi — Tue, 27 Sep 2011 19:21:31 +0000

September 11, 2011 changed not only the world we live in but had a major impact on the mental health of individuals around the world. Some of the individuals most impacted by the events of 9/11 were the Muslims in the United States and abroad. Based on research conducted post 9/11 by multiple individuals, Muslims and Arabs have suffered tremendously. For Muslims and Arabs living in the United States, the impact was two-fold. Not only were they mourning the loss of thousands of fellow countrymen and women who lost their lives on 9/11, but they were simultaneously dealing with discrimination, hate crimes, stigmatization, isolation, and fear for their own well being in a country they called home.

Dr. Mona Amer, a psychologist, conducted research about the mental health of Muslims and Arab Americans in 2006 but ironically ended up as a target of hate and discrimination after her research was reported in USA Today. In an article by American Psychological Association’s Monitor on Psychology, Rebecca Clay reports in her article “Muslims in America, post 9/11”, Dr. Amer received death threats from strangers. The negative attitude towards Muslims has not decreased since the 2006 study by Dr. Amer. Since 9/11, political candidates and TV pundits have contributed to the hostile attitude towards Muslims in the United States. The past 6 months alone Muslims have made front page news due to stories about Quran burnings, The Ground Zero Islamic Center, and anti-Muslim congressional hearings on Capitol Hill. Ms. Clay reports “according to the Pew Research Center, the number of Americans with favorable views of Islam dropped from 41 percent in 2005 to 30 percent in 2010. Ten years after 9/11, the positive attitude towards Muslims in the United States has declined rather than improved. Muslims receive constant negative messages through the media about their religion and culture. Dr. Amer states “there are things that are said in the media about Arabs and Muslims that would never be tolerated or said about any other group…you receive constant messages about how your community is full of terrorists, ignorant people, oppressive people” (APA monitor, 2011).

The constant Islamaphobic rhetoric is having a negative impact on the mental health of Muslims in the United States. Dr. Amer, who has the largest group of participants from the most demographically diverse Arab-American population, has found many Muslims and Arabs suffer from anxiety, depression, and even post-traumatic stress disorder (PTSD). Although the majority of the participants were Muslims, we must note not all Arabs are Muslim, yet many suffered the back-lash due to being Arab. In the study which will soon be published in the Social Psychiatric Epidemiology, Dr. Amer, along with Dr. Hovey of the University of Toledo, found 50 percent of the study participants had depression that warranted further evaluation and 25 percent reported moderate to severe anxiety. Ongoing racial profiling, discrimination (verbal assaults and work place discrimination), and other stressors unique to Arabs is reportedly the cause. According to Kaplan (2006), violent acts against Arabs and those perceived to be Arabs rose sharply over the 9 weeks following 9/11. Although the majority of participants in the study reported feeling safe to extremely safe pre 9/11, more than 82 percent reported feeling unsafe to extremely unsafe post 9/11. Dr. Amer and Dr. Hovey note feeling unsafe is a predictor of Post Traumatic Stress Disorder (PTSD).

According to Padela and Heisler (2009) there are roughly 5.4 million Muslims in the United States, made up of African Americans, South Asians, and Arabs; additionally, there are approximately 2.5 million non-Muslim Arabs residing in the U.S. There is a large portion of the Muslims in the United States who are immigrants, many from war torn countries such as Palestine, Iraq, & Afghanistan. There are many stressors and trauma inherent to immigration, such as loss of home and land, acclimating to a new culture and environment, and dealing with cultural and linguistic barriers. Many immigrants from war torn countries have also suffered trauma as a result of their experiences back home. For these Muslim immigrants, the added stressors related to post 9/11 exacerbate their symptoms.

For many Muslims, turning to religion, as opposed to mental health practioners, is the first line of defense. Many individuals tend to intensify their religious practice by additional fasting, reading the Quran, praying, and regular mosque attendance. Abu-Raiya et al (2011) surveyed 130 Muslims living in the United States and found most experienced at least one stressful event related to their Muslim identity such as anti-Muslim comments, special airport security checks, and discrimination. In the study, Abu-Raiya reports participants used both religious and non-religious coping strategies to best handle these stressful situations. Abu-Raiya identifies the non-religious coping strategies as reaching out to others (either Muslim or non-Muslim). Reaching out to others resulted in positive changes such as personal strength and better appreciation of life. Those individuals who isolated themselves from others experienced increased depression and anger. Abu-Raiya identifies positive and negative religious coping strategies in his study. Positive religious coping involved feeling the love of Allah and praying for consolation. It also involved reading the Quran and seeking support from members of the Mosque. Negative religious coping strategies included feeling Allah was punishing them for their bad actions or lack of religious devotion and practice. Abu-Raiya found the positive religious coping was associated with greater “post traumatic growth” and the negative religious coping was associated with higher levels of depression. Individuals should focus on the positive religious coping strategies and avoid the negative religious coping strategies.

For many Muslims, seeking out mental health professionals is a challenge due to the lack of Muslim mental health practioners in their community, and having to work with non-Muslim mental health practioners. Muslims should seek out mental health support if they are dealing with depression and/or anxiety. Dr. Amer, who is also the co-editor of “Counseling Muslims: Handbook of Mental Health Issues and Interventions” (Routledge), reports many non-Muslim mental health practioners “don’t necessarily get into the specifics of what can or should be done differently when serving a Muslim client”. Dr. Amer suggests mental health professionals should address ethnic background, history, and immigration status when working with Muslims and don’t assume all Muslims are the same. Also consider the fact that Muslim Americans can include African-American, Latino, and Caucasian converts, members of long settled Arab communities, and immigrants from diverse backgrounds such as China, India, Pakistan, Africa, etc. Dr. Amer encourages non-Muslim therapists to bring religion in therapy. Therapists should encourage a religious dialogue with their Muslim clients and make an attempt to better understand the specific needs of their clients.

If you are Muslim and have reason to believe your mental health is suffering from any of the symptoms we’ve described above it is critical that you seek treatment as soon as possible before your symptoms worsen. For information or help finding a therapist in your area please email us at info@mentalhealth4muslims.com.

