I. Medieval Islamic Psychology
Advances during the Medieval Period
- Establishment of first mental hospitals: The first psychiatric hospitals were built in the medieval Islamic world from the 8th century.
- Development of clinical approach to mental illness: Medieval Muslim physicians relied mostly on clinical observations.
- Development of experimental approach to study the mind
- The ninth to the twelfth centuries is the period of rigorous philosophizing that characterizes classical Islamic philosophy
- They made significant advances to psychiatry and were the first to provide psychotherapy and moral treatment for mentally ill patients, in addition to other forms of treatment such as baths, drug medication, music therapy and occupational therapy.
- In the 11th century, İbn-i Sina recognized 'physiological psychology' in the treatment of illnesses involving emotions.
- He first described hallucination, insomnia, mania, nightmare, melancholia, dementia, epilepsy, paralysis, stroke, vertigo and tremor.
- refers to the study of the Nafs (meaning "self" or "psyche" in Arabic)[3] in the Islamic world, particularly during the Islamic Golden Age (8th–15th centuries) as well as modern times (20th–21st centuries), and is related to psychology, psychiatry and the neurosciences.
· Nafs (self or soul) - was used to denote individual personality and the term fitrah for human nature.
· Nafs encompasses a broad range of topics including the qalb (heart), the ruh (spirit), the aql (intellect) and irada (will).
· al-‘ilaj al-nafs - in medieval Islamic medicine in particular, the study of "mental illness was a speciality of its own",[9] and was variously known as "diseases of the mind,“
· al-tibb al-ruhani - "psychotherapy"),[10] ("the healing of the spirit," or "spiritual health") and tibb al-qalb ("healing of the heart/self," or "mental medicine").[3]
• The main factor which distinguishes Islâmic Psychology from secular or modern Psychology is its source. Islâmic Psychology is based on Divine Revelation, not human speculation.
• The two primary sources of”Islâm:
1. Qur’ân (also spelled: Koran) - direct Words of God revealed to Prophet Muhammad (salutations and peace be upon him) via the archangel Gabrie
2. Hadeeth (or Sunnah) - is the explanation of the Qur’ân, theoretical as well practical. It is also considered a source in its own right, which was also brought by Angel Gabriel but spoken in the words of the Prophet .
III. Early Beliefs on Mental Illness (Ethics and Theology)
- It was believed before in most ancient and medieval societies (Judeo-Christian and Greco-Roman societies) that mental illness was caused by “demonic possession or punishment from God”, this was a negative attitude towards mental illness
- Islamic ethics and theological views on Mental Illness: was based and exemplified in Sura 4:5 of the Qur'an:[6]
-
- "Do not give your property which God assigned you to manage to the insane: but feed and cloth the insane with this property and tell splendid words to him."[11]
- * this summarize the Islamic attitude towards the mentally ill, that they should be treated humanely and they should have guardian who will look after them.
- This positive neuroethical understanding of mental health consequently led to the establishment of the first mental hospitals in the medieval Islamic world from the 8th century,[4] and an early scientific understanding of neuroscience and psychology by medieval Muslim physicians and psychological thinkers, who discovered that mental disorders are caused by dysfunctions in the brain.[12
IV. Ibn Sbina (Avicenna, 980-1037 AD): His contributions to the Medieval Islamic Psychology and Philosophy
· Born Afshana near Bukhara, now in Uzbekistan (then Persia), and died in Hamadan, Persia (Iran).
