The Concept of Compassionate Engagement in Islam

Nazila Isgandarova
azerwomensc@yahoo.ca

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Abstract

Muslim spiritual and religious caregivers are the main providers of Islamic spiritual care. When visiting the sick in hospitals, prisons, etc., Muslim spiritual and religious care givers do not have sacraments to administer and there are no formal rites to perform. However, all devout Muslims consider their prayers important. In the case of terminal illness and death, many families turn to mosques or other Islamic institutions for help. The majority prefer imams to visit the hospital during these difficult times. The therapeutic or healing relationship of Muslim spiritual and religious care givers with a client is a face-to-face individual interaction that is mainly based on the “therapeutic relationship,” which is a healing relationship between patients and the spiritual care givers. Such relationships involve the most essential techniques - talking, modeling, and creating awareness in the client.

Literature Review: Spiritual Care according to the Muslim Scholars

Since Islam’s inception, many Muslim scholars have made significant contributions to the topic of spiritual care in Islam. Developments in modern science and technology, including medicine, have challenged Muslims to update their knowledge and information and to understand the developments in the context of the sacred Book of Islam as well as in narrations of the Prophet Muhammad.

Turkish theologian Badiuzzaman Said Nursi (1994) notes that medicine is both a science, and an art. He contends that the goals of medicine depend on the inclusion of God as the ultimate Healer.  He also goes on to say that doctors find the perfection of their profession through seeing God’s compassionate manifestations in the vast natural pharmacy of mother earth. According to Fethullah Gulen (2003), the perfection of medicine is fulfilled with prayer, because prayer allows the patient to become an active member of the medical team.  For him prayer is “a mysterious key to Allah’s everlasting treasures, a point of support for the poor and hurt, and the most secure shelter for those in distress. Those who step into this shelter are considered to have obtained this key, and the poor, weak, and needy who join this governance attain that for which they had hoped.”

Islam regards both health and illness to emanate from God, closely linking the art of healing to worship. The one who practices the art of healing does so for the sake of God’s pleasure. In this context, both physician and patient are become united through a spiritual bond. (Iqbal, 1998).

Islamic spiritual healing has been considered related to the cosmic order in the universe through the basic doctrine of the correspondence between all levels of reality, as Syed Hossein Nasr (1987) has pointed out in his book, Science and Civilization in Islam:

“There is in the Hermetical-alchemical natural philosophy which was always closely tied to medicine in Islam via basic doctrine of the correspondence between all the various orders of reality: the intelligible hierarchy, the heavenly bodies, the order of numbers, the parts of the body, the letters of the alphabet which are the ‘elements’ of the Sacred Book, etc.” (p. 120).

Almost all Muslim scholars support the view that the effective spiritual care starts with prayer; however, they also mention that such spiritual care should follow proper medical treatment.

Spirituality in Islam

In Arabic, the term ‘spirituality’ means ‘ruhaniyyah’. ‘Ruh’, which is the root word of ‘ruhaniyyah’ means ‘spirit’ and constitutes the immortal part of human existence. In Hebrew text Tanakh, the word ruach has also similar meaning.  

 The body is healthy if the spirit is healthy, and the spirit is healthy if it is not in conflict with the Divine Writ, otherwise, the person losses a sense of wholeness (Isgandarova, 2005). Like the body, the soul has also its own maladies like forgetfulness of the Divine presence, greed, jealousy, etc. The body has also its own ailments but both are combined in one living entity: the human being.  The unique integration of body and spirit is linked to the rest of the universe and its Creator (Isgandarova, 2005).

The principle of Oneness (al-tawheed-unity) should be taken into consideration in any study of spirituality in Islam. For Muslims, only God is the foundation of life; without God nothing can exist or function. This is also an essential principle in Christianity and Judaism. St. Augustine said that humans are made for God and their hearts will not rest until they rest in God (Morin, 2008). This monotheistic essence was expressed in Judaism first in Adonai, Echad which means “The Lord is one.”God mentioned in the Qur’an: “I have created jinns and humans so that they worship Me”(51:56). Therefore, everything in Islamic civilization, including the health sciences, has come from this fundamental statement. Muslim’s sense of self is not limited to identification with the physical body. It means that our identity is not limited even to our intelligence or our spiritual awareness but goes beyond it (Mattson, 2002).

Thus, the bodily health depends on a healthy spirit. Health is a blessing and sickness is an test because it is the messenger of death and the reminder and announcer of the Hereafter (Cosan, 2000). This idea of suffering is based on the notion of the imperfection of human life: “Verily, we have created man into a life of pain, toil and trial” (Quran 90:4). The Qur'an emphasizes on healthy spirit because unhealthy spirit may lead to direct or indirect physical and mental ailments, e.g. depression accompanied with chronic pain or fatigue, grief, organic brain disorders, drug side effects, cancer and endocrine or hormone imbalances. Therefore, the primary focus of the Divine message is on moral and ethical diseases and in this regard, the Qur'an is referred to as a book of healing for Muslims (Isgandarova, 2005).

