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April 1st, 2014

Is religious extremism a mental illness?

A friend of this blog has referred us to this news in the Digital Journal.

"Kathleen Taylor, a neurologist at Oxford University, said that recent developments suggest that we will soon be able to treat religious fundamentalism and other forms of ideological beliefs potentially harmful to society as a form of mental illness."

8 Responses to “Is religious extremism a mental illness?”

  1. April 1st, 2014 at 8:58 pm
    From Zahid Aziz:

    This calls to mind the following hadith from near the beginning of Bukhari:

    Abu Hurairah reported that the Prophet, may peace and the blessings of Allah be on him, said:

    "Religion is easy, and no one exerts himself too much in religion but it overpowers him; so act aright and keep to the mean and be of good cheer and ask for (Divine) help at morning and at evening and during a part of the night."

    Commenting on this, Maulana Muhammad Ali writes in A Manual of Hadith (ch. 2):

    "This hadith shows what the Islamic conception of religion is. Religion does not consist in performing too many devotional exercises; these are in fact discouraged as they ultimately overpower the man who indulges in them. Religion is the name of acting aright and keeping to the mean course; this would keep a man in good heart. The truly religious man will smile in the face of everyone, as did the Holy Prophet. What generally considered to be Divine worship is really the seeking of Divine help for acting aright and keeping to the mean."

    Not only an excess of devotional exercises, but just being too obsessed with religion in the way that extremists are, will "overpower the man" mentally.

    This is why the famous prayer is taught in the Quran: "Our Lord, grant us good in this world and good in the Hereafter, and save us from the chastisement of the Fire" (2:201). There is a balance here to be maintained between "worldly duties" (i.e. what all human beings have to do) and religious obligations.

    A test that could be applied to determine if religion has or has not made someone mentally ill is to see whether a person, having taken up a religion seriously, treats other people better than before or worse than he did before. For example, a Muslim convert has non-Muslim parents, or a nominal Muslim by birth who starts practising Islam has parents who are non-observant Muslims. Has his adoption of Islam, or greater adherence to Islam, led him to treat his parents (such as they are) better than before in terms of parental rights? Or, have those who drew him towards Islam made him turn against his parents and cut himself off from them? That test will distinguish between a true moral acceptance of religion and a fanatical acceptance due to some psychological or character flaw.

  2. April 2nd, 2014 at 12:01 am
    From Muhammad Abdullah:

    Quran says:

    In the name of Allah, the Beneficent, the Merciful.

    (By) the inkstand and the pen and that which they write!

    By the grace of thy Lord thou art not mad.

    And surely thine is a reward never to be cut off.

    And surely thou hast sublime morals.

    So thou wilt see, and they (too) will see,

    Which of you is mad.

    Surely thy Lord knows best who is erring from His way, and He knows best those who go aright.


    Commentary :

    “The Prophet’s possession of the sublimest morals is a further proof that he cannot be a madman. In fact, he had already won from his contemporaries the recognition of his sublime morality, inasmuch as he had won the title of al-Amin, the faithful one. The Arabs, on account of their haughty spirit and tribal and family feuds, could not bow their heads to a man who was neither a king, nor the chief of a tribe, nor a great warrior, nor a famous poet. Nor could flattery have been their motive in according an unparalleled honour to a man who would not even mix with them, and led the life almost of a recluse. By calling him al-Amin, the people expressed their high appreciation of his sublime morality, as if he were the one, and only one, as indicated by prefixing alwho could be trusted in all mattersHis moral greatness was thus testified to by ‘A’ishah, than whom none was more intimate with the Holy Prophet: His morals are the Qur’an; meaning that all the pictures of sublime moralitydepicted by the Holy Qur’an afford really a glimpse of the moral greatness of the Prophet

    Translation and commentary by Hazrat Maulana Muhammad Ali

    So this is the standard, which is presented by Quran to differentiate between a  mentally healthy and a mad person.

    The great life of our holy prophet Muhammad, may peace and the blessings of Allah be on him, completely filled with purely  great morals is also a great treatment for those who are really any kind of extremists and not living a balanced life.Medicinal treatment may also be necessary as a secondary tool.

    Brother  Zahid Aziz presented a very logical test which is truly based on Quran o Sunnah.

  3. The subject matter of the referenced article is essentially an “Alice in the Wonderland” trip to the world problems, all fanciful but beyond the realm of today’s science. The title of the said article while referring to the statement of the author sums its application as “Religious fundamentalism could soon be treated as mental illness,” read radical Islam instead.

