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Muslim experiences of OCD

Dr Yusuf describes how Muslims might experience OCD in distinctive ways, focusing on scrupulosity OCD
So you’ve had a quick overview as to what OCD is obsessive compulsive disorder? Here’s a slightly different way of taking a look at it. It’s what you might call the triangle of OCD. Obsession. Compulsion. Disorder. A person experiences an intrusive, distressing thoughts and their anxiety levels go up. In order to deal with those anxiety levels, they engage in a particular form of behavior called a compulsion that drops the anxiety level back down again, the disorder component is the fact that they then go straight back again to the experience of the distressing thought. Here’s an example of how this might work. I go upstairs nighttime and then I think, oh, I didn’t lock the door. My anxiety levels go up.
I checked the door. Go back down, check the door, it’s locked. My anxiety levels go down. I go off to sleep and carrying on my way. But you know, what you have is I have a distressing thought, haven’t locked the door. My anxiety levels go up. I therefore go and check the door. My anxiety levels come down. But then immediately again, I get the same thought and my anxiety levels go back up again. I have to do the same action, go back and check the door. And it keeps on going round in the triangle.
So OCD is this three step triangular process the obsession, which is anxiety provoking, the compulsion which is anxiety reducing and the disorder, which is the failure of the action to calm the thought. Another important thing about it is that it affects tends to affect the thing that is most important to you. I remember an example once of and one of the first cases I ever dealt with in psychiatry was a nursery school teacher. And she was exactly what you would expect a nursery school teacher to be, she was as sweet as apple pie. Young lady who wouldn’t hurt a fly.
And she started getting recurrent, intrusive, distressing thoughts when she passed by an old person about shoving them into the road in front of ongoing traffic. And she was horrified, absolutely horrified and thinking, What kind of person am I that I would have this feeling about pushing an old person into the road? And she was genuinely, genuinely distressed by it. And I said to her, the reason you were having this particular type of obsessive thought is because it goes completely against the grain of who you are, which is a gentle person who wouldn’t hurt a fly.
How does this relate to the Muslim experience of OCD? Now, of course, a Muslim person can experience OCD, normal OCD, checking OCD, symmetry, you know, germ phobia and so forth. But there is another element here, which is obsessive ideas and compulsive rituals that relate to something that is deeply important to you as a person, which is your faith. Doubts about whether or not you believe in God. Horrible thoughts about the Prophet Muhammad, peace and blessings upon him. Uncertainty as to whether you have correctly performed the ritual washing and so forth.
And these can be just as distressing for that person as this nursery school teacher who is thinking about pushing always having these intrusive thoughts about pushing people into the road.
Hence, it’s really important, and it can be tremendously comforting, actually for a person with OCD to say that these thoughts are targeted directly at the thing that is most important to you and therefore almost as mirror images they are uncovering to you. What is important to you as a person, you will tend to find religious OCD, which is called scrupulous city, particularly in Muslim patients who have recently become religiously practicing and observant. You tend to find that they go and they kind of boomerang into a into a very obsessive practice of religious and of religious practice. And I’ve seen this quite a lot, and it’s something that is deeply, deeply distressing for them.
Now, the term for obsessive compulsive disorder in Islam is Westwater, and most Muslims will recognize this concept of incessant internal whispers that are deeply distressing. This is something that is contained in our scripture in the in the Koran itself and was spoken about by the prophet, peace and blessings upon him. And there is actually a tremendous amount of resource within the Islamic tradition for dealing with precisely this type of obsession ality. As such, the Muslim or Islamic approach to OCD is a great example of the bio psycho socio spiritual model in action.

In this video, Dr Yusuf describes how Muslims might experience OCD in distinctive ways, focusing on scrupulosity OCD.

Scrupulosity OCD can refer to obsessional ideas that relate to faith and ritual practice such as washing before prayer (wudu), or prayer itself. Dr Yusuf suggests that scrupulosity OCD can be found particularly amongst those Muslims who have recently started to practice their faith, for example recent converts to Islam.

Because scrupulosity OCD has a distinguishable spiritual component, it is an example of a mental health problem where the benefits of including the perspective of a Muslim practitioner (for example, an imam) with knowledge of Islam are clear. The religious practitioner can make clear, in a way that is likely to be trusted and therefore accepted by the person with scrupulosity OCD, what the religious guidance is around acts of worship.

As an Islamic scholar and a psychiatrist, Dr Yusuf can provide mental health support for Muslims using the bio-psycho-social-spiritual framework in a single setting. Non-Muslims practitioners, or Muslim practitioners who do not have the Islamic knowledge to answer faith-related question, may find it helpful to consult a religious scholar.

Over to you

As you listened to Dr Yusuf in this video, did you think of any questions for Dr Yusuf about using the bio-psycho-social-spiritual approach?

Please share these questions, and any thoughts or reflections, below.

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Understanding Mental Health in Muslim Communities

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