WIAMH - Newsletter Vol. II, No. IV. Sixteenth Issue, August 2003

WIAMH

	Newsletter Vol. II, No. IV. Sixteenth Issue, August 2003 Letter from the Editor There was something fascinating about Italian and Muslim Scholars meeting in Narni, Italy 9-14 June 2003 to reunite the cultures of the Mediterranean. In this international meeting, colleagues from USA, Egypt, Bosnia, United Kingdom, Palestine and Italy met to train Palestinian mental health workers to cope with the effects of traumatization. This was particularly interesting as they focused on the role culture plays in the treatment, prevention, and rehabilitation of victims of trauma. The central theme was Transcultural Psychiatry and Mental Health of Victims of Man-Made Disasters. It's been an amazing week. We have had the privilege of working with wonderful and generous people. The Mayor of the city of Narni and members of its council; colleagues from Transcultural Psychiatry section - WPA, Italian Institute of Transcultural Psychiatry, Dr. G. Bartocci, and World Islamic Association for Mental Health, Prof. Afzal Javed and Dr. Ahmed Abou El Azayem, all of whom were deeply committed to bring the Narni meeting to successful completion. I have no doubt that you as readers will find in the Multicultural Week in Narni (Terni), Italy 9-14 June 2003 reviewed here below, enjoyment, surprises and fascination. The Mediterranean Congress: Transcultural Psychiatry and Mental Health of Victims of Man-Made disasters 9 - 14 June 2003 Narni, Italy. The city of Narni, Italy in association with World Psychiatric Association - Transcultural Psychiatry section, the Italian Institute for Transcultural Mental health, the Italian Society of Transcultural Psychiatry, Eastern Mediterranean Council for Mental Health of the (EMRC - WFMH) and the World Islamic Association for Mental Health (WIAMH), organized the Multicultural Week in Narni (Terni), Italy 9-14 June 2003. This constituted of a workshop followed by an international congress on Islamic Identity. The venue of this endeavor was the city of Narni, a historic attraction located in the center of Italy. Throughout the whole sojourn we could experience a world that has remained virtually unchanged for centuries, enjoy archaeological and artistic sites and develop a sense of respect for history. The central theme of the training course was Transcultural Psychiatry and Mental Health of Victims of Man-Made disasters. The plan was for cooperation between Mediterranean countries and in particular between Italian and Islamic Scholars. The program included a training course directed towards young professionals from Palestine and other Islamic countries. Below is the program of this activity. Comune di Narni The Italian Institute for Transcultural Mental Health (IMT), Eastern Mediterranean regional council for Mental Health of the (EMRC/WFMH) & The World Islamic Association for Mental Health (WIAMH) Invites you to The Multicultural week in Narni (Terni), Italy, 9-15 June 2003 Transcultural Psychiatry and Mental Health of victims of Man Made Disasters, 9-13 June 2003 Mediterranean Conference on Multiculturalism and Conflict Resolution Albornoz Castle, Narni (Italy), 9-14th of June 2003. Program At Glance MONDAY 9TH OF JUNE 2003 Morning session 09:00 - 10:00 Opening session 10:00 - 10:30 Tea Break 10:30 - 12:30 Session number one: Chairperson: Dr A. Husain Co-Chairperson: Dr R. Wintrob Topic: Role of transcultural studies in an ever changing world Speaker: Prof. Bartocci, M.D Topic: Difficulties facing Conflict resolution efforts Speaker: Leila Dane, Ph.D. Afternoon session 02:00-04:00 Session number two: Chairperson: Dr R. Wintrob Co-Chairperson: Dr L. Dane Topic: Origin of the recent world conflict Speaker: Mohamed Khaleel Ahmed Abou Homaied Topic: Demedicalisation of Trauma: a culturally appropriate program Speaker: Farouk El-Sendiony, PhD Topic: PTSD in Palestinian Children Speaker: Gultan Abou Homaied TUESDAY, 10TH OF JUNE, 2003 Morning Session 09:00-11:00 Session number Three: Topic: Structured Groups with traumatized children Speaker: Prof. W. Anderson 11:00-11:30 Tea Break 11:30-12:30 Session number four: Chairperson: Dr M. Fessenden Brauer Co-Chairperson: Dr M. Hassanovic Topic: Continuous stress disorder: Experiences from Palestine Speaker: Walid El-Salhy, Ph.D Topic: Five year follow up for children of community violence in Algeria Speaker: AbdulKader El-Khaiaty, M.D. Topic: Victims of violence, Palestinian experience Speaker: Mamdouh Gabr, Ph.D Topic: The acculturation problems of the school children and adolescents in the process of repatriation Speaker: Dr M. Hassanovic WEDNESDAY 11TH OF JUNE 2003 Morning Session Greetings From Prof. G. Stanghellini - WPA Section Clinical Psychopathology 09:00-11:00 Session number six: Speakers: A. Husain W. Anderson T. Gallimore 11:00-11:30 Tea Break 11:30-12:30 Session number seven: Speakers A. Husain W. Anderson T. Gallimore Afternoon Session 02:00-03:30 Session number Eight Topic: Conflict and reconciliation Speakers Prof. Gallimore 03:30-04:30 Session number Nine Chairperson: M. Gabr Co-Chairperson: H. Rashid Chaudhry Topic: "Sognando Palestinna" Review of the book Comments: Dr. Mandy Fessenden Brauer Topic: Victims of trauma and the crisis of Mental Health in EMR Speaker: Ahmed Abou El-Azayem, M.D Topic: Experience of Victims of Trauma Speaker: H. Amer Topic: The contribution of religion in pushing the peace process in the Middle East Speaker: M. Samara THURSDAY, 12TH OF JUNE 2003 *simultaneous translation: English, Arabic, Italian* Morning Session 09:00-10:30 Session number Ten Chairperson: A. Husain Co-Chairperson: G. Bartocci Topic: Psychological well-being of traumatized Iraqi refugee Families and children Speaker: Amer Hosin, M.D. Topic: Il PTSD costituisce un' entita' nosografia specifica o piuttosto una sindrome culture bound? Speaker: L. Frighi Topic: The psychology of suicidal bombing: Background and management Speaker: Dr. Ahmed Abdullah M.D. 10:30-11:00 Tea Break 11:00-12:30 Session Number Eleven Chairperson: L. Frighi Co-Chairperson: M. Afzal Javed Topic: Thoughts on helping traumatized children Speaker: Dr. Mandy Fessenden Brauer, Ph.D Topic: PTSD in children: prevention and therapy Speaker: G. Biondi Topic: Family therapy and Muslim families: a brief solution focused approach. Speaker: W. Valiante Topic: Percorsi migratori e percorsi di esilio: i rischi per la salute mentale Speaker: V. Infante Afternoon Session 02:00 - 05:00 Session Number Twelve Chairperson: G. Bartocci Co-Chairperson: M. F. El Sendiony Topic: Religious healing: experience from different cultures Speaker: Afzal Javed, M.D. Topic: Il sacro e la morte Speaker: N. Lalli Topic: Working with Dreams in Cambodian Refugees Speaker: R. Wintrob Topic: Recognizing psychological consequences of man made disasters Speaker: A. Husain Saturday, 14th of June, 2003 *simultaneous translation: English, Arabic, Italian* 09:00-09:30 Greetings from Mayor and Authorities Transcultural and human sciences: the polyvalent center of formation, study and researches in Narni 09:00-09:45 Speaker: G. Bartocci Topic: Transcultural Psychiatry and Multiculturalism: World scenery 09:45-11:00 Session number thirteen Chairpersons: L. Frighi - N. Lalli - G. G Rovera Speakers: M. F El Sendiony, F. M Ferro, M. Afzal Javed, R. Wintrob, A. Husain, A El Azayem Topic: Mental Health in Muslim and Western countries 11:00-11:20 Discussion 11:20-11:40 Tea Break 11:40-12:40 Session number fourteen: Chairperson: M.Allam Speakers: K. F. Allam, R. Gritti, B. M Mazzara, A. Colajanni Topic: Cosntruction of Muslim identity and the problem of social integration 12:40-13:00 Discussion List of Participants: 1- Maha Shahada Ahmed, Palestine 2- Mohamed Khaleel Ahmed Abou Homaied, Palestine. 