· A child prodigy
a. Knew the Koran by heart at age 7
b. Also vast tracts of Persian Poetry
· Ibn Sina's two most important works (out of 450) are The Book of Healing and The Canon of Medicine.
a. The first is a scientific encyclopaedia covering logic, natural sciences, psychology, geometry, astronomy, arithmetic and music.
b. The second is the most famous single book in the history of medicine
Philosophical Approach
A. Philosophy of the mind (Dreams and Intellect) and Consciousness Studies
Avicenna (Ibn Sina) (980-1037),
- He referred to the living human intelligence, particularly the active intellect, which he believed to be the hypostasis by which God communicates truth to the human mind and imparts order and intelligibility to nature
- Avicenna attributes self-consciousness to the soul, an ego that has self-awareness and is not to be identified unilaterally with the rational faculty (Rahman 1952, 66). Depending primarily on the amount of knowledge it accumulated, but also on the life the person lived, with its virtues or vices, the immortal soul experiences continuous pleasure or pain.[25]
- while he was imprisoned in the castle of Fardajan near Hamadhan, wrote his famous "Floating Man" thought experiment to demonstrate human self-awareness and self-consciousness and the substantiality of the soul.
- The deviation from the hylomorphic ontology of Aristotle is apparent in the famous thought experiment that Avicenna devises, conceiving of a person suspended in air in total isolation from any physical or sensory experience.[27] The purport of this experiment is to show the ability of a person to deduce the soul's existence intellectually, without assistance from the sensory or imaginative, material faculties of the soul. For Avicenna this proves that the soul is an independent intelligent substance, both prior to involvement with the world, and afterwards, when the corporeal organs that service the soul perish
- He thus concludes that the idea of the self is not logically dependent on any physical thing, and that the soul should not be seen in relative terms, but as a primary given, a substance.[16]
- Avicenna also wrote about the potential intellect (within man) and active intellect (outside man) and that cognition cannot be produced mechanically but involves intuition at every stage. As an analogy, he compares the ordinary human mind to a mirror upon which a succession of ideas reflects from the active intellect. He writes that a mirror can be rusty at first (i.e. before acquiring knowledge from the active intellect), but when the mirror is polished (i.e. when one thinks), the mirror can then readily reflect light from the Sun (i.e. the active intellect).[17]
- Dreams are consisted of 3 parts according to certain hadeeths
- Early Muslin scholars also recognized 3 different kinds of dreams: false dreams, pathogenic dreams, and true dreams[10]
B. Empiricism, tabula rasa, nature versus nurture
- Theory of Knowledge - one of Avicenna's most influential theories in psychology and epistemology , in which he developed the concept of tabula rasa, a precursor to the nature versus nurture debate in modern psychology.
- He argued that the "human intellect at birth is rather like a tabula rasa, a pure potentiality that is actualized through education and comes to know" and that knowledge is attained through "empirical familiarity with objects in this world from which one abstracts universal concepts" which are developed through a "syllogistic method of reasoning; observations lead to propositional statements, which when compounded, lead to further abstract concepts."
- He further argued that the intellect itself "possesses levels of development from the material intellect (al-‘aql al-hayulani), that potentiality that can acquire knowledge to the active intellect (al-‘aql al-fa‘il), the state of the human intellect at conjunction with the perfect source of knowledge."[19]
-
- In the 12th century, the Andalusian-Arabian philosopher and novelist Ibn Tufail (known as "Abubacer" or "Ebn Tophail" in the West) first demonstrated Avicenna's theory of tabula rasa as a thought experiment in his Arabic novel, Hayy ibn Yaqzan, in which he depicted the development of the mind of a feral child "from a tabula rasa to that of an adult, in complete isolation from society" on a desert island. The Latin translation of his work, entitled Philosophus Autodidactus, published by Edward Pococke the Younger in 1671, had an influence on John Locke's formulation of tabula rasa in An Essay Concerning Human Understanding,[20] which went on to become one of the principal sources of empiricism in modern Western philosophy, and influenced many Enlightenment philosophers, such as David Hume and George Berkeley.
- Avicenna recognized, with Aristotle, a faculty of intuition (hads) that is the key step in obtaining certain knowledge.
- This is the ability a person has to discern suddenly the middle term of a putative syllogism, the proposition that anchors a particular argument.[33] Avicenna recognizes that occasionally brilliant individuals exist whose intuitive sense is so innately strong that they can do without much prior experience, empirically or rationally.
