Followers

13 April, 2013

'Religious' Causes of OCD in Muslims


If knowledge is power, then the knowledge of disease amounts to a kind of power over that disease. Particularly in the cases of mental disorders, the way we think about the disease entity has a lot to do with how the sufferer regards his or her condition.


In 1973 a researcher wrote about OCD with confidence that it is ‘unquestionably one of the rarest forms of mental disorders’ (Davis, 2008:209). And, now after just a few decades we are living in times when OCD is considered the fourth most common mental disorder (National Institute for Health and Clinical Excellence, 2006). World Health Organization’s 2001 mental health report mentions Obsessive Compulsive Disorder as one of the top 10 causes of disability in the world (Davis, 2008:210). Davis (2008) questions this sudden rise in OCD, and attributes it to the way perception has been modified by mass-media campaigns etc. He argues that we are living in an age of ‘obsessional panic’.

We cannot understand diseases like OCD without a thoroughgoing knowledge of social, cultural, historical, anthropological, and political view of that ‘disease entity’ ( a term coined by Davis, 2008). The history of disease itself contains a therapeutic narrative. What is in essence a bio-cultural knowing of diseases can empower patients as well as physicians to rethink the way that disease is enforced and distributed through cultures and represented in popular and professional imaginations. In bio-cultural case, the disease isn’t controlled through cure and eradication, although those goals are always worthy ones, but through a systematic rethinking of the way disease is structured and positioned in our society (Davis, 2008).

This article reviews the ‘religious’ causes of scrupulosity (religious version of OCD) amongst Muslim population.  According to Hyman and Pedrick (2010) strong religious beliefs do not increase the likelihood of religious OCD (scrupulosity). However, having dealt with Muslim OCD sufferers for last couple of years, the author opines that the predominant cause of OCD amongst Muslim population is the way religion is preached, and an incorrect and imbalanced understanding of religion that has been promulgated over centuries.

What is Scrupulosity

According to Ciarrocchi (1998:8), it is a condition of ‘seeing sin when there is none’. Psychiatrist David Greenberg (1984) pointed out essential principles of distinguishing normal religious beliefs and practices from pathological or overly scrupulous beliefs and practices:

- In scrupulosity, religious practices go far beyond the requirements of religious law and custom, and people may act more ‘catholic than the pope’.
- In scrupulosity, beliefs or practices have an overly narrow, trivial focus. In prayer, excessive attention is devoted to ‘saying it right’ or ‘perfectly’. The person with scrupulosity spends excessive time and energy on minute, trivial aspects of religious observance, often ignoring more important aspects of spiritual life.
- Scrupulosity interferes with practicing the religion, such as when a person with blasphemous thoughts avoids going to church/mosque altogether.
- The excessive preoccupation with doing religious rituals until they are ‘just right’, praying repetitively, and confessing unnecessarily etc.

Some examples of scrupulous obsessions and compulsions amongst Muslims:



1- Taking a lot of time for Wudu (Ablution, ritual purification). Individuals without OCD take a couple of minutes to complete Wudu , however individuals can even take half an hour performing this activity and still remain in doubt whether or not they have done it right.

2- Fear that they have not performed Salah (prayer) correctly and repeating it again and again. At times they will take hours to perform Salah. Some people will take extreme measures. A guy from Netherlands whom I counselled used to record his Salah and monitor it for discrepancies later. Similar fears exist for other religious activities like Umrah, Hajj (pilgrimage) and Fasting.

3- Fear that they are not reciting Qur’an correctly. They would repeat a certain Ayah (verse) again and again until they feel they have done it right. Recitation forms part of all religious activities in Islam, and hence these individuals spend more time in all activities than normal people.

4- Fear that they have carried out some activity that breaks Wudu (state of ritual purity necessary for prayer). Most people fear releasing gas while praying. Some also fear urine drops coming out.

5- Fear of contamination. Preoccupied with the thoughts of contaminations, and thinking that impurity might have been transferred to them. Contamination multiples in a contagious way in the mind of such people. For instance, a person who drinks alcohol comes to their home, and sits on their sofa, rendering it impure, and when someone else sits there it becomes impure too. Similar, viral contamination might occur from a dog touching your clothes while walking or splashes of water / liquid in the toilet or in the street.

6- The fear of sinning. The fear that they have or will indulge in activities that God dislikes. This fear can occupy their mind throughout the day, and disable them from performing any activity correctly.