3- Aiman Abdul Rakhofe Al-Harbagi (accompanied by his son Abdul Rakouf), Palestine 4- Soha Al-Herbage, Palestine 5- Dr. Fekry Abdul-Azeez, M.D 6- Maamdouh Gabr,Ph.D, Palestine 7- Amal Shaieb, Ph.D, Algeria. 8- Abdulkader A-Khaiaty, Algeria 9- Prof. Haroon Rashid Chaudhry (Pakistan) 10- Prof. Amin Gadit (Pakistan) 11- Dr. Kanwal Qayyum (Pakistan) 12- Amber Farooq (Pakistan) 13- Farida Saifi (Afghanistan) 14- Dr. Amina Choudhry (UK) 15- Hameed Khan (UK) 16- Ali Mohammad (UK) 17- Vinay Kumar (UK) 18- Dr.Melvudin Hasanoviae (Bosnia) 19- Lotfy Mansour, Kafr Kasem, Jerusalem B. Speakers: 1- Prof. Arshad Husain, MD 2- Prof. Farouk El Sendiony, PhD. 3- Ahmed Gamal Abou El-Azayem, M.D. 4- Leila Dane, Ph.D 5- Mandy Fessenden Brauer, PhD 4- Mamdouh Gabr, Psychologist from Palestinian Refugee committee, Palestine 5- Prof. Hassan Omar, PhD professor of psychology, Kafr Kassem, Jerusalem 6- Mustafa El-Kaiaty, M.D, Algeria 7- Dr. Leila Dane, Ph.DWashington 8- Mohamed Khaleel Ahmed Abou Homaied, Ph.D 9- Gultan Abou Homaied Ph.D, Palestine 10- Prof. Gallimore, USA 11- Amer Hussain, Ph.D, England 12- Prof.A.Anderson, Ph.D, USA 13- Ahmed Abd Allah, M.D, Egypt 14- Abdul Kader El-Khaiaty, M.D ACKNOWLEDGEMENTS BY DR FAROUK EL SENDIONY, SECRETARY GENERAL OF WIAMH Life seemed so wonderful to all of us who participated in those happy days during the: Multicultural Week held in Narni (Terni), Italy 9-14 June 2003. I wonder whether the splendor of the city of Narni has cast a spell over all of us. Beautiful and brown, it beguiled us. I wish to express my gratitude for the City of Narni and its Mayor for providing the funds that made this Multicultural Week possible, and for assistance at all stages of preparation for lodging accommodation, sightseeing, and transportation for all participants of the Multicultural Week. I also wish to acknowledge my depth of gratitude for Professor G. Bartocci, whose dynamic initiation of this activity, made this reunion of the cultures of the Mediterranean possible. Lengthy though it may be, the above list does not give due credit to all those who have assisted in the Multicultural Week, Mirella Pioli and Catiousha Ariso who were a source of rich assistance and much personal kindness and the sisters, nuns and workers at the abbey who have given so generously and whose humanity was in rich supply. Finally, I am deeply grateful to the Mayor of Narni and Professor G. Bartocci who on the day before departure did me the honor of toasting me as an honorary citizen of Narni. THE NARNI TRAINING COURSE AND CONGRESS: A UNIQUE EXPERIENCE, by M. F El Sendiony The four-day training program followed by a one-day congress held at Narni (9-14 June 2003) mirrored increasing awareness of the importance of cultural factors in Mental-Health especially as they affect decisions about diagnosis, treatment and management of victims of trauma. This fact has transcultural psychiatric implications. 8 of the 20 participants were Palestinians and the ratio of trainers to trainees was out proportional. His Honor the Mayor of Narni inaugurated the conference. "Kudos" to the Mayor of Narni for his efforts to bring this reunion of the cultures of the Mediterranean to successful conclusion. Many thanks to his kindness and warmness. We have never been so welcomed. The keynote address was given by Professor G. Bartocci who spoke on "The role of Transcultural Studies in an ever-changing World". The rapidity of socio-cultural change is staggering, causing dizzying disorientation hitherto unprecedented. Despite this fact, Transcultural Psychiatry continues to play an essential role in diagnosis, prevention and treatment of victims of war trauma. The range of topics discussed in the training course covered all aspects suffered by victims of war trauma. They were designed to promote culturally appropriate means of evaluation and care of traumatized populations. Focus was on developing realistic, non-stigmatizing culturally based and culturally sensitive intervention for traumatized children, (Gallimore). The topics discussed display an unusually strong commitment to demedicalizing the personal responses to trauma. It repeatedly designates as "normal" the typical and widespread reactions to these experiences. By so-doing it appears to question the wisdom of using medical diagnostic labels to quantify distress and to justify services in these circumstances. It is inferred that relatively few persons will require psychiatric care if the interventions outlined here are utilized to their fullest (El Sendiony). The world of psychiatry and psychology is often dedicated to assessing pathologies that are observed already existing in patients, groups, organizations or entire societies. The reasons behind this "Post-Mortem" approach are many and varied and not necessary to elaborate on here, but it has become our primary lens that we spend much of our professional time patching up the wounded after they fall, or quickly providing emergency medications and coping tools after they have lost the battle. We have, for example proudly identified Post Traumatic Stress Disorder complete with multiple approaches and interventions designed to mitigate the outward overt symptomatology, as well as numerous psycho-somatic manifestations born out of the individuals' attempt to cope with the trauma after it has taken its toll. But, what if the trauma is "continuous" as the Palestinian and other countries caught-up in long armed conflicts testify? (El Salhy) We should differentiate between populations where trauma was the result of past atrocities and the Palestinian situation, where, in addition to the trauma brought by decades of occupation, each and every passing day brings the threat and often the reality of new and even greater traumatic experiences to many members of the population. This leads to the following questions. How can it be post if it is continuing? Dr. Mandy Brauer answered this question as follows: The Palestinians are not dealing with Post-Anything. She uses Dr. Masoud Khans' concept of "cumulative trauma" and goes on to say "Their Trauma is cumulative and continuing". The contribution of religion to peace, prevention, management, and treatment of victims of trauma was discussed (M. Samara). Islamic social influences upon victims of trauma were discussed along 2 main lines. The preventative aspects were illustrated by the Islamic religious code with its encouragement of patience in the face of natural and Man-Made disasters. A mental-health worker may use these Islamic principles to encounter the inevitably painful traumatic experience. In this connection he may invoke the Holy Quran: "You might hate something that is good for you". From the psycho-therapeutic point of view, religious practices, especially prayers (Which provide hope), improve morale and enable temporary states of relaxed detachment from mundane problems relieve the despair of the traumatized Muslim and uplift his/her morale. The prophet Muhammad used to invoke special prayers whenever he experienced a disaster. It is interesting to note that there are usually traditional means for the alleviation of the effects of trauma. The individual is not altogether left at loose ends; he may obtain some relief and reassurance through the utilization of institutionalized defenses. Victimization was covered by various researchers including the following: "Victims of Trauma and the Crisis of Mental Health in EMR" (A. El Azayem) "Experience of Victims of Trauma" (H. Amer) and "Victims of Violence, Palestinian Experience" (M. Gabr). While we condemn violence in the Middle East, we don't blame the victims. Contributors thought it worth reporting on the psychological effects, this warfare is having on the center of the melee. On this personal level, our sympathies extend to Palestinian Victims and Israeli Victims while observing that Palestinians are significantly more victimized and