By Samaiya Mushtaq
Soon after I started residency in psychiatry, the movie Spotlight was released, about The Boston Globe’s investigation and groundbreaking story on sexual abuse within the Catholic Church. I remember thinking then how the seed of psychiatric illness for so many of my patients was planted the same: childhood and adolescent trauma. The parent who beat me. The uncle who molested me. The clergy who took advantage of me. Often, the ones who had the responsibility to protect also had the power to do the most harm. The second injury was that when young, those abused couldn’t really ever tell anyone, particularly when it was the person whom they would tell that was perpetrating the abuse. And that was the very worst part: that their ability to trust was left totally shattered.
Now as I end residency, the most rewarding part of my job as a psychiatrist is my role as a therapist, treating patients primarily using psychodynamic (insight-oriented) therapy. It is joyful work in which I can examine some of these old hurts with people in order to help them live a more meaningful and satisfying life. When I reflect on what makes my work safe for me and my patients, it boils down to these three key precepts:
- Acknowledgment of the inherent power dynamics. Over the years, I have become very aware of the one-sided intimacy of the therapeutic relationship. It demands a lot of vulnerability from my patients to entrust me with the most private aspects of their lives. Simply knowing that guides how I phrase my questions and the balance I strike between supporting and challenging my patients. Which leads to…
- Awareness of and respect for boundaries. In training to be a therapist, I was taught about the transference (the patient’s feelings towards the therapist) and countertransference (the therapist’s feelings towards the patient). Sometimes, the transference is erotic. Sometimes, the countertransference involves frustration. To be aware of that in real time is critical in maintaining a healthy therapeutic relationship. Clear boundaries are the kindest thing we can do to protect both our patients and ourselves as therapists while preserving a healthy clinical relationship. Boundaries around after-hours communication, meeting in a dedicated therapy space, holiday gifts, or physical touch when a patient wants a hug can all be discussed. Which is further protected by…
- Oversight and accountability to third parties. I spent several hundred dollars and months obtaining licensure from the Texas Medical Board, which tracks malpractice against healthcare providers. I am regularly evaluated by my peers and faculty at the medical center where I am employed. And for every hour of therapy, I conduct as a trainee, I have a half-hour of supervision with senior providers with whom I discuss my cases. All these pieces create both a regulatory climate and a rich learning environment for my own growth as a therapist. This can go on even after residency when psychiatrists participate in continuing education to maintain licensure and or seek the counsel of mentors.
I can’t imagine practicing therapy safely and effectively without these guidelines, and so for a long time, it has disturbed me that the realm of spiritual counseling does not share some of these safeguards. As it is now, imams are often the first point of contact for our community members (1) when congregants are in the throes of marital discord or divorce, suffering internal spiritual turmoil, and even when decompensating from psychiatric illness. Whether they elect to be or not, they are also in the position of acting as counselors during these experiences of their congregants’ with potentially no codified set of ethics to guide them.
To put imams in this position of responsibility untethered hurts everyone, including imams, many who work for little pay and often no benefits. Without clear professional guidelines when it comes to spiritual counseling, both our imams and community members are left vulnerable and face dire consequences. It’s no wonder then that you’ve got fertile ground for situations such as, according to a pending lawsuit in Irving, Texas, an imam completely traumatizing a congregant through exploiting his access as a spiritual counselor (2). The organization investigating this case reported that, in the wake of this nightmare, the mosque dealing with the fallout stopped providing counseling on their premises and began outsourcing counseling into the community through referrals and funds (3).
Imam As Counselors
That was one mosque in one city. As it stands now within our greater community, however, we have not yet refined the role of imams-as-counselors, and trying to get to the roots of the problems within that role is an uphill battle. There is still little acknowledgment of the inherent power dynamic of an imam’s privilege in our society. Mention of #MeToo in Muslim spaces or the real threats to women at the hands of powerful men is quickly met with anger and conspiracy theories about an all-powerful Western machine designed to brainwash Muslim women through a feminist-but-secretly-Islamophobic agenda.
