Spiritual care in Islam (English)

Theology of the heart and spiritual care – reflections from an Islamic perspective
by Naveed Baig, hospital chaplain and project coordinator, Ethnic Resource Team, IKS

 

Islamic theology is the knowledge of God’s revelation and its relation to the world.[1] The Latin word theologia translates to ‘discourse of God.’ One definition states ‘the study of religious faith, practice and experience…’[2] Islamic theology is based on divine religious books or sources, namely the Qur’an and the Prophetic traditions.’ Apart from that the contribution of the early generations of Muslims up till today’s scholars has also had an important impact in forming Islamic theology. Since all Islamic fields are directly connected to God’s guidance to humanity, it can be said that all aspects of Islam have a theological status.

 

The sciences of kalâm, (discourse), tibb, (medicine), falsafa, (philosophy), tasawwuf, (mysticism/spirituality) and in addition, the discourses on and evolution of fiqh (jurisprudence) all certify that numerous theological developments and expansions even within these sciences have occurred in Islamic learning throughout history. The theology of spiritual care is in spirit already incorporated in the purpose of God’s revelation which is inherent in the Islamic fields of akhlâq (morals and character), tasawwuf (Islamic spirituality) etc. which are extracted from the Sunnah (practice and teachings) of the Prophet of Islam. This field of spiritual care (in the encounter between Muslims and modern western societies) though, has not been developed systematically to accommodate the ever-growing needs of Muslims that interact with hospitals, hospices, old age homes, women crisis centres and other social institutions and services etc.

 

A theology of Muslim counselling
The objective of this article is to provide a simplified and systematic understanding of this form of theology which can assist health-care, social, religious leaders and laymen alike in their daily care of people in need. After giving a general overview on the rationale of human existence on earth, the paper will focus on the ‘spiritual heart’ or qalb of human beings, its function and role in spiritual care for the ‘other’. Some important aspects of spiritual care in Islam have been examined and lastly a short introduction of a spiritual care and counselling project in the Copenhagen area is given.

 

According to the Muslim theologian Imam Raghib there are three purposes of life on earth:

 

1. To inhabit the earth, ‘to be’ (Q: wa istamarakum fiha).
   
2. To worship. ‘I have only created the invisible beings (jinn) and the human beings so that they may (know and) worship Me.’ (Q 51:56-58). Here worship is flexible and a rich term as Al-Ghazali points out in one of his many masterly works: The purpose of creation is to worship God and through this to attain ‘ma’rifah’ or the realization of God’ (Kimiya-I-Sa’adat).
   
3. To represent God on earth. When the realization is perfected through devotional and sincere worship, then can one truly be legible to the title of khalifat-ul ard or God’s representative on earth. (Q 2:30).
   

 

The habitation of earth by human beings is not coincidental. The Qur’an indicates that man has a special position and role in the universe. Man is different in the universal scheme of things primarily because he has been created to be different. While speaking about the inner mental elements of man, the Qur’an uses a number of words like rûh (spirit), nafs (self), qalb (heart), ‘aql (intellect) which have different meanings and functions but are related to each other as they form the inner nature of man.

 

Behold! Thy Lord said to the angels: I am about to create man, from sounding clay, from mud moulded into shape; When I have fashioned him (in due proportion) and breathed into him of my spirit, fall you down in obeisance unto him. (Q 15:28-29).

 

The essence of the inner nature is described here. God’s breathing from His own spirit (rûh) and His fashioning implies God’s own personal interest and omnipotent will in the shaping and making of man. Zafar Haq Ansari, a professor researching in Islamic psychology explains that ‘while the ruh (spirit) seems to refer to the special spiritual and divine elements in man, the qalb (heart) is presumable the operating agency of psyche which transforms the spiritual potentiality into actuality.’[3]

 

The spiritual heart
‘Blessed are the pure in heart, for they shall see God.’ [4]

 

The heart (al-qalb) has a variety of meanings. These include fluctuation, turning around or reversing. Al-Ghazali points out in his magnum opus that the heart ‘denotes two things, the physical heart and the ‘divine entity.’ (Ihy⒠‘Ulûm ud-Dîn). He mentions that the ‘spiritual’ qalb is the essence of man. It is incumbent that this ‘divine entity’ or the potential seat of God’s illuminations and serenity is kept sound and healthy for the physical body to operate optimally. As the Prophet of Islam explained ‘Surely in the breasts of humanity is a lump of flesh, if sound then the whole body is sound, and if corrupt then the whole body is corrupt. Is it not the heart?’ This underlines the fact that the heart can become unhealthy with various ‘diseases’ like lust, anger, jealousy, hate, etc..[5] But these maladies cannot be rooted out only by mantra reading or other superficial formulae.

