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The OCD Stories
Dr Fahad Khan: Islamic religious OCD (Waswasa & OCD) (#505)
00:42:57
In episode 505 I chat with Dr Fahad Khan. Fahad is a licensed clinical psychologist. He currently serves as the Deputy Director at Khalil Center, providing psychological services while supervising clinical and research work. He co-wrote The Islamic...
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- [00:00]
A
You're listening to the OCD Stories podcast hosted by me, Stuart Ralph. The OCD Stories is a podcast dedicated to raising awareness and understanding around obsessive compulsive symptoms. I do this through interviewing inspired therapists, psychologists and people who have experienced OCD. Welcome to the OCD stories and welcome to episode 505 of the podcast. And in this one I chat with Dr. Farhad Khan. Fahad is a licensed clinical psychologist. He currently serves as the Deputy Director at the Halil center providing psychological services while supervising clinical and research work. He co wrote the Islamic Workbook for Religious ocd, a guide for overcoming Intrusive thoughts and compulsions. And in this episode we discuss his therapy story Waswassa Compulsive Prayer, Helping Imams and other community members in Understanding OCD Exposure Response Prevention Therapy, Culturally Attuned erp, Traditional Islamic Integrated Psychotherapy or TIP for short. Words of hope and much more and thanks to our podcast partners. Nocd. If OCD is interfering with your life, NOCD can help their licensed therapists specialise in Exposure Response Prevention therapy. The most proven therapy For OCD with NOCD, effective treatment that is 100% virtual is available for children and adults with OCD and most members can get started within seven days on average. No hassle, just real science backed help and support between sessions. Begin your journey@nocd.com or I'll put the link in the episode description.
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B
So thank you so much to you guys for listening as always, it means.
- [01:44]
A
A lot and thank you to Fahad for giving his time and coming on and chatting with me. I personally learned a lot and I hope you enjoy the episode. Without further ado, here he is.
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B
Welcome to the podcast, Fahad.
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C
Thank you. Thank you for having me.
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B
Yeah, it's good to have you on. So initially, whenever I get a clinician on or researcher or anyone like that, I like to find out, you know, who they are, why they got into this line of work and what they do.
- [02:12]
C
Yeah, so My name is Dr. Fahad Khan. I'm a licensed clinical psychologist. I'm licensed in several states in the United States. I have a master's in biomedical sciences and a doctorate in clinical psychology. I kind of got into it. I'm a big on religion and spirituality. I have a very firm commitment with my own faith and I try to be as spiritual as possible. So I like to attribute it to the plan of God because I really didn't. Ten years ago I didn't think I would be here and I don't know where I'll be 10 years from now, so we'll see where life takes us. But I think the commitment to want to help people and those who are struggling was probably a very, like, foundational value that was instilled in me, you know, since I was young. So I think I grew up in a house like that, and in culture and in religion where, you know, there's a lot of value to helping others. So naturally, I think I would have probably gone into a field like psychology or maybe like medicine, where I was directly helping others.
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B
Yeah, brilliant. Brilliant. And can you tell us a little bit about the Khalil Center?
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C
Yeah. So Khalil center started about 15 years ago now, and it started off as a clinic where we wanted to help the Muslim community in Chicagoland area, because in the Chicagoland area, there's a large Muslim community, and the ones that are very conservative, they actually are very shy to go to people who are not Muslim. They want religion to be part of their therapy process. And so Khalil center was established. But what we saw was like this. I mean, just to give you some numbers, in. In 2015, when we started collecting data, we were doing about 300, 400 sessions a year. And the last I checked, in one calendar year, we were doing about 20, 22,000 sessions. So it has grown exponentially. I would say it is probably the largest provider of Muslim mental health in the. In the Western country. So definitely United States and Canada. I don't have the numbers to compare with European countries, but it's pretty large. And so we have offices, like physical locations all over U.S. canada, we have some international locations as well. Like in Turkey, for example, we have clinicians, and then we have a virtual presence. Most of us, like myself, we're licensed in multiple states, and so we're able to provide therapy in different states. And we have clinicians in some states where we don't have any physical location.
- [04:41]
B
Yeah. Wow. Awesome. That's amazing. And so you obviously have experience with OCD and OCD research, and you co authored the religious OCD book for Muslims, right? That was the word, Yes. I forgot the term.