In the meantime you can also benefit from reading the Seerah of the Prophet Muhammad (peace be upon him) and reflecting on all of the traumatic events he and the earlier generation of Muslims experienced. There are also specific verses from the Qur’an and hadith that can provide relief in time of difficulty such as:

” Certainly, We shall test you with fear, hunger, loss of wealth, lives and fruits; but give glad tidings to the patient – those who, when afflicted with calamity say, “Truly to Allah we belong, and truly to Him shall we return.” It is those who will be awarded blessings and mercy from their Lord; and it is those who are the guided ones.” (Qur’an 2 :155-157)

“..Be mindful of Allah, you will find Him before you. Get to know Allah in prosperity and He will know you in adversity. Know that what has passed you by was not going to befall you; and that what has befallen you was not going to pass you by. And know that victory comes with patience, relief with affliction, and ease with hardship.” (Tirmidhi)

Know Thyself, Know Thy Community: A Mental Health Survey of Muslim College Students

Dr. Nafisa Sekandari and Sr. Hosai Mojaddidi — Thu, 18 Aug 2011 20:10:59 +0000

By: Farhana Jahan and Zahra Murtaza

As originally published in Al-Bayan magazine: The Muslim Student Publication at the University of California, Berkeley

“Verily in the remembrance of God do hearts find rest.” (Qur’an Surah Ra’d 13:28)

When was the last time you had a mental health check-up? Most Americans would have a difficult time answering that question. If you’re an American Muslim, you probably would too, and then some. An appointment with a psychologist has not yet achieved the casual normalcy with which a doctor’s appointment is made. The stigmas that surround mental health pervade society. From caricatures of Freudian psychoanalysts relating everything to sexual suppression as they sit remote behind a reclining client, to the belief that popping a few psychiatrist-prescribed pills will solve the problem, these notions discredit the benefits of seeking actual therapy from professionals proven to improve the quality of one’s life. In addition to these perceptions in the wider community, certain cultural taboos, a lack of knowledge regarding mental health in Islam, and only blaming supernatural forces such as jinn may be particularly impeding to American Muslims from seeking professional help for their mental health needs.

The purpose of [this] survey titled “Muslim College Students and Mental Health” was an attempt to understand this very topic by gathering data and experiences of actual American Muslims. The population studied was Muslim undergraduate and graduate students from the United States. Questions on the survey ranged from asking participants their opinions on awareness and acceptance of mental health issues in the Muslim community to more specific questions about their own personal mental health and family history. It also inquired as to how likely one would be to seek help, which factors would affect their decision, and what methods helped individuals cope with mental health needs. Finally, in a desire to incorporate positive psychology, the survey included questions on what uplifted participants’ mood, how happy they felt on a regular basis and how Islam impacts their mental health.

There were 160 responses to the survey from ethnically and socioeconomically diverse participants. The majority of respondents (68%) believed that there is little or no awareness or acceptance of mental health issues in the Muslim community. The results show a slight trend of participants believing that the Muslim community’s acceptance of these issues is even worse than its awareness.

28% of participants reported a family history of mental illness with 11% of participants themselves reporting that they have a diagnosed mental condition such as (but not limited to) depression, bipolar, anorexia or bulimia nervosa, schizophrenia, autism, OCD, ADD/ADHD, or others. A large percentage (32%) felt that they may have an undiagnosed psychological condition which is a surprising finding indeed. This highlights the need to seek help for one’s personal psychological health rather than living in doubt.

According to the National Institute of Mental Health, serious mental illness affects about 5% of adults. The rate of serious mental illness is higher for the 18-25 age group than for any other group (almost 8%). On the other hand, the United States Surgeon General estimates the national proportion of mental disorders to be around 20% in a given year. The results of our survey (11%) indicate a trend between these two figures, highlighting the fact that American Muslims are not too different from the national populace. In fact, similar concerns about mental health affect us all simply because we are human.

Self-rating on overall mental health was generally positive. Only 9% believed their mental health was very poor or poor, 28% thought it was average and the majority (45%) thought their mental health was good. 18% rated their mental health as very high or very good. This scale matched very well with the scale “How content and at peace are you feeling on most days”. The majority (44%) rated themselves a 4 out of 5 in which they feel quite content and at peace on most days.

78% of respondents reported that Islam influences their mental health quite a lot or very much (4 or 5). In terms of how Islam impacts one’s mental health, many people cited closeness to God, prayer, keeping everything in perspective, and having a purpose or meaning in life as helpful.

While our survey did have a large sample size, we should be wary of over-reliance on the results as our sample may over represent individuals with strong opinions or interest in this topic. Another area to be cautious of is the gender disparity amongst respondents, the majority of whom were Muslim women (74%). While many psychological conditions hold true for both genders, there are still some distinct differences (such as the statistical prevalence of internalizing disorders such as anxiety and depression in women) which may be overrepresented in our results.

Some very personal stories were shared in the survey that deeply affected us. There were individuals who had never come out before with their stories or had not shared with many others. One particular case of a sister who had schizophrenia highlighted struggle, stigma, and resilience. There were several stories of depression and coping with changes in life and a common theme of fighting all odds and paving one’s own path within the community which does not accept mental illness or variant mental health conditions so openly. We were honored that these individuals took the time to respond and we hope the survey was a means for our community to begin thinking and conversing about this little-discussed topic. Furthermore, we hope the results of the survey will be helpful in endeavors to address mental health needs in our American Muslim community.

Where do we go from here?

It’s difficult to address what it means exactly to treat an American Muslim’s mental health due not only to their diverse backgrounds and varying levels of religious practice, but also to the lack of empirical research done on the demographic. There are many issues present within the Muslim American community that remain unaddressed psychologically, such as how the large immigrant population copes with life changes, culture shock, and often separation from extended families that can lead to psychological distress. Immigrants from war-torn countries such as Bosnia, Palestine, Afghanistan ,or Iraq may also be dealing with untreated post-traumatic stress disorder, unaware that there is help for their mental suffering. Emerging evidence shows that the stress and anxiety from increased discrimination against American Muslims post 9/11 is proving to be psychologically detrimental (Ahluwalia & Zaman, handbook). Dr. Nafisa Sekandari, Psy.D., a licensed clinical psychologist and practicing Muslimah, notes that depression and substance abuse are among the prevalent issues her Muslim clients face, not unlike issues that individuals of many communities face. As members of the larger society, and specifically as college students, American Muslims must deal with balancing Islamic ideals within conflicting frameworks of identity in addition to school, career, and familial responsibilities that can lead to great amounts of stress that not everyone is prepared to handle.

There is an assumption that mental issues should be easy to fix because they’re “in your head” and therefore somehow under one’s control. It is normal to experience strong emotions, but when those emotions become debilitating to one’s life it is necessary to seek help. Depression is especially misunderstood as a condition of being ungrateful for the blessings given by Allah (swt). This view displays a lack of knowledge regarding the actual suffering of individuals living with depression and hinders them from seeking the help they need. It’s not easy to change the ways one feels and acts. It requires effort, education, and assistance.