 

The term ‘tazkiyah’ (purification) goes deeper than that. It’s a disciplined process that takes its seed with a revolutionizing strike that lays its foundation in the heart at first. This enlightenment, a moment of unique divine intervention or the first ray of divine light that expands the heart is the beginning of a personal transformation. ‘Have We not expanded thee thy breast? (Q 94:1). Then when the seed is laid, the nourishment and protection of that divine light can start. The different states of the hearts mentioned in the Quran exceed 120 in number. Therefore the importance of the heart, its various states and wellbeing along with the purification voyage should not be underestimated.

 

It is He who sent down tranquillity into the hearts of the faithful, so that they might add faith to their faith. (Q 48:4)

 

One way towards adding faith to one’s faith is ‘dhikr’ (remembrance) of God’s beautiful names (asm⒠al- husnâ). ‘And Allah’s are the most beautiful names, so call on Him thereby…’ (Q 7:180)

 

This remembrance is both outward (with the tongue) and inward (with the heart) and the goal is for remembrance to become permanent state (Q 3:190). Shaykh Abdul Qadir Jilani[6] mentions in ‘Sirr ul-Asrâr’:

 

‘The way to free the heart, to purify it, is to remember God. At the beginning this remembrance can only be done outwardly, by repeating His divine names, pronouncing them aloud so that you yourself and others can hear and remember. As the memory of Him becomes constant, remembrance sinks to the heart and becomes inward, silent. Allah says:
 
Believers are those, when Allah is mentioned, feel a tremor in their hearts, and when they (see and) hear his manifestations their faith is strengthened.’ (Q 8:2)

 

Tremor here signifies awe, fear and love of God, according to Jilani. In the same treatise he concludes that when one reaches inner purity, as a result, he/she is beautified with the best of character, morals and manners. One is simply clothed with the divine attributes. It should be noted that the divine ‘essence’ is something totally different and should not be confused with the attributes. This is however not the subject matter of this paper.

 

God’s attributes
The study of God’s attributes (sifât) as expounded in the asm⒠ul-husnâ (beautiful names of God) is essential,[7] but how can these attributes assist the human being in his/her daily life? The answer to this question (which will follow) would lead us to approach a practical theology of God’s attributes.

 

Qualities such as the Patient (as-Sabûr), the Giver of serenity (as-Salâm), the Protector (al-Muhaymin), the Protecting Friend (al-Walî), the Pardoner (al-‘Afu), the Clement (al-Halîm), the Merciful (ar-Rahmân), the Subtle (al-Latîf), the All-embracing (al-Wâsi’), the All-responsive (al-Mujîb), the One Who expands (al-Basit), the Loving (al-Wadûd) to mention a few, indicate how significant these immeasurable attributes are and what potential the human has to offer humanity. It should be mentioned that only God has the ‘patent’ to these names in absolute terms. Humans can contemplate upon and enrobe these qualities but cannot ‘own’ them in their entirety. The qualities are already implanted in the human ‘fitrah’ or nature as it is often translated. But these qualities have to be explored, discovered, identified and polished in the self (nafs). The Qur’an directs man to do exactly that.

 

By the nafs,
And the proportion and order
Given to it,
And its inspiration
As to its wrong and its right;
Truly he succeeds
That purifies it,
And he fails
That corrupts it.
(Q 91:7-10)

 

It is God’s attributes that are implanted in the self but they have to be ‘known.’ A good example of this discovering and reflection is the example of Adam who is given knowledge of all the names. (Q 2:30). But to comprehend these at a higher intensity he had to repent, redress and reflect over his actions after the fall. So the human being through the example of Adam is encouraged to ponder over and actively come to terms with the inner tribulations in order to learn valuable and untold information about the self.

 

Returning to the world and serving creation
F.C. Happold in his very descriptive work called ‘Mysticism’[8] narrates the idea of containing reality and at the same time seeing the world with renewed vision:

 

‘This process of self-emergence in the world is, however, different from that of the typical nature mystic. For the Sufi aspirant was taught that, in order to be able to see the world as it really is, the senses must be purified; the would be mystic must free himself from egocentric judgement, his organs of perception must become clear and unclouded, this I-hood must be surrendered, his affections and will must be subjugated. Then, and only then can his heart become the measure of divinity; then and only then can the rhythm of his inner life be in tune with the universal life, with spirit, with self, with the love…Because the mystic has become merged in God,[9]  he is able to see the world as it is. That is as God sees it.’

 

Also one of the Prophetic prayers in Arabic was ‘allahumma arina ashya kama hiya’ (Oh God, show us things as they really are!)