- [04:57]
C
Yeah, yeah. No, no. So I. It's. It's the Islamic workbook on religious ocd. And it's in. In the religious sense, it's called Waswasa, which is like whispering of Satan. And. And so what we noticed was. What I noticed was that OCD was very common, especially amongst those who were very religious, and its manifestation is very unique in religious Muslims, and in certain areas that it tends to manifest in. So, you know, I was able to go and get some trainings. I worked with the International OCD foundation and to really become someone who could offer this service. In the beginning, it was just me and my. One of my colleagues. We were doing most of the work and then we trained others and we wanted to work on this workbook because it was a need not only for people who struggle with ocd, but also those who. Clinicians who have had. Who have Muslim clients and they want to help them. So it would become a resource for them as well.
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B
Yeah. Awesome. And Waswasa is, if I said that right? Is that in the Quran, like as a term?
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C
Yes, it is mentioned in the Quran as well. Yes, because it's a. It's a. Yeah, go ahead, sir.
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B
Sorry, I was just going to say, is that. Are we now attributing, say, religious OCD to this term of saying it's like Waswasa? Or do you think that's maybe what they meant when the. The Quran was wrote, that they were referring to this religious ocd?
- [06:27]
C
So our belief in. In as a Muslim is that we have forces that exist that are metaphysical. Right. And we can't see and measure them. And one of those would be like Satan for ex. And so when it comes to thoughts in Islam, you know, there's multiple sources of thoughts that can exist. They can coexist, or they could be like, mutually exclusive. So, for example, if my heart desires something, I really want something. If I really want ice cream, for example, I'm going to have continuous thoughts about ice cream. Then I could have thoughts about something that I get triggered. So I see something and there's a certain environment, certain temperature, certain memory that can also trigger some thoughts. And then we have, like we say the devil also gives us thoughts, and the angels also, you know, produce thoughts within us. And so that's why in Islam, a person is not considered sinful if they have thoughts. And the sin only comes in if they act on their thoughts. But this also doesn't apply to OCD because there's no. It's oftentimes very difficult and there's a disease element here. But for a normal, healthy individual, if I have thoughts about something, then I have to recognize, is it a healthy thought, is it unhealthy thought, what could be the source of the thought? And if it's from the devil or if it's a negative, negative thoughts. So for example, if I'm, you know, having a bad day with my. My wife and I have thoughts like, oh, she's ungrateful or whatever, Maybe I should leave her. Somebody better. You know, these are normal thoughts that people have in relationships. We attribute that to the devil, because really, you know, that would be the. The. The intention of the devil, or what the devil wants, is to make sure that I'm not in a healthy relationship. I'm not living healthy Muslim or healthy human, and so my life is disturbed. So that's where that element comes from. And in Islam, the prophet, for example, Prophet Muhammad, has said there's specific type, the specific devil that's meant to give you these thoughts again and again. So OCD is considered. No, not ocd. So I would say obsessions are considered normal. Like, everyone will have some level of obsessive thoughts, and some thoughts like, did I lock this? Did I do this? You know, for example, if I'm leaving the house and I'm driving away and I'm like, did I lock my door? So as Muslims, we say that's a normal thing to do, but then that's where we bring in our reliance on God, that, you know, we have trust in God, that God is the one who protects. So a healthy Muslim can bring that in, and then they won't act on their thoughts, or then the thoughts will just, you know, kind of go away. But someone who has OCD because of their biological weakness, you know, the. The way that. And we know this, you know, through the. Through proofs, like, we know that genetically OCD runs in families because of that vulnerability, those thoughts don't really go away. And so there's a higher, like, level of presence and higher prevalence of those thoughts.
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B
Interesting. So, yeah, the intrusive thoughts, the thoughts are kind of not seen as normal, but then it's the OCD component that. That's what. That makes them. Sticky.
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C
Yeah. And, you know, even if you look at, like, if you took religion out of the picture, you look at, like, the modern science and how OCD is conceptualized, I think it's hard to really determine what is the source of the thought. Right. You can, like, talk about the biological asp of ocd. When I was attending an OCD conference in Chicago years ago, I remember one of the presenters she was talking about, she was saying as she was presenting to those people who were suffering with ocd, that your OCD says, do this and then you do it. You says, do this and you do it. And she kept doing this. So I went up to her afterwards and I said, you keep doing this. What is this? I want to know from your opinion what this is, because this is something that's telling you to do something. So she was saying how we teach some of the OCD patients to externalize their thoughts and to not attribute it to themselves, rather that this is a thought that's coming into their mind. So then I told her, I said, for us, that's the devil. Right? That's what we say. And so having that actually is a beneficial thing for Muslims or even, I would say believers of any religion who believe in devil and good and evil and, you know, God and angels and devils is that then, then you see this enemy that exists that's, you know, purposefully trying to hurt you and harm you, and it says to do something, then you have to learn to deal with it, manage it and not act on it. So that's what it means. Like the. Even, the even from a scientific perspective, there is this idea that there's thought that's coming in. Right. But we don't know where it's coming from. Right. Is it produced automatically in the brain or is there some kind of external element to it? I mean, obviously science is not going to try to measure that because you can't measure it. But then you have the psychodynamic approach that says it's subconscious and has to do with personality development. And you know, CBT has its own language to talk about it. But certainly there's something that's happening that's coming in that's intrusive, it's intruding into your mind. Like where, where is it coming from? Who's doing the intrusion? For us, it's the devil.