- In extreme and rare cases, there are individuals, like the prophets, with a developed intuitive acumen, dhakâ’ (Aristotle's anchinoia), that enables them to know instantly the entire subject matter of a given science. While not part of his normative epistemology, Avicenna attempts to accommodate this phenomenon scientifically, seeing it not as an innate power of an internal sense, but as an expression, however rare, of the emanative powers of the Agent Intellect.
C. Sensory Perception
- Avicenna was the first to divide human perception into five external senses (the classical senses of hearing, sight, smell, taste and touch known since antiquity)
- and five internal senses which he discovered himself: the sensus communis (seat of all senses) which integrates sense data into
- percepts; the imaginative faculty which conserves the perceptual images;
- the sense of imagination which acts upon these images by combining and separating them, serving as the seat of the practical intellect;
- Wahm (instinct) which perceives qualities (such as good and bad, love and hate, etc.) and forms the basis of a person's character whether or not influenced by reason;
- and intentions (ma'ni) which conserve all these notions in memory.[22]
- Avicenna located the internal senses in three ventricles of the brain, placing two in each ventricle, with receptive and retentive capacities respectively.[28] The common sense and (one aspect of) the imaginative faculty comprise the first pair, located in the front ventricle of the brain. The common sense coordinates the impressions received by the individual senses, in order to produce a unified picture of a sensible object. This indicates a certain capacity to make judgments present already in the common sense.
- The middle ventricle is the location of the next pair of internal senses, as Avicenna first conceived them. They comprise a novel faculty of “estimation” (following the Latin aestimatio), wahm in Arabic; and a second, chameleon type faculty. It functions both imaginatively (in animals and humans), and rationally (in humans alone).
- Avicenna posits the existence of an estimative faculty in order to explain the innate ability in all animals (humans included) to sense a non-sensible intention (ma‘nan) that is intrinsic to the object as perceived by the subject. Intentions are thus the extra-sensible properties that an object presents to an animal or person at the moment of perception. These intentions affect the perceiver powerfully, such as the negative feelings a sheep senses in perceiving a wolf, or the positive feelings sensed in perceiving a friend or child.[31
- The sensible forms that the common sense receives and unifies are then transmitted to the imaginative faculty, as Aristotle had said; except that Avicenna divides this faculty, calling the first appearance a quwwa musawwira, or khayâl. It retains these forms fully, and is thus called in English, after the Arabic, the “retentive” as well as “informing,” or “formative,” imagination.[30]
- Avicenna believes that the intentions that the estimative faculty obtains are received in the third and rear ventricle of the brain, in memory, hafizah . Memory shares the third ventricle with a faculty of recollection (dhikr), which retains the estimative intentions ready for recall.
- Remembering for Avicenna thus consists in the collation by the imaginative/cogitative faculty of estimative intentions on the one hand, and the appropriate sensible forms retained by the formative imagination, on the other. For that reason, this “second” aspect of the imaginative faculty is referred to as the “compositive imagination;” both it and the cogitative faculty deal with specific sensible forms and concepts, respectively, presenting them exactly and completely. They do this by combining the impressions received by the common sense and estimation, and separating out what is not relevant to the object.
- The cogitative faculty is primarily concerned with practical issues rooted in material being, forming judgments based on empirical data with the help of innate powers of abstraction and logical acumen. In what may well be a nod to tradition, Avicenna counts the “reports (al-akhbâr) to which the soul gives assent on account of unbroken and overwhelming tradition (shiddah al-tawâtur)” as a further credible source for forming practical judgments.[34]
- Avicenna considers estimation to be involved with the cogitative faculty in reconstructing a specific, physically based concept. As such, it can influence that faculty, and when excessive, be responsible for the fantasies and fictions in our dreams and thoughts (Black 2000, 227-28). Similarly, the estimative faculty can over-reach itself in logical matters by using the syllogisms that it helped create to pass judgments on immaterial beings, thus leading to false judgments in metaphysics.[36]
D. Sufi Psychology
- In Sufi psychology, Nafs is considered to be the lowest principle of man. Higher than the nafs is the Qalb (heart), and the Ruh (spirit). This tripartition forms the foundation of later, more complicated systems; it is found as early as the Koranic commentary by Ja'far al-Sadiq. He holds that the nafs is peculiar to the zalim (tyrant), the qalb to the muqtasid(moderate), and the rūh to the sābiq(preceding one, winner); the zālim loves God for his own sake, the muqtasid loves Him for Himself, and the sābiq annihilates his own will in God's will. Bayezid Bistami, Hakīm at-Tirmidhī, and Junayd have followed this tripartition. Kharrāz, however, inserts between nafs and qalb the element tab', "nature," the natural functions of man
- At almost the same time in history, Nūrī saw in man four different aspects of the heart, which he derived in an ingenious way from the Koran:
- Sadr (breast) is connected with Islam (Sūra 39:23);
- qalb (heart) is the seat of īmān (faith) (Sūra 49:7; 16:106);
- fuad (heart) is connected with marifa (gnosis) ( Sūra 53:11);
- and lubb (innermost heart) is the seat of tauhīd ( Sūra 3:190).