 

Therefore the seeker must plunge and function with the world in order to understand what the reality of the world really is. The Quranic message, which was embodied in the Prophet’s lifestyle, suggests the same. So what happened was a shift from a personal mystical contemplation to an active social ethical code in case of the Prophet. (Though the mystical tradition was never completely abandoned, the centre of attention was shifted.) The cave of Hira[10] where the Prophet Muhammad spent much time in seclusion and deep contemplation was abandoned when the time to spread the message was in (Q 74:2). The purpose of almsgiving, rights of neighbours, bringing up children, visiting the sick, feeding the hungry, helping the oppressed all point towards the vast responsibility that God laid on people from the Islamic faith. The care and regard of humanity is a vital and praiseworthy act. The Prophet of Islam mentioned ‘All creatures of God form the family of God, the best of you are those who are most beneficial to humanity.’ At another place he drew the analogy of the caring shepherd also told in the Bible:

 

‘Mankind is a fold, every member of which shall be a shepherd unto every other, and shall be accountable for the welfare of the entire fold.’[11]

 

Hence the concept of theological humanitarianism and the unity of man cannot be ignored in Islamic teachings. Also providing care to other creatures than the humankind, including the mineral and plant worlds including nature in general, is a recommended duty for Muslims. The Prophet relates a pre-Islamic story from the tribe of Israel, where a prostitute who tied her shoe to her scarf and fetched water from a well to give to a thirsty dog was forgiven by God.[12] The companions of the Prophet were amazed in hearing the amount of reward given for caring for animals. This story does have many dimensions to it, but the fact that the Prophet narrated this particular story is interesting. It obviously had a huge psychological and spiritual impact on the listeners and their world view. Maybe a few prejudices were expunged and totally wiped away.

 

Many of these responsibilities have been categorized under the science of higher ethics and character or referred to as ‘ilm ul-akhlâq in Arabic. Akhlâq includes manners, morals, behaviour and the rich Arabic term adab often translated as courtesy but also meaning ‘knowing, doing and being’[13] beautifully. ‘Do what is beautiful, as God has done what is beautiful to you.’ (Q 28:77). It is in reality the broad science of ‘ilm ul-akhlâq that deals with the theology of the heart and the concept of social ethics.

 

Some aspects of spiritual care
‘Iyâdah (visiting the sick) is the practice, rifq (exemplary kindness/care) is the approach, and ihsân (doing what is beautiful) is the optimal state in which spiritual care should be offered. The Prophetic words ‘Doing what is beautiful (ihsân) means that you should worship God as you see Him, for even if you do not see Him, He sees you,’ points towards the state of vigilance and self-awareness also known as ‘murâqabah’ that is essential in spiritual care work.

 

The Arabic ‘iyâdah comes from the root that means ‘to return’. People return to visit the sick unless of course it becomes a burden on the patient. ‘The most rewarding visitation of the sick is the one that is appropriately brief,’ the Prophet is quoted to have said.[14] Rewarding because it takes into account the condition and state of the patient. This suggests that meeting the patient where the patient is, is vital. The visitation of the sick is according to some Muslim scholars a social obligation. The visitation in itself is purification for the visitor. It can erase one’s misdeeds and transgressions. That’s why many visitors will ask the patient to pray for them, since there is a lot of effect in the prayers of patients according to hadith literature. God is also near to those who suffer and are confronted with pain and anguish. Sickness and pain should not be understood as the wrath of God, (as some suggest) rather God states that these afflictions are to test and try humans. 

 

God is with those who patiently persevere (Q 2:153)

 

The concepts of patience (sabr), pre-destination/free will (qadr/qadha), thanksgiving (shukr), steadfastness, (istiqâmah) hope (ra’ja) are central in understanding the relationship that Muslims have to death, disease and bereavement. Death is not the end of life as such, but death is the transition from one state of existence to another. Therefore death is not a taboo related issue for many Muslims.

 

Institutions for spiritual care – before and today
In early times, already by the start of the 7^th Century, under the reign of Ummayad Caliph Al-Walid I the first hospice, possibly a leprosarium was founded.[15] Rifq developed also through the efforts of the Sufis. Right from the Prophet’s time, the Sufis have played a major role in especially practising and expanding the concept of rifq. Through the establishment of zâwîya, rabât, khanqahs, and tekkes (all mean spiritual hospices in various languages) where both spiritual training and caring for the poor and sick was combined, the true implementation of rifq was accomplished. A paragraph from a biography on Sayyid Ali Hamadani explains very well the concept and function of the spiritual hospices.

 

Here they found a social order entirely different from their own. All lived, slept and ate together. The sacred book was open and accessible to all demonstrating the Islamic idea of ‘Tauhid’ as a working principle in social life, the medieval khanqah’s of the Musulmans in the subcontinent, conciliation and concord between the various culture groups was not only a moral and intellectual demand but an urgent social necessity. The Muslim mystic contributed much to liquidate social, ideological and linguistic barriers between the culture groups of the subcontinent and helped in the development of a common cultural outlook’[16]

 

Other functions of these hospices and convents included poor-feeding and support of the maltreated, the orphans and captives who were fed in love of God. Moreover some hospices served as refuge for divorced women, where they were provided with maintenance till they were remarried.[17]

 

Even during the Prophet’s own time a group of poor and needy companions, known as ashâb al-suffa (companions of the bench), lived, worshipped, and looked after each other. This bench was very close to the Prophet’s own simple dwelling.

