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Traditional Healing Practices Sought by
Muslim Psychiatric Patients in Lahore,
Pakistan
Yasmin Nilofer Farooqi
a
a
University of the Punjab, Pakistan
Version of record first published: 28 Nov 2006.
To cite this article: Yasmin Nilofer Farooqi (2006): Traditional Healing Practices Sought by Muslim
Psychiatric Patients in Lahore, Pakistan, International Journal of Disability, Development and
Education, 53:4, 401-415
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International Journal of Disability, Development and Education
Vol. 53, No. 4, December 2006, pp. 401–415
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Traditional Healing Practices Sought
by Muslim Psychiatric Patients in
Lahore, Pakistan
Yasmin Nilofer Farooqi*
University of the Punjab, Pakistan
40dryasminfarooqi@yahoo.com
Yasmin
00000December
LahoreFarooqi
2006
International
10.1080/10349120601008530
CIJD_A_200748.sgm
1034-912X
Original
Taylor
2006
53
and
&
Article
Francis
Francis
(print)/1465-346X
Journal
Ltd
of Disability,
(online)
Development and Education
This research explored the type of traditional healing practices sought by Muslim psychiatric
patients treated at public hospitals of Lahore city, Pakistan. The sample comprised 87 adult
psychiatric patients (38% male and 62% female). The patients self-reported on the Case History
Interview Schedule that they had sought diverse traditional healing methods, including Homeopathy, Naturopathy (Tibb), Islamic Faith Healing, and Sorcery, for their psychiatric disorders prior
to their current treatment from licensed psychiatrists, with the majority indicating they had sought
more than one of these traditional healing practices. Patients with different psychiatric disorders
sought multiple traditional healing methods for the treatment of their mental disorders: somatoform (73%); personality/conduct disorders (73%); schizophrenia (70%); affective disorders
(68%); and anxiety disorders (55%). Proportionately more male than female patients used multiple traditional healing practices. The male patients showed a higher number of visits per week to
traditional healers than their female counterparts. These different help-seeking practices may be
attributed to gender discrimination in mobility and taboos attached to women’s consultation of
male traditional healers. The study demonstrates Islamic religious traditions and Pakistani cultural
norms affected the health care choices of Pakistani psychiatric patients.
Keywords: Gender discrimination; Islamic faith healers; Pakistani cultural norms;
Psychiatric/mental disorders; Sorcerers; Traditional healing practices
Introduction
Communities that consider religion as the fundamental resource for their legislative
framework give rise to cultures that knead traditions that are practiced through
generations with faithful devotion (Al-Krenawi & Graham, 1997; Eliade, 1964;
*School of Psychology and Applied Psychology, University of the Punjab, Quaid-e-Azam
Campus, Lahore, Pakistan. Email: dryasminfarooqi@yahoo.com
ISSN 1034-912X (print)/ISSN 1465-346X (online)/06/040401–15
© 2006 Taylor & Francis
DOI: 10.1080/10349120601008530
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402 Y. N. Farooqi
Fillon, 2002; Spickard, 1995). Consequently, religio-cultural rituals influence
thought and belief systems about the universe, creation, creator, human nature,
health, disease, life, and death. Pakistan is one such country where religio-cultural
traditions are a way of life and influence health-related practices (Atherton, 2005;
Farooqi, 2005; Qidwai, 2003; Raja, 2004; Rizvi, 1989). This article explores the
traditional healing practices used by patients in Lahore city of the Islamic Republic
of Pakistan. The findings of this research may promote international understanding
and sensitivity towards Pakistani Muslim healing practices, which are primarily
based upon a body of traditional knowledge derived from unique Islamic religiocultural norms and values. The Islamic faith and values are the means by which
the Pakistani community conceptualises and interprets mental health and mental
illness. Policy-makers and providers of mental health services in Pakistan and other
Islamic faith countries interested in launching mental health programmes that are
responsive to patients could address patients’ unique religio-cultural norms and
values.