traumatized. Traumatized children and their families were given adequate room as the following paper testifies: "PTSD in children: prevention and therapy" (G. Biondi), "Thoughts on helping traumatized children" (Mandy Brauer), "Structured Groups with traumatized children" (Prof. W Anderson), and "PTSD in Palestinian children" (Gultan A. Homaid). In all these endeavors the cultural factor was never missed in diagnosis, prognosis, management and treatment of victims of trauma. There were also papers covering conflict resolution, given by Leila Dane, the head of the Institute of Victims of Trauma: "Difficulties facing conflict resolution efforts"; M. A Homaid a notable Palestinian historian, "Origins of the Recent World conflict"; T. Gallimore "Conflict and Reconciliation" and A. AbdAllah "The Psychology of suicidal bombing, background and management". Although most of the topics and papers presented were related to the Arab culture, they were not all culturally bound to this culture area. Examples of papers from outside the Arab World are the following (R. Wintrob) "Working with Dreams in Cambodian Refugees" and Mevludin Hasanovic "The acculturation problems of the school children and adolescents in the process of repatriation" enclosed herewith in this newsletter. The University of Missouri - Columbia's delegation was led by child psychiatrist Arshad Husain and consisted of Professor W. Anderson and Professor T. Gallimore, of the International Center for Psycho-Social Trauma. These people risked their lives to help traumatized children and their families around the World. This team trained mental health workers to treat traumatized victims of war from diverse cultural backgrounds, e.g. Bosnia, Kosovo, and Chechnya and Palestine. Although Dr. Arshad Husain was positive about the present training program in Narni, he had some reservations about it. His concern was about the ratio of trainers to trainees. In previous training programs, in which they crossed the globe to provide assistance, the trainees outnumbered trainers. In August 2002, his team of mental health professionals from the University of Missouri, Columbia's International Center for Psycho-Social Trauma conducted a 5-day training program in Cairo, Egypt to train approximately 40 trainees, most of them Palestinians. The trainers' team consisted of 4. Following this endeavor the same team from Missouri led by Dr. Husain conducted a 4-day training course with 20 - mental health workers in the West Bank of Palestine, and 4 days with 30 mental health workers in the Gaza strip. This took place during November 2002. Although they worked under the most dangerous conditions, they rated their training course in Palestine as the best program they have ever done. This is why the Missouri team were disappointed by small number of trainees at Narni. But this may be quite misleading. It is true that the number of trainees in Narni was small compared to the number of trainers. However, among this small number of trainees, 4 were potential leaders of the Palestinian community. In contrast to previous training courses given by the Missouri team, most of the trainees were commoners. Therefore, it is thought that the present training program in Narni is unique and it will have a more positive impact on the mental health of the traumatized community. The reason is, some of the trainees were leaders, who will act when the situation requires action and who were respected in their own right for their own action in the community at large. The lesson which will come from Narni's training is that it is possible to deal with the mental health of the traumatized community by recognizing and training their leaders and giving them responsibility for action. Not until we are prepared to recognize the men and women that the Palestinians recognize as leaders will trainers be able to deal with mental health of victims of trauma and bring about significant changes in the mental health of the traumatized community. More than that, it was impossible for trainers not to learn from the trainees. On the 14th of June there was a workshop on "Transcultural Psychiatry and Multiculturalism: World Scenery" followed by another session on "Mental Health in Muslim and Western countries". The final session was on: "Construction of Muslim Identity and the problem of social integration". There was a fruitful discussion between Muslim Scholars and Italians' foremost authorities on Islam. Professor G. Bartocci is to be congratulated for his pioneer efforts. Transcultural psychiatry can benefit from the perspective that Islam can provide for the treatment, prevention and management of victims of trauma. We must applaud the Mayor and city of Narni for supporting this venture. THE ACCULTURATION PROBLEMS OF THE SCHOOL CHILDREN AND ADOLESCENTS IN THE PROCESS OF REPATRIATION Master thesis defended on February 06th 2003. Mevludin Hasanovic MD SCHOOL OF MEDICINE, UNIVERSITY IN TUZLA, 75 000 TUZLA, BOSNIA AND HERZEGOVINA Summary This research is to establish difficulties of trauma experiences, stress level, level of personality disorder, and the maladjustment problem of acculturation in countries of foreign culture and language as well as the maladjustment problem during the process of repatriation of adolescent returnees who stayed during recent period in one or more foreign countries, and after that they are returning in homeland. The sample comprises 239 examinees, which are divided into two groups. The experimental (E) group (N=120) is consisted from younger subgroup (E 1), elementary school students from the 5th to the 7th grade (N=60) and older one (E 2), secondary school students from the 1st to the 3rd grade (N=60); who during the war (1992-1995) and after Dayton agreement (1995-1998) were refugees in foreign countries, and nowadays they are in the repatriation process. Control (K) group (N=119) is consisted from younger subgroup (K 1), elementary school students from the 5th to the 7th grade (N=60) and older one (K 2), secondary school students from the 1st to the 3rd grade (N=59); who were refugees during the war period (1992-1995) as well as in the post-war period (1995-1998) in their homeland Bosnia and Herzegovina (BH), without possibility to return into their own homes. All examinees are Boshnyac equal in number of male and female sex. Psychometric methods, questionnaires and statistical methods are used in the research. Psychometric methods are used to estimate the personality structure (PIE), and for neuroticism and extroversion of examinees (HANES). The questionnaires are used to carry out of: psycho-socio-demographic characteristics; traumatic events, their severity and the expressiveness of the PTSD symptoms; the parents and trustees estimation on the examinees acculturation and the repatriation problems; finally data's about school behaviour disorders were collected from the teachers. Out of statistical methods the t-test, analysis of variance, X²-test and correlation test were used and in this way, the significance of the results obtained between the groups in the sample established. Obtained are results indicating that all examinees in the sample have outstandingly high number of traumatic events, with high level surviving difficulties, which is permanently retaining after the war. The returnees are traumatized almost equally as their peers who stayed during whole war period in the catastrophic life conditions. The stress level of all examinees in the sample is in outstandingly high correlation toward the level of traumatic experience difficulty. Returnees are practically equalized in the expression and difficulties of PTSD symptoms with their peers in the control group. The father loss is very important catastrophic event, which determined extremely high level of completed PTSD development in the whole