Our celebrity shaykh culture has run away with us, to the point where individuals pay hundreds of dollars to get a selfie with scholars and communities and give them carte blanche to speak to anyone and everyone on anything and everything from fiqh to racial injustice; even when they are not fully learned in either. We place no boundaries on their scope. And finally, we have little oversight regulating our imams and few governing bodies that communicate internally. When we do have nascent organizations that try to provide accountability, we tear them down or question their funding and motives.
This isn’t where we have to be, though. This is an opportunity for us to collectively examine the necessary role of imams in our lives and what we expect it to look like. We have to honestly ask ourselves how much more we are willing to risk putting imams and congregants in unsafe situations when we know this risk can be mitigated. Can we decide that now is the time when: men can acknowledge their privilege over women? When spiritual leaders acknowledge their power over their congregants? When the older generation can acknowledge their influence over young people? When a central body requires an imam to have the training to counsel people? When mosques are willing to enforce this? When mental health professionals provide supervision for imams to discuss their challenging cases? When imams can be taught about transference/countertransference and learn how to navigate those complexities? When mosques enforce boundaries during counseling on how you meet people, where you meet people, how often you meet people, to the exclusion of any kind of relationship outside of the counseling one? When imams are accountable to God as well as His creation?
The most egregious wrong is the inaction of our society in situations that call for anything but. As we turn the corner in providing resources for and destigmatizing mental health care, I hope we can combat willful ignorance within the domain of spiritual counseling, because, with free reign, no boundaries, and zero accountability, this isn’t the last time “counseling” will be trauma in disguise.
- A study conducted by this writer found that almost 70% of individuals in Nashville, Tennessee’s Muslim community would seek mental health care from imams. http://www.medicineandreligion.com/bringing-psychiatry-into-the-mosque-analysis-of-a-community-psycho-education-intervention.html
Samaiya Mushtaq, MD is a resident psychiatrist based in Dallas, Texas. She teaches workshops on wellness and conducts research on help-seeking populations.
How To Be Positive In Hard Times
We all know that we should be grateful. And we definitely know that we should be certain that whatever happens is good for us as believers. However, when we are tested -as we inevitably are-, many of us crumble. Why is that? Why are we not able to ‘pass’ these tests, so to speak? Many of us after a tragedy become hapless, sad, depressed, angry, or bitter.
The essence lies in knowledge that is beneficial, and the best form of knowledge is that which an individual can apply to their day-to-day life on their own. Here are a few tips to increase your patience in hard times. Like building muscle at the gym, it takes time to exercise this habit, but becomes easier over time:
Unfortunately, stressful events are abundant in our lives. People under stress can find themselves falling into thinking errors. These thinking errors include -but are not limited to-: black and white thinking, mind-reading, self-criticism, negative filtering and catastrophizing. Together this can affect how we perceive reality. Next time you are tempted to make a catastrophe out of a situation, stop and ask your self two questions:
- Is this really a big deal in the larger scheme of things?
- Are there any positives in this situation?
Have a Realistic Perspective of Qadr:
Although it is part of our creed to believe in divine destiny, personal responsibility is still of importance and we cannot simply resign ourselves to fate; especially if we have some sort of influence over a situation.
Allah says in the Quran:
لَهُ مُعَقِّبَاتٌ مِّن بَيْنِ يَدَيْهِ وَمِنْ خَلْفِهِ يَحْفَظُونَهُ مِنْ أَمْرِ اللَّهِ ۗ إِنَّ اللَّهَ لَا يُغَيِّرُ مَا بِقَوْمٍ حَتَّىٰ يُغَيِّرُوا مَا بِأَنفُسِهِمْ ۗ وَإِذَا أَرَادَ اللَّهُ بِقَوْمٍ سُوءًا فَلَا مَرَدَّ لَهُ ۚ وَمَا لَهُم مِّن دُونِهِ مِن وَالٍ
For each one are successive [angels] before and behind him who protect him by the decree of Allah. Indeed, Allah will not change the condition of a people until they change what is in themselves. And when Allah intends for a people ill, there is no repelling it. And there is not for them besides Him any patron. [Surah Ar-Ra’d;11]
This puts the responsibility on us to change ourselves. Notice the word, themselves. We are not responsible for events beyond our control. These events include the behavior of our spouses, the affinity of our children to the religion, the love in the hearts of people, the weather, the gender of our child (or how many we have), or even the amount of money we will earn in a lifetime -to name a few. Often we become stuck and focus on our conditions, rather than focusing on our own behavior.