Religio-cultural Traditions in Pakistan
Pakistan comprises more than 136 million identified Muslims who adhere to the
Islamic faith (Ash, 1997). Pakistanis regard submission to the will of Allah (God) as
fundamental to their existence, and strive to develop a strong super-ego (conscience)
that is considered imperative to the development of a healthy personality. The
majority of Pakistanis follow the teachings of the Holy Book of Quran and Hadith in
their everyday life.
The word Islam comes from the Arabic root word “Salaam” (Peace) and literally
translates from Arabic to English as “Surrender—devotion to surrender/submit
oneself to Allah’s will … accepting everything that happens in life, as it is and as it
comes, with trust and serenity, listening with hope to the teachings of life” (Farooqi,
2005 p. 2). However, this “surrender” does not refer to a passive attitude of submission but a continued volitional effort to attune oneself to the eternal realities of
which the focus is Allah. This deep acceptance of being in relation to Allah is
believed to be health-promoting and to have healing qualities. Pakistanis believe that
by observing life in unity with the will of Allah, the ego transcends all boundaries of
concern for power, success, and wealth. Thus, for Muslims, submission to Allah
becomes the ethical way of being for optimal mental health and lasting joy.
Pakistan is a developing Muslim country with an alarmingly low literacy rate, a
weak democratic system, a patriarchal system of status and role, and an unstable
economy (Farooqi, 2005). It also has a culture that is an amalgam of rituals, traditions, and folk beliefs (Ghouri, 2004; Hassan, 1991; Hussain, 1998; Mubbasher &
Saeed, 2001; Qidwai, 2003; Raja, 2004; Rizvi, 1989). Many of these rituals and
traditions are based upon the Islamic ideology derived from Quran and Hadith—
therefore, the beliefs in the existence of ghosts, jins, demons, and apparitions; the
existence of the spirits of good and bad; miracle healing; the cult of saints; witchcraft; and pilgrimage (Ahmed, 1981; Akhtar, 1987; Eliade, 1964; Majid, 2001;
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Pakistani Traditional Healing Practices
403
Qidwai, 2003; Raja, 2004; Rizvi, 1989). There also are traditional and informal
Pakistani explanations for the fortune or misfortune, luck or bad luck, and health or
illness. Such traditions also include beliefs in dreams, premonitions, fairies, spirits
(good and evil), use of certain items (taweez) for protection or to bring good luck,
bad luck signs (e.g., the colour black); or folk beliefs and rituals about dying, burial,
and the funeral. Some Pakistanis consider Sufis (a type of traditional healer) capable
of applying magic to speak to the spirits of nature, performing both physical and
spiritual healings, and discovering supernatural powers through ecstasy and fasting.
Some Pakistanis also believe in the supernatural power and divine role of inanimate or non-living things or objects, such as Lake Saif-ul-Maluk in Kaghan, a
scenic city in North West Frontier province of Pakistan (Almeida, 1996; Biddulph,
1986; Muhammad, 1980). They may also believe in exorcism, ancestor worship,
voodoo or charms, or the supernatural powers of some individuals (Pirs) and Black
magicians who can cast spells/magic or haunt or have “second sight”. Magicians
are also believed to carry out other forms of communication through time and
space. In their ancestor worship, some Pakistanis may also believe in the divine
power and divine guidance of the dead (sajjada). The use of voodoo and charms
with spirit possession that is prevalent in Africa, North America, Cuba, and Haiti is
also practiced by some “Aamils” in Pakistan (Actionaid, 2002; Traditional Healers
Fellowship, 2005).
Some of the main reasons for these folk beliefs and rituals (e.g., exorcism, voodoo
death, ancestor worship) seem to be the following:
1. The deep impact of Hinduism on the Pakistani Muslim community for more
than two centuries prior to the partition of the Indo-Pak subcontinent in 1947.
2. The misunderstood Islamic religious beliefs due to ignorance, poverty, political and economic instability, poor formal education, and the deplorably low
literacy rate.
3. The blaming of others (supernatural) for one’s misfortune or failures.
4. The lack of costly mental health services, especially in the rural remote areas of
Pakistan.