- The Sufis often add the element of sirr, the innermost part of the heart in which the divine revelation is experienced. Jafar introduced, in an interesting comparison, reason, aql, as the barrier between nafs and qalb -- "the barrier which they both cannot transcend" ( Sūra 55:20), so that the dark lower instincts cannot jeopardize the heart's purity .Each of these spiritual centers has its own functions, and Amr al-Makkī has summed up some of the early
Sufi ideas in a lovely myth:
God created the hearts seven thousand years before the bodies and kept them in the station of proximity to Himself and He created the spirits seven thousand years before the hearts and kept them in the garden of intimate fellowship (uns) with Himself, and the consciences—the innermost part—He created seven thousand years before the spirits and kept them in the degree of union (waṣl) with Himself. Then he imprisoned the conscience in the spirit and the spirit in the heart and the heart in the body. Then He tested them and sent prophets, and then each began to seek its own station. The body occupied itself with prayer, the heart attained to love, the spirit arrived at proximity to its Lord, and the innermost part found rest in union with Him [26]
Other philosophical theories of the mind
- Al-Kindi dealt with psychology in his First Philosophy, and Eradication of Sorrow. In the latter, he described sorrow as "a spiritual (Nafsani) grief caused by loss of loved ones or personal belongings, or by failure in obtaining what one lusts after" and then added: "If causes of pain are discernible, the cures can be found." He recommended that "if we do not tolerate losing or dislike being deprived of what is dear to us, then we should seek after riches in the world of the intellect. In it we should treasure our precious and cherished gains where they can never be dispossessed…for that which is owned by our senses could easily be taken away from us." He also stated that "sorrow is not within us we bring it upon ourselves."[14]
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- In the Encyclopedia of the Brethren of Purity (10th century), the Brethren of Purity discussed the soul, brain, and process of thought. They divided the soul into three parts: the vegetative, animal and rational human souls. The vegetative soul is concerned with nutrition, growth and reproduction; the animal soul is concerned with movement, sensation, perception and emotion; and the rational human soul is concerned with thinking and talking. Contrary to the Aristotelian view of the heart being the most important organ, the Brethren of Purity considered the brain as the most important organ of the body, due to it being responsible for higher functions such as perception and thought.[27]
-
- The Arab Muslim physician An-Naysaburi (d. 1016) wrote the Kitab al-Uquala al-Majanin, in which he used the term Mahwus for patients with delusions and hallucinations. He attempted to explain the phenomenon of madness and insanity in philosophical terms, rather than the psychopathological methods used by his contemporaries. He considered life as a blending of opposites such as health and disease, and wrote that reason is mixed with madness so that even the sane are never free from madness.[28]
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- Ibn Miskawayh (941–1030) wrote the books Tahdhib al-Akhlaq (Cultivation of Morals) and Al-Fauz al-Asgar (The Lesser Victory),[27] in which he gives psychological advice on certain issues, such as the fear of death, the need to develop traits to restrain oneself from faults, and the concept of morality. He also introduced the concepts of "self reinforcement" and response cost, where he advises Muslims who feel guilt to learn to punish themselves physically or psychologically through charity, fasting, etc.