7- The fear of blasphemy. Fear that they have carried out some activity that makes them disbelievers.

8- Sexual obsessions. Fear of committing impermissible sexual act or preoccupation with sexual thoughts.

Above mentioned examples are just a few from a wide range of shapes that OCD can take amongst Muslims. It is often noticed that that when one particular obsession or compulsion is checked through ERP or cognitive restructuring, other similar obsessions or compulsions emerge. Hence, it is imperative to discover the root-cause and eradicate it. For this reason, the author will not try to provide specific examples of imbalanced preaching that results in the above obsessions/compulsions, rather, the focus will be on more generalized examples that tackle the root causes vividly.

If knowledge is power, then the knowledge of disease amounts to a kind of power over that disease. Particularly in the cases of mental disorders, the way we think about the disease entity has a lot to do with how the sufferer regards his or her condition. Hence, the sufferer of OCD needs to be empowered as to how our view of obsession has been altered over the years, which is essential for cognitive restructuring i.e. perhaps the most important element of cognitive behavioural therapy. (Davis, 2008)

Detailed Rulings regarding Ritual Worship

Salah (prayer) is the most frequently performed ritual worship by Muslims. Every Muslim is obliged to stand before God, on appointed times, and pray five times daily. This ritual prayer is the corner stone and foundation of Islamic worship. For Muslims with OCD, prayer which in itself is a means of earning peace becomes a tough ordeal. OCD sufferers have to battle a hoard of debates, disputes, rulings and intrusive thoughts before they can accomplish any prayer.

There is no single matter regarding prayer which is not disputed by the ‘luminaries’. Muslim ‘scholars’ have debated over small issues regarding the performance of ritual worship for centuries. Scholars have ‘added’ God’s concern in every small movement of prayer by writing volumes of books with detailed rulings. And ironically they do so in the name of service of religion.

Example: Do you know what the magic distance between feet during prayer is? According to several Hanafi luminaries it is the distance of 4 fingers. It doesn’t state clearly whether it is four fingers of the feet or the hands, and which finger exactly! And that’s not it. How did the magic number come into being? The primary source of religious rulings in Islam is Qur’an. Qur’an does not state anything on the matter. The secondary source of information, which explain the Qur’an, are the actions and sayings of Prophet Muhammad, i.e. the Hadith. The Hadith as it turns is silent on the matter. Nevertheless, there are detailed linguistic discussions in some sayings of companions of Prophet, and the magic number was born. And since then, it is widely accepted by the Hanafi school of thought, and preached either as a Sunnah (The prophetic way) or Mustahab (The better way). Any sane mind would question, why there is need for ruling in such a matter to begin with? And, it might have been ok if everyone agreed on the magic number. But, the fact of the matter is, schools of thoughts greatly differ on what the distance ‘should’ be. So, there is a basic flaw here which needs cognitive restructuring. Even if there was a narration which mentioned clearly that Prophet Muhammad had distance of four fingers between his feet during prayer that would not have made it compulsory or even better for us to do the same. We need not find detailed rulings about every matter in ritual worship. If someone out there is telling you which brand of clothes to wear during Salah, you’ll laugh at him. Then why are things different when he tells you the distance between your feet or the length of your trousers?

And, this is just what example and not so ‘serious’ example as far OCD sufferers are concerned. OCD sufferers are concerned more with actions that ‘nullify’ your Salah. And as it turns out it’s a huge list. Furthermore, every school of thought has its own list, and it would be virtually impossible for anyone to perform his Salah in any possible way, without nullifying his Salah according to some rule in a combined list of all schools of thoughts. So, that makes life difficult. It becomes a problem when according to one school of thought your Salah is void when you recite behind an imam in congregational prayer, and according to another it becomes void when you do not recite.

There are books named ‘Characteristics of Prophetic prayers’ by dozens of authors and all stating different things, and debating others opinions. In-fact, there are volumes of books on single matters of prayer, like whether or not to ‘raise your hands’ while saying Takbeer (God is the greatest) during Salah. To add to the problem, there are hundreds of ‘extreme’ opinions out there. According to some scholars in Pakistan, Salah is not acceptable if performed behind an Imam (leader) who is using microphone. Many declare Salah to be void, if performed behind an Imam (leader) that does not have a beard.