Traditional Spiritual Care in Islam

In early school of Islamic thought, spiritual and religious care was an important element of patient care in Islam and the art of medicine meant to preserve health and restore it, if one falls into illness, into the normal condition (Deuraseh and Yaacob, 2005). The importance of spiritual care to the sick is expressed in one Qudsi Hadith in Islamic literature:

“God will say on the Day of Judgment: “O son of Adam, I was sick but you did not visit me.” “My Lord! How could I visit you when You are the Lord of the whole world,” we will reply. God will say: “Did you not know that so-and-so from among my servants (i.e. human beings) was sick, but you never visited him or her? Did you not know that if you had visited, you would have found me there?” God says: “O my servant! Health unites you with yourself but sickness unites you to me.” God also visits the sick and says, “O My servant! Health unites you with yourself, but sickness unites you to Me” (al-Nawawi, 1997, pp. 15-17).

The prior statement is reminiscent of Jesus’s sermon in Matt. 25 when he spoke of the separation of the goats and sheep to the left hand and to the right.

“Then the righteous will answer Him, saying, ‘Lord, when did we see You hungry, and feed You, or thirsty, and give You drink? ‘And when did we see You a stranger, and invite You in, or naked, and clothe You? ‘And when did we see You sick, or in prison, and come to You?’ “And the King will answer and say to them, ‘Truly I say to you, to the extent that you did it to one of these brothers of Mine, even the least of them, you did it to Me....’ “Then He will answer them, saying, ‘Truly I say to you, to the extent that you did not do it to one of the least of these, you did not do it to Me.’ (37-46).

Visiting the sick is a social obligation for Muslims just as it is a religious obligation in Jewish and Christian tradition. In Islam, there are different forms of spiritual and religious care. These are ‘iyâdah (visiting the sick or the spiritual and religous care practice), rifq (exemplary kindness/care or approach), and ihsân (doing what is beautiful) or the optimal state in which spiritual care should be offered (Baig, 1997). The Prophetic words ‘Doing what is beautiful (ihsân) means that you should worship God as you see Him, for even if you do not see Him, He sees you’ (Bukhari and Muslim), points towards the state of vigilance and self-awareness also known as ‘murâqabah’ that is essential in spiritual care work (Isgandarova, 2005). Illness may be seen as a dependency on close relatives or caregivers for usual daily needs and basic necessities (Kobeisy, 2004), however, such visitation reminds the spiritual caregivers that “all humans begin their lives helpless and end their lives helpless” (Mattson, 2002). 

 The effective spiritual care means a “compassionate engagement” as CAPPE (Canadian Association for Pastorial Practice and Education) defines. The Qur’an like the Bible condemns the visit which is “without natural affection, unloving” (Rom. 1:31). In Islamic literature the loving engagement is expressed in effective ‘sohba’ - a term denoting companionship and presence. The effective and fruitful sohba happens when uplifting comfort, inspiration, love, encouragement, strength, exhortation to fortitude and healing are achieved.  For this purpose, the Muslim spiritual and religious caregivers recite the certain chapters from the Qur’an, especially sura al-Fatiha, Baqarah, Saad, Falaq, Naas, etc. (Rahman, 1998) and the Prophetic supplications before, during and after treatment. The traditional spiritual and religious care techniques also include Islamic daily prayers and worship, with the most important being the rhythmic and continuous invocation of prayers and the names of God to elevate the spirit (dhikr); encouraging the person to follow the Prophetic example and principles of Islamic law; analysing metaphoric stories of dreams, etc. (Jurich, 1998).

Muslim spiritual caregivers also use Sufi method (the mystical tradition of Islam) of care, which is the main basis of Islamic psychology (Abdullah, 2002). This therapeutic process in Sufism is called “Tazkiat Alnafs” (Mohit, 2001) which starts with repentance (tawba) or the conscious resolve to abandon the worldly life and commit oneself to the service of God (Arberry 1979, p.75); or “to return from that which is blameworthy to that which is praiseworthy” (Von Schlegell & Algar,1990, p.2). Repentance starts with seeking forgiveness (the Qur’an, 3:17; 73:20; 110:1-3; 11:1-3; 41:6, etc.). Prophets such as Adam, Jonah, etc. discovered and reflected the divine attributes by repenting, redressing, and reflecting over their praxis.

