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YEARS ago, while buying provisions, I came across a man engaged in a heated conversation with the shopkeeper. He was complaining about how his latest business venture had failed. “It’s the Hindus that always conspire against me! They know that if I succeed I will become the greatest leader of the Muslims the world has ever seen. This is why they always make sure I fail.” The shopkeeper nodded sympathetically.
On Sept 25, a prison guard Mohammad Yousaf shot Mohammad Asghar, a mental patient convicted for blasphemy. According to friends, Yousaf had previously claimed to have dreams and visions in which he received ‘religious guidance’. It was such a dream, said the local SHO, that compelled him to try and murder Asghar.
Just a few days ago, a person tweeted about how his colleague had pledged allegiance to the Daesh ‘Khalifa’ Omar al Baghdadi. He claimed to be part of a group in Lahore that had also pledged allegiance to Daesh and warned that his colleague was opposing Islam by refusing to join him. On investigation it emerged that this person was undergoing treatment for paranoid schizophrenia.
Delusions of being either chosen or persecuted are common in paranoid schizophrenia, which is what all three persons mentioned here seem to suffer from. In these cases, the delusions have taken on a distinctly religious character.
Some delusions take on a distinctly religious colour.
Religious delusions are not uncommon. An analysis of several surveys on mental health claimed that “a rate of 36pc of religious delusions was observed among inpatients with schizophrenia in the USA”. It also noted culture has a distinct impact of the prevalence of religious delusions, stating that there is a “higher incidence of religious delusions among schizophrenia patients in predominantly Christian countries than in other populations” and that the rate of religious delusions (among schizophrenic patients) in Germany was 21.3pc and 6.8pc in Japan.
The rate was 6pc in Pakistan. That figure may seem low, but that can also be explained by a lack of record-keeping on this issue. Certainly, conversations with mental health professionals do indicate there has been an explosion of mental illness in Pakistan over the last few years, though this may also be due to greater reporting of the issue itself.
Another interesting finding in the analysis that can relate to Pakistan is that in Egypt “fluctuations in the frequency of religious delusions over a period of 20 years have been linked to changing patterns of religious emphasis”. In short, times of greater national focus/debate on religion have seen higher incidences of delusions with religious content. Given that overt (and skin-deep) displays of religiosity are increasingly the norm in Pakistan we can expect the incidence to be fairly high.
When it comes to treatment of mental illness, it is interesting to note that religion can indeed play a part, though there are also cases where deeply held religious beliefs may in fact be a barrier to treatment. An article in the Journal of Psychosocial Nursing and Mental Health Services notes that some patients may indeed substitute faith for treatment, in effect worsening their conditions. Certainly, it has been noted that delusions with religious content seem more resistant to treatment than ‘conventional’ delusions.
The article concludes that while “Clinicians should not involve religion in treatment of patients who do not desire it … for patients who desire it and with whom the clinician has compatible beliefs, religion can be an invaluable adjunct to psychiatric care.”
While Freud considered belief in a single god to itself be a delusion, in Pakistan many psychiatrists point to the desirability of a strong spiritual centre in keeping a patient grounded and some point to the efficacy of joint prayers and rituals to help build a sense of community.
It is important to note that such practices must not and cannot replace conventional treatment but can be used to supplement such treatments. This is also not to be confused with the practice of confining persons suffering from mental illness to shrines or leaving them in the hands of sometimes fraudulent, abusive faith healers.
But in a country with a severe paucity of mental health professionals, what is the way forward? One answer may be found in the hybrid system developed in India’s Mira Datar Dargah. Here, under the auspices of a mental health professional called Milesh Hamlai, faith healers and conventional psychiatrists have joined hands to treat thousands of patients.
The chains that were previously used to bind patients have been dispensed with and the healers and doctors seem to have arrived at some kind of middle ground between prayer and treatment, simply by keeping an open mind and focusing on the welfare of their patients.
The writer is a member of staff.
Twitter: @ZarrarKhuhro
Published in Dawn, October 6th, 2014
