What is it about the terms “therapy” and “counseling” that gives people the heebie-jeebies? Instead of thinking that a person is taking important steps to improve their well being, we rush to judgment and ask, “What’s wrong with them?” I’ve heard people express stronger opinions about mental illnesses and treatments to alleviate their symptoms than they do about the failing economy or the presidential race.
I’m sure I’m not the only one who’s heard the whole “It’s all in their head,” argument. That one really bugs me because the comments that accompany it serve to explain how the person is basically making it all up. Yeah, it’s made up, because people have so little to do that they fake hallucinations, give themselves panic attacks, or rage out of control just to break the glasses in the kitchen they don’t like.
Most people don’t know a lot about mental health care. After all, it’s not even given real merit as a necessity in our healthcare coverage. As someone who works in the field, I can assure you that it’s not made up. I’ve watched people have anxiety attacks, go through rage blackouts, and even hallucinate that there are ghosts following them. I’ve seen their hands tense up and their legs move uncontrollably when they are anxious. I’ve even had to go to their houses to take them to school when their depression kept them buried under their covers, physically unable to move out of bed. I’ve seen these illnesses do things to people that no one would ever intentionally, or with good reason, do to him or herself.
I’ve heard people express stronger opinions about mental illnesses and treatments to alleviate their symptoms than they do about the failing economy or the presidential race.
Our mental and emotional well being are as important as our physical health when it comes to our daily functioning and ability to uphold the responsibilities of our education, careers, families, and everything else we are constantly juggling in today’s fast-paced world. Physical, spiritual, mental and emotional health are intricate systems within us that are more strongly tied together than people realize. And in order to be completely healthy, you have to take care of all of them.
“And We will surely test you with something of fear and hunger and a loss of wealth and lives and fruits, but give good tidings to the patient, who, when disaster strikes them, say, “Indeed we belong to Allah , and indeed to Him we will return.” Those are the ones upon whom are blessings from their Lord and mercy. And it is those who are the [rightly] guided.” [Quran 2:155-2:157]
As Muslims, regardless of level of devoutness, we are not immune to illness. We all know someone who has been touched by a serious or fatal illness like cancer. We may know someone living with a chronic or lifelong disease such as Crohn’s or diabetes. It may even be something that seems easily treatable like migraines, allergies, or eczema and therefore a non-issue to some. But like I explained earlier, illness and being unwell don’t only apply to our physical health. I can also assure you that allergies are way more than a non-issue for some of us, but I digress.
Mental illness is, overall, an under recognized and under treated issue across communities. According to a report done in 2014 by the Substance Abuse and Mental Health Services Administration (SAMHSA), 1 in 5 adults in America experience a mental illness and 1 in 25 adults in America live with a serious mental illness—yearly. That’s around 18% and 4%, respectively. And those are just the numbers for reported mental illnesses. What do these numbers mean for us? With over 3 million Muslims living in America, it means that mental health concerns are not avoidable by our community and they are, indeed, part of our paths as Muslims towards righteousness and towards Allah (SWT).
Reflecting on my own difficulties earlier this year (which I will talk about in future posts) led me to think about why getting mental and emotional support is so undervalued and underutilized within our community. What is it that makes our community so resistant or reluctant to talk about mental health issues? Why are we not as supportive of that as we are when a person has a stomach virus or breaks a bone? So many things happen to people that impacts their lives in ways they cannot possibly handle on their own—yet we expect them to. We don’t encourage others to seek treatment. And just for right now, let’s leave out people whose barrier to treatment is access or affordability.
I remember seeing this firsthand when I interned at a family services agency that was in the heart of a large, Muslim community. The agency was a bit of a taboo in and of itself because they had—wait for it—a domestic violence department. To the community, their ability to help people obtain and maintain their public health benefits was fine, but having counselors and court advocates to support women and their children find a safe alternative to the dangers they had to live with at home was not. It made no sense. People in the community were more upset that this department existed, than seeing a woman come to the office in a cast or on crutches as a result of her husband’s abuse. Outrageous. But, shhh – it’s shameful to talk about these things in public. So you can be assured that their mental health department had yet to gain traction.
I’m sure we’ve all been exposed to some form of the, “What happens in our home, stays in our home,” code of conduct. And that’s fair, most of the time. It’s not necessary to let people into the detailed intricacies of your relationships with others. But therapy and counseling are not just venting sessions like you have with your friends where you bash and blame all the people and situations that are complicating your life for everything that is going wrong at the moment. And getting help for whatever mental or emotional health concerns you have does not break the aforementioned code of conduct.
Part of the problem is the stigma attached to having any kind of illness other than a physical one. And that’s part of what’s holding our community back. And it’s creating rifts within families. You don’t have to study psychology to know that anxiety, depression, bipolar disorder, and many other mental illnesses impact the Muslim community. You don’t have to understand the complexities of these disorders to know that a person can’t treat or manage them, successfully and long-term, without help. And you don’t have to be a mental health professional to want to change the negative stigma and shame that surrounds this topic in our community. Because to limit our willingness to be supportive to our family, friends, and other companions to times we deem acceptable not only shows our ignorance, it means we’re not really the helpful and compassionate people we claim to be.