The most challenging stigma that effects people of faith, especially within the American Muslim community, is that if someone is a “good Muslim” they shouldn’t have any mental problems. This kind of judgment, that the individual is lacking in deen, can lead to feelings of guilt and additional pain, furthering the unwillingness to seek professional help. In addition, many Muslims learn to think in terms of “Alhamdulillah, at least I have it better than a lot of other people.” While it is beneficial to not lose sight of the bigger picture in the midst of one’s internal struggles, avoiding those personal mental issues doesn’t allow one to deal with them accordingly. If Allah (swt) wills, He will certainly respond to prayers with recovery. However one must also take initiative in bettering themselves. If it’s okay to go to a doctor and receive treatment for a physical ailment, then why is it so different to do so for a mental one?

Stigma associated with seeking mental health still flourishes in the American Muslim community. Some may perceive talking to a therapist as betraying family confidentiality or ghiba (backbiting). The perception that one is not allowed to share personal emotions makes an already intense and vulnerable experience even more difficult. Individuals interested in seeking help may be referred to Quranic verses and hadith that state the importance of concealing one’s sins, which inspire feelings of guilt or shame when it comes to dealing with one’s mental health as well as fear of being judged. While it is true that in Islam one should not boast or flaunt their sins, this does not mean one cannot seek sincere advice or assistance. The Prophet Muhammad (peace be upon him) said: “The Deen is Naseeha(sincere advice).” (Sahih Muslim) Mental health issues are not sins, just as physical health issues are not sins. Seeking help does not mean one is revealing their sins. So you are not revealing your sins when you are seeking help.

Many argue that they have no need to seek professional help when they have friends and family to speak to. Friends and family may have good intentions but unlike a therapist, their job isn’t to listen objectively with undivided attention or to offer support based on tested theories. Friends’ initial empathy can even turn into irritation, which the ill individual may pick up on and then feel worse. Many imams provide counseling and are great resources for spiritual needs. However, they are not trained mental health professionals equipped to deal with serious mental health issues and therefore may not recognize when a problem is serious.

In Islam, we believe that the true human potential can be realized and reached when one submits their will to Allah, the Most High. This not only gives the human self-worth and dignity but it also allows the human to have a clear and meaningful purpose in life. In theory, this is one of the most useful ways to increase mental well being. However, this does not necessarily mean “religious” Muslims don’t have mental health issues. Mental disorders and mental issues are human issues.

It can be difficult to talk about mental health issues. The first steps we can take to eliminate stigmas is to have open discussions about the topic and learn to empathize with individuals suffering from mental disorders. Even if someone does not have a disorder, mental health ups and downs are normal parts of life which everyone should look out for.

Some tips:

1. Be conscious of unnatural changes in your moods or habits.

2. Develop healthy methods to combat stress such as writing in a journal, talking about your worries, reading your favorite blog, exercising, consulting a professional.

3. De-tox unrealistic standards. At the end of day, it only matters what your Creator thinks of you.

3. Make it a point to make personal time for yourself; never be too busy for YOU.

4. Maintain close relationships with the community, friends, family.

5. Cultivate a personal and intimate connection with Allah and His Book. Find peace and solace in prayer and du’aa (supplication).

Also, there are many mental health resources available for free online:

www.mentalhealth4muslims.com

www.nimh.nih.gov

www.apa.org

http://naseeha.net/main/ - A free Muslim Youth Helpline

http://www.uhs.berkeley.edu/students/counseling/cps.shtml -Tang Center’s Counseling

and Pyschological Services

http://www.nimh.nih.gov/statistics/pdf/NSDUH-SMI-Adults.pdf

http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec2_1.html

Will Your Friendship Last?

Hosai Mojaddidi & Dr. Nafisa Sekandari — Thu, 07 Jul 2011 05:47:11 +0000

“Wishing to be friends is quick work, but friendship is a slow ripening fruit.” – Aristotle

For Muslims, there is no greater example of such a friendship than that of the Prophet (peace be upon him) and Abu Bakr (may God be pleased with him). Their friendship was unparalleled and never waivered no matter what circumstances they were in. The bond they had was truly unique and special, as the Prophet (peace be upon him) so beautifully describes in the following hadith:

Ibn Abbas reports: ”The Prophet (peace be upon him) came out during his illness from which he died, his head bound with a cloth. He sat on the minbar, thanked Allah, praised Him and said: “There is no one among the people who has been more generous to me with his life and his property than Abu Bakr ibn Abi Quhaafa and if I was to take a bosom friend, I would take Abu Bakr as my bosom friend. But, the friendship of Islam is better. Block off every door in this Masjid except the door of Abu Bakr.” (Bukhari)

Friendship provides us with many mental health benefits such as a longer and happier life, as well as increased ability to deal with daily stress and life problems. Having even one good friend can improve your attitude and make life more interesting and enjoyable. The physical and emotional benefits of having a good friend differs from your relationship with your spouse, siblings, parents, or children due to the different level of support, understanding, and communication between close friends.

Sadly, a great source of sadness and depression for many people today is the loss or drastic change in a friendship—not because of some major act of betrayal or deception, but rather because of a welcomed life change like a marriage or a new baby, or even a spiritual change that ends up forcing a wedge of distance between two people that perhaps were once inseparable.

Ex. 1: The Single Friend vs. the “Taken” Friend

This scenario is one that occurs far too frequently, especially among women, and can really put a friendship to the test. For some reason many girls simply disappear from the social scene once a man comes into their life. Perhaps it’s because there is much more pressure on young Muslim girls than on Muslim guys to get married by a certain age so some girls feel compelled to give all of their attention to a potential suitor, even if it’s at the expense of family and friends. Whatever the case may be, to prevent this problem from happening to your own friendship, consider the following points:

Tips for the Single Friend:

It’s not about you. Your friend may be going through one of the most exciting experiences that life has to offer, meeting “the one.” While it may be difficult to tolerate at times, you have to remember your job as the friend is to be as supportive and understanding as you possibly can be and remember this is his/her time to enjoy the moment. Don’t complain or get frustrated if they don’t always pick up your calls or seem to be preoccupied all the time. You should be happy for them even if it’s not something that you can directly experience as well.
Learn to let go—for a little bit. Remember you’ve had your friend for years before this new person came along, it’s only fair to share the amazing person you’ve come to love so much. Don’t feel threatened by the other person because they play a different role than you do and with time things will “normalize” between you and your friend.
Be realistic. Friendships inevitably evolve, especially when someone gets married or moves forward in reaching certain life goals. The friends we have in high school and college will hopefully be there for us but not always the same way we’re accustomed to. We have to be realistic about these natural life changes and be willing to allow for the change to take place instead of resisting it through resentment and misplaced feelings of betrayal.