-
- [22]Al-Ghazali (Algazel) (1058-1111) discussed the concept of the self and the causes of its misery and happiness. He described the self using four terms: Qalb (heart), Ruh (spirit), Nafs (soul) and 'Aql (intellect). He stated that "the self has an inherent yearning for an ideal, which it strives to realize and it is endowed with qualities to help realize it."[23] He also stated that there are two types of diseases: physical and spiritual. He considered the latter to be more dangerous, resulting from "ignorance and deviation from God", and listed the spiritual diseases as: self-centeredness; addiction to wealth, fame and social status; and ignorance, cowardice, cruelty, lust, waswas (doubt), malevolence, calumny, envy, deception, and greed. To overcome these spiritual weaknesses, al-Ghazali suggested the therapy of opposites ("use of imagination in pursuing the opposite"), such as ignorance & learning, or hate & love. He described the personality as an "integration of spiritual and bodily forces" and believed that "closeness to God is equivalent to normality whereas distance from God leads to abnormality."
-
- [29]Ibn Bajjah (Avempace) (d. 1138) "based his psychological studies on physics." In his essay, Recognition of the Active Intelligence, he wrote that active intelligence is the most important ability of human beings, and he wrote many other essays on sensations and imaginations. He concluded that "knowledge cannot be acquired by senses alone but by Active Intelligence, which is the governing intelligence of nature." He begins his discussion of the soul with the definition that "bodies are composed of matter and form and intelligence is the most important part of man—sound knowledge is obtained through intelligence, which alone enables one to attain prosperity and build character." He viewed the unity of the rational soul as the principle of the individual identity, and that by its contact with the Active Intelligence, it "becomes one of those lights that gives glory to God." His definition of freedom is "that when one can think and act rationally". He also writes that "the aim of life should be to seek spiritual knowledge and make contact with Active Intelligence and thus with the Divine."
-
- [29]Ibn al-Nafis (1213-1288) dealt with psychology in his Commentary on Anatomy in Avicenna's Canon. He developed his own theories on hylomorphic psychology and philosophy, mostly on a theological basis.[30] In particular, he made a distinction between the soul and the spirit, and he developed his own theory on the soul. He also crtiticized the ideas of Avicenna and Aristotle on the soul originating from the heart. Ibn al-Nafis rejected this idea and instead argued that the soul "is related to the entirety and not to one or a few organs." He further criticized Aristotle's idea that every unique soul requires the existence of a unique source, in this case the heart. Ibn al-Nafis concluded that "the soul is related primarily neither to the spirit nor to any organ, but rather to the entire matter whose temperament is prepared to receive that soul" and he defined the soul as nothing other than "what a human indicates by saying ‘I’."[31]
Clinical and medical approach
- Unlike medieval Christian physicians who relied on demonological explanations for mental illness, medieval Muslim physicians relied mostly on clinical psychiatry and clinical psychology, and clinical observations on mentally ill patients. They made significant advances to psychiatry and were the first to provide psychotherapy and moral treatment for mentally ill patients, in addition to other new forms of treatment such as baths, drug medication, music therapy and occupational therapy.[32]
Al-tibb al-ruhani and diseases of the mind
- The concepts of al-tibb al-ruhani (translated as "spiritual health" in Arabic) and "mental hygiene" were introduced in Islamic medicine by the Persian physician Abu Zayd Ahmed ibn Sahl al-Balkhi (850-934), who often related it to spiritual health. In his Masalih al-Abdan wa al-Anfus (Sustenance for Body and Soul), he was the first to successfully discuss diseases related to both the body and the soul. He used the term al-Tibb al-Ruhani to describe spiritual and psychological health, and the term Tibb al-Qalb to describe mental medicine. He criticized many medical doctors in his time for placing too much emphasis on physical illnesses and neglecting the mental illnesses of patients, and argued that "since man’s construction is from both his soul and his body, therefore, human existence cannot be healthy without the ishtibak [interweaving or entangling] of soul and body." He further argued that "if the body gets sick, the nafs [psyche] loses much of its cognitive and comprehensive ability and fails to enjoy the desirous aspects of life" and that "if the nafs gets sick, the body may also find no joy in life and may eventually develop a physical illness." Al-Balkhi traced back his ideas on mental health to verses of the Qur'an and hadiths attributed to Muhammad, such as:[3]
- "In their hearts is a disease."