One could go at length, expounding the eloquent and brief mention of prayer in the Noble Qur’an and contrasting it with the absurd, detailed and irrational details in the books of ‘luminaries’. However, this not being the topic of this article is left aside. It’s a mess of thousands of laws and rulings that have erupted in the name of exegesis. They might have done little or no service to the public, but what they have surely done is make ritual worship look robotic in nature. They have taken the spirit out of worship and make it look like complex mathematical equations. They have confused the masses by forming hundreds of opinions with each portraying his opinion as the ultimate one and belittling others opinion by labelling them as ‘against the Sunnah’, ‘against the will of God’, ‘against the texts’ etc. 

As a believer in God and rationality taught by God, I urge people to stop subscribing to every opinion that comes with a religious label. I ask people to not divide rationality and religion. This divide is a trap implanted by those who wish to enjoy their dominance over religious rulings. Start critically analysing what is injected into you as ‘religious rulings’ and stop believing in those who do not fear putting their words in God’s mouth.  Thousands on the pulpits mourn over the absence of true spirit of worship in prayers, today. However, none of them owns the blame for that. The blame is always on factors like worldly desires and distractions, and people are blinded from the flaws that exist within the Islamic scholarship.

The Call for ‘Perfect’ Recitation

Recitation forms part of all ritual worships in Islam. Recitation is done in Arabic. Prophet Muhammad was well-aware of the fact that people from other cultures might encounter difficulties in recitation, so he said:
Verily the one who recites the Qur’an beautifully, smoothly, and precisely, he will be in the company of the noble and obedient angels. And as for the one who recites with difficulty, stammering or stumbling through its verses, then he will have twice that reward. (Sahih al-Bukhari and Sahih al-Muslim)
In contrast to the beautiful teaching above, what is actually injected into the Muslim minds is an over-emphasized fear of incorrect recitation. Books have been written to elaborate how a ‘slight’ incorrect recitation, could put one’s belief in danger. How could God of all human beings ask people to recite ‘perfectly’ Qur’an using one set of phonetics, when they might not even exist in people from other languages? Learning to pronounce an alien phonetic, one had not learned during childhood necessitates momentous effort; how can one claim Islam to be universal religion and belittle those who cannot recite perfectly in Arabic at the same time?

The ‘details’ of perfect recitation are immense. Universities and institutions throughout the Muslim world run courses over several years teaching the art of recitation. The fear of incorrect recitation is administered through emotional statements like: ‘do you not fear changing the meaning of word of God’, ‘a slight change in diacritic could result in opposite meaning’, ‘how can you begin to understand Qur’an if you do not recite it correctly’ etc. The Qur’an schools rely on beatings and punishments, as well. This results in a wayward image of Islam, paranoia in the reciters and mental disorders. Qur’an claims to be a source of peace for the reciters and if the reciters start getting panicked and distressed instead, who is to blame?

The Long list of Impermissible acts

As there is useless detail in the ‘righteous’ acts, there is a long list of ‘wrongs’. Qur’an, as the primary source of Islamic rulings mentions the list of impressible actions that can be counted on finger tips. These include rape, intercourse out of wedlock, eating pork, drinking alcohol, murder, Riba (interest) etc. Hadith explains the items mentioned impermissible in Qur’an. The literature of hadith is quite broad, along with its interpretations. There are classifications of narrations as authentic and inauthentic. There are differences on how to classify narrations as authentic or inauthentic. And there are differences on whether the rulings mentioned in hadith are for Prophet Muhammad’s time or for the all times.  According to Iqbal (1930) and his likes, the laws mentioned in Qur’an are for all times, however, laws mentioned in hadith only have to be interpreted according to time and location, especially when there are various laws in hadith regarding the same issue. Other than these two, ‘scholars’ mention another source of law, and this is where it gets out of control. Anything over which there is Ijma’ (consensus) it becomes a law. And ironically, there is no consensus over consensus. There are hundreds of definitions of what consensus is.

Qur’an clearly says that ‘God wants ease for you and does not want difficulty for you’, but what we have today is a long list of impermissible which makes almost everything haram. Prophet Muhammad warned people from searching laws for everything and disliked when people would ask for ruling on matters on which nothing was revealed. Qur’an also mentions story of people of Israel who made things prohibited on themselves which were made lawful by God, and Muslims have done the same.  