Tips for the “Taken” Friend:

Too much of a good thing can be bad. Take time to get to know someone you’re considering for marriage and create healthy boundaries. In other words, don’t feel the need to sacrifice your time, energy and money just because you want to impress the other person or because you’re afraid that they may perceive you to be unavailable or unaccommodating. If they are truly interested in you, they will be in it for the long haul and will respect your time and responsibilities. Oftentimes by trying too hard to please one person you inadvertently push them away; this is especially true for men who generally prefer the challenge of the pursuit as opposed to being pursued. If things fizzle out eventually, then you’re left feeling especially lonely when you consider that in the process of talking to someone you’ve pushed away your friends and family as well.
The lover is always preoccupied with his/her beloved. Be sensitive to the fact that while your new budding relationship may excite you and it’s all you can think about or talk about, your single friends may not want to hear about it during every single conversation you have with them. By repeatedly reminding them of what you have, they may just walk away only saddened by what they don’t have. Be mindful to not be the one that is always bringing the conversation back to your situation and be considerate of who you are with.
To share or not to share? While many friendships are built on full-disclosure policies, you have to use your judgment and know who to tell and when to tell them about a new person in your life. Sometimes it’s best to keep things private until it really turns into something serious. It can help to legitimize your feelings about someone by waiting until some time has passed. When you speak too early about someone your emotions or excitement may be getting the best of you and in the end you may end up being discredited by those around you if things don’t work out.

Ex. 2: The New Parent vs. the Non-Parent

Babies are undeniably a wonderful blessing from Allah (swt), but they bring about a lot of changes, some are expected and some unexpected. If you or your friend has recently welcomed a new bundle of joy to your life then consider the following tips to protect your relationship:

Tips for the Parent

Don’t forget who you are. You are undoubtedly engrossed with all the joyful things that come with being a parent. It’s an exciting time of intense change and it may be difficult to really think about anything outside of your baby’s needs. With that said, remember that you were and still are a multi-faceted and multi-dimensional person before your baby. For those reasons, your friends and loved ones have come to appreciate and admire you, so remember to love your baby tirelessly but love yourself as well.
Know that your non-parent friends may care but they can’t always relate. It’s best to share the everyday details of your baby’s developments with friends who have kids and can relate to the experience. Your friends may love you and your baby to bits but it can be quite exhausting to hear you gushing about your baby over the phone or in the middle of a gathering when they just want to talk about the “usual” things you used to talk about.
Be sensitive. If you have a friend who is trying to conceive then it may not be the best idea to go on and on about how wonderful parenthood is. Be sensitive to your social circle and sympathize with the couples who may not yet be parents but want to be. Imagine how difficult it would be if you were a non-parent in a group of parents who only and primarily talked about issues related to their kids. At a certain point you would feel like you didn’t belong, right? Don’t make your friends feel alienated and learn to change the topic to other more inclusive things.

Tips for the Non-Parent

Be patient. Understand that there are a lot of hormonal changes happening to a new mom, especially if she is breastfeeding and a lot of environmental changes happening to a new dad. If your friend seems suddenly unstable or just not the fun, outgoing and energetic person that you remember him/her being, then it’s not that he/she is a different person but rather that they’re either responding to all the physical changes or the environmental changes that come with a baby. If you genuinely care about your friend then you won’t distance yourself because you don’t feel as fulfilled by his/her company anymore but rather you will try to ease some of their burdens. Offer to come over and tidy up the house, do laundry, watch the baby, or run some errands. Both mom and dad can benefit from an extra hand!
Learn to love the baby independent of your friend. It’s natural to see your friend’s baby as an extension of him/her and react accordingly. If you are upset or resentful of your friend because you feel he/she has changed after the baby then you may unknowingly transfer some of those negative feelings to the baby. Recognize that it’s not the baby’s fault that you may be having some issues with your friend, rather it’s the situation, and the fact that neither you or your friend have yet learned how to properly adjust to it. By taking some responsibility you can open yourself to loving the baby and sharing good memories that will last for a lifetime.
Be realistic and stop taking everything personally. If you expect that a baby won’t change the dynamics of your friendship then you really aren’t being very realistic. This is yet another phase of life that necessitates major changes from practically all directions. You and your friend may have been inseparable before, you may have gone snowboarding every single winter season or talked every night before going to bed but the reality is he/she has a new set of priorities that simply cannot be compromised for anyone, not even you.

Ex. 3: The Spiritually Driven vs. The Non-Religious

Many people experience a spiritual awakening at some point in their lives. Whether it comes as a result of a tragedy or because of some serious soul-searching, it happens for people at different times in their lives. It can be really difficult to maintain a friendship if and when one person goes through a major spiritual change, if you’re not prepared. Consider the following tips to protect your friendship:

Tips for the Spiritually Driven

It’s a personal thing. No matter how incredible your experience is with your newfound faith, you cannot expect everyone in your life to understand or relate to what you’re feeling. Spirituality is truly a very personal experience and you may end up alienating people from your life if they think you’re trying to force your beliefs down their throat. Learn to reign in some of that zeal around friends and family who are not as “spiritual” as you are. There is a time and place for everything and if they open up the conversation about why you suddenly decided to wear the hijab or grow out your beard, or why you don’t drink or smoke anymore, then engage them. Otherwise, try to remember that Islam is a religion built on invitation, and not just any type, but with beauty and poise.
Remember who you are. Again, like with any new change you have to remember that you have multiple interests and perhaps talents. While you are immersed in the beautiful experience of growing spiritually, you should try to avoid neglecting the other facets of your personality. Many people rush into religious practice very quickly and then suddenly burn out. There is no need to try to become a super-Muslim overnight. Take things slowly and keep your friends and family close to you by being the person they’ve always known you to be. When your character and outward behavior improves for the better, they will know it is because of your spiritual transformation and may feel inclined to learn more on their own.
Get off your high horse. If you begin to feel the cancer of self-righteousness spread throughout your spiritual heart, then hit the pause button immediately! Remember you are not responsible for whatever guidance and knowledge you have received; that is entirely a gift from God. So to look down on your friends and family for not being as receptive as you were is the height of arrogance. Their guidance is in the hands of Allah (swt) and if you wish for them to increase their practice or embrace the faith then stop judging them and turn to Him and increase your supplication for it.

Tips for the Non-Religious

Be understanding. While you may be skeptical or cynical when it comes to religion, it’s unfair to mistreat or dismiss the experience of a friend who is becoming more practicing in their faith. As a friend you should respect whatever new changes your friend undergoes so long as it doesn’t negatively impact you.
Be open-minded. If your friend wants to share a story or something that moved them then would it really hurt you to be receptive to listening to it? Perhaps you like to talk about a subject that doesn’t necessarily interest your friend but he/she respects you enough to at least listen to you talk about it. You owe it to your friend to give them the freedom to share something so important to them.
Be honest. If you feel your friend’s changes are too much for you to keep up with then be honest about how you feel instead of distancing yourself from them. They may not be aware that they are making you feel uncomfortable so it would be a good learning experience for them to hear it from you as opposed to someone else.

