Islamic Origins of Psychotherapy: An Introduction

Eminent Muslim Psychotherapists

The early Arab-Muslim physicians were greatly inspired by the teachings of the Quran and Prophet Muhammad in their medical pursuits. Some of them specialised in psychotherapy and contributed a great deal to its development. Their psychological methods of treatment are briefly introduced below.

Ali Ibn Sahl Al-Tabari (d. 861 CE)

He was the author of the earliest Arabic on medicine titled Firdaws al-Hikmah (Paradise of Wisdom). In it he has described psychological diseases as diseases of the head. Headache, loneliness, forgetfulness, hallucination, gloom and cheerlessness are described as their main symptoms. The physician has ascribed the causes of all these symptoms to mental disorders consequent upon psychological factors such as grief, anger, ishq (passionate love), etc. He has also suggested that such diseases can be cured by removing the causes of anger and insecurity to the patient as well as by pacifying his heart with pleasant conversations congenial to his ethos [13].

Ishaq Ibn Imran (d. 908 CE)

He was one of the most eminent Muslim psychotherapists of Kairouan (Tunisia). He was the first Muslim author who wrote an independent treatise on melancholia under the title Maqalah fi al-Malikholiya. This treatise was found so useful that it was translated into Latin by Constantine the African in the eleventh century. Sadness, loneliness, gloom and cheerlessness were described by him as the main symptoms of the victims of such diseases.

This physician has elaborated in detail the psychological conditions that overtake men and women in the face of great and recurrent emotional setbacks. He has also listed the condition of forgetfulness in some women due to frequent pregnancies. Side by side with treating these patients with drugs and medicine, he applied and recommended psychological methods of treatment also such as their entertainment through pleasant conversations, music, gentle behaviour and sightseeing as well as by massaging their bodies with soothing oils followed by their baths. He has also pointed out that the disease of melancholia is both acquired and hereditary [14].

Ibn Zakaria Al-Razi (d. 932 CE)

Al-Razi was a distinguished psychotherapist of his time. He was among the first in the world to write on mental illness and psychotherapy. His famous medical encyclopedia Al-Hawi contains numerous references to psychological diseases. He also wrote a separate book on psychotherapy under the title al-Tibb al-Ruhani (The Spiritual Medicine). In it he has thrown sufficient light on the method, application and scope of psychiatric medicine as well as interpreted general health precepts by pointing out the close relationship between psyche and soma [15]. He believed that physicians should be modest, soft-spoken and gentle while communicating with their patients to ease the anxiety of receiving bad news. They should also keep them hopeful of their recovery. He has discussed in detail the adverse effects of delusion, empty imagination and ishq (intense love) on the health of man. He concluded that even indigestion is preceded by psychological upheavals in the body. Psychological conditions, according to this physician, always have the upper hand in regulating health, because the ethos of the body is governed by the impact of such conditions dominating the mind. That was the main reason why he emphasized the importance of the psychological aspect in the science of medical treatment.

On the basis of this argument he held that only a competent psychotherapist could become a successful physician [16]. He was also known for successfully treating patients suffering from melancholia by stirring up their spiritual capacity and internal organs through psychotherapy [17]. Al- Razi’s code of medical ethics requires the physician to keep the patient always hopeful of his recovery even if he holds a view contrary to that.

Al-Razi worked as the director of a hospital in Baghdad. He is also credited with having introduced the concept of psychiatric wards for patients with mental illnesses. He held that mental disorders of patients should be treated as medical conditions rather than considering them to be the symptoms of their having been under the possession of evil spirits or demons. He was one of the first known physicians to describe the idea of psychotherapy and psychiatry on modern lines. He described depression as a form of “melancholic obsessive- compulsive disorder”, which is triggered as a result of changes of blood flow in the brain [18]. He conducted and maintained detailed clinical observations of patients suffering from mental illnesses and applied a holistic method of treatment through diet, medication, baths, massaging, aromatherapy, entertainment, etc.

