We spent some time talking to Berak Hussain about anxiety and what it means for someone who has faith to support them during moments when it may reach its peak. Berak is a registered psychotherapist and works at a medical and counselling clinic at a university in Ottawa, Canada. She holds a Masters of Education in Counselling and continues to work closely with the Muslim community advocating mental health awareness across the world.
Why do people suffer from anxiety?
So there are different definitions for what it could be; it could be a straightforward response and anxious people are over worried and fearful, constantly overthinking things – and we all think about things, and worry about missing the bus etc – but when it becomes a disorder or an illness, it’s when a person becomes obsessively and constantly overthinking something to the point where it prevents you from your full potential and prevents you from your normal day-to-day functions.
Is it normal to suffer from anxiety and how can one identify ‘worrying’ as being an issue?
Somebody who is failing as a student, for example, and is no longer doing well in exams may have a problem with anxiety. If in the exam they may blank out and get ‘exam anxiety’ – they’re not doing well and reaching their full potential. Another example is if you have fear of judgement, so you start to not leave the house anymore, you don’t go to the mosque, or meet people, or go to the gym to workout anymore or such things… So when it stops you from doing your daily functions, that’s when it becomes an issue, and this goes for any mental illness, not just anxiety; depression as well.
Would you say that stage fright is like a form of anxiety?
Absolutely; anything that causes you to have that kind of fear and that gets your heart racing, it can be called that. When we talk about the symptoms of anxiety, it could range from sweaty palms to shaking, to your heart racing, feeling jittery etc. A lot of people have stage fright, such as speakers, reciters, students who need to give a presentation; they all get the jitters before, but it becomes a problem when you’re standing up there and not performing.
Does suffering from anxiety, and battling with any mental illness mean not having complete faith in God?
Looking at it from the outside, people may definitely suggest that it’s all from a lack of faith and trust in God and how things are going to be, but I don’t believe it’s from a lack of faith You can have people who are wholehearted believers, but when it becomes an illness, I think it becomes independent of your faith. Faith will help, and much research has shown that faith or spirituality will help with the overall mental well-being of a person. I get many clients who are Muslim who come in and they may have spoken to the Sheikh at the mosque, and they may have told them to pray more, don’t miss any, read more supplications, read more Quran – we’ve all heard that, but we know that’s not how it works! It doesn’t mean you have a lack of faith, it doesn’t mean you’re not a good Muslim.
So many people are made to feel so bad and so guilty and I know I’m going to be very unpopular for saying this, but at times I tell clients who say that they can’t find themselves praying, quite simply, just don’t pray then. I give them the analogy of a broken arm or leg; can you then function properly? No, you’re not at your full potential, so let’s say if you can’t do the full prayer with a broken leg, so you do some of it, or complete the actions as best as you can. Don’t completely break it off from your routine because then the ritual loses value, we forget the routine of daily salah, especially if we have been trained from a young age. So still do what you can, and that feeling of prayer, fake it till you make it.
I don’t tell them straight out not to pray, but I throw it out there and see their expression, playing devil’s advocate to see if it is something they would even consider and it comes as a shock it coming from a religious woman, and you know they wouldn’t even consider it. And with this, they come to realise that even when they’re not ‘feeling’ the prayer,’ they can still benefit from it. And that’s the thing with psychology and therapy: there are ideas with which you play around with and then you allow for them to come up with the solution. That’s the idea of faking it till you make it – to allow yourself to laugh and smile even when you don’t feel like it because what happens biologically? You trigger endorphins and eventually, you will actually start feeling it, and this works the same way.
What are the practical steps, if someone identifies themselves as suffering from anxiety, that they can implement in their lives to get themselves out of it?
Well as a therapist, of course, I’m going to say go out and seek therapy. I know that it’s really hard and that it takes courage and strength to do so and to talk to somebody about something so private; you’re not used to sharing details about yourself, your illnesses and whatnot. It’s frightening and you’re afraid of judgment. However, in the therapeutic process, that’s what you’re going to be working on step by step. What are your fears, what are the things that are stopping you from reaching your full potential? And that’s how I like to work when it comes to anxiety, it’s actually making people face their worst fears; so you’re going to fail the exam – now what? What is it that you’re going to do about it?
So break it down, and face your actual worst fears, and eventually what it really all comes down to is being afraid of what others may think about you, or when it comes to academic failure, and then the fear of not being able to face your family. Again, you go down to the roots of the issues and work with that, and then work your way back. For people with anxiety, this is what it looks like, they’re funnelling it out, they are imploding and exploding again all at once, so what do I do? I funnel it down and break it all down. This imploding and exploding, the overthinking and the exaggeration of the issue, thinking that it’s worse than it actually is; this is what they go through. For people living with anxiety, we try to take that explosion and break it down. This therapeutic process is used by Dr David Burns and he once did an intense three-day training programme with us and he always came down to that concept of questioning, is it really that bad?
