Clinicians, Imams, and the Whisperings of Satan
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Definitions, Context, and Categorization
Then Shaytaan (Satan) whispered to him, saying: ‘O Adam! Shall I lead you to the Tree of Eternity and to a kingdom that will never waste away.’ (The Quran, 20:120)6
A. Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
Note: Young children may not be able to articulate the aims of these behaviors or mental acts.
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder…
Types of Severe Waswasah
The Clinician’s Role: Different Types of Therapy
(1) thinking about an action is the same as doing it; (2) failing to prevent harm is morally equivalent to causing harm; (3) responsibility for harm is not diminished by extenuating circumstances; (4) failing to ritualize in response to a thought about harm is the same as an intention to harm; and (5) one should exercise control over one’s thoughts.18
The Prophet ﷺ said: “Allah has forgiven for my ummah (followers) that which is whispered to them and which crosses their minds, so long as they do not act upon it or speak of it.” [Narrated by al-Bukhari, 6664; Muslim, 127]19
Exposure Response Prevention
Acceptance Commitment Therapy
Additional Therapies and Techniques
Collaboration with Imams
Seeking Refuge in Allah
And if an evil whisper from Shaitan (Satan) tries to turn you away, then seek refuge in Allah. Verily, He is the All-Hearer, the All-Knower. (The Quran, 41:36)24
And say: “My Lord! I seek refuge with You from the whisperings (suggestions) of the Shayatin (devils). And I seek refuge with You, My Lord! lest they may attend (or come near) me. (The Quran, 23:97-98)25
Abul-‘Ula reported: ‘Uthman bin Abul-‘As came and said to the Prophet: “O Messenger of Allah, Satan is spoiling my prayers and confusing my reciting of the Quran.” The Messenger of Allah ﷺ said: “That is a satan called Khinzab, so if you think that (he is around) say: ‘I seek refuge with Allah from you.’ Then blow breath with light spit on your left three times.” Uthman said: “I did that and Allah took him away from me.”26
…Verily, in the remembrance of Allah do hearts find rest. (The Quran, 13:28)29
Abu Hurairah narrated that the Messenger of Allah ﷺ said: “Allah says: ‘I am as My slave thinks of me, and I am with him if he remembers Me. If he remembers Me in himself, I too, remember him in Myself; and if he remembers Me in a group of people, I remember him in a group that is better than that. And if he comes one span nearer to Me, I go one cubit nearer to him and if he comes one cubit nearer to Me, I go a distance of two outstretched arms nearer to him. And if he comes to Me walking, I go to him running.’”30
O Allah, I am Your servant, son of Your servant, son of Your maidservant, my forelock is in Your hand, Your command over me is forever executed and Your decree over me is just. I ask You by every name belonging to You which You named Yourself with, or revealed in Your Book, or You taught to any of Your creation, or You have preserved in the knowledge of the unseen with You, that You make the Qur’aan the life of my heart and the light of my breast, and a departure from my sorrow and release for my anxiety.31
O Allah, I take refuge in You from anxiety and sorrow, weakness and laziness, miserliness and cowardice, the burden of debts and from being overpowered by men.32
Narrated Abu Huraira: I heard Allah’s Apostle ﷺ saying, “There is healing in black cumin for all diseases except death.”34
Clinical Analysis and Recommendations
1 A manual published by the American Psychiatric Association that identifies and categorizes mental illness. This is the standard book that all American psychologists, psychiatrists, and mental health therapists use to assess and diagnose their clients for potential mental illness.
2 Pollard, A .(2010). Scrupulosity. Retrieved from https://iocdf.org/wp-content/uploads/2014/10/IOCDF-Scrupulosity-Fact-Sheet.pdf
3 Utz, A. (2011). Psychology from the Islamic Perspective. Riyadh, Saudi Arabia: International Islamic Publishing House.
4 Ibn Kathir, H. (2003). Tafsir Ibn Kathir (2nd ed.). Riyadh: Durussalm.
5 Utz, Psychology from the Islamic Perspective.
6 Al-Hilali, M. & Khan, M. (1999). Translation of the Meanings of The Noble Quran in the English Language (reprinted ed.). Madinah, Saudi Arabia: King Fahd Complex for the Printing of the Holy Qur'an.
7 Radomsky, A., Alcolado, G., Abramowitz, J., Alonso, P., Belloch, A., Bouvard, M., Clark, D., Coles, M., Doron, G., Fernandez-Alvarez, H., Garcia-Soriano, G., Ghisi, M., Gomez, B., Inozu, M., Moulding, R., Shams, G., Sica, C., Simos, G., & Wong, W. (2014). Part 1. You can run but you can’t hide: Intrusive thoughts on 6 continents. Journal of Obsessive-Compulsive and Related Disorders, 3, 269-279. Retrieved from http://dx.doi.org/10.1016/j.cbpra.2009.10.002
8] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing, pp. 129-130.
