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A Muslim experience of psychosis: Muslim mental health practitioner experience

Masira Hans presents a case study of providing support to a Muslim woman who was experiencing psychosis
There’s another woman that I was working with, and she was in her forties and she was diagnosed with schizophrenia. And she would have hallucinations and delusions. And, you know, it’s psychosis essentially. Now, what was interesting about this woman is she felt that her illness or her condition or symptoms were actually as a result of black magic. It wasn’t anything that was to do with trauma, it wasn’t anything that was to do with psychology, or her experiences. It was all black magic.
Now in like mainstream and diagnosis, even the mention of black magic, it’s almost like, well, you are experiencing hallucinations, delusions, it just doesn’t exist, a phenomenon of black magic or a higher deity or supernatural kind of elements - it is always classed as actually psychosis, it’s nothing else than that. So was in the system for quite a while, people almost couldn’t kind of connect with her or if they were connecting with her it was on a clinical basis, and they weren’t really getting to the root of the problem.
Or she maybe wasn’t ready for that at that point up, until maybe she’d been referred to me that she was able to actually say, Yeah, I think it’s black magic and this is why, and this is what it was. And again, it was okay, right? You think it’s black magic? Okay, that’s fine. Maybe it’s, you know, that’s obviously in your religion. It’s a big, big thing for you. I’m not going to say no, it’s definitely not black magic, it can’t be black magic. As, unfortunately, other therapists had done in the past. I said okay, fine. Maybe it is black magic, if it is black magic, right, let’s go back to the scriptures.
What is it that can overcome that black magic? What can you pray that will provide you with peace and also potentially loosen some of them threads, shall we say, black magic? And I think she was quite surprised at that point. She was like, You believe me? And I was like, if that’s your truth then that’s your truth, I’m not going to say no. I’m of Muslim background so I do believe in them things as well. And I’m not saying that it’s not.
But if I’m going to say, okay, fine, if it is black magic let’s look at this, this and this, and you’re willing to try that, would you also be willing to maybe try some of this kind of therapy? Would you be willing to engage in like some more trauma focused work and start talking about what’s happened to you in your past and for example why you think someone’s done black magic on you, who this person is, why you think maybe they would want to do this to you and maybe we can unpick it that way. And she was like, actually, yeah, why not?
So I’ll try and pray a certain thing, I will also engage in actual conversation with you, and we’ll try and get to what’s causing this disconnect and what’s causing you discomfort. And then also within that, why can’t you take your medication, if you’re not taking medication and that’s causing lots of relapses, how do we get you to feel comfortable enough to consistently take this medication so you’re feeling somewhat well. And then when she did, thankfully. She tried the prayers and scriptures and things and then she also did engage in kind of therapy with me. And then I obviously referred her on to someone else who then engaged in some more focused trauma work with her as well.
Asma: Okay. Thank you. And what do you think made the difference with her, for her with regards to taking medication through her engagement with you? What had stopped her from taking it before? Is it, was it because she didn’t see that as the root of her problem? I think, yeah, she didn’t believe it. She was like, my problem isn’t something chemical in my brain so I’m not going to take it, what’s the point? I’m like, oh, okay. Okay.
Asma: So what made the difference then? I think for me, and I may be wrong, the same thing that kind of almost works for everyone. People want to be heard, people want to be validated, and people want to be believed. And I think as soon as you genuinely do that, that makes all the difference to people. Because, I mean, we’re sat here today, but I’m sure when you go to someone, you want to be listened to, and if people are constantly invalidating you and thinking, that’s not a thing, that can’t happen, that’s going to, it’s going to damage you.
And the first step for me is always about meeting people where they are, and how they are, working within them, within what they want. To an extent, obviously, to get them where they’re feeling better about themselves. That’s the ultimate aim.

In this video, Masira Hans presents a case study of providing support to a Muslim woman who was experiencing psychosis.

Masira Hans is Serious Mental Illness Programme Manager at the mental health charity ‘Mind’, in Bradford. Before this, Masira worked at a third sector organisation that provided support specifically for ethnic minority communities. This case study is from her work there.

The person in this case study had a diagnosis of schizophrenia, but believed that her mental health problems were caused by black magic. She had not disclosed her belief to practitioners she had worked with before meeting Masira. Masira told the service-user that she accepted her belief about the cause of her mental health problems, because as a Muslim she shares this spiritual belief.

Masira then presented the service-user with a range of spiritual solutions to the problem such as prayer and reading scripture but asked her to engage with trauma-focused talking therapy with another specialist practitioner and to take her medication too. The service-user accepted all the support offered. She had previously not taken prescribed medication because she was convinced that her mental health problem had a spiritual cause and therefore believed that the medicine would not help.

Masira feels that the changes came about because she had heard, validated and believed the service-user’s explanations for her mental health problems – constant disbelief and invalidation of religious beliefs can be damaging to mental health.

Over to you

Do you think that you can work with religious beliefs like black magic in your mental health support practice, and what support and guidance would you need to do this? If you don’t feel you can, why?

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Understanding Mental Health in Muslim Communities

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