Now attach faith to that equation; is it really that bad, when Allah (swt) himself says “verily you may like something and it is bad for you.” This is when trust and faith in God comes in. God doesn’t give or put you through anything that you cannot handle. So when you combine all of these things together, it’s actually quite beautiful to see the mix of psychology and these Islamic concepts coming together.
From a spiritual perspective, what are the kinds of things and solutions that someone could work into their life?
Essentially, working through it all step by step so, what is your worst fear with this issue at hand? We then work on figuring out on if it’s really so bad, and when it’s faith-based, we work on the concept of trust. Some people say, I’m not that religious, but I do believe in God and destiny and free will, and so it then begs the question, so why are you worrying about this issue so much; let Him worry about it for you! Do your absolute best and then leave the rest of Allah (swt). So many of these students will sit there and literally just think about that and take stock of it all and start thinking about whether or not they really are trying their best and working to avoid issues. Some will realise that they really are not, and so we look at practical ways of how we can help them reach their full academic potential, their physical health and emotional well-being. And if they feel like they’re doing their best, then we help them realise it and to come to the conclusion that they are doing their best and to leave the rest to Him to sort out for you.
I’ve seen a lot of anxiety cases like that and it’s been interesting to see (after seeing them after the initial session) their updates and their ‘homework’; I give every client homework as I don’t believe in just ‘talk’ therapy – it’s great when someone is grieving or when you just want to share a problem and get it out. They have something practical to work on outside therapy and can realise what things work best for them personally. And a majority of the time it works because that concept of leaving it all to God while you too do your best, it can work wonders for the right person who needs to hear it at the right time.
How can a person avoid episodes of anxiety in the future, especially if you don’t feel like you may be someone prone to anxiety?
Ahead of all else, you need to recognise your own stress signs and symptoms and this could be from your behavioural, mental, physical and the emotional level. For example, from a physical side of things, some of us will start to lose sleep or start to over-eat, and from the behavioural side, we might start becoming more irritable or angry, mentally, we may start to forget, or start to lose focus and concentration and emotionally, we can become very tearful or emotional over the smallest things. So we need to be aware of how our body responds or changes as a result of situations; if we can recognise these signs ahead of time and pick up on all the red flags, we will be more aware the next time we become stressed. If we don’t take care of our stress properly and have a healthy balance from all these sides, from eating well, sleeping well and exercising ourselves spiritually, when you’re hit with a difficult situation, we won’t be able to handle it very well. If these signs come to you and you’re ignoring them, you can easily be hit all of a sudden with a panic attack and these thoughts all come together to trigger a physical response within you.
That being said, anxiety can also be a biological disorder, and this comes in many forms, and at times it may even require some medication – and part of the problem in the Muslim community is this fear of medication, getting addicted and questioning what it could really mean if a person is found to be struggling with a mental disorder. The way I present it to my clients is that I don’t believe that simply taking a pill will make it go away, although, for some clients, that’s literally all they needed. But for some, the things we work on together, working on their eating, sleeping and spirituality, just isn’t enough because their anxiety levels are so high, that sometimes we need to have it lowered by means of medications. How it works is the medication will work with the nervous system to lower the heart rate, the nervousness and other biological issues that comes from anxiety, just to help balance things chemically in the brain. Sometimes people need the long-term use of medication, and when they are scared of that, I compare it to being diabetic; you need to take insulin and balance it out with a healthy lifestyle too. The problem is that it’s the same with mental illnesses but because we don’t see it physically the way you do with other diseases, we don’t respond and treat it the same way and don’t care for the spiritual healing.
This is why I went into the field, because I believed in working on the mind, the body and the soul, and working through the soul as a means of getting better. But aside from that, you need to find what works best for you and channel it to make yourself feel better and help you to find that balance, spiritually and physically. I don’t think that it’s fair to jump only to faith as a means of healing when the person is broken in spirit; yes, it’s perfectly good to do so and I am an advocate of it too however for some, you can’t go towards faith right away. Sometimes they need to work on lifestyle changes and when they’re feeling better and the intensity of the symptoms are low, that’s when faith will help a person. When they’re feeling better and the read Quran or listen to a supplication, that’s when it will really get through to them and can really start to heal them. The power of salah itself, when you really look at it and understand it, it’s incredible; so many studies have looked at the yogic movements in prayer and the physical benefits of it but when a person comes with real issues, they won’t get that when they’re feeling unwell. We need to address all the issues and then allow for faith to make the real and lasting change in a person.
For more from Berak and the team, keep an eye out for the upcoming ‘Real Talk’ podcast on The Muslim Vibe.