Example: Emoticons have been declared haram by various ‘scholars’. Follow this link for a YouTube where a Zaid al-Madkhali declares emoticons as baseless.  Here you can see a detailed ruling on prohibition of emoticons because they are imitation to Allah’s creation. Mufti Ibrahim said on his website askimam.com:

The use of emotional signs, for example, smile, sad, etc. in a cell-phone falls in the category of animate pictures.
It is prohibited to make use of such emotional signs in a cell-phone.

For good reasons, now this fatwa (religious ruling) has been removed and replaced with a new fatwa that allows the use of emoticons, without any admission of their previous folly.  Previously, the same website contained a fatwa that said that using an emoticon smaller than tip of finger was allowed. For all such rulings I just have one reply J.

Example: Various scholars in Pakistan have declared prayer behind microphone impermissible, because the real voice of the Imam (leader) is not heard.

Example:  Numerous have regarded pant shirts as haram. I have met those who regard ‘collars’ as haram. Many have declared neck ties to be haram.

The activities that you do during the day: television, photography, video games and Facebook etc., all have been declared haram by various scholars. Recently a sufferer was troubled by the fatawa (religious rulings) on impermissibility of drawing animate objects and photography, and he asked me how I can stay away from them when they are everywhere. I advised him to stay away from such fatawa instead.

Example: The last example is that of music. Most declare it haram, but there are many others rendering it permissible. There is no mention of its prohibition in Qur’an. There is no explicit mention in hadith too. However, using lengthy exegesis, many declare musical instruments to be haram, other than the daff (tambourine). However, there is nothing in the text that differentiates between tambourine and other musical instruments. And, when asked, If God wanted musical instruments other than tambourine to be impermissible why he didn’t say so clearly in the Qur’an or why didn’t the Prophet mention that clearly, they have no answer. The next card they use is that of ‘consensus’, and when asked how do you declare consensus on it when hundreds of scholars declare it permissible, they start doubting your beliefs. Years ago, the author wrote an article about permissibility of music, and quoted al-Ghazali and Ibn-e-Hazm, the famous Islamic Philosophers and Scholars. The author mentioned the use of musical instruments by Prophet David as mentioned in the bible and pointed out by Islamic texts. The author was declared a heretic for holding such views.
The fault is not merely of those who issued such rulings, but also of those who are ready to buy them. Those who tend to put all logic and rationality aside, and accept anything that comes with a religious label.

The Strict Modesty Laws

Qur’an preaches modesty at various locations, without any detailed ruling about every single matter. But, ‘scholars’ on the other hand are more concerned with specificities. They fill the gaps with their ‘own’ understanding and give them the label of divine law. Most of them begin by labelling any conversation with the any non-mehram (one whom you can marry) member of the opposite sex as prohibited, and then they mention exceptions to that rule. Qur’an or Hadith do not mention any such prohibition, in-fact there are very cases of the otherwise. Similarly, they stress on physical segregation of the opposite sexes much more than the Prophet himself showed. They label co-education, mixed offices etc. as prohibited.  To add to that, they present people as weak, as if one glimpse of the opposite sex would render them hypnotized. Hence, if such over-sensitized Muslims have to communicate with opposite sex, they are disturbed emotionally and sexually. No doubt the way, sexuality is portrayed in the mass media, has a lot to do with the state of those who suffer from sexual obsessions. In addition, the extreme rulings make the matter worse by making people over sensitive on such matters.

Islam does define boundaries, for instance, it asks women to cover themselves when they go in public. It asks stranger man and woman not to stay together in seclusion. It asks stranger men and women not to indulge in unwanted physical contact. However, it does not ask women to start covering their hands, faces and to wear a gown all the time. It does not ask men and women to live in separate cities. Some scholars have gone to the extreme opinion of saying that women cannot raise their voice in front of men. To this one scholar rightly responded by saying ‘if that’s the case we may as well send them to another planet’.
And it is strange that most people would buy the extreme rulings that have no basis. And they would ignore other clear rulings. Qur’an and hadith ask for simplicity in marriage, and early marriages at various locations, but we see the opposite happening in Muslim society. So, we have Muslim societies where anyone talking to a stranger from opposite sex would be deemed to have an impure intention. Parents would never want their children to have any interaction with the opposite sex. But, when it comes to the topic of fulfilling their need of companionship and sexual desires at the appropriate age, parents and scholars tend to turn a blind eye.  Qur’an asks parents / guardians to marry young men and women who are under their care, and says “If they should be poor, Allah will enrich them from His bounty”.  However, what we see in the Muslim world is that youngsters are married after they’ve settled in their jobs, irrespective of what their age might be then. Similarly, marriage process is filled with undue complications. Love marriages are considered an unforgivable crime. All this from the followers of Prophet Muhammad who taught: “The best thing for two people who love each other is marriage” and “The best of marriage is the simplest”.