 

An example of today’s spiritual care and counselling from Denmark is the establishment of the Ethnic Resource Team (ERT) which caters for the need of ethnic minorities, mostly Muslims in their meeting with the health sector. The ERT is a theological novelty in many ways since its formal and systematized approach in the midst of individualization in the West is unique. ERT has more of a visiting and counselling aspect, a therapeutic dimension which tries to assist the growing need of ethnic minorities in crisis and affliction through considerate counselling and creating networks for them. It also strives to facilitate and make smooth the encounter between patients/relatives and the healthcare/social systems, through its bridge-building initiatives and ethical guidelines. This can be done because ERT has a variety of workers (all of them volunteers) from different lingual, cultural, religious, ethnic and professional backgrounds who have an in-depth understanding of both ‘worlds’ (ERT members have also been through extensive specialized training courses). ERT also provides the tools of understanding this form of care to health/social sector personnel through courses, workshops, seminars and offering counselling help. This type of knowledge and the ethical reflections can help create a sector where both patient and healthcare/social staff can feel accepted, respected and can hopefully increase the quality of life for all.

 

The essence of spiritual care has and always will be the same, albeit the forms and structures may very well vary. The finest form of theology is that which critically recovers the theology from the past and constructively develops theology for today’s challenges and needs.

 
 

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[1] This paper was given at a compact course at the Dept. of Systematic Theology, Copenhagen University, January 2007.

[2] Merriam Webster Online Dictionary.

[3] Ansari, Afaq Zafar ’Quranic Concepts of the Psyche’ (editor), Islamic Research Institute Press, 1992.

[4] These were the words of Jesus in his Sermon on the Mount according to the Gospel of Matthew 5,8. Yusuf, Hamza is referring to this sentence in his book, ’Purification of the Heart’ (translation), Starlatch Press, 2004.

[5] Numerous books throughout history have been written on these
topics – Risalah Qushayria, Kitab al Futuwwah, Kitab at-Ta’arruf, al-Wabil al-Sayyib, Kashf al-Mahjub etc.

[6] Founder of Qadariyyah Sufi order, one of the major Sufi brotherhoods today. His small treatise ‘Sirr ul-Asrâr’ or ‘secret of secrets’, reveals briefly the essence of Islamic spirituality showing how the outer dimensions contain a wealth of inner realms, that if discovered enable humans’ access to the highest of realms, the divine abode of the Almighty. He died in 1166 in Baghdad.

[7] Imam Fakhruddin Razi (d.1209) and Imam Muhammad al-Ghazali (d.1111) both hold this view.

[8] Happold, F.C., ’Mysticism, A study and an Anthology’, Penguin Books, 1963.

[9] This does not signify divine incarnation but an intense state of awareness of God and God’s actions in relation to creation. One can then see everything as acts of God. There is no otherness and the recognition of reality behind everything becomes evident. That’s why the seeker sees goodness in all things, even difficulties, trials and tribulations as they can give insight and wisdom. Imam al-Mawlud points out in his ‘Purification of the Heart’ that this wisdom ‘gives an opportunity to grow, purify oneself, learn patience and draw near to God. ‘It may be that you dislike something, though it is good for you. And it may be that you love something, though it is bad for you’ (Q 2:216).

[10] It was also here where the first revelation from God through the archangel Gabriel was revealed to Prophet Muhammad. The cave is situated in the outskirts of Mecca.

[11] Qutbi, Ali Muhammad ’Fragrance of Sufism’, Royal Book Company, 1993.

[12] From the famed Hadith collections of Bukhari and Muslim.

[13] Barbara, Metcalf ’Moral Conduct and Authority – The Place of Adab in South Asian Islam’, University of California Press, 1984.

[14] Related by Imam Abu Shuja Ad-Daylami. D. 1115.

[15] Smith, E. Savage ’Islamic Culture and the Medical Arts’, US National Library of Medicine, 1994.

[16] Hamadani, Agha Hussain ’The Life and Works of Sayyid Ali Hamadani’, National Institute of Historical and Cultural Research, Islamabad, 1984. Sayyid Ali Hamadani d. 1385 was a Kashmiri Sufi and philosopher who gave religion a social dimension through the establishment of hospices in Kashmir and Central Asia.

[17] Schimmel, Annemarie ’Mystical Dimensions of Islam’, Vanguard Books, Pakistan, 1988.