    Before addressing the religious fundamentalism, the fundamental question that arises from reading the article is that does the said author-researcher even have any real sense of what mental illness means? The said article gives the impression that she has confounded mental health with mental illness. She is also confusing a social disorder with a mental disorder. Her background is neurology and she must understand that mental illnesses are not diseases at present, rather are symptom clustering. Any given mental or behavioral symptom cluster goes under the label of disorder e.g. Bipolar Disorder, Major Depressive Disorder, Anti-Social Personality Disorder etc. At the end of the day, the conscious brain acts as a whole because each thought, mood or behavior manifests as an integrated function of motor, sensory (-all 5 modalities), memory, executive function and emotional areas of the brain. These areas are located in different anatomical regions of the brain which in turn are further integrated with other peripheral organs and functions e.g. heart rate, metabolic rate, breathing rate, muscle tone etc. by further complex combinations of peripheral nervous system and endocrine system. The circuits embedded in one person are not limited for their actions to one body alone. Soon the behavior and thought of one starts to affect the corresponding circuits of other people e.g. via ‘mirror neurons’ and the idea in one person starts to spread into ‘social networks’ and it is not too surprising that nations start the unison chants of Heil Hitler, Deus Vult, Onward Christian Soldiers etc. Subsequently, the masses one and all, carry same emotions, thoughts and behaviors. The behavior, individual or collective then can range from virtuous to wicked one.

    Before the author even tries to treat the novel mental disorders, she first has to define each one of them, each with its full symptom clustering. Will she be willing to entertain Crusaders and Zionists, both of which, even today have blood and tears of millions at their hands? Ironically, some of their leaders get presidential protocols at United Nations:

    “…radicalizing ideologies may soon be viewed not as being of personal choice or free will but as a category of mental disorder. She said new developments in neuroscience could make it possible to consider extremists as people with mental illness rather than criminals.”

    She also has to come very clear as to what can be treated and what she cannot. Will she treat the belief of bodily ascension of Jesus Christ and Atonement, which if looked at objectively is essentially a delusion, but psychiatry does not call it so because it is a culturally congruent belief. One does not treat cult ideologies, only rehabilitates them:

    "One of the surprises may be to see people with certain beliefs as people who can be treated. Someone who has for example become radicalized to a cult ideology — we might stop seeing that as a personal choice that they have chosen as a result of pure free will and may start treating it as some kind of mental disturbance."

    One of the attributes of a mental disorder is that it leads to some harmful or distressing outcome for the individual suffering from it or others who suffer because of the patient. One of the worst human suffering that has been inflicted on mankind is by the scrooge of interest, for example a penny borrowed 2012 years ago at an annual interest rate of 5% would have accrued a debt of $42,000,000,000,000,000,000,000,000,000,000,000,000,000.00 (-Compound Interest). Jesus Christ fought it. This might seem as a dramatic example, instead why not solve a doable problem in which the “The 85 richest people own the same wealth as the 3.5 billion poorest people” (Oxfam). Must we not then treat the 85, rather than the 3.5 billion sufferers?

    Taylor admits that the scope of what could end up being labelled "fundamentalist" is expansive. She continued: "I am not just talking about the obvious candidates like radical Islam or some of the more extreme cults. I am talking about things like the belief that it is OK to beat your children. These beliefs are very harmful but are not normally categorized as mental illness. In many ways that could be a very positive thing because there are no doubt beliefs in our society that do a heck of a lot of damage, that really do a lot of harm… But how much less "fundamentalist" than an Osama bin Laden is a nation of capitalist ideologues carpet bombing civilian urban areas in Laos, Cambodia and North Korea?"

    Humanistically, the heart of the author is in the right place where she gives ethically balancing statements towards the end of the article on the assumption that her science may be able to do what she claims.

    The moral-ethical dimension arises from the predictable tendency when acting on the problem, armed with a new technology, to apply to the label "fundamentalist" only to our ideological opponents, while failing to perceive the "fundamentalism" in ourselves.

    The jihadist's obsession with defending his Islamic ideological world view which leads him to perpetrate and justify such barbaric acts as the Woolwich murder are of the same nature as the evangelical obsession with spreading the pseudo-religious ideology of capitalism which led to such horrendous crimes as the murder of hundreds of thousands of civilians in four years of carpet bombing operations by the Nixon administration caught in a vice grip of anti-communist paranoia.