- [11:19]
B
Interesting that. That's really helpful from a cultural context for me to understand. But for me, when I work with my own clients of Muslim faith. Yeah, interesting. So with Waswasa, or can I call it Waswasa, acd. Yeah, yeah, yeah, yeah.
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C
Scrupulosity was all. Same thing.
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B
Yeah, yeah, okay. All right, I'll go with scrupulosity because that's probably most familiar to most of my listeners. Do you see when, when working at the Halil center, do you see a lot of Waswasa cases or is it mixed with your contaminations, your harm, all of that stuff, or is it.
- [12:06]
C
Yeah, yeah, yeah, no, no. So, so what we see is. So there is a difference between Islam and many other religions. And I don't, I'm not an expert in comparative religion. This is just like I'm saying in a broad perspective that Islam tends to govern every aspect of our day to day living. So, like when I wake up, what do I do as a Muslim? How do I interact with my spouse, my children. If I'm eating, how am I eating? If I'm using the washroom, like, what hand am I using to. To clean myself? You know, all these things. If I'm eating, I'm eating with the right hand. Like, all these things are part, like, it's very detailed, right? There's a lot of aspects like, and it's not meant to control, but rather it's like you're just mindful at all times. Like, when I wake up, I'm mindful of God. When I live my day up, I'm mindful of God. When I go to sleep, I'm mindful of God. So then what happens with people with OCD is that if they're mindful Muslims, which most people who practice, who are practicing Muslims, tend to be that way, then that OCD kind of takes that turn towards that aspect. So, for example, contamination, or people who worry about, like, something being dirty, then it takes the aspect of, as a Muslim, right, if I'm dirty, if my prayer doesn't count, for example, and if I'm trying to do, like, ritual washing before prayer and I need to wash myself, but if I keep thinking I'm not washed, right, and I keep thinking my hands are dirty or my body is dirty, then my prayer won't count. So the contamination piece comes into that, and people have, like, just right, ocd, then it goes into that. People who have relationship ocd, they might start thinking about their relationship with God. For example, if I'm having this thought, or for example, in Islam, like, one of the bigger areas where we see OCD present is a relationship between husband and wife. So the matters of divorce, for example, so as a Muslim, if I say to my wife, I divorce you in a. In a healthy state of mind, like as a normal individual, then that divorce takes place. Like you. I don't have to have a legal, you know, the judge sign off on it. That process exists obviously because of the jurisdiction that we're in. But as far as the relationship is concerned, it has ended. So now that anxiety related to relationship and OCD that manifests in relationships can then become more of a religious OCD, where the person's thinking, okay, like I said this word, I said divorce. I thought about divorce. I had a client who said, you know, I was having a fight with my. My wife, and she was leaving my car, the car in the parking lot. And I said, go. And then when I said go, I was thinking of, like, divorce. So I think divorce happened. So there's like now this, like fear and like, then there's compulsive behaviors and things that people are doing. So I think that's what it ends up happening here is that most people, most Muslims, most, I would say devout Muslims, practicing Muslims who have ocd, it tends to be very religiously grounded. Ocd.
- [14:59]
B
Yeah. Which makes sense as well. Right, Where OCD often latches onto the things that matter most to us. Yeah, exactly. So I guess, yeah, anyone that considers themselves a devout any religion, that good chance their OCD is going to attached to that. And I imagine then, yeah, relationship OCD might be quite high as well because, you know, marriage is really important in your religion. Right. And. And I don't want to annoy any other religions, obviously is in the others. But, you know, divorce is maybe less so. So I imagine that that latches on for a lot of people. If I'm mad at my wife or husband, I shouldn't be.