As a result, the material and cultural aspects of the aforementioned folk beliefs are
manifested in relics of saints, voodoo dolls, and certain carvings. Believers also make
pilgrimages to sacred groves and graveyards or shrines that also serve as sources of
faith healing.
The Central Role of Islam in Pakistani Perceptions of Health and Healing
The majority of Pakistanis believe in the Islamic concept of self and metaphysical
theory that furnished the very foundation of Humanistic and Existential theories.
They believe that human beings are created on ahsan-ul-taqvim (the best of designs),
but have also been given the choice of doing evil and, thus, descending into a state
that is the lowest of the low. By observing life in accordance with the teachings of
Quran and Hadith, an individual can differentiate what is good and what is evil.
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404 Y. N. Farooqi
Thus, the Islamic perspective of a normal person is not that of a hermit, but an
active member of society whose needs are met in a spiritual or moral framework
without causing a conflict with Islamic ideology.
The Islamic faith explanation of mental illness is that it is caused by doubt and
dissociation due to one’s own compelling needs or outer pressures that are counter to
the teachings of the prophet and Quran. As doubt and conflict increase, the person
may develop symptoms of mental illness. As a result, the majority of Pakistanis
adhere to Shahaada—belief in One Allah and the Final Prophet Muhammad (peace
be upon him)—to five prayers a day, to Zakat, to fasting, to Haijj/Pilgrimage to
Mecca, and to other obligatory practices pertaining to diet, gender roles, dress, interpersonal relationships and family values to promote their mental and physical health
(Hassouneh-Phillips, 2001; Lumumba, 2003; Mazhar, 2000; Mehmud, 2000).
However, the ethnic, cultural, and national differences can influence the status, role,
and mental health of Muslim women in each Islamic community (Haddad &
Esposito, 1998; Hasan, 2002).
There is an acute shortage of trained, licensed, clinical psychologists and psychiatrists in the public hospitals in Pakistan. As a result, many Pakistanis seek the most
affordable spiritual/traditional treatment from Pirs, Aamils, Hakims, magicians,
palm readers, folk healers, and other “quacks” rather than seeking medical, psychological, or psychiatric help from the licensed mental health professionals. The costly
services available at private clinics and hospitals are beyond the capacity of the average Pakistani patient. The standard medical, surgical, and psychiatric facilities are
available only in few large Pakistani hospitals and in big cities like Lahore, Karachi,
and Islamabad. Consequently, all types of traditional faith healers enjoy a flourishing
business in remote areas of Pakistan where people are mostly ignorant and mental
health facilities are almost non-existent. However, the limited number of costly
mental health professionals would not be able to cope if traditional healers stopped
working (Naeem & Ayub, 2004). Mubbasher and Saeed (2001) and Qidwai (2003)
found that in Pakistan the most commonly used traditional healing practices are:
Homeopathy, Naturopathy (Tibb), Acupuncture, Chiropractics (Jerrah), Islamic
Faith/Spiritual Healing, Sorcery, and Danyalism.
Homeopathy is a therapeutic method that clinically applies the law of similarities
and uses medically active substances in infinitesimal doses. The underlying rationale is that the same thing that causes the disease can also cure it (World Health
Organization, 2001). Unani Tibb (or Naturopathy) uses herbs as its tool to fight
ailments of any sort. The underlying rationale is that the dominant quality of an
herb, coupled with its specific pharmacological action, counteracts the opposite
abnormal quality in the body or any of its organs, or subsides, evacuates, alters,
strengthens, or tones up as the case may be (Chishti, 2005).
Islamic Faith/Spiritual Healing focuses on helping individuals clarify their values
and work out a meaningful way of “being in the world”; that is, submission to the
will of Allah and adherence to the teachings of the Quran and Hadith. The spiritual
bond between Muslim Saints/Sufis and their followers facilitates empathetic understanding, catharsis, and insight into one’s intrapsychic and interpersonal conflicts.