    What we perceive from our perspective as our legitimate self-defensive reaction to the psychosis of the enemy, is from the perspective of the same enemy our equally malignant psychotic self-obsession.

    The title of her book is "The Brain Supremacy." Physical brains are dime a dozen in any poor country. It is the ideas that count. A song on a CD could be worth millions, whereas the CD players are cheap. In the end it is the ideas that survive not the brain. There is a book out there “The Idea Supremacy” sold under the name Quran, which is like that of the bee which makes honey by extracting nectar from various flowers; in this sense the Qur’ân is the extract of all the goodness in previous Scriptures of all nations; like honey, it is of varying hues which is a cure for the people. In fact, in this there is a sign for a people who reflect (16:69).

    In terms of religious extremism, the solution is quite simple. In the words of Amineh Browne (Islamic Review, Vol. XIX, No. 5, May 1931, Woking Muslim Mission and Muslim Literary Trust):  “What we think about God, molds our very actions.” Fix the God first; ideology, no matter how extreme, thereafter is merely a downstream issue that gets solved naturally.

  4. April 2nd, 2014 at 10:57 am
    From Zahid Aziz:

    As to who might have suffered from mental illness, Lord David Owen, former Foreign Secretary of UK (equivalent to US Secretary of State) during the 1970s, founding leader of a political party during the 1980s, and himself a medical doctor, has written about mental illness and personality disorders in world political leaders, especially those of USA and UK, and how this affected their decision making. He wrote a book entitled The Hubris Syndrome: Bush, Blair and the Intoxication of Power (see link at Amazon).

    Here are a few links in this connection:

    Review from 2008 in the Daily Telegraph (suitable for the lay person). I quote from it:

    "Even when he was foreign secretary he carried on (rather pedantically) calling himself a medical practitioner in official documents, as if politics was a sideline.

    Political psychology took hold of him when he was a young medic helping to treat MPs for alcoholism and depression.

    He saw the pressures they were under and began to consider how illness affects the decision-making powers of leaders. And he noticed that some leaders who weren't actually ill in the conventional sense became so intoxicated with power that it warped their judgment.

    There were warning signs: unshakeable self-confidence, contempt for advice and inattention to detail. Gradually, they would lose their grip on reality.

    There was no name for such a condition, so Lord Owen invented one: Hubris Syndrome (HS). His book of that title, published last year, was really just one chapter of a six-year study of illness in heads of government, rushed out to coincide with Tony Blair's departure from No 10.

    In it, he argued that the mental health of Blair and President George Bush was undermined by HS. They'd stopped listening and were behaving recklessly, taking their instructions direct from the Almighty.

    An almost messianic fervour led to the biggest foreign policy blunder for a century: the invasion of Iraq."

    Here are two more links of interest:

    Articles on Lord Owen's own official website.

    Paper in journal Brain: Hubris syndrome: An acquired personality disorder? A study of US Presidents and UK Prime Ministers over the last 100 years

    Symptoms of this syndrome as described by Dr Owen are:

    The behavioural symptoms in a head of govemment which might trigger the diagnosis of hubris syndrome typically grow in strength and are represented by more than three or four symptoms from the following tentative list, before any such diagnosis could be contemplated :
    • a narcissistic propensity to see the world primarily as an arena in which they can exercise power and seek glory rather than as a place with problems that need approaching in a pragmatic and non self-referential manner ;
    • a predisposition to take actions which seem likely to cast them in a good light – i.e. in order to enhance their image;
    • a disproportionate concern with image and presentation;
    • a messianic manner of talking about what they are doing and a tendency to exaltation;
    • an identification of themselves with the state to the extent that they regard the outlook and interests of the two as identical;
    • a tendency to talk of themselves in the third person or using the royal 'we";
    • excessive confidence in their own judgement and contempt for the advice or criticism of others;
    • exaggerated self-belief, bordering on a sense of omnipotence, in what they personally can achieve:
    • a belief that rather than being acccuntable to the mundane court of colleagues or public opinion, the real court to which they answer is much greater : History or God;
    • an unshakeable belief that in that court they will be vindicated,
    • restlessness, recklessness and impulsiveness;
    • loss of contact with reality; often associated with progressive isolation;
    • a tendency to allow their 'broad vision', especially their conviction about the moral rectitude of a proposed course of action, to obviate the need to consider other aspects of it, such as its practicality, cost and the possibility of unwanted outcomes;
    • a consequent type of incompetence in carrying out a policy, which could be called hubristic incompetence . This is where things go wrong precisely because too much self-confidence has led the leader not to bother worrying about the nuts and bolts of a policy. It can be allied to an incurious nature. It is to be distinguished from ordinary incompetence, where the necessary detailed work on the complex issues involved completed but mistakes in decision-making are made nonetheless.

