Dr Shabnam Berry-Khan, clinical psychologist, Advanced BABICM case manager and founding director of PsychWorks Associates discusses Ramadan and how, with realistic goals and respect, clients can express themselves authentically, families become whole and share experiences, and professionals to demonstrate their compassion, safe inclusive practices and, ultimately, their care
“There’s a transformation that happens in the person when [a physical, social, nutritional and ideally spiritual] shift takes place. It might be that something about the nighttime and switching these rhythms makes us understand the world in a different way” (Imam Mustafa Umer, director of California Islamic University)
Understanding the world is key to feeling comfortable and safe in the lives we live. And something, as helping professionals, we strive heavily to achieve on behalf of our clients and their families.
Thinking of holistic models of health, like the Biopsychosocial model, we consider physical rehabilitation, with physical therapies, medical interventions, personal care support, and equipment. We seek emotional support by building a strong therapeutic alliance, listening, expressing compassion and offering psychotherapy, when required. We encourage social interactions with friends and family, community outings and holidays.
But, we rarely or perhaps trepidatiously, talk so easily about faith, religious practices and cultural needs. Perhaps this is a British thing – perhaps it’s more widespread globally. Who knows!
As someone with a faith, I find this lacking quite strange, but mostly unfortunate. Regardless of the level of spirituality that one has, it is often a big part of a ‘faithful’ person’s life, presenting itself on a monthly, weekly or even daily basis and therefore needing integration into any support package in order for a client or family to feel whole or fully understood.
I have written previously about how to work with clients and their families during Ramadan, but this article is taking a more Eurocentric approach, unpicking practices within Ramadan from an evidence-based perspective since it is one of the biggest occurrences in the Islamic calendar and one that, in my opinion, can get some flack when bringing its practices in the personal injury client arena.
Dr Shabnam Berry-Khan, director of Psychworks Associates
But, first a little remind about what Ramadan is about as its significance can help us understand the weight behind a Muslim’s conviction and expressions when talking about it:
The ninth month of the Islamic calendar is considered to be the month in which the Quran, the Islamic Holy book, was revealed to the Prophet Mohammed (PBUH). It is believed that in this month, good deeds carry more weight, prayers are more likely to be answered, and bad habits must be stopped. Fasting is observed from sunrise to sunset, charitable deeds are taken up, prayers increase and family is prioritised. Ramadan begins when the new moon is sighted and ends similarly. Typically, Ramadan lasts 29 or 30 days.
So now we have established what Ramadan is about, here is that science I promised you:
- Religion plays a big part in mental wellbeing
While there are masses of intersectionality in the relationship between religion and mental wellbeing, there is still a lot of research linking positive wellbeing with having a faith. Whether this is because there is a ritualistic framework to guide one in an otherwise confusing world (Raday, 2003) or the social element wards of loneliness and promotes belonging (Malone & Dadswell, 2018) or because believing in a bigger purpose encourages positive coping strategies which is linked to wellbeing (Wortmann, 2013), it can be very significant if it not supported within a package of care and therapy.
- Belonging within a wider faith community is key to emotional stability
Belonging has been identified as a key factor in emotional stability. Rogers (1951) defined belonging as a unique and subjective experience that relates to a yearning for connection with others, the need for positive regard and the desire for interpersonal connection. George, Ellison and Larson (2002) found that belonging to be one of many mediating factors in subjective well-being. In other words, the value of religion and the social aspects of religious practices is not for us as professionals to assume or judge, consciously or unconsciously. It is for us to explore and encourage safely.
- Routine changes for a quieter schedule is likened to the benefits of mindfulness
There is therapeutic value in practising Ramadan. Ramadan reminds us to be more self-aware, conscious and non-judgemental – mindful, if you will – in daily activities on a daily basis, year-long. And we know mindfulness improves mental health, including difficulties like trauma, stress, depression and anxiety. Preventative approaches to mental health needs of personal injury clients is vital within integrated underpinnings of the support we provide so we can achieve those rehabilitation goals and maximise outcomes.
- Breaking unhealthy routines
We tend to stick to things we know because, simply put, our brains tell us via a surge of dopamine that ‘it feels right’. Change can be registered by the brain as threatening because the dopamine hit is less strong and therefore the mind and body register change or difference as ‘not quite right’. Bad habits and even addictions (in the soft and hard sense of the word) is conceptualised as the brain being efficient and finding the easier, maximised route to send messages around the body. By introducing change and developing a dopamine hit related to another behaviour – like during Ramadan – it can be protective for the brain and provide an excuse for an alternative, perhaps healthier, way to live life.
- Focusing on pacing and gratitude rather than achievement and loss
When the ‘deficit model’ is applied to Ramadan, it can be hard to see what is gained from what can appear to be extreme behaviours of not eating or drinking. Sometimes, a reframe is needed more by those outside of the faith than those within it. Sometimes, those within the faith also need reminding as Ramadan is not easy and motivation can wax and wane. Using rehabilitation and therapeutic underpinnings, it helps Muslims observing Ramadan to be communicated with using a strengths-based or positive psychology approach rather than with loss, changes or challenges at the core of the message. In the same way we support clients by pacing according to a ‘what can be done in the circumstances’ attitude, inclusive support adapts the pace during Ramadan. Exploring what a client has gained from their daily activities can also strengthen motivation and gratitude during a period of time that is about duty and experiencing hardship.
- Charitable acts, donations and the neuroscience of gift giving
Muslims are one of the largest charity donating cohorts in the world especially during Ramadan. Neurologically-speaking, humans are hardwired to help and to give, with the altruism centre part of the brain situated in the primitive brain – you only have to see reactions to a child in trouble to understand how instinctive a response it is. Donating is a powerful way for our brains to make us feel joy via the release of dopamine, serotonin and oxytocin. For Muslims, there is also the added belief that donating is one of the 5 obligatory pillars of the faith and that by doing good deeds, charitable work and donating to charity, you are following Allah’s (SWT) to live with humility, compassion and love. It is a simple act of humanity which the Quran holds in great esteem. Donating during Ramadan then becomes 2 of your 5 obligations achieved! Understanding the obligation of charity and planning in such financial duties for personal injury clients is core to providing Muslim clients and their families inclusive support that aligns with values made more significant with faith.
In summary, neuroscience says Ramadan is not all bad and, if done with positive intention, with realistic goals and respect, can be a necessary way for clients to express themselves authentically, families to become whole and share experiences, and professionals to demonstrate their compassion, safe inclusive practices and ultimately, their care.
Ramadan starts on or around 22 March 2023. Eid is likely to be on or around 21 April.
For case management and treating psychology support for seriously and catastrophically injured clients and families with a focus on EDI values, please contact us on www.psychworks.org.uk or admin@psychworks.org.uk – we would be happy to support you and your clients!
References:
-Raday (2003) “Culture, Religion, and Gender.” International Journal of Constitutional Law 1 (4): 663–715. doi: 10.1093/icon/1.4.663
-Malone and Dadswell (2018) The Role of Religion, Spirituality and/or Belief in Positive Ageing for Older Adults – PubMed (nih.gov)
-Wortmann (2013) The Role of Religion, Spirituality and/or Belief in Positive Ageing for Older Adults – PubMed (nih.gov)
-Rogers (1951) Client-centered therapy. Boston: Houghton Mifflin.
-George, Ellison and Larson (2002) Explaining the relationships between religious involvement and health. (apa.org)