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C
Yeah, yeah. So the big areas where it tends to come up in Muslims, we have a relationship and divorce, some marriage and divorce, we have like ritual cleaning, purity. And then you have like worship. So prayer, for example, we pray five times a day. And different times it is different, like length of the prayer, different units of prayer you can say. And so there's like ocd. But did I. Did I do enough units or not? You know, did I perform this act or I didn't perform this act. Like, people who are very, like, detailed oriented or just write ocd, like, tend to have that type of ocd. And then there's also related to like blasphemy. So like, if I think this way, did I commit blasphemy or not? And so that also kind of, you know, comes up. So these are very common themes that we see amongst Muslims, at least.
- [16:32]
B
Interesting. Yeah, thank you for that. And so with scrupulously, for say, Christians, one of the big compulsions is compulsive prayer. And obviously in Christianity, there's no set. You kind of pray, I guess, as and when you want. So it can be endless when OCD gets involved. So how does compulsive prayer come into the five times? Do you find people they're just praying way more than the five or is?
- [16:58]
C
Yeah, yeah, we see a combination, unfortunately. So, I mean, sometimes the prayer has to do with like, I've committed a sin, so I need to pray to cleanse myself. Right. So it's a compulsive act because the obsessive thought is like, you know, I'm sinful, I've done something that's sinful. And that sin could even be like, I divorced my wife. Or I, even though I think my wife is divorced, I was intimate with her, which is sinful. Now because it's, you know, outside of marital relationships, you're being intimate in their mind, in the mind of someone who's ocd. And so then that prayer can be as a compulsive behavior. Then sometimes, like the units of prayer, like I said, am I doing it right? Did I do enough? Did I forget something? Or sometimes, like, I had a client who talked about how he would stand up to pray, and then, you know, he would start having thoughts about, like, I'm feeling thirsty, my throat is dry. You know, I think I need to drink water. And I can't be praying. I can't focus on prayer if I didn't drink water. So then he would break his prayer, go drink water or eat something, come back. And then he would start thinking about it again. And then it was like, okay, now I'm thinking about this. My prayer doesn't count, so I need to repeat my prayer. So a prayer that usually takes, I would say, maybe five minutes on average. Like a. Five daily prayers, but each prayer takes about five minutes on average. So that then turns into like an hour long prayer, unfortunately. Or then the cleanliness part of it. Because like a healthy Muslim, for example, if I go wash myself and I come and I'm praying, let's say that I, you know, had flatulence, I passed gas, then I'm supposed to break my prayer, go wash myself and come back pray again. But this is not a common thing, right? Obviously it happens maybe once, like, you know, rarely. Like once every like a year or something, right? Unless if you're older and you have some more gas problem. But like with ocd, it's like, I think I felt it, I think I passed gas, right? And I, you know, I felt something, I'm not sure. So I'm gonna break my prayer, I'm gonna go wash and come back. So that cycle continues. I had another client from, from the UK actually, who was, I was consulting him because she was seeing someone there locally. You know, she would have this issue of like, I haven't cleansed myself properly. So she would use the bathroom and there's like water splashing from the toilet. So that water is dirty and therefore I can't pray in that, in with that water being on my body. So then she would start taking shower. But even in the shower, the water's splashing and there's dirty water. That's coming back to my body. So then that shower would take like one hour, one hour and a half. And that was her kind of daily routine, unfortunately. So now, obviously, see, from a religious perspective, there's different rulings for someone who's struggling with a disease versus someone. Like, even to give you a simple example, if you're old and you have a flatulence problem and it's a common thing, like daily you're having this issue and you can't control your gas, then for someone like that, it wouldn't, you know, even if you just wash yourself and you're praying, you don't have to break your prayer and go wash yourself again. Because for that person, there's an excuse. It's a valid reason. Right. As compared to someone who's young or doesn't have that issue. So similarly with ocd, one of the things that we do to help them is we educate them as to what is your legal and religious responsibility. We have them see a scholar at the Khalil center or anywhere scholar who's knowledgeable about ocd, so that scholar can give them a verdict, a religious verdict. As in, like, you know, for you, this is how it should be. So that's where like, you see different manifestations of like, the same kind of pattern of problems.
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B
Wow. Yeah. I can really see how OCD uses the, the guidance or structure of the Quran against the person. Like it, it twists, you know.
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C
Absolutely, absolutely. Yeah, yeah. And there's a lot of fear based, like, religious, you know, mindset, right? Like, oh, I'm gonna go to hell, God hates me, or God is punishing me, or I'm gonna get punished in hell if I don't do this, you know, so. And I'm a bad Muslim, I'm a bad believer. I shouldn't have these thoughts. There's a lot of guilt that exists there. And so that gets used against people. And for most devout religious believers, religion is very important part of their life. Their relationship with God supersedes their relationship with anyone else. Same for the Muslims. And so if that's the most important relationship in your life, then you get hyper focused on making sure that one that's healthy so there's less hope and there's more fear. And so part of therapy process is also helping them to combat that fear with hope, bringing in aspects of religion that have to do with hope rather than fear.