  5. Thank you Dr. Aziz for drawing our attention to the Hubris Syndrome (or Disorder).  It is a real fun to read parody of power and how it consumes the otherwise the best of the society. This is acknowledged by the authors. After enumerating the Presidents and Prime Ministers, they state – “hubris syndrome can affect anyone endowed with power, and examples have been quoted by others amongst business leaders (Schwartz, 1991; Maccoby, 2000) artists and religious gurus (Storr, 1997). The world has recently seen that in the financial collapse of 2008 some leading international bankers also displayed marked signs of hubris.”

    This article can be a source of wonderful classroom discussion as its critique touches upon the very definition of mental illness and ethics of labelling one with a diagnosis without 1:1 interview/evaluation. The syndrome has inherent statistical weakness of small afflicted numbers to be called a diagnostic entity.  Its symptom clustering is centered on Cluster B personality traits without falling into any identified personality disorder, though heavily weighted on Narcissistic Personality Disorder and some unique traits of its own. Still, it cannot be personality disorder because personality disorders are like an indelible stain in a cloth that emerge in early adulthood, whereas Hubris typically takes hold much later in life, unless the sufferer is put on a throne much earlier like a heir or an artist. Since the condition remits after the power is lost, then it is more of a temporary condition that is more close to an Adjustment Disorder with disturbance of conduct, but such a condition is more characteristics of juveniles. Since, Hubris fully manifests itself after coming to power, and it is the power that sustains it, then it closely parallels a stimulant drug use like cocaine and methamphetamine. But, the drug use itself can fall into a spectrum of abuse vs. dependence, where the latter needs ever increasing amount of drug due to development of tolerance (to power) and there is accompanying withdrawal, whereas in power intoxication there is no moment of withdrawal unless the point is reached when the ‘reign’ ends and there is a fall from the high pedestal. The syndrome has high comorbidity of other mental illnesses of depression, anxiety, bipolar and alcoholism. This is common to most mental disorders because there is no exact cut-off point for any disorder which are spread across a spectrum of such conditions with various intensities. Hubris like many mental illnesses runs in the families but it too suffers from the omnipresent debate of nature vs. nurture. Hubris uniquely lacks the luxury of twin studies because the heirs to the throne are known to kill all siblings or challenges. Even though the authors are more inclined to place Hubris in Axis I ( e.g. Schizophrenia, Bipolar, Depression, Anxiety, Substance use etc.) rather than Axis II (the personality disorders and mental retardation), but we know that former Axis is amenable to treatments (medications, therapies) whereas the latter is not. One relationship the authors missed upon was that of Hubris is more like a psychosis, where the sufferer tends to lose touch with reality and has poor insight into his condition even to seek help.

    The treatment suggested by the authors of term limits, oversight by board of directors or congress and other similar modalities are more of damage control rather than a treatment. For someone suffering from severe pathological Hubris, even a year in office or power, of running a country or terrorist organization, can be too devastating for the masses who can suffer the consequences of the decisions of such a Hubristic mind. Unless an illness is an identified source of danger to self or others or the person becomes gravely disabled because of it, the condition for which court allows forced treatment, how can one even consider treatment of such person who might be the one who is writing the law himself? Even more, who will bell the cat?

    The authors enumerate the top leadership of the Capitalistic and Communistic world of the last century as case studies to prove their point. Is it not a paradox that the ‘best’ of our times are fundamentally the worst?

    The solution for such a paradox was provided by the personal example of Prophet Muhammad and his companions Abu-Bakr, Umar, Uthman and Ali, besides many others. They shunned power and the pedestal, both literally and figuratively as both were a burden and an obligation for them. They did not ride the shoulders of others, but gave their shoulder to those they were entrusted with. The served rather than ruled. Still, the more power that converged on them, even more “Hubris-free” they became. There were no medals, victory parties, parades, autobiographies or trials of the vanquished under their reign. Why? But, that is a topic for another time.

  6. April 3rd, 2014 at 1:13 pm
    From Zahid Aziz:

    Isn't the following a case of one person suffering from the Hubris syndrome, who argues with another who is not, as quoted in the Holy Quran?

    18:32           And set forth to them the parable of two men — for one of them We made two gardens of grape-vines, and We surrounded them with date-palms, and between them We made corn-fields.