As mentioned earlier, friendships may come and go, but the ones that last are those that can evolve seamlessly with whatever changes that come. If you and your friend are experiencing a rough patch then just remember the example of the Prophet (peace be upon him) and Abu Bakr (may God be pleased with him) and ask yourself what would they advise? Their friendship was so completely selfless that they truly only wanted the best for each other. Do you truly want the best for your friend, even if you can’t share in that experience? If you can sincerely answer yes to that question, then rest assured that your friendship will indeed make it through, God-willing!

Coping with Trauma

Maryam Kazi — Fri, 24 Jun 2011 21:32:29 +0000

“Just as the body goes into shock after a physical trauma, so does the human psyche go into shock after the impact of a major loss.” -Anne Grant

What does it mean to experience trauma? What if one day you were going about your daily business and you receive an unexpected phone call. Suddenly you have found out a loved one has been in a car accident or a natural disaster has struck in a loved one’s city? That moment might change everything. What if something happens to you? Do you quit or run away? In order to properly deal with trauma we need to realize its impact on our life. It can impact our thoughts, behaviors, feelings or relationships.

Maybe you are a refugee and have escaped your country in hope for a better future. Maybe you were subject to child or sexual abuse when you were young. The intensity of the impact trauma will have on our lives is indefinable. Everyone has a different threshold for pain so it is difficult to say how a person may react. Some traumas may be more severe than others but nobody can tell you how you feel. The point is, now you want to move on with your life.

What is Trauma?

We have heard it on the TV, radio and newspapers, but what does it really mean? Trauma can be a result of trying to find your family after the levies break in Louisiana, watching planes crashing into the World Trade Center on the television, listening to recap of the shootings at Virginia Tech, police coming to your door to question a murder down the street or needing to call an ambulance to your home for an unexpected death. Sometimes trauma may have been experienced in the past but something in the present triggers a reminder of those feelings. It may have happened to you or it happened in your world and you were an observer of a traumatic event. Regardless, enough has happened for you to be affected. In times of stress remember Allah and, “Say, “O Allah , Owner of Sovereignty, You give sovereignty to whom You will and You take sovereignty away from whom You will. You honor whom You will and You humble whom You will. In Your hand is [all] good. Indeed, You are over all things competent” (Qur’an 3:26).

Reactions to Trauma

There are emotional responses which we experience as a result of trauma that may include being in a state of shock or feeling numb. There may also be anger toward others involved or feelings of being unsafe or vulnerable. Fear, depression, guilt, frustration, loneliness, sadness are all emotional responses. Physical responses such as dizziness, headaches, muscle tension, upset stomach, and increase in heart rate may occur. There can also be a change in sleep patterns or appetite. Mentally we respond to trauma by confusion, difficulty concentrating or remembering details of the event. Behavioral responses include a fear of being alone or isolating oneself, decreased energy, irritability, crying, etc. Sometimes even marital and relationship conflict or an increased use of alcohol or medications are possible responses.

Certain factors may impact how people react to trauma. It could be the amount of preparation before an event such as a hurricane (more time) versus an earthquake (no time). Perhaps the degree of damage someone experienced physically or to their personal belongings. The amount of devastation witnessed in an event or even the amount of responsibility a person may feel for not preventing or even causing the event.

PTSD

Post-traumatic stress disorder (PTSD) comprises of three types of factors: pre-event factors, event factors and post-event factors. According to the 2005 National Comorbidity Survey-Replication study, PTSD affects about 7.7 million American adults in a given year, though the disorder can develop at any age, including childhood, as reported in NIMH PTSD fact sheet. PTSD is treatable.

Pre-event factors influence how a person reacts to traumatic events such as previous exposure, early substance abuse, gender, age and even genetics. Event factors may contribute to the possibility of developing PTSD. These include geographic closeness to the event, what that event means to you or duration. Post-event factors may be an absence of good social support, neglecting self or being passive.

Criteria for PTSD can be found here: http://www.ptsd.va.gov/professional/pages/dsm-iv-tr-ptsd.asp

Managing Stress

Time for recovery is crucial. Any mental responses listed earlier are most likely short term reactions. However, when they interfere with job responsibilities, seek help through a counselor or therapist. Share your feelings and thoughts with the people closest to you. Talking about our experience is part of the healing process, so don’t try to block recollections. Care for your body by eating well and exercising. Most importantly, don’t compare how other people reacted to the event because each person’s reaction and experience is unique. Seek help through patience (sabr) and prayer (salat) (Quran 2:45). Sabr actually means more than just patience, it also means being steadfast despite what might be happening. Allah knows we have the strength to control our reactions to situations and the proof for that is that we have been given the quality of sabr. It is our choice to put it into practice during stressful times.

Tips:

Focus on concrete, easily achievable tasks.
Talk to people who have been supportive in the past.
Avoid caffeine, chocolate, nicotine or any type of stimulant.
Find a comfortable environment.
Look into professional therapy if these symptoms persist.
Ask Allah for guidance and patience. The Prophet (peace be upon him) said: “Allah is angry with those who do not ask Him for anything.”(Tirmidhi)

Remember that Allah is always with you. “Whoever does righteousness, whether male or female, while he is a believer – We will surely cause him to live a good life, and We will surely give them their reward [in the Hereafter] according to the best of what they used to do.” (Qur’an 15:97)

Refrences

National Institute of Mental Health (NIMH) http://www.nimh.nih.gov

Handling a Break-Up with Dignity

Dr. Nafisa Sekandari and Sr. Hosai Mojaddidi — Tue, 07 Jun 2011 22:10:21 +0000

The “Highs” & Lows of Love

“Love is of all passions the strongest, for it attacks simultaneously the head, the heart and the senses.” – Lao Tzu

Falling in love can make you feel as if you are high on cloud nine. You see the world in a totally different way which in turn impacts how you act and appear physically. A relationship break-up can be equally emotional regardless of the time spent with the loved one. Just as falling in love can stimulate the same region of the brain that is connected to cocaine and nicotine addiction, so can the break-up. A break-up can be similar to going through withdrawal from cocaine and nicotine just as falling in love can be similar to getting high on cocaine and nicotine. The reason a break-up can be so painful for us not only mentally but physically is because our brains are wired for bonding. This bond is essential for our survival and we are wired from early on to make these connections. The reason you feel as if a part of your body is being ripped off after a break-up is because you begin to think of your partner as being a part of you. The withdrawal of that connection triggers the same part of your brain that makes addicts crave drugs. When you find yourself constantly checking his/her Facebook page, or reminiscing over old letters or pictures, you are seeking to trigger the reward center of your brain. You might also feel physically drained from the loss. This lethargy is meant to allow you time to heal and regroup your mind and body. Fortunately, time reduces the activity in the part of your brain which registers attachment, allowing you to eventually move on.