sample. Younger examinees in both group present low level of adjustment, high level of caution and distinct depression tendency, relatively disorganization and planning unfitness, they present bitterness and significantly more aggression related to normal values. The father loss of returnees increasing repatriation maladjustment: the tendency to reject the new adopted, disorganization and aggressiveness. Older returnees' present significantly expressed stiffness and maladjustment, caution, fearfulness, passivity, and they are eager to leave leading role to the others, they are passive and they are missing decisiveness. The father loss of older returnees is essentially increasing the tendency for rejection. Older girls' returnees present meaningful repatriation maladjustment. Neuroticism of returnees is in the range of normal values, what point to the high level of natural resistance, adjustment ("resiliency"). Secondary school age returnees demonstrate essentially higher neuroticism than younger', while the sex and the father loss do not influence essentially onto the shown neuroticism level. Both returnees and examinees of control group with the father loss expressed pathological introversion. The most expressed acculturation problems of returnees during their staying in abroad are: meditating about relatives, reflecting about original place in homeland after arrived in the place of exile, The missing of friends, desire for the returning to homeland, listening to the news out of homeland, intensive feeling of longing after coming in the country of exile. The sex of returnees has no essential influence onto development and persisting of acculturation level during sojourn in abroad, meanwhile the father loss essentially influenced onto worsening of acculturation during the exile in abroad. The highly presented repatriation problems that examinees meet after returning in homeland are: the schooling system is different related to country of exile; examinees mostly watch satellite TV at their homes; the economic situation is worse than before exile; outstanding sadness; the meeting with previous friends missed after return to homeland. In the school milieu among returnees the most distinct disorders are: they can't sit calmly, they are restless and hyperactive; impossibility to focus their concentration onto teaching; they act as if they are confused, as they can't orient themselves; than the attaining of bad results by school learning. The teachers noticed a series of behavior disorders which point onto increased maladjustment during repatriation. Secondary school age returnees drink occasionally alcohol beverages significantly more than their peers which stayed in BH during whole war. FAMILY THERAPY AND MUSLIM FAMILIES: A SOLUTOIN FOCUSED APROACH By Wahida C.Valiante BSW, MSW, OASW Narni, Rome, June 2003 Introduction: Over the years, family therapy has emerged as a separate and distinct discipline, one practiced very often by those outside the formal fields of psychiatry and psychology -- such as social workers, family therapists, counselors, and others. This diversity of practitioners illustrates well that there is no universal theory of psychotherapy. Many different approaches, techniques and theories seem to produce positive changes and results. Psychotherapy itself has also gone through several changes, from Freud's "unconscious and deficit focus" to behavioral and cognitive therapies in the "here and now." Currently it is moving toward "future orientation" with a primary focus on individual strengths, knowledge, abilities and the potential for change. The individual is neither stuck in the past, nor the present, but is looking also to the future. Based on the writer's own clinical experience, and without excluding other family therapy models, this presentation points to striking links between certain Qur'anic concepts and Solution Focused Therapy, which suggests that the latter may be especially applicable to treating post traumatic stress disorder in members of this particular cultural and religious minority. Rationale: Demographics: - There are approximately 1.5 billion Muusliims in the world. - Millions of Muslims live in North Amerricaa and Europe; 6 to 7 million in the U.S. and 650,000 in Canada (May 2003 statistics) - The United States has the highest divoorcee rate worldwide (48.6 percent) - The United Kingdom has the second-highhestt divorce rate (36 percent) - Muslims in North America have the thirrd-hhighest divorce rate at 33 percent (source: New York-based Muslim sociologist Ilyas Ba-Yunus) - There are large numbers of Muslim refuugeees from war-torn nations who suffer from post-traumatic stress disorder, psychological and physical traumas, rape-induced traumas, and other varieties of serious loss - There is an urgent need for an alternaativve Family Therapy, practiced from the Islamic perspective Study of the Muslim Family: There is a paucity of written and researched material by Muslim scholars and scientists on the family, as viewed from historical, socio-cultural, psychological, behavioral, and political perspectives. AbuSulayman (1993) points out that most Muslim scholarship on family and gender relationships is restricted by and confined to the formative years of Islamic law, "that is, to the first four centuries or so of Islamic history (roughly from the seventh to the eleventh century)." This is also the period during which Islamic Law (or Sharia) developed, and when Muslim society reached the zenith of its political, social, legal and economic maturity. The end of this period marked the culmination of a religious-legal process to which nothing of major moment has since been added. Unfortunately, this is also the period that culminated in stifling any further development of intellectual, social, philosophical and legal thought by Muslim minds in light of the faith's revealed text, the Holy Qur'an. It is important to note that most classical and contemporary Muslim scholars have studied families only from a religious point of view. According to this approach, the family is viewed exclusively from a religious perspective, which is held up as both normative and idealized. This normative view of family, however, presents a version of sociological and ideological reality that is at odds with the actual state of the family (i.e., not "what it should be") in most of Muslim society. This creates insurmountable difficulties in critically examining the validity of the patriarchal structure, the role and status of women, and the concept of equality in light of current Qur'anic knowledge and of the Prophet Muhammad's own family practices. For centuries, Muslims all over the world have been superimposing on their faith laws that were developed in response to local cultural, social, political, or legal needs. But many of those cultural and indigenous practices, or legal traditions, have serious implications for the Muslim family in general and Muslim women in particular, who are caught between the opposing worldviews; the Qur'an and the other One of the most compelling arguments against this classical body of Muslim knowledge is that it restricts the worldview of the Qur'an itself to certain socio-cultural, behavioral, and historical time-space factors. Furthermore, it limits family study to idealized versions instead of existing reality, and avoids seeking solutions to correct the existing situation. Brief Solution Focused Therapy: For most of its history, Psychotherapy has focused on identifying and eliminating the problems presented by individual pathologies and deficiencies. There is, however, an emerging trend or focus shift, from pathology and deficit toward developing personal strengths, competence, capabilities, and resources through therapy. It is a way of thinking that projects visions of what might be, and what should be, thereby helping people in therapy see the potential for change that generates solutions and actions that otherwise might not have materialized. Relating Qur'anic concepts to aspects of Brief Solution Focused Therapy: The Qur'an presents itself as a "guide" from the One Creator of all things to humanity, through a representative of Allah (Qur'an 6:165), who is the trustee of free will (Qur'an 18:20), and who is under moral obligation to change him/herself and society to create a just and morally balanced world (Qur'an 3:110). The purpose of the Qur'an is not to be rigid and dogmatic, but to guide humanity to find solutions to heal the whole person -- body, mind and soul -- as part of social reality. It is focused on applying solutions through action, rather than blindly following spiritual precepts alone. In the Qur'an, the individual is defined in a unique way. One is responsible for his/her own actions; " But proclaim (to them) this (truth): That every soul delivers itself to ruin by its own act."