    18:33           Both these gardens yielded their fruits, and did not fail in this at all, and We caused a river to gush forth in their midst,

    18:34           and he had fruit. So he said to his companion, while arguing with him: I have more wealth than you, and am greater in followers.

    18:35           And he went into his garden, while he was unjust to himself. He said: I do not think that this will ever perish,

    18:36           and I do not think the Hour will come; and even if I am returned to my Lord, I will certainly find a better place of return than this.

    18:37           His companion said to him, while arguing with him: Do you disbelieve in Him Who created you of dust, then of a small life-germ, then He made you a perfect man?

    18:38           But as for me, He, Allah, is my Lord, and I set up none as partner with my Lord.

    18:39           And why did you not say, when you entered your garden: It is as Allah has pleased — there is no power except in Allah? If you consider me as less than you in wealth and children —

    18:40           then maybe my Lord will give me better than your garden, and will send on (yours) a reckoning from heaven so that it is dust without plant,

    18:41           or its water will sink down into the ground, so that you are unable to find it.

    18:42           And his fruit was destroyed; so he began to wring his hands for what he had spent on it, as it lay waste, its roofs fallen down, and he said: Ah me! I wish I had not set up any partner with my Lord!

    18:43           And he had no forces to help him against Allah, nor could he defend himself.

    18:44           Thus protection is only Allah’s, the True One. He is best to (give) reward and best for (determining) the final end. 


    Compare, for example, the description in 18:36 "and I do not think the Hour will come; and even if I am returned to my Lord, I will certainly find a better place of return than this", with two of the symptoms given above:

    • a belief that rather than being acccuntable to the mundane court of colleagues or public opinion, the real court to which they answer is much greater : History or God;

    • an unshakeable belief that in that court they will be vindicated,

  7. Dear Dr. Aziz: To diagnose a disorder in psychiatry it has to meet certain criteria. For example, a personality disorder is identified by certain component traits. The following is the ‘DSM-IV TR’ criteria for Narcissistic Personality Disorder with its nine traits:

    A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

    (1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

    (2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

    (3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

    (4) requires excessive admiration

    (5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

    (6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

    (7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

    (8) is often envious of others or believes that others are envious of him or her

    (9) shows arrogant, haughty behaviors or attitudes

    Any given disorder is usually a cluster of symptoms and the disorder or syndrome itself can be diagnosed with a statistical certainty when minimal criteria are met as identified in the superset of symptoms. In case of Hubris Syndrome (assuming that there is one such) there are 14 traits (as listed above by Dr. Aziz), Owens lays down the following rules:

    The behavioural symptoms in a head of govemment which might trigger the diagnosis of hubris syndrome typically grow in strength and are represented by more than three or four symptoms from the following tentative list, before any such diagnosis could be contemplated.

    What the verse 18:36 is pointing to are only two of the traits of Hubris syndrome. It does not meet the criteria of three or four symptoms/traits laid down by Owen for Hubris syndrome.

    It is not too uncommon for ‘normal’ people to have some traits of a disorder. If one peruses the traits of Narcissistic Personality Disorder or Hubris syndrome, it will not be out of place to relate to one or more traits in oneself or other people in one’s life, but it does not mean that a person has that disorder or that it needs treatment.

    For any condition in Psychiatry, irrespective of its label, it must cross a certain threshold before it may be considered worthy for a treatment. The threshold (as defined by me) for any condition for a treatment is that it must create some Distress, Dysfunction, Disorganization, Drug-use, Disability, Danger-to-self or Danger-to-others for the patient, else it is just one more situation in life, and life is never perfect for mortals. Simply put, no ‘Ds’, no treatment.

  8. Frequently, while discussing psychology, certain terms such as ‘disorder’ and ‘syndrome’ are loosely used and their meanings are stretched far from their actual definition:

    Disorder – 1: to disturb the order of. 2:  to disturb the regular or normal functions of (Merriam-Webster)

    Syndrome – 1: a group of signs and symptoms that occur together and characterize a particular abnormality or condition. 2: a set of concurrent things (as emotions or actions) that usually form an identifiable pattern (Merriam-Webster)

    Phenomenon – something (such as an interesting fact or event) that can be observed and studied and that typically is unusual or difficult to understand or explain fully (Merriam-Webster)

    The use of the word “syndrome” is at times misapplied to something that is more appropriately a “phenomenon”. A case in point is the following article that appeared in a Pakistani newspaper under the title – “The Overnight Mullah Syndrome” (link)

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