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A Muslim experience of psychosis: religious practitioner perspective

Dr Ali presents a case study of a Muslim experience of psychosis, from the perspective of an Islamic scholar and imam
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15.8
There was a lady who gave birth and then um she um apparently she was possessed by the demons. And the demons were calling her at 11 o’clock pm every single night to go and play with her, uh play with them. And obviously doctors got involved and it was actually an extreme psychosis of postnatal depression and the moment the doctors took away all of the uh clocks and all the watches then she didn’t know when 11 o’clock was and therefore she didn’t call out to go to these friends.
53.1
And it was because she was she was in the house, she’s from Bangladesh, she’s got no family members here and she was feeling really lonely um and but her family members thought that she was actually possessed by the devil, by the jinns.
70.9
Asma: But she believed that at 11 o’clock at night she was being called by jinns? Yeah and she believed that she was also possessed by the jinns and these jinns and when doctors, obviously because the case came to me and um I basically immediately recognised it as a postnatal Depression. I told the family to get in touch with um doctors. They did and they kept me updated on what was happening.
96.2
So one of the things that the doctors um asked her to do was to draw a picture of these friends, and you know like the way in a horror movie you’ll see that a child in horror movies where the child is possessed and they’re asked or they sometimes draw out their dreams and images that they’re seeing and it’s like people with uh you know fangs and what they see so she was Actually, she drew three of her friends on a swing and and they looked like you know out of a horror movie they had fangs blood dripping and things like that so that was her projection.
128.8
But the moment the doctors took away all the clocks and all the watches she didn’t know when 11 o’clock was. But still what was very interesting was that her family was still adamant that she was possessed because um in Bangladesh, or in Pakistan, people who manifest this kind of behaviour immediately they’ll think that you know there’s a jinn, A demonic possession yeah.
153.7
Asma: And was there concern that a religious exercise hadn’t taken place? Not… not really, I mean that’s one of the reasons why they came to me and I read what I needed to do you know the generic Ayat ul Kursi. One of the reasons why I did that was because to a certain extent, imams are also people who know human psychology even though we’ve not done psychology and if I was to basically say oh no no this is not a religious problem this is you know you have to go to the doctor, then they’ll basically think well this imam doesn’t know anything. So there is an element of performance as well so like which works as a placebo effect.
194.8
so I basically said well I’ve read all my Quran, dua, and everything and I realised that it’s not a spiritual problem it is a you know medical Problem, and I knew that from the beginning but I just couldn’t say because they won’t take me seriously.
208.8
Asma: So there needed to be some form of performance? It’s always performative yeah. Unfortunately sometimes people who do this they also kind of abuse as well you know for financial gains. I mean I didn’t really talk to her but I observed her and then I spoke to the family and I took information of all the context, the context is okay when did this happen, how did this happen, what are the circumstances? And they said well it happened straight after birth. Any kind of manic behaviour that women exhibit after birth normally is you know postnatal depression so immediately I knew that there was some form of postnatal depression happening.
255
You know so that’s just my kind Of, I’m not a medical doctor but I think I know that much.
263.3
Asma: So you said that you incorporated some spiritual elements as a reassurance really. And was that to reassure the family more or the woman in question? No the woman the woman in question basically she she wasn’t in the right state of mind but To, I mean let’s backtrack a bit, it wasn’t 100% um performance in the sense that I wasn’t doing it a hundred percent for them as a Placebo, I also genuinely believe that the um the Quran and duas from the Quran does have calming and soothing effect. So although yes there was an element of placebo but I also believe that there is, the Quran also does have an effect so it’s not 100% performance yeah.
308.3
Although sociologically, that will also be a performance yeah. I… as a… I mean different people might do this differently but I don’t tend to follow up things with people because then, then sometimes what happens is it messes with the therapy you know because they’re already seeing a doctor and then if you’re coming in and then say so what about this, what about this, it’s two professionals involved and sometimes people are not very happy with the, or they’re not convinced with the therapy they’re getting and they fall back on you as well and I don’t, I don’t like to do that because like it’s like Um… I don’t want to mess with the actual sessions and the counselling.
349.5
So I, unless people come to me and ask me or tell me, update me, I don’t really go and ask. And there’s this Also, this is as a chaplain, you know I worked also as a chaplain in a high security hospital, there is a question that a chaplain who is contracted, who is a contracted employee, where does the chaplaincy job role end, is it with you know the moment that you step outside your institution at five o’clock or do you never switch off? And there are situations where um… chaplains who haven’t you know they haven’t switched off and they did follow-up visits outside of work hours and the results were kind of negative.
400.6
And at that time they’re not also insured right so if something goes wrong then they are going to be in trouble so I try to keep it really really professional now, if they’ve gone and seen somebody professional then it’s not my job to kind of follow up unless they come and tell me. Yeah and that’s something that I’ve learned along the way, yeah yeah it’s professional boundary.

In this video, Dr Ali presents a case study of a Muslim experience of psychosis, from the perspective of an Islamic scholar and imam.

As had been covered in previous steps, psychosis among Muslims is often related to beliefs about spirit (or jinn possession). Although belief in jinn as an element of the unseen supernatural world is part of the worldview of Muslims, it can become implicated in a mental health problem – psychosis.

Dr Ali was consulted by the family of a woman who was considered, by the family and the woman herself, to be displaying signs of jinn possession. After speaking to the woman and her family, Dr Ali felt that this was a mental health problem rather than a spiritual problem and he advised the family to seek medical support.

As part of his support for the woman and her family, Dr Ali provided spiritual support by reciting verses from the Quran that are considered to have protective properties, including the Ayatul Kursi (The Throne), a Quranic verse (you can learn more about this verse below). Even when religious practitioners recognise mental health problems, spiritual guidance and support can be reassuring for Muslims with mental health problems and their families. Additionally, the ‘performance’ of religious rites can help to establish the authority of a religious professional such as a chaplain or an imam with those who are seeking support, making them more likely to accept their guidance.

Dr Ali prefers not to follow-up with people who he has identified as having a mental health problem after signposting them to mental health support providers. He explains that this is to avoid people relying on spiritual support from him rather than professional support from mental health practitioners.

In the next step, we hear from a trained Muslim mental health practitioner who supported a service-user experiencing psychosis.

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Understanding Mental Health in Muslim Communities

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Listen to a recitation of the Ayatul Kursi in Arabic with English translation.

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What biological, psychological, social, and spiritual causes of psychosis can you identify in this case study? Share your response below.

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This content is taken from Cardiff University online course
Understanding Mental Health in Muslim Communities
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