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In the past, when the term 'mental illness' was unheard of and often misdiagnosed as a person being possessed or having an unsound mind, a 9th-century scholar, Abu Zayd Ahmad ibn Sahl Al-Balkhi, was centuries ahead of his peers and most likely the first Muslim physician to provide a clear definition between psychological and mental disorders, i.e. psychosis and neurosis1.
The Green Mosque of Balkh in modern-day Afghanistan.
Born in the year 235 AH (849 CE), Al-Balkhi grew up in a Persian village within Balkh (now part of Afghanistan). He was a versatile scholar and an extensive writer, penning over 60 books and manuscripts exploring a wide range of subjects, including geography, medicine, theology, politics, philosophy, poetry, Arabic literature, Arabic grammar, mathematics, ethics, and more2. As an avid seeker of knowledge, he ventured out of his hometown and resided in Baghdad for eight years “in search of religious and secular knowledge, and to acquire the scholarly methodology of his time”3.
Read: The Importance of Seeking Knowledge in Islam
Unbeknownst to many, he had written his only manuscript on psychological medicine entitled ‘Sustenance for Bodies and Souls’ (Masālih al-Abdān wa al-Anfus). This manuscript is preserved today in the Hagia Sophia library located in Istanbul. It contained two distinct parts: the first part focusing on the body, and the second part focusing on the soul, which has been translated and annotated by Dr Malik Badri, the father of modern Islamic Psychology, and published with the title ‘Abu Zayd Al-Balkhi's Sustenance of the Soul’2.
Credit International Institute of Islamic Thought
An individual of remarkable intellect, Al-Balkhi’s analyses of human psychopathology (the study of mental disorders and abnormal behaviour in individuals) and diagnosis of psychological disorders such as stress, depression, fear, anxiety, phobic and obsessive-compulsive disorders, along with their treatment through cognitive behaviour therapy, resonate deeply and align closely with modern psychology. Al-Balkhi was the first to adopt a psychological approach and identify symptoms of emotional disorders.
For example, some may think Obsessive-Compulsive Disorder (OCD) was first talked about in the 1600s. However, Dr Rania Awaad, an Egyptian-American Islamic scholar, psychiatrist, and professor, changed history by highlighting in her scientific paper that it was actually described way back in the 9th century by Al-Balkhi.
Al-Balkhi is now recognised as the first to accurately classify, diagnose, and propose functional treatments for psychiatric illnesses such as OCD, nearly a millennium before similar advancements were made in European psychiatry. Interestingly, his depiction of obsessive disorders stemming from an individual's innate temperament parallels the DSM-5 characterisation of Obsessive-Compulsive Personality Disorder4.
He also acknowledged the significance of mental health and did not dismiss it as merely an indication of a lack of iman (faith). He emphasised that just like it is normal for people to experience physical sickness like the flu or aches, it is also very normal for them to feel emotions such as sadness, anxiety, or anger on any given day. His aim was to normalise the concept of mental health among the people and provide them with psychological remedies for it.
Read: Dealing with Chronic Depression Inspires Singaporean Woman to Help Others
Significantly, his insights also encompass a broader dimension, integrating considerations of the soul and the worship of God. His promotion of holistic mind-body-soul wellness predates Western psychology by nearly a thousand years, underscoring the trans-historical significance of his contributions. His manuscript is unique in that it emphasises the intimate interaction between the soul and the body, and how an imbalance between the two would affect both sides:
"And when the soul is afflicted (with psychological pain) the body will lose its natural ability to enjoy pleasure and will find its life becoming distressed and disturbed. Not only that, but psychological pain may lead to bodily illnesses."5
Just like how we would use a first-aid kit in the event of an injury, Al-Balkhi mentioned that having your own psychological first-aid kit is as important. For example, when we are agitated and there is no one available to lend a listening ear, our first source of aid should be generating positive thoughts within our soul to help us suppress the agitation. Keeping healthy thoughts and feelings as our psychological first-aid kit will support us in our times of emotional outbursts.