9 Sookman, D., Abramowitz, J., Calamari, J., Wilhelm, S. & McKay, D. (2004). Subtypes of Obsessive Compulsive Disorder: Implications for Specialized Cognitive Behavioral Therapy, Behavior Therapy, 36(4): 393-400. Retrieved from https://www.researchgate.net/publication/222412431_Subtypes_of_obsessiveCompulsive_disorder_Implications_for_specialized_cognitive_behavior_therapy
10 Pollard, A .(2010). Scrupulosity. Retrieved from https://iocdf.org/wp-content/uploads/2014/10/IOCDF-Scrupulosity-Fact-Sheet.pdf
11 Abramowitz, J., Jacoby R. (2014). Scrupulosity: A cognitive-behavioral analysis and implications for treatment. Journal of Obsessive-Compulsive and Related Disorders, 3, 140-149. Retrieved from: http://jonabram.web.unc.edu/files/2014/05/Scrupulosity-model-2014.pdf
13 Al-Haj, H. 2016, October, 18. Email.
14 Abramowitz, J. (2009). Postpartum and perinatal OCD. International OCD Foundation. Retrieved June 28, 2016 from https://iocdf.org/wp-content/uploads/2014/10/Postpartum-OCD-Fact-Sheet.pdf
15 Foa, E., Yadin, E. & Lichner, T. (2012). Exposure and Response (Ritual) Prevention for Obsessive- Compulsive Disorder (2nd ed.). New York, NY: Oxford University Press.
16 Knapp, P. & Beck, A. (2008). Cognitive therapy: Foundations, conceptual models, applications and research. Retrieved from http://www.scielo.br/pdf/rbp/v30s2/en_a02v30s2.pdf
17 Foa, et al. (2012).
18 Foa, et al. (2012).
19 Abdul-Rahman, M. (2004). Islam: Questions and Answers - Jurisprudence and Islamic Rulings: Transactions, Part 5. London, United Kingdom: MSA Publication Limited.
20 Koran, L., Hanna, G., Hollander, E., Nestadt, G., & Simpson, H. (2007). Practice guideline for the treatment of patients with obsessive-compulsive disorder. The American Journal of Psychiatry, 164 (7), 5-53.
21 Twohig, M. P., Hayes S. C., Plumb J. C., Pruitt L. D., Collins A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of acceptance and commitment therapy vs progressive relaxation training for obsessive-compulsive disorder. Journal of Consulting & Clinical Psychology, 78(5), 705-16.
22 Harris, R. (2006). Embracing your demons: An overview of Acceptance and Commitment Therapy. Psychotherapy in Australia, 12 (4), 2-8. Retrieved from http://www.livskompass.se/wpcontent/uploads/2012/11/Russ_Harr_A_Non-technical_Overview_of_ACT.2006.pdf
23 Foa, et al.. (2012).
24Al-Hilali, M. & Khan, M. (1999). Translation of the Meanings of The Noble Quran in the English Language (reprinted edition). Madinah, Saudi Arabia: King Fahd Complex for the Printing of the Holy Qur'an.
26 Al- Mundhiri, A. (2000). The Translation of the Meanings of Summarized Sahih Muslim Arabic-English, Volume 2. Riyadh, Saudi Arabia: Darussalam Publishers & Distributors, p. 767.
28 Ellison, C., Bradshaw, M., Flannelly, K. & Galek, K. (2014). Prayer, Attachment to God, and Symptoms of Anxiety-Related Disorders among U.S. Adults. Sociology of Religion, 75 (2), 208-233. Retrieved from http://www.baylorisr.org/wp-content/uploads/Sociology-of-Religion-2014-Ellison-208-33.pdf
29 Al-Hilali, M. & Khan, M. (1999). Translation of the Meanings of The Noble Quran in the English Language (reprinted edition). Madinah, Saudi Arabia: King Fahd Complex for the Printing of the Holy Qur'an.
30 Al- Mundhiri, A. (2000). The Translation of the Meanings of Summarized Sahih Muslim Arabic-English, Volume 2. Riyadh, Saudi Arabia: Darussalam Publishers & Distributors, p. 997.
31 Al-Qahtaani, S. (1996). Fortification of the Muslim through remembrance and supplication from the Qur’aan and the Sunnah. Riyadh, Saudi Arabia: Safir Press, p. 156-157.
32 Ibid, p. 165.
33 Beheshti F., Khazaei M. & Hosseini M. (2016).Neuropharmacological effects of Nigella sativa. Avicenna Journal of Phytomedicine, 6 (1), 124-141.
34 Khan, M. (1995). The Translation of the Meanings of Sahih Al- Bukhari, Volume VII. Medina: Dar AHYA Us-Sunnah, p. 399.
35 Twohig, et al. (2010).
36 Foa, et al. (2012).
37 Amri, S. & Bemak, F. (2013). Mental Health Help-Seeking Behaviors of Muslim Immigrants in the United States: Overcoming Social Stigma and Cultural Mistrust, Journal of Muslim Mental Health, 12 (1). Retrieved from http://quod.lib.umich.edu/cgi/p/pod/dod-idx/mental-health-help-seeking-behaviors-of-muslim-immigrants.pdf?c=jmmh;idno=10381607.0007.104