Nourish Positive Thinking:
In order to be able to have a wise and calculated response to life’s events, we must learn to interpret these events in a way that assign positive meaning to all. Allah is after all, how we perceive Him to be. Shaytan interferes with this process through waswaas (interjecting thoughts that are based on negativity and falsehood). His goal is for the Muslim to despair in Allah’s mercy. The goal is not to be happy all the time; this is unrealistic. The goal is to think well of Allah as consistently as possible.
- Create a list of what you are grateful to Allah for daily.
- Remind yourself everyday of the positive aspects of situations when your mind falls to default negative thinking. Self-criticism will will only encourage you to take full responsibility for negative life events and become depressed, or at the opposite end take no responsibility whatsoever; either mind-set does not help us improve our self.
Remind yourself as well as others of the benefits of Positivity:
- On an individual level, once we begin to think positive about ourselves and our life, we become optimistic. This positivity will then also effect our perception of others. We become more forgiving, over-looking, and patient with others when we can see the positives in any situation.
- Increased rizk and feelings of well-being
- Reduced likelihood of reacting in a negative way to life’s events; increased patience.
- Increased likelihood of finding good opportunities in work, relationships and lifestyle.
- Higher energy levels and motivation to take on acts of khayr and benefit.
Practice self-care as a daily routine:
Our bodies have rights on us. Our souls have rights on us. Our family has rights on us. Allah has rights on us. Often, when there is an imbalance in one area, our whole being can sense it. This creates anger and resentment towards those around us and life in general.
- Take care of your body, feed it well and in moderation and exercise in a way that makes you feel relaxed.
- Pray your prayers, read the Quran, maintain the rights Allah and your own soul have on you.
- Take care of your tongue by avoiding back-biting and complaining.
- Take regular showers, comb your hair, brush your teeth, and wear clean clothes; even if you are at home.
- Take care of your mind by doing dhikr as much as possible and letting go consciously of ruminating on situations.
Do not over-rely on your emotions:
Our emotions are a product of our thoughts. Our thoughts can be affected by slight changes in the environment such as the weather, or even whether or not we have eaten or slept well.
كُتِبَ عَلَيْكُمُ الْقِتَالُ وَهُوَ كُرْهٌ لَّكُمْ ۖ وَعَسَىٰ أَن تَكْرَهُوا شَيْئًا وَهُوَ خَيْرٌ لَّكُمْ ۖ وَعَسَىٰ أَن تُحِبُّوا شَيْئًا وَهُوَ شَرٌّ لَّكُمْ ۗ وَاللَّهُ يَعْلَمُ وَأَنتُمْ لَا تَعْلَمُونَ
“And it may be that you dislike a thing which is good for you and that you like a thing which is bad for you. Allah knows but you do not know.” [Surah Al-Baqarah;216]
Ultimately, our perception can be manipulated by our thoughts, shaytan, and other factors. Allah is not limited in His perceptions due to stress, emotions, or circumstances and moods. Therefore, we should be humble to defer our judgements to Allah’s ever-lasting judgement. Far from naval gazing, the more we are aware of our internal perceptions, emotions, and motives, the more able we are to practice Islam in its full essence. Our forefathers understood this deeply, and would regularly engage in self-assessment which gives you a sense of understanding and control of your own thoughts, emotions and actions.
Mindful or Mind-full? Going From AutoPilot to Aware
“Remember that God knows what is in your souls, so be mindful of Him.”
[Sūrat al-Baqarah 2:235]
Mindful or Mind-full?