“Be kind, for everyone you meet is fighting a harder battle”. — Plato

Unfortunately, with the popularity of texting, social networking, and e-mail, many people become very careless in how they end relationships (whether short term engagements or long term marriage). Keeping in mind the deep physical and mental pain associated with break-ups, it’s important to learn how to break relationships without destroying the potential to move on in a healthy way, not just for you but also for your partner. The ideal break-up allows for acceptance and minimizes the long term mental damage. It’s important to make an effort to end the relationship in a way that is honorable but allows you to respect yourself and the one that at one time met your deepest needs. Handling a break-up honorably also avoids the potential for stalker behavior. Oftentimes, when break-ups are handled badly, the pain associated with the break-up can be so intense that some may become overly obsessed with their ex-partner by doing anything to make the pain go away (stalking on Facebook, obsessively calling the ex-partner, harassing the ex-partner physically or mentally, etc.). When looking at love as an addiction and break-ups as withdrawal, it makes sense that individuals who resort to stalking have the addictive and withdrawal center of their brain activated.

Attachment and Break-ups

Knowing your attachment style can help you understand how you will deal with break-ups. If you had secure attachments as a baby, meaning your caregivers were responsive and instilled in you a sense of trust that they would always be around when you needed them, you will be more likely to handle break-ups (whether breaking up or being broken up with) with integrity and be careful not to be hurtful and cause undue damage to your partner. Even if you’re the one being dumped, you understand the pain associated with the loss but aren’t overly dramatic about it. You acknowledge the pain but are able to heal and move on. Those with insecure or anxious attachments as infants (those with parents who were inconsistent with their attention during the 1^st years of life) will do what they can to keep the relationship going at all cost rather than suffer the pain of a break-up. These individuals usually hang on and become clingier. They are also less likely to initiate a break-up and more likely to be unable to let go once dumped. The insecurely attached individuals are often the ones that end up stalking their partner or keep going back into the dysfunctional relationship just to avoid the pain of loss.

Self-Esteem and Break-Ups

How we move on from a broken relationship also depends on our overall self-esteem. Those with high self-esteem are less likely to take on all the blame after the split and continue to view themselves in a positive light despite the break-up and move on. Individuals with low self-esteem have the most difficult time with the break-up and tend to fully blame themselves for the unraveling of the relationship. This over-reaction might lead to unhealthy coping strategies, resulting in withdrawal from social interaction or remaining emotionally closed off from potential new partners.

How to Break-Up With Dignity

“O My slaves, I have forbidden injustice for Myself and forbade it also for you. So avoid being unjust to one another.” (Hadith)

Seeing how painful a relationship break-up can be for the person being dumped as well as the person dumping, it’s important to handle it the right way so all parties involved can move on in their lives in a healthy way. Although we can’t control how our partners will react to the break-up biologically, physiologically, psychologically, or physically, we can control how we break up so that all involved can minimize the emotional impact as much as possible.

If you are the one initiating the break-up, it’s important to take responsibility and be honest. Some may push their partner to break up with them because they are unable to take the steps. If you are no longer interested in being in the relationship or feel it’s best to end the relationship, it’s important to state your feelings to your partner in an honest and caring manner.
It’s crucial you are honest but you don’t have to be hurtful. It’s important to keep in mind the self-esteem of your partner and not be so hurtful that it makes it impossible for them to have a healthy relationship in the future. You can state they are not who you are looking for, or you are not a good match but you don’t have to point out minute negative traits. Sometimes it really is just about a bad match rather than something being wrong with either of you. In the wrong relationship we can bring out the worst in each other without necessarily being bad individuals.
Face to face break-up is a must. You might think it’s less painful to deliver the hard news to your partner via e-mail, text, or Facebook but this method can cause more damage to the long term psychological well-being of your partner than if you have a face to face exchange. The non-verbal communication associated with face to face interaction can be reassuring to both parties and lead to closure. Anything less than face to face interaction can leave the person being dumped to be stuck in emotional limbo due to the absence of direct social contact. Without this closure, the person being dumped is left wondering what went wrong, leading to endless rumination and depression. Many go on to be distrustful of others in the future, making it difficult for them to move on in a healthy way or have close relationships in the future.
Be dignified during the break-up. Make sure to keep the insults and hurtful comments out of the break-up. By ensuring the continued self respect of your partner, you ensure your own self respect.
You should avoid softening the blow too much by falsely owning the blame without giving a clear explanation, even if it’s brief. Saying “it’s not you, it’s me” is not helpful with the moving on process.
Avoid looking at all the specific details of where the relationship fell apart. Neither one of you will ever agree to the details or you might get sucked back into the dysfunctional relationship you were trying to get out of.
It’s o.k. and even encouraged to talk about the positive aspects of the relationship and your own disappointment of things not working out between the two of you. This not only ends the relationship in a positive way but also reassures your partner they are and were valued.
Once you accept the rejection, it’s important to not go into the “all is lost” mentality. You might begin to think you’ve lost your one true soul mate that you were meant to spend the rest of your life with but it’s important to realize there isn’t just one person that is “perfect” for you. Love makes us think there’s only that one person for us due to our feelings but the reality is there are many people who we can potentially be compatible with. The Prophet (peace be upon him) reminds us “…And He has an appointed time for everything” (Hadith). As the hadith states, everything ultimately must end but with it comes new beginnings and opportunities. It’s natural to resist saying good-bye to things you care about but by holding on to a doomed situation, you make it worse by refusing to let go. By forcing the relationship to continue, it will inevitably turn hateful causing even more pain than letting go. Keep in mind that even during difficult times, there are things you can find yourself being grateful for. “When Allah tests you, it is never to destroy you. Whenever He removes something from your possession, it is only to empty your hands for an even better gift.” Ibnul Qayyim
It’s very important to make the break clean and move on. Don’t suggest you be friends or keep in touch. Suggesting this might make you feel less guilty but it will stand in the way of your partner from fully moving on. If you are the one being dumped, don’t beg and plead for the relationship to continue. The best way to speed up the healing process is to accept the relationship has ended and begin to move on. Those who can make a clean break have a better chance of fully recovering from the withdrawal like symptoms than the ones who make attempts to win back their partner. Even one e-mail or phone call can trigger the craving and addiction symptoms. It’s best to stay away from all contact with the partner. Do not try to remain friends, destroy those e-mails and pictures, and get rid of sentimental mementos.
Do not avoid the pain you are experiencing. The end of a relationship can be extremely painful as mentioned above but it’s crucial that you take the time and grieve the loss. The sooner you face the pain, the sooner you put yourself on the road to healing. Avoiding the pain can only prolong your suffering. It’s important to seek professional help as needed and surround yourself with caring and supportive friends and family to help you through this tough time. Isolating yourself is not healthy and may delay your recovery process.