(Qur'an 6:70). Personal responsibility is also tied to relationships -- those of kinship, masakin (the needy), orphans, even wayfarers, as well as with one's community, society at large, and ultimately with the world. Similarly, an ethical or spiritual action, whether positive or negative, is bound to have an impact on oneself, others, society, community, and the world. Herein lie some ideas that illustrate ready parallels with Solution Focused Psychotherapy, with its concepts of solutions, including: action, free will, the ability to make choices, responsibility for one's own action and behavior, individual responsibility, and the ability to change (jihad) oneself and society. Through constant growth, gender-neutral interconnectedness, small changes, and small goals, human nature is basically healthy and strong, and miracles do happen. Analysis: Emphasis on Individual Behavior and Strengths, Rather than Past History: The focus of reform in the Qur'an is the individual, who is not only an integral part of his/her family, society, community, and the global congregation (or Ummah) of Islam, but is also the recipient of the best physical form and temperament (fitra); "Surely, We have created human beings in the best of molds" (Qur'an 95:4). In addition to free will, human beings are also given the faculties of hearing, seeing, feeling, and understanding, in order to make evaluative judgments between right and wrong (Qur'an 67:23). Therefore, personal choice and responsibility for individual behavior is central to Islamic thinking; "…every soul draws the consequences of its own action." (Qur'an 16:111). In fact, there is a constantly renewed opportunity for choice between right and wrong actions, so that past behavior is only relevant insofar as it acts as a strong predictor of current and future behavior. Working with individual strengths and current behavior, with only selective references to the individual's past history, corresponds to the approach of Solution Focused Therapy. Emphasis upon Action, Rather than on understanding the Pathology or the Problem: "…Surely Allah does not change the condition of a people until they change their own condition…"(Qur'an 13:11). The precedence of action over understanding the background pathology or problem is a central Islamic concept. The Qur'an states that human beings are created to be representatives (vicegerents) of Allah (Qur'an 6:165) and are under a moral obligation to continually reflect and reform them selves (Qur'an 3:110). Thus, according to the Qur'an, one's successes in this life and in the Hereafter are measured not solely in terms of personal inter-psychic growth, but in terms of personal growth as shown in relationship to others and to God. The Qur'an reminds us that change does not come about by ritualistic pursuits only, since reward and punishment are considered more immediately in relation to one's actions, rather than to one's professed faith. Bearing this in mind, Islam declares action to be a necessary concomitant of faith. In popular terms, Islam always seeks to "walk the talk." Similarly, the approach of Solution Focused Family Therapy is also more concerned with action than with retrospective insight. It aims to change the individual's behavior in order to alter his/her conditions of living rather than their attitudes to it; that is, from saying "I do not know what to do," to "what can I do to change things?" Emphasis on the Individual rather than Gender: A further point of strong contact between Qur'anic teachings and Brief Solution Focused Therapy is the notion of individuality; that is, each individual has the ultimate responsibility of helping himself or herself, and therefore carries the personal responsibility of discerning free will and actions, and of seeking solutions and setting goals that will not be impaired because of gender. Above all, solution focused therapists do not assume "deficiency" in their female clients. In the Qur'an, the creation of man and woman out of a single soul (Qur'an 4:1) does not distinguish between men and women along the lines of traditional male or female attributes. Nor does it divide human nature and divine nature according to gender, or assign any specific cultural functions or roles to either men or women. In fact, there is no arbitrary pre-ordained eternal system of hierarchy. The Qur'an treats women as individuals in the same manner as it treats men as individuals. This Qur'anic individuality is distinguished on the basis of "Taqwa" -- faith, as well as deeds and actions. Therefore, Allah's promised rewards are also distributed to individuals in strictly equal terms, based on merit and not gender. "Whether male or female, whoever in faith does a good deed for the sake of Allah will be granted a good life, and rewarded in proportion to the best of what they have accomplished". (Qur'an16: 97). A Small Change is all that is Necessary: Allah tells us that, "in whatever you are occupied when you recite the Qur'an, and in any other work you may be doing…We are a witness to your actions…AND even the smallest things that you do, do not go unrecorded" (Qur'an 10: 61). Thus, even a small action can have major impact on the individual self, others, society, and the world. So if Islam is a prescription for internal and external peace, then change comes about -- to paraphrase Edward Lorenz's "butterfly effect" -- through active application and not benign neglect. The solution focused therapist's approach is that no matter how complex and difficult the situation, making only a small change in one person's behavior can lead to profound and far-reaching differences in the behavior of all persons involved. This approach applies the same Qur'anic principle that "a small change is all that is necessary." Change is Constant: The Qur'an states that change is both constant, and inevitable. "You shall surely travel from stage to stage," (Qur'an 84:19). Addressing the question of heaven (the Hereafter), it says, "We have built Heaven with power. Verily, We are expanding it" (Qur'an 51:47). The solution focused therapist's foundational understanding that "change is inevitable," parallels the Qur'anic concept that nothing stays still in all of creation, including the diverse situations of humanity. Emphasis on Goal Setting: It is often said that that the most successful among us are those who set small, attainable goals, and reach them. With consistent application toward these "attainable goals," life then becomes a series of positive reinforcements; ultimately, we make it to the end point, the "pot of gold" as it were. But those who set huge, unrealistic goals are destined for disappointment and failure. Solution Focused Therapy's approach to setting attainable goals (specific, concrete, and in behavioral terms) with the full