“Allah does not charge a soul except [with that within] its capacity.” [Quran 2:286]
People in our community have a tendency to shame and judge people for having these issues and then make them feel guilty for seeking help. Some believe that all of it is within an individual’s control and he or she is just not doing enough. Or they tell them their problems are the result of not having enough faith in God. Example; The women in the domestic violence department apparently didn’t pray enough for their husbands to stop abusing them and their children. All this does is cause people to get stuck in a never-ending cycle that leaves underlying issues unresolved. But these are not the kinds of problems that get stored away neatly in a compartment in one’s brain and stay put. They eventually become complications in a person’s life that can impact their career, their marriage, their relationships with others, and even their dedication to their faith, to name a few. Mental and emotional health issues can only be suppressed for so long. So, while we believe that Allah swt only puts us through what we have the ability to get through, that in no way means we have to do it alone nor should we suffer in silence.
…Therapy and counseling are not just venting sessions…
I know a woman who, to the outside observer, has a “wonderful life.” She also has depression. People don’t understand it. And they often make her feel bad about it. “Ugh, what does she have to be depressed about?” and, “There are so many people that are worse off than her and they know how to be happy,” are comments that are often made about her. But that’s exactly the point! She does know how to be happy, however, there is an internal barrier to accessing the happiness that others think should come easily to her. It’s not rational. All the more reason for us to understand that depression is not a choice—no mental illness is a choice. You know what is a choice, though? Treatment. Treatment is a choice people can make to get to a better place and to have the possibility of living their best lives.
Even Islamic history refers us to a period of time known as “The Year of Sadness” when the Prophet Muhammad (peace be upon him) was overcome with sadness and grief and his emotional struggles impacted other areas of his life. This period of time came after the losses of his uncle, Abu Talib and wife Khadijah (RA). The sorrow he experienced impacted his ability to lead. But even the Prophet (PBUH) didn’t suppress his emotions. He acknowledged that this wasn’t something he could just bounce back from. Life is not easy to bear. And expressing that, shouldn’t be viewed with the negative connotation that it is today.
That example is also a testament to the fact that the issues people face are not the result of their own doing. For many of the clients I’ve worked with, there was a trauma from their past that caused major instability in their mental and/or emotional functioning. And for a lot of them, it was worsened by not getting treatment sooner. One of my clients was the victim of an incident that was only revealed years later when her parents discovered she had an eating disorder—the result of the emotional struggles she suppressed after the trauma. So for years the family had to work backwards through the layers of issues that had accumulated as a result.
What it comes down to, is that people have a tendency to fear and make assumptions about what they don’t know or understand. People will instinctively decline therapy because they dislike or are scared of the idea of talking about their innermost thoughts and feelings. But there’s much more to it than that.
I can tell you, from the other side of things, that therapy does not consist of me nodding and agreeing with my clients and then asking them, “How does that make you feel?” While I do validate their experiences and show empathy towards them and the situations they have been through, I spend the majority of that time challenging the things they do that are not helpful to them or the progress they want to make: pointing out unhelpful and problematic behaviors, helping them learn to recognize the irrational thoughts and feelings that cause problems and teaching them how to replace them with positives, and giving them alternatives to the unhealthy ways they are coping with their triggers and stressors. Then we focus on the application and implementation—which is their responsibility to put into practice in their everyday lives. And they keep doing that until they get better at doing it on their own, make more positive choices, and cope more appropriately and in safer ways with things that would previously set them off.
“… And whosoever puts his trust in Allah, then He will suffice him…” [Quran, 65:3].
Seeking help for mental health concerns is an old taboo that needs to be diminished in the 21st century Muslim community. We need to stop placing shame, guilt, or judgment on people who address their mental and emotional needs. And we should emphasize that doing so does not mean you have lessened your trust in God. Seeing a therapist or counselor does not conflict with tawakkul (trust in God’s plan) or full faith in Allah (SWT) because asking for the help you need is very different from complaining; it is not a sign of ingratitude. It can’t be said enough that the possibility for positive outcomes by going to therapy is significantly higher than doing nothing at all, so there is most definitely no shame in that.
…People have a tendency to fear and make assumptions about what they don’t know or understand.
So while prayer and duaa (supplication) absolutely help during difficult situations, we must remember that those aren’t the only resources we can access when it comes to figuring out how to create and maintain harmony within ourselves. But if you think that is the case, ask yourself, would you tell a cancer patient not to undergo chemotherapy and pray instead? Should someone with diabetes not take their insulin and just pray? Would
you yourself not to take a pain reliever when you have a headache at the end of a long day and pray instead? No, no, and no. After all, when asked about the camel, the Prophet Muhammad (PBUH) didn’t say to have faith and then be idle about its protection. He said, “Trust in Allah (SWT) and tie your camel.” Improving our mental and emotional health is us tying the camel.