Ever felt frustrated when you were trying to talk to your spouse, your children, your students, or your youth group and they would just not pay attention? This is a prime example of being on autopilot and getting carried away without actually being aware of what is most important in the present moment.
A recent Harvard study shows that our minds are not present in the moment and wander about 47% of the time1. In a world of technology and continuous sensory overload, the lines between work and home, friends and family, necessity vs. purpose, world-centric vs. Allah-centric have become blurred. We are either living in the past or ruminating about the future, and in the process, we are forgetting to live, enjoy, cherish, and make the most of our present moments.
For parents, teachers, youth leaders, and anyone in the beautiful role of guiding, teaching, coaching, or mentoring others, we can make a huge difference by modeling Mindfulness ourselves. But where do we start? The answer is to go from autopilot to becoming aware.
Autopilot to Aware
Being on autopilot is when you are distracted in the present moment, where your mind is wandering into the past or the future, and you are less aware of yourself, surroundings, or others. Autopilot can actually be pretty helpful for your regular habits. Waking up, brushing your teeth, getting ready for your day, going to school or work – many of the things we do habitually every day can be done more seamlessly without having to think, and that is a good thing. But there are times when you have to learn to turn off your autopilot to become aware. But how?
Here is a Mindfulness tool that can be done in just a minute or two for you to become more aware.
Step 1: Breath as a Tool. Say Bismillah. Focus on your breath. See where you experience the breath – the breathing in and breathing out of your body. Is your breath stemming from your nostrils, your chest, or your stomach? Just bring your attention to your breath and relax and stay with it there for a few moments.
Step 2: Body as a Tool. Relax your body. We carry so many emotions in our bodies2. Our stress from the past or anticipation for the future sometimes finds its way into our necks, other times in our chest muscles or our backs. Pay attention to what emotions and sensations do you feel, and try to relax all parts of your body.
Step 3: Intention as a Tool. As you have centered your thoughts to the present moment through your breath and your body, ask yourself: “What is most important now? In this present moment?”
Just simply being aware makes us more mindful parents, teachers, youth and professionals – being aware makes us more Mindful of Allah SWT. Mindfulness is the ability to be aware of your mind and body and bring your attention to the present moment.
Real Life in the Present Moment
You are an on-the-go parent: It has been a long day and you have to pick up the kids from school, but work is still pending. You’re picking up the kids from school, feeding them, and then shuffling everyone to their afterschool activities, be it Qur’an, softball, soccer, swimming, or the million other things that kids seem to have these days. You squeeze pending work in between drop-offs and pick-ups, and you function by living from one task to the next.
The Autopilot Impact: You’re getting a lot done, but are so engrossed in quickly moving your children along from one thing to another that you are unable to really cherish your time together.
The Mindfulness Suggestion: You can try to go from autopilot to awareness by focusing on your breath, paying attention to your emotions, and relaxing your body. As you do so, ask yourself: “What is most important now?” Make the intention to slow down, listen to the children more mindfully, and cherish and enjoy your time together.
You are a busy teacher: Last night you had to take all the grading home and spent two hours poring over students’ work. This morning, you woke up early to pick up some classroom supplies after dropping off your own kids to school. You’ve already had two cups of coffee and are trying to think through everything you have to do today. You like the idea of Mindfulness, living life in the present moment, and enjoying every day to its fullest, but your mind is not free to even enjoy the beautiful morning sunrise as you drive to school.
The Autopilot Impact: You want to listen and pay attention to every child’s needs, and enjoy the rewards of their growth, but you can’t. What’s more, you judge yourself for just trying to get through your activities for the day. You wish you could connect with your students better.
The Mindfulness Suggestion: Whenever you are stressed with an unpleasant parent or student interaction, think about breathing, relaxing your body, and asking what you need to focus on now. Try to do one thing at a time, and relax into what you’re doing.
You are an overstretched youth director: You are a role model. You have this major weekend event you are planning with the youth. Your budget is still pending from the board, you have to call all these people, have to get the graphics and remind everyone about the event, you have to visit all these masjids and MSAs to announce and remind people about the weekend.