participation of the client, reflects the Qur'anic world view that there is no divorce between thought and action; "the human being can have nothing but what he/she strives for" (Qur'an 53:39). Emphasis on Cultural and Racial Neutrality: As a universal religion, Islam views each individual in exactly the same way, since God "created you of a single soul" (Qur'an 4:1), with some characteristics that distinguish oneself from all other humans. Thus it recognizes racial, cultural and religious differences, seeking to preserve them by addressing the psychological and spiritual needs of those living within its sphere. "We have created you male and female and have made you nations and tribes that you may know one another. Indeed, the noblest of you in the eyes of Allah is the best of you in 'Taqwa,' faith and action" (Qur'an 49:13). Solution Focused Therapy's emphasis on individual behavior for the locus of change, rather than race and culture, is parallel to the Qur'anic concept of "vicegerency," or being representatives of Allah. This implies that all human beings, independent of gender and race, are held accountable for their actions and behavior; the Qur'an further points out that without these attributes, the human condition cannot change. The Miracle Question: This is a rather intriguing concept of Solution Focused Therapy, because of its dual connotations -- clinical as well as religious. First, it seeks to set specific and concrete goals through the process of thought and action, both of which are within the control of the individual. Secondly, it seeks to foster a belief in change (through goals and action) that is understood to happen beyond the control of the individual. This parallels the Qur'anic concept of one God (Tawhid), who has the ultimate power to change human conditions and situations. In other words, miracles do happen, because Allah answers the prayers of those who call upon Him; "do not despair of the mercy of God…Indeed God is Most Forgiving, most Merciful" (Qur'an 39:53). As our society, Canada's in particular, moves away from the melting-pot ideal and toward that of cultural and religious pluralism, so must psychotherapy and clinical counseling move from a secular assimilationist perspective back to more orthodox ideologies in order to meet the varied needs of multicultural communities. Therefore, clinical assessment should go beyond an analysis of the presenting problem(s) and the identification of individual pathologies, to include the religious, cultural, social and personal experiences of these families. As a result, the emphasis on diagnosis and assessment of families can become holistic, rather than fragmented into body, mind, and social environment. References: AbdulSulayman, A AbdulHamid. (1993) Crisis in the Muslim Mind: translation by Yusuf Taalal DeLorenzo. Virginia: International Institute of Islamic Thought. Bucaille Maurice. (1979) The Bible The Qur'an and Science: Pakistan: Kazi Publications. Irving. T.B. (1991) The Qur'an: India: Goodword Books McGolderick, M. (1982) Ethnicity and Family Therapy: an overview. In: M.McGolderick, J. Pearce and J. Giordano (eds), Eethnicity and Family Therapy. New York: Guildford. Muhsin-Wadud, Amina. (1992) Qur'an and Woman. Kauala Lumpur: Penerbit Fajar Bakti Sdn.bhd. Tarrant, D. (1987) Family Therapy with Evangelical Christian Families: Dissertation submitted for Diploma in family marital therapy. University of London, Institute of Psychiatry Valiante. C. Wahida. (1992) Domestic Violence in the South Asian Family: Treatment and Research issues. In South Asian Symposium: a Reader in South Asian Studies, The Center for South Asian Studies Graduate Students' Union, University of Toronto 1993. Yousef Ali. The Glorious Qur'an REPORT THE MEDITERRANEAN CONFERENCE ON MULTICULTURALISM AND CONFLICT RESOLUTION Narni, Italy June, 2003 By Dr Mandy Fessenden Brauer The World Islamic Association for Mental Health, along with the Eastern Mediterranean Regional Council for Mental Health of the World Federation for Mental Health, the Transcultural Psychiatry Section of the World Psychiatric Association and the City of Narni hosted a conference and workshop on Transcultural Psychiatry and Mental Health of Man Made Disasters from 9 to 13 June 2003 and the Mediterranean Conference on Multiculturalism and Conflict Resolution from 14 to 15 June 2003. The latter conference, which was primarily in Italian, had simultaneous translation in Italian, English, and Arabic the first day. Special mention must be made of those who spent an inordinate amount of time involved in the planning of the overall Multicultural Week in Narni, especially Drs. Ahmed Abou El Azayem, Farouk El Sendiony, Arshad Husain and Afzal Javed from the World Islamic Association of Mental Health and Dr. G. Bartocci from Italy. These people planned and coordinated the event plus contributed their own resources to make sure the conference was a success. Without their dedicated involvement the conference might well not have occurred. The city of Narni also deserves special mention for its generous hospitality in hosting the conferences. The other people who deserve special mention are the translators, particularly Catiuscia Ariso, the young woman who was with the group all week and went out of her way to help us learn about her country. She also translated instructions and material from Italian into English or vice versa and assisted attendees in solving various personal and business matters as they arose. The first day of the second conference had simultaneous translation which greatly assisted in forging new and important connections between the Arabic-speaking countries from the Eastern Mediterranean area and the Italian mental health community. Numerous important presentations during that day of coming together provided valuable background, information and research data for all in attendance. Participants and presenters at the first conference came from Bosnia, Egypt, India, Israel, Pakistan, Palestine, and the United States. Attendance was less than anticipated because of regional problems including political instability and conflict and a recent earthquake that struck Algeria. Problems with anticipated funding for participant travel further limited attendance from Third World countries but those who did attend were enthusiastic about the chance to come together for such meaningful work and expressed willingness to work toward a similar conference/workshop in the future. One evening there was a focus group conducted by Dr. Ahmed Abou El Azayem with Arabic-speaking presenters and participants. Major goals were decided upon by the group, the most crucial being the need to improve and coordinate activities, research and other material concerning mental health issues. Other goals were voted upon and chosen as points of focus. It was not clear, however, how the group planned to work toward reaching the goals selected. There was no formal evaluation of the conference/workshop which participants felt would have been especially useful in reinforcing significant points stressed in the workshop-focused training and the many presentations and would have provided valuable material for future planning. This point was stressed by those involved in research and teaching. There were many positive consequences of the conference/workshop. Many were grateful there was a forum in which they could be heard! Historically this has been a major problem for those from the Third World. Put into a framework of transcultural mental health, the needs of people dealing with long-term, man-made conflict and occupation became more evident and more pressing to discuss and deal with openly. The Palestinian presenters felt they succeeded in presenting evidence-based data in an international forum about the extent and severity of traumatization