**Keep in mind that if you suspect your partner might react violently to the break-up, surround yourself with others and keep safety a top priority.

Adapted from “Breakup: the thoroughly modern guide” by Elizabeth Svoboda for Psychology Today.

Top 10 Effective Parenting Strategies

Dr. Nafisa Sekandari and Sr. Hosai Mojaddidi — Wed, 04 May 2011 19:21:17 +0000

“It’s not only children who grow. Parents do too. As much as we watch to see what our children do with their lives, they are watching us to see what we do with ours. I can’t tell my children to reach for the sun. All I can do is reach for it, myself.” ~Joyce Maynard

Parenting is undoubtedly one of the most rewarding gifts of life, however, it can also be just as challenging and daunting. Many parents today are overwhelmed by the fast-changing world around them and often feel lost about how to keep their kids safe from the ever present dangers while still allowing them to find their own identities. Parenting can feel like a tight-rope act; on the one hand we fear being too permissive since no one wants to raise a brat, but on the other hand we fear overly controlling our children and raising a trembling and sullen child. We need to focus on a middle ground where our children grow up to be respectful, caring, and well behaved. It’s important to start the discipline process early when your children are young and teach your children they are part of the family system and everyone’s in it together. Expect everyone to pitch in, even in a small way such as being cooperative when you are dressing them. Also keep in mind respect is mutual. If you expect your children to listen to you, it’s important to set a good example early on. If your child complains you are not listening when they try and tell you something, stop what you are doing, focus your attention on your child, and listen! You can then require the same level of courtesy from them later on.

Whether you have a toddler or a teen, here are some helpful tips to keep in mind:

1.) Be consistent. Follow through and mean what you say and never make empty threats! Consistency is key with parenting…it’s the one way to raise an emotionally well balanced child. Even if you are consistent with one rule or chore, your child will benefit tremendously from it. Being firm and consistent actually communicates to your child that your care enough about him/her to expect responsible behavior. Inconsistency on the other hand creates confusion and chaos in a child’s mind.

2.) Be reliable. Keep your word, arrive on time, and keep your promises. The sure fire way to lose credibility with your children is to do one thing and say another. Set a good example and take responsibility seriously. This also teaches your child respect.

3.) Be rewarding. Tie rewards to good behavior. Don’t just give it away if it’s not earned or deserved. Many parents give the toy away for free without tying it to good behavior or they expect the child to behave appropriately AFTER getting the toy. Just as we as adults need to be reminded of our rewards (paycheck) and consequences (getting fired) at work, children need similar reminders to make good decisions and be responsible.

4.) Be clear. Give children meaning for what is expected of them by spelling things out and being clear about your expectations. Children need rules to be clear and specific, not vague. Telling your child to “be good” before dropping them off at school is not being clear. Instead say “remember to keep your hands and feet to yourself and listen to the teacher when she is talking”. You can explain to them why this is important for their well being as well as for the well being of others around them. In the above example you can add “by doing that, you will be able to follow along with the rest of the class, your teacher won’t get mad at you, and you won’t miss any class or recess time with your friends since you won’t be sent to the office for inappropriate behavior”. This might seem like it’s above the younger child’s head but it’s not. I have these conversations with Kindergartners often. Sometimes simply re-directing your child as you are explaining the reason is enough to convey the message that you will not tolerate unacceptable behaviors.

5.) Be firm. Never ask “why”. Having a dialogue with your kids about every little thing, especially when trying to discipline them can backfire on you. Stay in control and be the one to end the discussion. Sometimes it’s necessary to just put an end to the negotiations and firmly restate your expectations. Some negotiations can be listened to if they are appropriate but be careful not to reinforce whining or avoidance of consequences.

6.) Be loving. Always offer unconditional love. Withholding love is cruel and will make your child distrusting of you in the long run. Keep in mind your child can do bad things but not be “BAD” as a person. Convey this message to your child and let them know that although you are upset, disappointed, or angry about their behavior, you still love them for who they are. Take a moment after you are both calm to explain why you were upset and what they could do differently in the future but don’t punish your child by withholding love from them.

7.) Be forgiving. Just as you erred as a child, so too will your children. Don’t be self-righteous and learn to teach rather than judge. This goes along with #6. By being loving, you are also teaching them forgiveness. Remind yourself we all make mistakes and teach your child the important lessons mistakes can teach us. Use the opportunity to teach your child the lesson while forgiving them for their mistake. A beautiful story about Prophet Muhammed (peace be upon him) that speaks to this is a narration by Umm Khalid: “I (the daughter of Khalid ibn Said) went to Allah’s Messenger (peace be upon him) with my father and I was wearing a yellow shirt. Allah’s Messenger (peace be upon him) said, “Sanah, Sanah!” (`Abdullah, the narrator, said that sanah meant “good” in the Ethiopian language). I then started playing with the seal of prophethood (between the Prophet’s shoulders) and my father rebuked me harshly for that. Allah’s Messenger (peace be upon him) said, “Leave her.” The Prophet, then, invoked Allah to grant her a long life thrice. (Bukhari & Muslim)

8.) Be playful. Make “fun” time with your kids, even when asking for help with chores. Remember that they live in the temporary world of ease and wonder, leave them there and feel free to join them from time to time. It’ll do wonders for you as well! I find it helpful to turn on some fun music and make chores playful. Kids will begin to look forward to doing chores rather than dreading it. Children crave fun time with their parents so the more fun you have and the less you direct them from one chore to the other, the more enjoyable your time with your children will be. Remember to build self esteem first and worry about chores later! Fingerpaint more and point the finger less. Take hikes and spend time outdoors throwing the ball around or flying a kite. Stop being so serious and seriously learn to have fun with your child! When the Prophet (peace be upon him) was in sujood, Imam Hussain would climb on his back. The Prophet (peace be upon him) would make his sujood very long. When his companions asked why his sujood was so long, he (peace be upon him) replied that he didn’t want to disturb Hussain while he was playing by getting up from sujood. Another example: A Companion named Mahmud b. Rabi related that when he was five years-old, the Prophet (peace be upon him) took some water from a bucket and tossed it into his face and that he did the same to the other children. (Bukhari)

9.) Be alert. Intently look out for good behavior and catch them in the act. Watch your children engaging in appropriate behavior and praise them for it. Tell them how proud of them you are for the small steps they are taking. You’ll be amazed at how closely the relationship to increased positive behavior is with increase praise and reward. Kids are watching us intently and wondering if we notice so make sure you are alert and catch them being good!