- [21:20]
B
Yeah, I like that. And you, you know, you mentioned, I guess, going to an iman to get a verdict to kind of say, look, given ocd you're okay if you, you know, pass gas during prayer because this is your, your reason. How else do you tie in? Maybe other people in the faith as part of the OCD treatment?
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C
Yeah. So I think, as you probably know, this, like, having family support, having community support is very helpful in terms of treatment and healing. So now in terms of the support from the imam, one of the things that we have to be very cognizant of is that sometimes OCD manifests in that relationship. So we see a very common pattern. For example, if I have OCD and I contact my, my IMAM and ask them a question, and then they respond, like, if I say, hey, I, you know, I think I broke my a prayer or I think I passed gas, so I broke my prayer. And then I might say, no, no, no, don't worry about it, you know, it's fine. And then. But then OCD comes back with something more nuanced and I go back to the same person. I say, but what if this happened? But what if I felt like it? What if I think I heard something? And then this says, no, no, it's fine. And then you come back because intrusive thoughts don't go away. So then the compulsive behavior is that you keep going back to the imam, asking the same questions again and again. So the imam needs to know what's happening because most of the imams are not aware of it, unfortunately. They know what waswasa is, but they don't see this unhealthy manifestation of like, how it can be present in an unhealthy individual, in someone who has ocd. So they have a tendency to want to respond back because they're seeing that as a service to the congregation, that I'm responding back to the questions of someone who's asking me this for guidance. And then it become. But they don't recognize that they're only kind of completing the cycle of hostility. The vicious cycle will just keep going. So part of our work with the imams is like, you know, you recognize that in some cases, don't answer, don't respond back. Let the person sit with the anxiety. What we've done at Khalil center, one of our, I would say, biggest accomplishments in the west, in the U.S. was that we have this eight hour training that we do with the imams and community leaders. And in that training we talk about multiple different mental health issues that the community can have, like, including even marital problems and domestic violence and anxieties and depressions, trauma. But we also talk about ocd. So we can educate them that, you know, if someone is doing this, just be mindful they might have ocd. So you don't want to respond back. Rather you might, you should refer. At the Khalil center, we have scholars who have background in psychologies. Some of our clinicians are actually dual trained, so they went to religious schooling as well. But we tried not to mix the role. So if you're a clinician who's doing OCD treatment with your clients, you're not. Your role is not to become an imam and a religious scholar. In that moment, you have to be the therapist. But we have scholars who are present in case someone needs a religious consultation. So in that consultation, we have the scholar, we have the clinician, we have family member, the patient, and we sit together and they explain the process, and the clinician informs the scholar what's happening. And then the scholar will then give this, like I said, individualized fatwa is the Arabic term verdict. Basically, you don't have to worry about prayer. If you feel that way, don't worry about it. Continue. Your prayer will still count. So that actually helps people because then they, when they hear, they're like, oh, wow, okay, I didn't know that. The same rulings don't apply to me. So then they're better able to manage and just sit with the, like, okay, this is a thought from the devil. I'm just gonna not really do much about it because, you know, I'm gonna continue with my prayer because I know that my prayer will count because I, I spoke with a scholar, someone who's more educated.
- [24:55]
B
Yeah, that's really interesting. I'm glad you do the, the training with Emma Iman's. Yeah. I think all religious leaders need that sort of training to really understand and help their congregation the best they can. Because obviously they're doing the best they can anyway. But it's much like when families accommodate. They're doing it because they care and they love their child or whatever, but they don't realize it's actually feeding into the ocd cycle. Okay. And I think, just reading my notes, did you co. Create tips or T I, I P. Yes, I did.
- [25:31]
C
Yes.
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B
Yeah. Could you just tell us what that is and, and why it's useful?