of children in the West Bank and Gaza that was irrefutable. The chance to meet international mental health figures provided those from developing countries an invaluable opportunity to exchange ideas and plan future collaborative activities in the future. It was also enlightening to learn about the problems involved with repatriation issues such as being experienced in Bosnia, and in large migration issues such as is occurring in Italy. There were some areas which the participants and presenters felt could be improved and with which they are willing to help with for future conferences: Translation of presentations, questions and comments could have assisted immensely! Some of those whose primary language is Arabic could not follow the presentations. Translations of written material into English and Arabic would have provided valuable reading and teaching material to take back to local areas and would make facilitate the transfer of knowledge. A summary of the conference would also reinforce learning, as would an evaluation, especially were results to be distributed. Many felt time management could have been improved, although some wanted more presentations, some wanted longer and more in depth presentations while others wanted more time for discussions around the presentations themselves. Another suggestion was that teams of presenters be given specific time slots and have the responsibility of coordinating overall presentations, each team being responsible for devising specific evaluations. Some were concerned that it is premature to discuss conflict resolution when there seem so few steps toward justice. Many attendees, however, felt that specific steps involved in encouraging conditions for conflict resolution needs to be the focus of future conferences as well as how to implement and teach conflict resolution skills. Since an overriding theme of the conference was to look at Islam and mental health, it was suggested that those who use Islam specifically in treatment interventions be encouraged to present papers about treatment issues in a future conference. Specific clinical material would be helpful. Several suggested that the conference be held in a single place (such as the abbey where some stayed in Narni) which would allow for work and presentations in the evenings. Translation, of course, would be critical. Abstracts of papers required ahead of time would facilitate overall conference coordination, and could be translated, printed and distributed. Papers from the conference could be published in Arabic and English and distributed to the participants and presenters. It was felt that this should be a goal at any future conference and that presenters prepare their papers ahead of time in dual language versions. Participants expressed willingness to work with the coordinators of future conferences to help find funding and speakers. Several suggested trying to get some of our Arabic-speaking neighbors to sponsor a participant or presenter, to provide funding for translators and/or to translate papers. It was felt that adequate translators who would be glad for the opportunity to go to Italy or any other country and would translate for nominal fees could be found ahead of time. Attendees of the workshop/conference left feeling they had not only learned a great deal of value but had, also, been heard by those who don't always hear about the extent and nature of the mental health problems being dealt with on a day-to-day basis. Further, participants and presenters alike were able to connect to others interested in mental health and conflict resolution from other parts of the world and knowledge and contacts were exchanged and in many cases appeared to be leading to some sort of collaboration in the future. Overall, it seems to the participants, presenters and coordinators of the conference that it was a success. On the basis of the work accomplished, it was suggested that funding efforts for next year commence by placing news releases about the conference just held and then requests for funds in newspapers and professional journals throughout the region. In addition, contacting medical syndicates and business organizations throughout the region about the aims of the next conference and asking for support could bring favorable results. The promotion of mental health and conflict resolution is in the interest of everyone, not just those who attended the conference. The final recommendation of those who were in Italy for the recent conferences is to develop a conference in 2004 which would focus on treatment-based, cross-cultural issues. It was felt by the organizers of the conferences, the presenters and the participants that it would be of special benefit to bring together those who treat from specifically religious perspectives, especially Christian and Muslim, to share findings and intervention techniques. Conference organizers might also consider inviting mental health practitioners who use a Buddhist framework or one that is more generically "spiritual" for treatment. Emphasis needs to be on what helps the patient and the overall community: that is, when and how is religion or spirituality utilized for the benefit of the patient and his or her community and when might it be contraindicated. Clinical issues drawn from cross-cultural treatment could be very informative. Papers which shed light on Christians treating Muslims or vice versa could be very illuminating. It might even be beneficial to hear a "secular" mental health provider discuss concerns and difficulties treating religious patients. Another area of consideration could be how mental health professionals draw on religion and spirituality for their own emotional sustenance. Religion and spirituality seem to be an intrinsic part of the human condition and therefore must be considered when viewing the whole person and seeking to improve mental health individually and collectively. All agreed that the June 2003 conferences in Narni, Italy built initial connections which will further the above goals in the future. MA thesis Discussion Last semester, WIAMH was invited by Al Aqsa University in Gaza and Ain Shams University in Egypt to formally discuss the following MA thesis in Psychology. The topic was the following: THE EFFECTIVENESS OF RELIGIOUS THERAPY IN REDUCING ANXIETY AMONG YOUNG MALE AND FEMALE IN GAZA'S GOVERNORATE, BY ABD EL FATAH ABD EL GHANY EL HOMS, AQSA UNIVERSITY, GAZA, 2003 Formal Discussant, Farouk El Sendiony Supervisors: Prof. Dr. Nabil Abdel Fattah Hafiz, Faculty of Education, Ain Shams University, Cairo Prof. Dr. Nazmi Awda Abou Moustafa Dean of Faculty of Education for Qualitative Sciences El Aqsa University, Ghaza, Palestine Below is a review of the thesis. Two samples - an experimental sample (E) and a control sample (C) were drawn in such a way that they were as nearly alike as possible at Time 1 in regard to all factors potentially affecting the result. Experimental group numbered 20; 10 male and 10 female. The control group consisted of the same number of female and male. The experimental and the control group were matched according to anxiety level, IQ, socio-economic status, age. El Homs measure of intelligence was a version of Raven's matrices standardized for the Palestinian environment. This matching procedure produced comparable mean scores for the experimental sample and the control sample on the above variables. The presumed causal factor X (religious treatment) was introduced by the experimenter into the experimental sample but withheld from the control sample. It was hypothesized that: "Religious Treatment causes significant reduction in anxiety." Religious treatment was operationally defined as a variety of religious activities ranging from Quranic readings to prayers as pertaining to anxiety. Religious treatment lasted for 