- — Qur'an 2:10
- "Truly, in the body there is a morsel of flesh, and when it is corrupt the body is corrupt, and when it
- is sound the body is sound. Truly, it is the qalb [heart]."
- — Sahih al-Bukhari, Kitab al-Iman
- "Verily Allah does not consider your appearances or your wealth in (appraising you) but He considers your hearts and your deeds."
- — Musnad Ahmad ibn Hanbal, no. 8707
Mental hospitals
- As a result of the new positive Islamic understanding of mental illness, the first mental hospitals and insane asylums were built in the Islamic world as early as the 8th century. The first mental hospitals were built by Arab Muslims in Baghdad in 705, Fes in the early 8th century, and Cairo in 800. Other famous mental hospitals were built in Damascus and Aleppo in 1270.[4][33]
-
- Al-‘ilaj al-nafs and tibb al-qalb
- Ali ibn Sahl Rabban al-Tabari's Firdous al-Hikmah written in the 9th century was the first work to study 'al-‘ilaj al-nafs (translated as "psychotherapy" from Arabic)[10] in the treatment of patients. His ideas were primarily influenced by early Islamic thought and ancient Indian physicians such as Sushruta and Charaka. Unlike earlier physicians, however, al-Tabari emphasized strong ties between psychology and medicine, and the need for al-‘ilaj al-nafs and counseling in the therapeutic treatment of patients. He wrote that patients frequently feel sick due to delusions or imagination, and that these can be treated through "wise counselling" by smart and witty physicians who could win the rapport and confidence of their patients, leading to a positive therapeutic outcome.[14] In his chapter on mental illness, al-Tabari first described thirteen types of mental disorders, including madness, delirium, and Fasad Al-Khayal Wal-Aql ("damage to the imagination, intelligence and thought").[9] He also clearly highlighted mental illness as a speciality of its own.
- The Tunisian Arab Muslim physician,[34] Ishaq ibn Imran (d. 908),[35] known as "Isaac" in the West,[36] wrote an essay entitled Maqala fil-L-Malikhuliya, in which he first described psychosis, and also described a type of melancholia: the "cerebral type" or "phrenitis". He described the diagnosis of this mental disorder, reporting its varied symptoms. The main clinical features he identified were sudden movement, foolish acts, fear, delusions, and hallucinations of black people.[35] This work was later translated into Latin as De Oblivione (On Forgetfulness) by Constantine the African.[34]
- The Persian physician Muhammad ibn Zakarīya Rāzi (Rhazes) (865-925) wrote the landmark texts El-Mansuri and Al-Hawi in the 10th century, which presented definitions, symptoms, and treatments for many illnesses related to mental health and mental illness. Razi's texts made significant advances in psychiatry. Razi also managed the mental ward of a Baghdad hospital. Such institutions could not exist in Europe at the time, because of European fears of demonic possession.[32]
- In the centuries to come, Islam would serve as a critical waystation of knowledge for Renaissance Europe, through the Latin translations of many scientific Islamic texts. Razi, al-Tabari and Ahmed ibn Sahl al-Balkhi were the first known physicians to study al-‘ilaj al-nafs.
- Ali ibn Abbas al-Majusi (d. 982) discussed mental illness in his medical text, Kitab al-Malaki, where he discovered and observed a type of melancholia: clinical lycanthropy, associated with certain personality disorders. He wrote the following on this particular mental illness:[35]
- "Its victim behaves like a rooster and cries like a dog, the patient wanders among the tombs at night, his eyes are dark, his mouth is dry, the patient hardly ever recovers and the disease is hereditary."