Al-Razi’s books became very popular in the West. His magnum opus Al- Hawi was early translated into Latin by the Jewish physician Faraj Ibn Salim under the title Liber Continens. Several editions of the book were published at Brescia in 1486, and at Venice in 1500, 1506, 1509 and 1542 [19].

Ibn Sina(d. 1038 CE)

Ibn Sina was another important Muslim physician who contributed a great deal to the development of psychotherapy. His medical encyclopedia The Canon remained the supreme authority on medicine for about six centuries nit only the Muslim world, but also in the West. He has discussed a number of nervous and psychological diseases in this book. Since he was fully aware of psychological factors of diseases, his prescriptions for physical ailments were usually accompanied by his exhortations for moral reformation and spiritual regeneration of the patients.

He has clearly pointed out that the physical health of man is closely related with his inherent and acquired psychological conditions. He further revealed that much of the natural disposition of the mother is diffused into her children through breast-feeding. He therefore advised that the breast-feeding mother should keep herself on a high level of morality, and that she should remain unaffected as far as possible by bad emotions caused by anger, fear, grief and cowardice. He made full use of his knowledge of human psychology in curing patients. He was fully aware of the tremendous and remarkable capacities of the human body when adapted and empowered psychologically.

Ibn Sina’s book Al-Qanun fi al-Tibb (The Canon), which remained supreme in Europe for about six centuries, passed through several editions. It was first translated into Latin by Gerard of Cremona. It was in such great demand that in the last thirty years of the fifteenth century it was published sixteen times; and more than twenty times in the sixteenth century. It was later translated into Hebrew, German, Turkish, English, Uzbek, Persian and Urdu also.

Other Prominent Psychotherapists

In addition to the above, there were numerous other physicians who excelled in this branch of medical treatment. A passing reference to a few of them is given below.

Ibn al-Jazzar (d. 1005), author of Siyasat al-Siyan wa Tadribuhum (Management and Training of Children), Tibb al- Mashaikh wa Hifzu Sihhatihim (Treatment of Old People and Preservation of their Health); Ali Ibn Ridwan (d. 1067), author of Al-Kifayah fi al-Tibb (Sufficient Knowledge on Medicine), in which he has illustrated the point that the beating of the heart is closely related with the psychological factors of the mind; Ibn Zuhr (d. 1162), an eminent physician of Muslim Spain, who has dealt with a number of psychological diseases in his medical works; and Dawud Ibn Umar al-Antaki (d. 1600 CE), the last eminent Muslim psychotherapist of the pre-modern era, who has discussed in his writings all kinds of melancholic diseases that were known upto his time.

Psychotherapeutic Aspects of the Hospitals

It is a well-known fact of history that psychotherapeutic methods of treatment were applied in all the hospitals built by the Muslims during the heyday of their civilization, of which the Ibn Tulun Hospital of Egypt, the Adudi Hospital of Baghdad, the Nuri Hospital of Damascus, the Mansuri Hospital of Cairo and the Muwahhidi Hospital of Morocco were very famous. Almost all the hospitals were equipped with rich libraries which provided books to the patients. For example, the Ibn Tulun Hospital is said to have contained more than one thousand hundred books on different subjects.

Special attention was paid to the care of the patients suffering from psychological diseases in these hospitals. They were provided with professional musicians, story- tellers and excellent reciters of the Quran. While musicians and story-tellers entertained the patients with soft music, interesting stories and humorous anecdotes, the reciters of the Quran sought to stimulate their spiritual capacity in order to solidify their self-confidence. Besides, they were made to walk in the open air, They were also given relaxing baths, and their garments were changed every morning in order to mitigate their distress by relieving symptoms of tension. So much attention was paid to the care of the sleepless among the patients at some hospitals that adhan (the call to prayer) in the morning was sounded two hours earlier than its usual time to make the night appear shorter to those who could not sleep [20].

More or less the same system was in vogue in all the major hospitals in the world of Islam. The caliphs and rulers also paid attention to the maintenance and organization, regularly visited them, and personally inspected the state of affairs in them as well as enquired about the conditions of patients.