8 weeks and consisted of 24 sessions. The dependant variable (Y) (significant reduction in anxiety) was observed in both samples at both Time 1 and Time 2. "Significant reduction in anxiety" was operationally defined as a decline of 10 points or more on Tylor's anxiety scale. The changes occurring in the experimental sample (dE) were then compared with the changes occurring in the control sample (dC). Statistical analysis showed that (dE) was significantly larger than (dC). For a psychiatrist working in Palestine, knowledge of Islamic religious treatment is essential to the Palestinian situation where, in addition to the trauma brought on by decades of a brutal occupation, each and every passing day brings the threat and often the reality of new and even greater traumatic experiences to many members of the population. One feels that it would have been helpful for a Muslim mental health worker to look deeper into his Islamic heritage for religiously and culturally appropriate ways to deal with the exposure to continuous traumatization. And this is what the contributor of the present investigator is all about. To evaluate whether his hypothesis is supported by empirical evidence, he conducted the present study. However, the investigator has not resolved methodological problems. In the present study, the treatment comprised a wide and loosely defined variety of religious activities, from Quranic readings to Zikr (repetitive mentioning of Allah's name), prayer's, and asking God for forgiveness. The investigator was left largely to his own resources and treatment thus consisted of "the application of whatever skills the researcher was capable of doing." Because the results had shown a significant difference between the 2 sets of young Palestinians, the researcher has been able to conclude that religious treatment was somehow effective in reducing anxiety, without knowing exactly which aspects of the treatment program were responsible. Another methodological problem concerns experimenter bias. The experimenter himself was the person who administered the treatment and he was aware of who was not receiving treatment and he knew what results were expected from religious treatment. The fact that double-blind studies of "religious-treatment" have not yet been conducted is another reason for caution in drawing conclusions about this treatment. The investigator is to be commended for his pioneer effort. Transcultural Psychiatry can benefit from the perspective that Islam provides for the treatment of anxiety. WIAMH's Online Consultative Service In the year 2003 we have started an international consultative service in which we attend to the needs of people from different cultures who consult us on questions pertaining to the relation between Islamic culture and mental health. An example of this service is as follows: Question: From: "Shakil Ahmed" To: [email protected] Subject: Cognitive Dysfunction and Spirituality in Islamic Society Date: Fri, 14 Mar 2003 16:17:42 -0600 Assalam-o-Alaikum Wa Rahmatullahe Wa Barakatehu! My name is Shakil Ahmed, and I am a member of the Islamic Speakers Bureau (ISB) of Nebraska, in Omaha, Nebraska, USA. Our bureau is invited by various academic and religious organizations to give brief talks about various Islamic topics, including "Introduction to Islam". Recently, I have been invited to speak briefly (about 20 minutes) on the suggested topic of, "Cognitive Dysfunction and Spirituality in Islamic Society". I have come up with some ideas about treatment of our older parents, and older people in general, but I need some Islamic references for this topic. It will be nice if I could have some Quranic or Hadith references on this topic that how an Islamic society deals/guides us to handle the cognitive dysfunction (including Alzheimer disease) within the society. Could you please help me in pointing out those references? Thank you in advance for your help, Jazakumullah Khairun! Wassalam-o-Alaikum Wa Rahmatullahe Wa Barakatehu! Shakil Ahmed... Answer: From: Farouk El Sendiony To: Shakil Ahmed Subject: Re: Cognitive Dysfunction and Spirituality in Islamic Society Date: Fri, 21 Mar 2003 13:36:30 -0800 (PST) Dear Brother Shakil, Assalamo Alaykum Wa Rahmat-Allahe Wa Barakatehu Your topic is interesting as it mirrors increasing awareness of the importance of cultural factors in mental health especially as they affect decisions about diagnosis, prevention and treatment of mental illness of old age. Your central theme is concerned with "Islam and Mental Health" with special emphasis on the Islamic approach to treatment, management, and prevention of Alzheimer's disease. The Preventative aspects are illustrated by the Islamic religious code with direction of handling personal, interpersonal, and inter-group problems. This code enables Muslims to distinguish values, roles, attitudes, and transactions in situations that otherwise could precipitate psychiatric disorders for old people (El-Islam, 1982). Closely related to this is kindness to parents, as is expressed in the following quotation from the Quran: "I will recite unto you that which your Lord hath made a sacred duty for you: that ye ascribe no thing as partner unto Him and that ye do good to parents," From verse 151 Surah 6. Al-An'am Meaning of the Holy Qur'an by Marmaduke Pickthall A prophylactic measure against senile psychosis is given in the following verse of the Muslim Holy Book. 23. Thy Lord hath decreed, that ye worship none save Him, and (that ye show) kindness to parents. If one of them or both of them to attain old age with thee, say not "Fie" unto them nor repulse them, but speak unto them a gracious word. 24. And lower unto them the wing of submission through mercy, and say: My Lord! Have mercy on them both as they did care for me when I was little. (Surah 17. Al-Israa Verses 23-24) Meaning of the Holy Qur'an by Marmaduke Pickthall From the Psychotherapeutic point of view the previous Verses from the Quran will also apply in the treatment and management of Alzheimer. It shows profound compassion for old people including Alzheimer patients. This is a welcome change from and all-too prevalent cold clinical approach which regards patients as experimental subjects rather than people in need of treatment. Religious practices especially prayers, (which provide hope, improve morale, and enable temporary states of relaxed detachment from mundane problems), relieve the despair of the Alzheimer Muslim patient who otherwise would feel as a social outcast if he is socially isolated from his kin group. Therefore he is kept at home. This is why a Muslim community dislikes the institutionalization of Alzheimer's patients as it represents a violation of Islamic values. The religion of Islam has protected the family against the shock of urbanization. In Islam the community and the family are the corner stones of human relations. Thus as long as the Muslims prescribe to these values pertaining to old people it is difficult to conceive the creation of a geriatric problem with all its possible miseries for the old-age population. May I suggest that you read the following paper: "Sharia in Islamic Therapies for the Aged" in "Current Psychiatric Therapies", Vol. 22, Edited by Jules H. Masserman, M.D, 1983 by Grune and Stratton, Inc. I will be more than happy to supply you with additional information if required. Best Regards ------------------------------------------------- WIAMH newsletter can be found on the Internet at www.geocities.com/wiamh2001 In addition we have started an online service in which we are approached by Muslim patients from Western countries who consult us on various clinical problems. We refer them to interested Muslim Colleagues who are aware of the relation between culture and Mental Health.
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