Read: What does Islam say about Mental Health?
Through his research, Abu Zayd Al-Balkhi found that the things people were fearful of were not really harmful if they were to think through it logically and rationally. His method was to replace the negative thoughts of his clients with positive ones, and for them to reach the realisation that their initial negative thoughts were invalid statements about themselves.
Read: Overcoming The Feeling of Loss and Purposelessness in Life
This method is similar to rational emotive behaviour therapy (REBT) – a type of cognitive behavioural therapy (CBT) that seeks to assist a person in overcoming unproductive thinking in order to prevent negative feelings or actions. REBT was only developed in the 20th-century6, which allows an individual to lead a better quality of life by making them realise they have more control over their reactions than previously thought7.
Al-Balkhi also used a distinct approach to therapy, which holistically involved faith in Allah s.w.t. and the Islamic conceptions of human nature. He reminded his clients that the world is not a place of pure joy or a place to obtain all of one's desires. This realisation helped to cognitively alleviate their symptoms of emotional disorders1.
Read: Dua for Anxiety and Depression
Alhamdulillah, we have reached an era where there has been progress in global perception and attitude towards mental health. While mental health issues still carry a stigma in many societies till today, we have seen more open conversations, advocacy, and increased awareness in recent years, offering more pathways for people to seek solutions to their respective predicaments. Furthermore, the entire body of discipline contributed by modern psychologists has developed over the years, suggesting multiple interventions to address psychological issues based on scientific studies.
The relevance of Abu Zayd Al-Balkhi’s contributions proves the significance of mental health in Islam and that it is not merely a product of modernity. In fact, Islam offers valuable insights to humanity in this discipline. As seen in this article, faith plays an integral role in achieving overall well-being and human flourishing. This distinct approach is derived from how Islam views the human being holistically, recognising that a human is not just the body and mind but also the soul. In recent years, we have also seen the emergence of Islamic psychology through our scholars, which has helped us to improve our understanding of mental health and human nature.
By acknowledging diverse perspectives like Al-Balkhi's, we can enrich and diversify our understanding of mental health, moving away from a one-size-fits-all approach. Let us continue to expand a healthy discourse on mental health, thus empowering us to be more informed and mindful in our decisions and appreciation of this matter.
Let us also look out for each other. It is important that we know how and where to look for help. Pergas (Singapore Islamic Scholars and Religious Teachers Association) offers the Asatizah Solace Care to provide emotional and spiritual support service. Alternatively, you may also consider the following helplines and online resources:
- Institute of Mental Health’s Mental Health Helpline: 6389-2222 (24 hours)
- Samaritans of Singapore: 1800-221-4444 (24 hours) /1-767 (24 hours)
- Singapore Association for Mental Health: 1800-283-7019
- https://mindline.sg/
- MindSG
And Allah knows best.
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Notes
1 Higuera, V., & Whitington, R. (2022, October 26). Understanding Neurosis vs. Psychosis. Healthline.com.
2 Abu Zayd Ahmad ibn Sahl Al-Balkhi, and Mālik Badrī. 2013. Abu Zayd Al-Balkhi’s Sustenance of the Soul : The Cognitive Behavior Therapy of a Ninth Century Physician. London: International Institute Of Islamic Thought (IIIT). https://doi.org/10.2307/j.ctvh4zfhk.7
3 Ibid, p4
4 Awaad R, Ali S. Obsessional Disorders in al-Balkhi's 9th century treatise: Sustenance of the Body and Soul. J Affect Disord. 2015 Jul 15;180:185-9. doi: 10.1016/j.jad.2015.03.003. Epub 2015 Mar 19. PMID: 25911133
5 Ibid, p29
6 Ellis, Albert, and Debbie Joffe-Ellis. 2011. Rational Emotive Behavior Therapy. Washington, Dc Etc.: American Psychological Association, Cop.
7 Fletcher, Jenna . 2022. Rational Emotive Behaviour Therapy: Technique, Efficacy, vs. CBT. www.medicalnewstoday.com. May 31, 2022.