- [25:37]
C
Yeah, sure. So, I mean, as a psychologist, when I was training and going through schooling, and I think most Muslims observe the same thing. I mean, most people, actually, it's a very common, like a. One thing that we noticed when it comes to development of psychology in the West. Well, two Things one was, there seems to be a disconnect between, like the thought process that if you go back to the philosophers in 17, 1800 to 2000 years ago, so the history will talk about them, this history of psychology, and then it jumps to the 17th, 18th century. So it's like what happened in between? Who were the people that were talking about? Was someone talking about it or not? So there was a disconnect. The second thing is psychology and religion, oftentimes they're not talked about in the same sentence or the same gathering. And I think this has to do with a broader kind of science versus religion, you know, battle that unfortunately exists out there. And so, and then the other thing within psychology too, you have like, people who follow psychoanalysis will hate people who follow CBT and vice versa. And so there's this kind of like reactionary development that happened within field of psychology now as Muslims, like, historically speaking, if you went back a thousand 1500 years ago, you'll see that there was a lot of work in psychology and there was no kind of like secular versus sacred, you know, battle. There wasn't this distinction that knowledge was considered everything, you know, from God. And most physicians at the time, Muslim physicians, when they, when their science at the time couldn't explain something, they went to, they turned to scripture, they turned to religion, and see if there's anything spiritual, anything that exists there that explains what's happening with us. So, you know, for example, the question, like, where do these thoughts come from? You know, they can say, okay, well, we know what's happening in the person's like, body, in their mind, in their soul, but where is it coming from? It's possibly it's coming from the devil. So like, you know, but that doesn't change the treatment of it. The treatment was still like exposure therapy even back, you know, if you go back 9th century, there's a scholar by name, Abu Zayd Al Balqi, who conceptualized OCD at that time. Right. He was able to call it a unique disorder by itself. And so anyway, so we noticed that and we, we also noticed that Muslims that we were working with wanted religion and spirituality to be part of therapy process. So keeping all these things in mind, we started working on developing a model. And the model is meant to really enhance the field of psychology. It's not meant to like, oh, this is nonsense. Don't believe in this yet, rather believe in this. So what we did was instead of just saying, okay, all of your behavior has to do with your subconscious thoughts, something like psychodynamic or psychoanalysis will talk about or it has to do with thoughts, not, not subconscious processes thoughts or has to do with behavior. So instead of getting into these, like pigeonholing yourself, you said, okay, you know, there's a human being is very complex. And so you have thoughts, you have behavioral inclinations, you have emotions, you have your spirit as well. You have, you know, you exist in this body, body has its needs, so you have like desires when they come from that body. But then you also have this connection with God that just is a spiritual connection. So this model was developed to kind of conceptualize human ontology from that perspective. And so it's, it's an integrated model. The TIP stands for traditional Islamically integrated Psychotherapy because it integrates from what exists in the modern psychology literature as well. Right. Because it doesn't contradict, most of it doesn't contradict with, with our religious values only I would say few, like very small percentage that does. And then we kind of leave that out. We don't have to like believe it. There's not even too much science to support it anyway. So this model is meant to be comprehensive. And so when we do the trainings, we do multiple trainings throughout the year. A lot of the clinicians, they say like this really kind of expanded my view and it broadened my perspective as a clinician. So it wasn't meant to cancel. Sometimes you see, like chiropractors don't like physicians, physicians like chiropractors, like you start to cancel the other others who don't agree with you. This is like, no, this knowledge comes from God. And you know, if you find any wisdom anywhere, you have the right to take it and apply it. And if it doesn't make sense rationally, which is part of like in the Islamic epistemology, rationality has value, you know, then you, you should just ignore it or if there's not enough data to support it, then you don't have to follow it. So that's kind of like where the model came from. And, and the current master's degree where I'm teaching in Qatar is actually, we're actually teaching the model here. This was, I would say, the first program internationally that is an Islamic psychology oriented program. And so we study all of the different theoretical orientations and then we kind of, you know, teach them to be like I said, very broad minded and comprehensive.
- [30:27]
B
Well that's amazing. And yeah, I agree with you that there's too much segregation and separation rather than we all need to work together and build on one another's. Work. Work rather than work in, in isolation. How. How is exposure therapy received within the Islamic community?