10.) Be affectionate. Offer loads of hugs and kisses and validate them often! Hugs and kisses help a child thrive not only emotionally but also physically and cognitively. Children who feel loved, accepted, and secure, tend to do better academically, socially, and emotionally. We can learn a lot from Prophet Muhammad (peace be upon him) in this regard…”He loved his granddaughter Umamah. He often went out with her on his shoulders, and even placed her on his shoulders while praying. When he prostrated, he put her down; when he had finished praying, he placed her on his back again.” (Sahih Muslim). Anas relates: “I never saw anyone more compassionate to his family than the Prophet (peace be upon him). The wet nurse of his son Ibrahim lived in one of Medina’s border neighborhoods. The husband of the wet nurse was a blacksmith. Going there everyday to the smoke filled house, the Prophet (peace be upon him) would embrace, sniff and kiss the child.” (Bukhari & Muslim)

Parenting: Understanding and Managing Behaviors

Sahar Javed — Thu, 21 Apr 2011 03:17:05 +0000

“If that child’s behavior is so severe that it warrants a behavior plan, that plan needs to be followed.” - Janice Argabright

Sara and her mother have gone shopping at Target. Sara sees a toy that she wants and asks her mother for it. When her mother tells her “no,” Sara begins to cry. Sara continues to beg her mother for the toy and her mother continues to tell her “no.” Sara then escalates and begins screaming, drops to the floor, and kicks her legs. Sara’s mother is now embarrassed as other shoppers begin staring at her and shaking their heads. She still has an entire list of groceries to gather, so in order to quiet her daughter she tells her that she can have the toy, and Sara stops crying.

Does this story sound familiar? Most of us have either seen, or experienced something similar. Situations such as these make you wonder whether the child or the parent is the one in control. Many times what happens is that through repetition of such instances, children slowly learn how to manipulate their parents to give in to their behaviors. In fact, one of the biggest challenges most parents face is knowing how to deal appropriately in such instances so that their child’s inappropriate behaviors don’t escalate and get worse.

What are behaviors?

Behavior is the response of an individual to their environment. The science of controlling and predicting human behavior is called Applied Behavioral Analysis (ABA). By functionally assessing the relationship between a targeted behavior and the environment, the methods of ABA can be used to change that behavior. ABA-based interventions are best known for treating individuals with developmental disabilities, such as autism; however, by analyzing behaviors, these techniques can help all parents in dealing with the everyday behaviors of their children.

Identify the Behavior

First identify the behavior your child is engaging in. There might be multiple behaviors, so identify them one at a time. Think about whether your child engages in tantrums, hitting, kicking, or screaming. Or does your child have self-stimulatory behaviors such as hand flapping, toe walking, lining up objects, or spinning? Whatever behavior they are engaging in, first identify it, then use the ABC method to further analyze, and determine why your child is engaging in that behavior.

A) Antecedent- List all of the potential triggers to the behavior

B) Behavior- Clearly define the target behavior

C) Consequence- List all of the consequences administered which have enabled the behavior to continue.

Example:

Antecedent	Behavior	Consequence	Function
Child is told that it’s time to leave the park and go home.	Child screams	Parent gives child 5 more minutes to play.	Access to a reward
A peer takes away the child’s toy.	Child screams	Parent distracts the child with another toy.	Access to a reward
Child is told to clean up their toys.	Child screams	Parent places child in time-out.	Escape/Avoidance
Parent is on the phone.	Child screams	Parent hangs up the phone and attends to the child.	Attention

Function of the Behavior

Once you have identified the behavior, proceed to determine the function of the behavior, or in other words, the cause of why the behavior is occurring. Try to categorize the behavior into one of four groups: 1) Attention, 2) Access to reward, 3) Escape/ Avoidance, or 4) Automatic. Take the example presented above. Although screaming is the behavior in every case, the function of the behavior has changed for each scenario. It is important to determine the function in order to establish an appropriate intervention for managing the behavior.

Managing the Behavior

When determining how to intervene with the behavior, take into consideration the antecedent (what triggers the behavior), the function (why the behavior is happening), and the current consequence (how you respond to the behavior). Based on the antecedent and function the consequence will change. Using the example above, when the child screams to gain access to a tangible, the appropriate consequence should be that they DO NOT receive access to that tangible. In order to change the behavior an appropriate replacement behavior should be taught, such as using appropriate language to ask for the item/activity. The chart below shows the appropriate replacement behaviors for each scenario in the example.

Antecedent	Behavior	Consequence	Function
Child is told that it’s time to leave the park and go home.	Child asks “can I please have 5 more minutes?”	Parent gives child 5 more minutes to play.	Access to a reward
A peer takes away the child’s toy.	Child asks “can I have that back?”	Peer gives toy back.	Access to a reward
Child is told to clean up their toys.	Child asks “can I have 5 more minutes?”	Parent gives child 5 more minutes to play.	Escape/Avoidance
Parent is on the phone.	Child taps parents shoulder	Parent attends to the child.	Attention

Reinforcement

Reinforcement can be positive and negative. Positive reinforcement is when you give something, such as praise or attention, in order to increase a particular behavior. For example, if your child cleans their room and you hug them and tell them what a good job they did, you are positively reinforcing their behavior. If an inappropriate behavior is positively reinforced it will also cause the behavior to increase. Take Sara’s behaviors at Target for example. Although Sara was acting inappropriately, her mother positively reinforced her kicking and screaming by buying her the toy.

Negative reinforcement is when you take something negative away, in order to increase a behavior. Although the word “negative” is being used here it doesn’t mean it’s bad. For example, if your child is given a list of 5 chores and they complete 4 of them and are about to begin on the 5^th, and you are so impressed with them that you take away the 5^th chore, you are negatively reinforcing them for their appropriate behavior because you are taking something “negative” away (the chore).

From a very early age, children learn what behaviors get them what they want. If a child screams and they get to play longer at the park, or they no longer have to clean up their room, or their parent attends to them, they have learned that screaming is the appropriate way to gain all of the above. In order to train children to respond appropriately, parents need to reinforce the desired behavior while extinguishing the undesired behavior. Continuing to use the example above, if the child screams in order to gain access to a tangible and the item/activity is given to them, the screaming behavior is being reinforced and will consequently increase. However, if the child screams in order to gain access to the tangible and the item/activity is NOT given to them, then the screaming behavior is no longer being reinforced. Again it is important to remember to give the child an appropriate replacement behavior to communicate their needs (i.e. “can I have 5 more minutes please?”), and after reinforcing this behavior it will increase.

Behaviors can be difficult to analyze and deal with; however, with practice parents can learn how to train their children to behave in ways that they find desirable. By teaching and reinforcing appropriate behaviors, and being consistent with their interventions, parents can gain control over their children.

The important thing to remember is that in order for an intervention to work successfully it must be used consistently across all caregivers.

Sahar Javed has worked in the field of ABA for seven years. If you are interested in receiving parent training or need parent consultation for behavioral interventions, please contact Sahar Javed at sahartherapy@gmail.com.

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