PERCEPTIONS OF MENTAL HEALTH PROBLEMS IN ISLAM: A TEXTUAL AND EXPERIENTAL ANALYSIS A Dissertation Presented by NADA ELTAIBA School of Social and Cultural Studies The University of Western Australia under the requirements for the degree of DOCTOR OF PHILOSOPHY 2007 This thesis is presented in partial fulfillment of the requirements for the doctor of philosophy. A Dissertation Presented by Nada Eltaiba _________________________________________ School of Social & Cultural Studies University of Western Australia ABSTRACT PERCEPTIONS OF MENTAL HEALTH PROBLEMS IN ISLAM: A TEXTUAL AND EXPERIENTAL ANALYSIS In this research I analyse how mental health problems are perceived in two primary Islamic texts: the Qur’an (the holy book for Muslims and the Hadith (the sayings and traditions of Prophet Muhammad). I then integrate this analysis with the perceptions of a cohort of Jordanian Muslims about their mental health problems and treatment. Two important theoretical frameworks underpin this research, namely the post-colonial theorizing of scholars such as Edward Said, Franz Fanon, and Homi Bhabha, and the Explanatory Model of Arthur Kleinman. Research on the assessment and treatment of mental illness in Islamic and Arabic culture is limited. What literature does exist, suggests that in spite of the increase in research on cultural issues related to mental health, there is a strong need for further research to explore the nexus between culture, religion and mental health diagnosis and treatment in non-western cultures, in order to advance cultural sensitivity amongst mental health professions. This research fills this lacuna in mental health scholarship about the mental health awareness and experiences of Muslims. All of the interviews were conducted at the Mental Health Centre in Jordan, where twenty male and female participants were selected and then interviewed using a semi-structured interview schedule. The textual analysis commenced while I was in Jordan but was completed on my return to Australia. The data were analysed using both NVivo software and manual coding. The results of this analysis are organized around the two main themes that emerged – those of ‘Causation’ and ‘Help- seeking’. Sub-themes to each of these primary themes provide a comprehensive picture of the understanding and behavior of Muslim people accessing assistance i from a mental health clinic, and contribute to understanding of mental health issues related to Islam and to Muslims living in Jordan. The research identifies that religion and religious belief are absolutely central to the way that this cohort of Muslim participants interpret the cause and development of their mental health problems and, further, it posits that this is due in part to the explanations of causation and coping contained in primary Muslim texts. ii TABLE OF CONTENTS ABSTRACT......................................................................................................................i TABLE OF CONTENTS.................................................................................................i ACKNOWLEDGMENTS .............................................................................................ix Chapter One ....................................................................................................................1 Introduction.....................................................................................................................1 Aims of the Research ............................................................................................2 The early stage of the journey...............................................................................2 Research Questions ...............................................................................................4 Theoretical Orientation .........................................................................................6 Post-colonial Theory .................................................................................7 ‘Otherness’ ....................................................................................9 ‘Hybridity’ ..................................................................................10 Explanatory Model..................................................................................12 Research Design and Methodology ....................................................................14 Contextual information .......................................................................................15 Islam........................................................................................................15 Jordan ......................................................................................................17 The Jordanian Family..............................................................................18 The National Centre of Mental Health....................................................18 Ethical Considerations ........................................................................................19 Thesis Structure...................................................................................................19 Chapter Two:.................................................................................................................21 Research Methodology..................................................................................................21 Research Design..................................................................................................21 Methods...................................................................................................22 Semi-structured interviews .........................................................22 The pilot study ................................................................23 The participants:..............................................................24 Sampling description.......................................................24 Participants’ Profiles: Male Participants.........................27 Participants’ Profiles: Female participants .....................29 Ethical issues...................................................................32 Content analysis ..........................................................................38 Data Analysis ..........................................................................................39 Summary .................................................................................................40 Chapter Three ...............................................................................................................41 Culture and mental health: Universal challenges .....................................................41 Culture.................................................................................................................42 Mental health.......................................................................................................45 Mental health problems.......................................................................................47 Culture and mental health ...................................................................................49 Historical development ...........................................................................49 Contemporary issues in mental health ....................................................51 1. The problems with the term ....................................................51 2. Lack of applicability of the mental health profession in non-western societies ............................................................53 3. Optimism about cultural mental health...................................58 4. The struggle to find the right place for culture .......................61 Summary .............................................................................................................63 Chapter Four .................................................................................................................65 Religion and Mental Health .........................................................................................65 Defining religion .................................................................................................66 The problems with conceptualizing religion...........................................69 Spirituality versus religion..........................................................70 Mental health professionals and religion ............................................................73 An early relationship...............................................................................73 An emerging antipathy............................................................................76 The changing situation ............................................................................79 Challenges and opportunities..................................................................83 Summary .............................................................................................................85 Chapter Five ..................................................................................................................87 Participants’ Perceptions of religion and religiosity..................................................87 Perceptions of Religion.......................................................................................88 Being religious ........................................................................................88 Religiosity and mental health..................................................................93