This weekend’s theme is Living a Life of Purpose and you are super passionate about it. However, the whole week you have had a hard time remembering to even pray one Salah with focus. Instead, your mind has been preoccupied with all the endless planning for this weekend. You love what you do but you wonder how to also be mindful in your everyday worship while you are always prepping and planning engaging activities for the youth.
The Autopilot Impact: You enjoy shaping the youth but you are losing steam. You are always planning the next program and unable to focus on your own personal and spiritual development. It is difficult for you to pray even one salah without thinking about all the events and activities planned for that week.
The Mindfulness Suggestion: Get serious about taking some time for yourself. Know that becoming more mindful about your own prayers and self-development will also make you a better role model. Take a minute or two before every Salah to practice the simple, 3-Step Mindfulness Tool. You say Bismillah and breathe, focus your mind, and then relax your body. Empty your mind from everything else – what has past and what’s to come – and ask “What’s most important now?” to develop better focus in your Salah.
In Conclusion: Practice Simple but Solid Steps towards becoming more Mindful Muslims
Mindfulness is to open a window to let the Divine light in.
[Imam Al Ghazali]
Mindfulness gives us the ability to be aware. We can use Mindfulness tools to remember Allah , refocus, renew our intentions, and engage with the present moment in a more effective and enjoyable way. Mindfulness also invites awareness of our potential negligence in being our best selves with both Allah and His creation. To put it simply, being more aware of our selves can help us be better versions of our selves.
Mindfulness is both an art and a science, with brain and behavioral science research validating the importance of Mindfulness in improving our health, managing our stress, navigating our emotions, and positively impacting our lives3. In today’s modern and distracted world, let us treasure every tool that helps us center our attention on what matters the most.
- Bradt, Steve (2010). Wandering mind not a happy mind. Harvard Gazette. https://news.harvard.edu/gazette/story/2010/11/wandering-mind-not-a-happy-mind/
- Lauri Nummenmaa, Enrico Glerean, Riitta Hari, Jari K. Hietanen (2013). Bodily maps of emotions. National Academy of Sciences. https://www.pnas.org/content/early/2013/12/26/1321664111
- “What are the benefits of mindfulness,” American Psychological Association: http://www.apa.org/monitor/2012/07-08/ce-corner.aspx
To learn more about how to become mindful take the Define Course on Mindfulness and Emotional Intelligence.
Fall Apart: Be Weak to Find Strength in Allah
Growing up in Jeddah, every evening in Ramadan, we would pile into our car and whiz off to the mosque for Taraweeh prayers to Shoaibi Mosque and spend a few spell-bound hours under the reassuring baritones of Sheikh Abdullah Basfar. His beautiful voice became the anthem of my childhood in many ways but more than his voice, it was the building of tradition and memory that became ingrained in my system. By doing the same thing, day in, day out, year in, year out, my parents gave us a sense of stability and predictability that set the tone for our entire adolescence.
How that rhythm seeped into the very bones of who I am is something I am still discovering well into adulthood.
Last night, standing in my grandmother’s garden in Karachi, I experienced my first Taraweeh Khatam-e-Quran since leaving my parents home in Jeddah so many years ago. It is also, incidentally, my first Ramadan without both my parents, who last year seemingly decided they would much rather be together in Jannah than spend more time in this rubbish world and in quick succession, returned to their Maker, leaving me understandably grieving, awash in memories, struggling to steer my ship.
And so it was, that by the time the imam reached Surah Qadr, I was chokey. By Surah Kawthar, I had tears streaming down my face. And by the time the last three surahs, the comforting Quls, began, I was openly sobbing. Probably more openly than what is considered socially appropriate…but honestly, I was restraining myself. Because what I actually felt like doing was throwing my head back and howling up at the sky. Thankfully, I was flanked by women who knew, who understood, who with tears in their own eyes, let me be with my heaving shoulders and a chest that felt it would crack open under the weight of my emotions.