Hence, what we have is over-sensitized society and a completely over-turned institution of marriage This has resulted in several psychological issues amongst Muslim youth, and one hardly sees anyone talking about this burning issue. Several girls and boys are suffering from clinical depression, paranoia,  OCD, sexual obsessions due to delayed marriages, but what we see out there is still a ‘puritan movement’ seeking to abolish all interaction with the opposite sex, and lengthening the size of the veil, with no emphasis on correction of the marriage process.

Conclusion

The above discussion shows how extreme religious rulings, incorrect understanding result in OCD. Having personally dealt with such patients for past two years, I would strongly recommend every individual to learn to filter out such ‘rulings’. It is as important as learning to filter out the ‘obsessive thoughts’. Because if obsessive thoughts are the root cause of compulsions, these ‘rulings’ are one of the cause of ‘obsessive thoughts’.

 [Extreme Rulings -> Obsessions -> Compulsions]

The discussion was not meant to disregard the efforts of Islamic scholarship, or to label all of them as deviant, rather it was a notification to the common people that lots of things out there are preached in the name of religion that have nothing do with it. The intention was to unplug people from the angelic view of scholarship that is administered into them. And it was a call to change; in this time of information overload, one must do his part to keep one’s understanding of religion balanced.

"Religion is very easy and whoever overburdens himself in his religion will not be able to continue in that way. So you should not be extremists” (Prophet Muhammad)

References:

1- Ciarrocchi, J. (1998), Religion, scrupulosity, and obsessive-compulsive disorder, Obsessive Compulsive Disorders: Practical Management, 3rd edition.

2- Davis, L. (2008), Obsession – A History, The University of Chicago Press, London.

3- Greenberg, D. (1984), Are religious compulsions religious or compulsive? A phenomenological study, American Journal of Psychotherapy, 38 (4) pp. 524-532.

4- Hyman, B. and Pedrick, C. (2010), The OCD Workbook, Third Edition: Your Guide to breaking free from Obsessive Compulsive Disorder, New Harbinger Publications, Oakland.

5- National Institute for Health and Clinical Excellence (2006) Obsessive compulsive disorder: Core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder, British Psychological Society and The Royal College of Psychiatrist.< Available at: http://www.nice.org.uk/nicemedia/pdf/cg031fullguideline.pdf > [Last Accessed: 13th June, 2012]

6- Iqbal, M. (1930), Reconstruction of Religious thought in Islam

Bibliography:


1- Sahih al-Bukhari

2- The Bible

3- The Noble Qur’an

I am organising an online seminar on OCD in the muslim world. To register your interest please follow exploringpsyche.com/webinar 


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6 comments:

sulu nash said...

Iam worried about going gas and other things that invalidate wudoo and i dont get any peace of mind during salah and umrah.iam afraid to do umrah

Muhammad Awais Tahir said...

Please drop me an email at Muhammad.Awais.Tahir@gmail.com explaining your situation. Thanks.

hello said...

Assalamu Alaikum brother. I am really thankful for your article. I have a problem. after wetdream or being intimate i try to clean whole house like door handles, carpet everything small thing i touched. I spend lot of time in cleaning. i will take ghusl multiple times in the process of cleaning. after i clean up to my satisfaction and take ghusl, if i see any paper towel or any thrash piece struck on to carpet or else where ... i would clean all over again and do ghusl. i feel very unhappy i wasting energy and resources but i am not able to control it. i started analyzing and I am trying to learn the correct rules. is there a rule that we should retake ghusl if we find paper towel (or any other material) we used while cleaning after completing ghusl? i feel i am contaminated if i don't. please advise me on how to clean after wet dream/ or after being intimate.

shahul said...

https://www.youtube.com/watch?v=0ls2RhauICk

Muhammad Awais Tahir said...

To all those who have left questions in comments. Please contact me via muhammad.awais.tahir@gmail.com and I'll try and answer via skype. I'm unable to reply to comments here. Thanks

Elazar Ibrahim Sjahranie said...

Assalamu'alaikum. I'm sorry sir, but I would like to ask some questions about this article. Are you still available via skype ?

Thanks before. Wa'alaikumsalam wrb. :)

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