- [30:48]
C
I mean, it has like this science behind it, right? There's a. There's enough data to support its efficacy. So a real Muslim wouldn't reject it, right? Wouldn't say, well, no, this is nonsense, right? Because we know it works, it has helped people. And we even know, even in our tradition, like, if you go back a thousand years, you'll see documented cases of where exposure therapy was being implemented, was being used as a treatment to treat ocd. So we know that it's never been a problem. I think there's some cases where, for example, I remember I did a consultation with a clinician who had a Muslim male client who had ocd and his obsessive thoughts were that he kept divorcing his wife in his mind, and he kept having thoughts of divorcing his wife. So when the clinician was designing the hierarchy to expose, she put one of the things, as, you know, you need to sit in front of your wife and tell her, I divorce you. Right. So I had to kind of like talk to her and say, well, you can't really do that. That's probably not something you want to do because that, we know, is a very explicit, very direct way of divorcing, you know, your spouse. So I wouldn't use that as a, as one of the exposures. Right. And so I think that's where, like, it's like the application of it just have to be a bit mindful here and there. But besides that, like, for example, if someone thinks that they've passed gas or there's like urine that has leaked and they're about to prayer and then let's say if they saw their urine leaking, if their like, underwear was like wet or if it's like yellow stains on it and there's proof that a urine actually leaked, I mean, maybe an exposure therapist might say, well, go ahead and pray with it, right? So that's where we say, okay, well, you don't want to do that, right? So like, you don't want to go that far because that's not going to be. That kind of contradicts like a very basic Islamic belief. So from that perspective, we see that. But for the most case, that was a 99% of the times. There's no contradiction. There's nothing in the religion that stops a Muslim from, you know, taking that which has a strong foundation, empirical data and evidence.
- [33:00]
B
Yeah, a hundred percent. And yeah, I mean, you, you raise a good point. That just, it's good, good or best practice for ERP therapists generally to never do an exposure that goes against someone's values. And yeah, you know what you're speaking of. It's important that as therapists we are culturally competent and, and also I think you don't even need to be that culture competent because as long as you ask your client, you soon find where their boundaries are and their values and what you can and can't do. Interesting. So for any Muslims listening, what, what resources are out there? Do you think they can help them?
- [33:45]
C
Yeah, so this workbook is definitely one of them. So you can find this on Amazon and Google. If you don't have the money, you know, feel free to reach out to me. I'll send you a PDF copy of it. You know, we don't want people who can't afford it to not have access to it. And I would also suggest that sometimes people hesitate seeing someone who's not Muslim because they feel like, oh, if I see someone not Muslim, you know, there's this kind of like fear of like psychology being too secularized. And so if I go to someone who's not Muslim, they might, you know, make me less Muslim or, or take me away from my religion. So people sometimes don't send their children to therapy because of that reason. And some of that does can happen and people project in therapy and there are good and bad clinicians out there, but a good therapist, a good psychologist wouldn't do that anyway. So I always tell my Muslim community members that, you know, getting the help is, is, is necessary. So if you have someone, or if you yourself, you're struggling with ocd, don't wait to find a Muslim. If you have to go to Anonymous, go and you know, let them know that how important your religious values are to you and if they need consultation or if they need to reach out to us, like we're usually available and most of the, the clinicians will probably, you know, try to educate themselves, like you said, about the values of their, their clients and the beliefs that they have. So, so don't hold back. And if you have access to someone Muslim who's trained, that's the other important thing here too is just because it's a Muslim therapist doesn't mean they'll have training in ocd. So make sure you look up that, do they have actual training or they're just making claims? You know, you can have someone who's a, in the US for example, a certified BTTI therapist, for example from the ocd. Foundation to someone who's probably just done some coursework, maybe just supervision, consultation, or has experience like multiple years. So there's different levels of, of that. But you know, do your research before you go to someone. Especially if it's like ocd, you need to have people who know what they're doing to help. And not every therapist will know what they're doing in this case. But like I said, Workbook is available in the future. I think we're working on a project right now where someone is turning this into an app paired with AI. So hopefully in the near future we'll see that. And so whatever resources are available, make use of them.
- [36:02]
B
Yeah, awesome. Really good breakdown. And are you working on anything at the minute, research wise?
- [36:10]
C
So we have different individuals that are working on different projects. You know, we're looking at really the efficacy of our treatment, like I said, even this project with AI, the goal is to see how this can help those people who might not have the resources or the access to therapists. And then we also do a lot of community education workshops, seminars to just help people. Preventative work. As you know, part of the reasons why OCD develops, if you look at personality development, is sometimes people who grew up in harsher environments, sometimes the parents might have ocd, right. So, you know, or they're too hard when it comes to religion. They have a very fear based parenting rather than a hope based parenting when it comes to even religious parenting or religious beliefs. So some of our work goes into parenting and helping parents become healthy parents and, you know, making sure that they're not harming their children unintentionally. So besides that, we're just working on training and supervising and consultative work with clinicians. Some of them work with flu center, others work outside. And you know, we're always available because there's only so many clients that I can take or other authors of this book can take. But you know, if we're available to do some supervision and consultation, then, you know, we can have multiple people that can do this work. And it's a, it's a common problem. So they can be available for the individuals who are suffering.
- [37:30]
B
Yeah. Thank you for that.
- [37:32]
C
Cool.
- [37:33]
B
Is there, before I ask you a couple of more random questions, is there anything else you want to mention on this topic?