As the imam had recited surah after surah and the end of the Quran had approached, the ghosts of Ramadan Past had flooded into me and my body had remembered. It had remembered years and years of experiencing that same excitement, that same sense of weight as Sheikh Abdullah Basfar gently and methodically guided us over the course of the month through the Book of all books, that same uplifting, heartbreaking, momentous trepidation of offering something up to Him with the hope that He would bestow something shining in return.
Had this Book been revealed to a mountain, the mountain would have crumbled. You get a tiny glimpse of that weight when you complete a khatam. Here I am, Allah, here I am, in my little hole-y dinghy, with my itty bitty crumbs of ibaadah. Pliss to accept?
Back in Jeddah, after the khatam, we would pile back in the car and go for ice cream. Last night in Karachi, after the khatam, the Imam gave a short talk and in it he mentioned how we are encouraged to cry when conversing with Allah. We should beg and plead and insist and argue and tantrum with Him because He loves to be asked again and again. We live in a world of appropriateness, political correctness, carefully curated social media feeds and the necessity of putting our best, most polished face forwards at all times. How freeing then, that when we turn to our Lord, we are specifically instructed to abandon our sense of control. All the facades and the curtains are encouraged to be dropped away and we stand stripped to our souls in front of Him. In other words, He loves it when we fall apart. Which is exactly what I had just done.
Last night, I found myself wondering what exactly had I cried so hard over. Which tears were for Him and the desperate desire for His mercy? Which were for the loveliness of the Quran, the steadying rhythm of it, not just verse to verse but also, cover to cover? Which tears were for the already achey yearning of yet another Ramadan gone past? Which were for my breaking heart that has to soon face my first Eid day and all the days of my life without my beloved Mumma and Baba? Which tears were of gratitude that I get to stand on an odd night of the best time of the year, alongside some of my dearest people, in the courtyard of a house full of childhood memories, under the vast, inky, starry sky and standing there, I get to fall apart, freely, wholly, soul-satisfyingly?
And which tears were of a searingly humbling recognition, that I am so wildly privileged to have this faith of mine – the faith that promises if we navigate the choppy dunya waters right, we will be reunited with our loved ones in a beautiful, eternal place, that if we purposely, and repeatedly crumble under the weight of our belief in Him and His plans, our future is bright?
Today, I’m convinced that it doesn’t matter why I cried. Because here is what I do know:
1. “If Allah knows good in your hearts, He will give you better than what was taken from you…” (8:70)
2. “If Allah intends good for someone, then he afflicts him with trials.” Prophet Muhammad ﷺ
3. “Wondrous is the affair of the believer for there is good for him in every matter and this is not the case with anyone except the believer. If he is happy, then he thanks Allah and thus there is good for him. If he is harmed, then he shows patience and thus there is good for him.” Prophet Muhammad ﷺ
In losing my parents, I have drawn closer to Allah. And though I miss them dizzyingly, I am so thankful that through the childhood they gave me, through the anchoring to the Quran they gifted me with, through their own tears that I witnessed during those long-ago khatams in the Shoaibi Mosque in Jeddah, they left me with the knowledge that if in losing them, I have gained even an atom’s worth more of His pleasure, then that’s a pretty great bargain.
As a parent of three young ones myself, I’ve spent my days teaching my children: be strong, be strong, be strong. Stand tall, stay firm, be sturdy in the face of the distracting, crashing waves of the world. But now I know something just as important to teach them: be weak, be weak, be weak.
Crumble in front of Him, fall apart, break open so that His Light may enter and be the only thing to fill you. It’s not easy but it will be essential for your survival in the face of any loss, grief, trial and despair this world throws your way. It will help you, finger to tongue, always know which way the wind is blowing and which way to steer your ship. Straight in to the sun, always. To Jannah. Because how wondrous are the affairs of us Muslims that when it comes to our sorrows and our hopes, out there on the horizon of Allah’s wise plans, it all shimmers as one – The grief of what is, the memory of what was and brighter than both, the glittering, iridescent promise of what will be.