- Avicenna (980-1037) often used psychological methods to treat his patients.[23] One such example involved a prince of Persia who had melancholia and suffered from the delusion that he was a cow. He would low like a cow, crying "Kill me so that a good stew may be made of my flesh," and would not eat anything. Avicenna was persuaded to undertake the case, and sent a message to the patient, asking him to be happy, as the butcher was coming to slaughter him, and the sick man rejoiced. When Avicenna approached the prince with a knife in his hand, he asked, "Where is the cow so I may kill it." The patient then lowed like a cow to indicate where he was. By order of Avicenna in his role as the butcher, the patient was also laid on the ground for slaughter. When Avicenna approached the patient, pretending to slaughter him, he said, "The cow is too lean and not ready to be killed. He must be fed properly and I will kill it when it becomes healthy and fat." The patient was then offered food, which he ate eagerly and gradually "gained strength, got rid of his delusion, and was completely cured."[10]
-
Music therapy
- Al-Kindi (801–873) was the first to realize the therapeutic value of music. He was the first to experiment with music therapy, and he attempted to cure a quadriplegic boy using this method.[37]
- Later in the 9th century, al-Farabi also dealt with music therapy in his treatise Meanings of the Intellect, where he discussed the therapeutic effects of music on the soul.[15]
Cognitive therapy
- Al-Kindi developed cognitive methods to combat depression and discussed the intellectual operations of human beings.[14]
- According to the psychologist Amber Haque, the medieval Islamic scholar Abu Zayd Ahmed ibn Sahl al-Balkhi (850-934) was "probably the first cognitive and medical psychologist to clearly differentiate between neuroses and psychoses, to classify neurotic disorders, and to show in detail how rational and spiritual cognitive therapies can be used to treat each one of his classified disorders."[38]
- Al-Balkhi classified neuroses into four emotional disorders: fear and anxiety, anger and aggression, sadness and depression, and obsession. According to Haque, al-Balkhi further classified three types of depression: normal sadness (huzn) which is "today known as normal depression", "endogenous depression" which "originated within the body", and "reactive depression" which "originated outside the body".[38]
- Al-Balkhi also wrote that a healthy individual should always keep healthy thoughts and feelings in his mind in the case of unexpected emotional outbursts in the same way drugs and First Aid medicine are kept nearby for unexpected physical emergencies. He stated that a balance between the mind and body is required for good health and that an imbalance between the two can cause sickness. Al-Balkhi also introduced the concept of reciprocal inhibition (al-ilaj bi al-did), which was re-introduced over a thousand years later by Joseph Wolpe in 1969.[38]
Physical and psychological disorders
- The Muslim physician Abu Zayd Ahmed ibn Sahl al-Balkhi (850-934) was a pioneer of al-‘ilaj al-nafs, and the first to compare "physical and psychological disorders" and show "their interaction in causing psychosomatic disorders." He recognized that the body and the soul can be healthy or sick, or "balanced or imbalanced", and that mental illness can have both psychological and/or physiological causes. He wrote that imbalance of the body can result in fever, headaches and other physical illnesses, while imbalance of the soul can result in anger, anxiety, sadness and other mental symptoms. He recognized two types of depression: one caused by known reasons such as loss or failure, which can be treated psychologically through both external methods (such as persuasive talking, preaching and advising) and internal methods (such as the "development of inner thoughts and cognitions which help the person get rid of his depressive condition"); and the other caused by unknown reasons such as a "sudden affliction of sorrow and distress, which persists all the time, preventing the afflicted person from any physical activity or from showing any happiness or enjoying any of the pleasures" which may be caused by physiological reasons (such as impurity of the blood) and can can be treated through physical medicine.[3] He also wrote comparisons between physical disorders with mental disorders, and showed how psychosomatic disorders can be caused by certain interactions between them.[38]