Such technique reminds modern psychotherapeutic techniques which aim at overcoming the feeling of guilt associated with one’s failure to fulfill internal aspirations (psychoanalysis) or external expectations (behaviorism) (Othman et al, online citation). The Roman Catholic priests also use these techniques for releasing the feeling of guilt and shame resulting from committing sins through “confessions” in order to reconcile oneself with his/her human weakness and achieve adaptation (Safi, 1998). However, Islamic understanding of “confession” is different from Catholic understanding of “confession.” Muslims only confess their sins to God and work privately to obtain forgiveness. Therefore, in the counseling process, the Imams do not expect their clients to reveal all problems. As Imams understand this, they only encourage clients to deal with some issues on their own. However, both in Roman Catholic denomination of Christianity and Islam, the importance of repentance as a spiritual care is based on the idea of forgiveness of sin to restore client’s relationship with God and restoration of relationship with others.

Conclusion

Islamic medicine is based on the concept, which views human beings as an integral composite of physiological, psychological, and spiritual components. Muslims seek early medical attention according to the Prophet’s practice and teaching, which views our healthy body and spirit as a gift and trust from God.

The traditional Islamic spiritual care methods and techniques involve the basic tenets of the Islamic faith and life style. It starts with re-examining the purpose of life. According to Islam, spiritual diseases of a human being starts when he/she forgets the purpose of life. In Islam, the purposes of life are: (1). to inhabit the earth, ‘to be’, (2.) to worship God (the Qur’an, 51:56-58) and (3). to represent God on earth (the Qur’an, 2:30). Islam teaches that when human being forgets these purposes, then the heart becomes corrupted and when the heart is corrupted the physical body cannot operate well. Therefore, the ‘tazkiyah’ (purification) becomes necessary. The Muslim spiritual and religious care givers’ role is to explain the Islamic understanding of purification which is a disciplined and rich process and involves divine intervention with  enlightenment than expands the heart and launches a process of transformation.

Muslim spiritual caregivers try to achieve good mental and spiritual health of the individual through natural balance within the individual and the practice of social and religious obligation (Hamzah & Maitafsir, 2002; Shah, 1997). The spiritual and religious approach to the disease is interpreted as coping with reality and hope for the future. That’s why for the Muslim, the Qur’an, dua (prayer), asks for God’s protection which is a medicine in and of itself.  A strong faith and trust in God therefore, plays an important role in the cure of the disease.

References

Deuraseh, N. & Yaacob, H. (2005).  Issues on Medical Treatment in Islam, The Yale Journal for Humanities in Medicine, available at: http://yjhm.yale.edu/essays/ndeuraseh2b.htm

Gulen, F. (2003). Time to Pray,  The Fountain, 42, 13-14

Hamzah, M.D and Maitafsir, M.G. (2002). Transpersonal Psychotherapy: The Islamic Perspective. Retrieved 10th January 2007 from World Wide Web: http://www.ifew.com/insight/1408rch/transp.htm

Iqbal, M. (1998). “Islamic Medicine: The Tradition of Spiritual Healing”, Science & Spirit, 9 (4), 3-5.

Isgandarova, N. (2005). Islamic Spiritual Care in a Health Care Setting. I n Spirituality and health: multidisciplinary explorations (Eds. Augustine Meier, Thomas St. James O'Connor, Peter Lorens VanKatwyk). Wateroo: Wilfrid Laurier University Press, pp. 85-101.

Isgandarova, N. (2008).Muslim Spiritual Care and Counselling: A Case Study of a Resident with Parkinson’s Disease. The Spiritual Care Giver’s Guide: Transforming the Honeymoon in Spiritual Care Therapy. pp. 235-243.

Kobeisy, A.N. (2004). Shame in the Context of Illness: An Islamic Perspective, The Yale Journal for Humanities in Medicine, available at: http://yjhm.yale.edu/archives/spirit2004/shame/akobeisy.htm

Mattson, I. (2002). Dignity and Patient Care: An Islamic Perspective, The Yale Journal for Humanities in Medicine, available at: http://yjhm.yale.edu/archives/spirit2003/dignity/imattson.htm

Morin, M. (2008).Practice in Pastoral Counselling: Working with Symbols and Images. The Spiritual Care Giver’s Guide: Transforming the Honeymoon in Spiritual Care Therapy, pp. 97-116.

Nasr, S. H. (1987). Science and Civilization in Islam, second ed., Lahore, Pakistan: Suhail Academy.

Nursi, S. B. (1996). The Words, Istanbul, Turkey: Sozler Publishing House.

Shah, A.A. (1997). Psychotherapy in Vacuum: Irrelevance of Asocial and Value-alien Western Approaches to Muslim Societies. Paper presented at International Seminar on Psychotherapy: An Islamic Perspective, International Islamic University Malaysia.

Sahih al-Bukhari. (1984). translated by M. Muhsin Khan, New Delhi, India: Kitab Bhaban.

About the Author

Nazila Isgandarova is an instructor at the Emmanuel College of University of Toronto teaching Islamic spiritiruality in a healthcare setting.

Published: March 2, 2010