- [37:40]
C
Yeah, I mean, people who are listening are probably those who are struggling with ocd. I also want to say, you know, the guilt, like the idea that the devil is producing these thoughts. Just be mindful of two things. One is you don't want to take on the guilt of like, I'm listening to the devil, you know, because like I said, is a biological vulnerability, right? You know, like someone who for example, has a, has a short stature and then they get made fun of their stature, right? Because they have a certain weakness. People are using that weakness to hurt them, them. The goal is not to think, why am I short? Right? Because that's just the way it is, you know, the goal is to not let what other people are doing affect you. Same with here, you know, if you have a biological vulnerability, you know, it happens to a lot of people. Everyone has some kind of a struggle. Yours might be harder. In, in our workbook we talk about these basic principles, universal principles. And one of those things is like, you know, if you're struggling, you know, God has given you this struggle because he's testing you and he only tests those whom he loves. So don't take it as the sign of like weak faith, you know, have unhealthy guilt. Because that unhealthy guilt also comes from the devil, also comes from Satan trying to tell you that you're not worth it, you're not going to be saved. So, you know, have hope. And this struggle that you're going through is very valuable in the eyes of God. In fact, we believe that a person who lives a very comfortable life, has no struggles, should be more worried than someone who's struggling. Because a person who's living a comfortable life has nothing to respond to. Like, you know, it doesn't have the challenges that the other person has, but one who's going through the challenges, you know, can then get through them and not only grow themselves, but also then are rewarded in the eyes of God. So I want to just kind of clarify that as well that you know, not to have unhealthy religious guilt because we know like suicide rate is very high with ocd, unfortunately. And the reasons behind that is also because people start they can't take it anymore. Sometimes they have a lot of guilt. I don't want to go through this. So, you know, get help. Help and reach out to whomever you can.
- [39:38]
B
Yeah, good words. I like that. Thank you. So let's say you could pick up the phone and call the 20 year old. You what do you tell him?
- [39:49]
C
I would tell him that there's a plan. I would tell him to just keep going and not stress too much about being perfect or, or you know, trying to reach an ideal that's too far and just to be patient and that things are going to be okay. And that you are fine the way you are, and whatever weaknesses or problems that you have that don't define who you are, especially in the eyes of God.
- [40:16]
B
Nice.
- [40:18]
C
And I would also tell him to invest in Bitcoin, just a side note.
- [40:21]
B
Yeah, true. Yeah, absolutely. And gold skyrocketed. So you've got a billboard in Qatar. What do you want written on that billboard?
- [40:39]
C
As I said, billboard is a small place. I would say, you know, love everyone. You know, be. Be acceptful, accepting of everyone around you. You know, be. Be present with people. Right. Especially in this day and age where technology kind of removes that element from us. People are living together, you know, spending time together, but they're not really present. And I think most people don't realize the. The reason therapy is so effective, one of the main reasons, is because the. There's a therapist. There's a person who's present, who's giving you attention, who's empathizing with you, who's feeling your pain, and that's where a lot of the healing comes from. And I think some of that we can even mimic in our daily lives. So be present with those around you.
- [41:23]
B
Yeah, it's a really good point. Yeah. We're on our phones way too much. I am so.
- [41:30]
C
Yeah.
- [41:31]
B
Thank you so much. It's been awesome speaking with you. I'm glad to put this out there, and I hope it helps any of my listeners, but especially my Muslim listeners, who I haven't necessarily done a topic to really help them yet. So hopefully this serves them well. So thank you so much.
- [41:47]
C
Yeah, no, thank you for having me, and I appreciate the work that you're doing, and it's definitely needed. And like I said, I hope. Like you said, I hope it benefits someone out there in a good way. And. And again, if there are any questions, my email address is somewhere on the Internet. You can find it. Feel free to reach out to me.
- [42:03]
B
Brilliant. Awesome. Thank you so much.
- [42:06]
A
Thank you for listening to this week's.
- [42:07]
B
Podcast and thank you to our patrons who help make this episode possible. And if you would like to find out more about Patreon and the rewards and benefits, then there will be a.
- [42:16]
A
Link in the episode description. If you enjoy the OCD Stories podcast and would like to support us, please subscribe and rate the show wherever you listen to the podcast. And thank you to NOCD for supporting our work. If you want to find out more about nocd, you can click the link in the episode description and quick disclaimer. Guys, this podcast is not therapy. It is not a replacement for therapy. Please seek treatment from a trained professional and until we speak. Take care.
- [42:50]
C
Sam.