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- Ali ibn Abbas al-Majusi (d. 982) elaborated on how the physiological and psychological aspects of a patient can have an effect on one another in his Complete Book of the Medical Art. He found a correlation between patients who were physically and mentally healthy and those who were physically and mentally unhealthy, and concluded that "joy and contentment can bring a better living status to many who would otherwise be sick and miserable due to unnecessary sadness, fear, worry and anxiety."[3] He also first discussed various mental disorders, including sleeping sickness, memory loss, hypochondriasis, coma, hot and cold meningitis, vertigo epilepsy, love sickness, and hemiplegia. He also placed more emphasis on preserving health through diet and natural healing than he did on medication or drugs, which he considered a last resort.[15]
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- Avicenna (980-1037) recognized "physiological psychology" in the treatment of "illnesses involving emotions" and develop "a system for associating changes in the pulse rate with inner feelings" which is seen as an anticipation of "the word association test of Jung." Avicenna identified love sickness (Ishq) when he was treating a very ill patient by "feeling the patient's pulse and reciting aloud to him the names of provinces, districts, towns, streets, and people." He noticed how the patient's pulse increased when certain names were mentioned, from which Avicenna deduced that the patient was in love with a girl whose home Avicenna was "able to locate by the digital examination." Avicenna advised the patient to marry the girl he is in love with, and the patient soon recovered from his illness after his marriage.[32]
-
- Avicenna also gave psychological explanations for certain somatic illnesses, and he always linked the physical and psychological illnesses together. He described melancholia (depression) as a type of mood disorder in which the person may become suspicious and develop certain types of phobias. He stated that anger heralded the transition of melancholia to mania, and explained that humidity inside the head can contribute to mood disorders. He recognized that this occurs when the amount of breath changes: happiness increases the breath, which leads to increased moisture inside the brain, but if this moisture goes beyond its limits, the brain would lose control over its rationality and lead to mental disorders. He also wrote about symptoms and treatments for nightmare, epilepsy, and weak memory.[23]
Nosology and psychopathology
- In nosology, the Arab Muslim physician and psychological thinker Najab ud-din Unhammad (870-925) described in detail nine major categories of mental disorders, which included 30 different mental illnesses in total. Some of the categories he first described included obsessive-compulsive disorders (anxious and ruminative states of doubt), delusional disorders (which "manifested itself by the mind's tendency to magnify all matters of personal significance, often leading to actions that prove outrageous to society"), degenerative diseases, involutional melancholia, and states of abnormal excitement.[39]
- Unhammad made many careful observations of mentally ill patients and compiled them in a book which "made up the most complete classification of mental diseases theretofore known." The mental illnesses first described by Najab include agitated depression, neurosis, priapism and sexual impotence (Nafkhae Malikholia), psychosis (Kutrib), and mania (Dual-Kulb).[32]
- Unhammad also listed nine classes of psychopathology. This included the earliest description of Souda a Tabee (febrile delirium), which was in turn subdivided into Souda where patients showed impairment of memory, loss of contact with the environment, and childish behaviour; and Jannon (agitated reaction) which occurs when Souda reaches a chronic state and is characterized by insomnia, restlessness and sometimes "beast-like roars."[40]
Anatomy and physiology
- Avicenna discovered the cerebellar vermis—which he named "vermis"—and the caudate nucleus, which he named "tailed nucleus" or "nucleus caudatus". These terms are still used in modern neuroanatomy.[41] He was also the earliest to note that intellectual dysfunctions were largely due to deficits in the brain's middle ventricle, and that the frontal lobe of the brain mediated common sense and reasoning.[39]
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- A medical work by Ibn al-Nafis, who corrected some of the erroneous theories of Galen and Avicenna on the anatomy of the brain.
- Ibn al-Nafis (1213-1288), in his Commentary on Anatomy in Avicenna's Canon, corrected some of the erroneous theories of Galen and Avicenna (Ibn Sina) on the anatomy of the brain. Ibn al-Nafis quoted an error made by Galen, who believed that "blood reaches the brain itself at the section called forebrain through the duramater which divides the vault longitudinally into two equal halves at the sagittal suture." Ibn al-Nafis criticized this theory and corrected it as follows:[42]
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