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Pakistani Traditional Healing Practices
405
These Islamic faith healers are well versed in Quranic verses; Sunnah and Hadith.
They recite some verses from the Holy Book of Quran that are related to the symptoms and then breathe onto a piece of cloth or paper, or a container filled with
water, or an edible element or an amulet (taweez) that is then considered “blessed
with Allah’s approval”. Then the patient is asked to keep it, and is promised that
they will be normal soon. The patient is also given detailed instructions about their
daily chores and advised to be regular in prayers and never loose hope in Almighty
Allah. This process may be repeated depending upon the severity of the mental or
physiological symptoms of the patient. Such faith healers are reported to be the
major source of care for Pakistani people who have different mental disorders;
particularly the women from the rural areas of Pakistan who are the most underprivileged, economically deprived, and poorly educated group.
Sorcery practitioners use black magic and claim to have extraordinary powers
through which they can hurt or help a person. Their therapy consists of first
convincing the patient that someone (an enemy) has put a magic spell on them or on
their son or daughter and that it will cost a certain sum of money or a particular
number of goats or chickens for sacrifice to break the spell. The patient usually
comes to the healer every week. Sometimes the healer (usually a man) may give
some written magic words, which are usually written on paper, or numbers to the
sick person to be worn near the neck (it is usually wrapped by the patients in a small
piece of cloth or gold or silver so that it would appear like a chain/locket) or the sick
person is advised to keep the words in their room. The palmists and soothsayers read
the lines of the palm of patient’s hand and forecast the future. Or they claim to have
knowledge of future events by calculating the movements of stars and their association with one’s birth date.
Danyalism is a form of “Shamanism” that exists in northern areas of Pakistan.
A study was carried out in the traditional village (Chaprote) Gilgit, in northern
Pakistan, on the healing techniques of a native spiritual practitioner known as
“Danyal” (Hussain, 1998). A Danyal is a village man/woman, who after satisfactorily completing a recruiting process, becomes an expert in applying indigenous
methods to summon his/her Baraies (Spirits). In the village of Chaprote, where
people relied more on spiritual thinking than on social sanctions, Danyal’s role
seemed very important. In this northern region of Pakistan, a Danyal (as they now
have become known) has various roles. He is a spiritual practitioner who provides
information about the spiritual world, a healer who cures mental and physical
illnesses; and a foreteller who predicts future events.
Majid (2001) conducted a study in Allama Iqbal Medical College, Lahore,
Pakistan on the effects of Tahajjid Sawlaat (the late night prayer) in curbing depression. In this study, the experimental group was advised to recite the Holy Quran;
offer prayers and be busy with invocation (Zikr). The control group was advised to
remain busy with home tasks. The Hamilton Depression Rating Scale was used as a
pre–post measure with both groups. Twenty-five out of the 32 patients recovered
from depression. The control group showed no change at all in their depressive
symptoms.
406 Y. N. Farooqi
Goals of the Study
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The current research study investigated the following questions:
1. What types of traditional healing practices are sought by psychiatric patients of
Lahore city, Pakistan?
2. Is the Islamic faith/spiritual healing method sought more often than homeopathy, Tibb, and sorcery?
3. Are there any differences in the choice of treatment for a particular mental
disorder?
4. Are there any gender differences in the type of traditional healing practices
sought by the psychiatric patients?
5. Do female psychiatric patients visit the male traditional healers as frequently as
their male counterparts?
Method
Research Design
For the present study, a retrospective ex post facto research design was used. Ray
(2003) defined an ex post facto design as an attempt “… to use empirical procedures
for suggesting meaningful relationships between events that have occurred in the past”
(p. 248). Elmes, Kantowitz, and Roediger (2003) argued that in ex post facto research
designs, “the results usually have occurred because of some naturally occurring events
and are not the result of direct manipulation by an experimenter. Thus, the researcher
categorizes or assesses the data and then probes for relationships” (p. 101).
In the current research, the groups are naturally formed as per their diagnosis and
gender; thus, an ex post facto design seemed to be the most suitable for this study.
Goodwin (2003) also stated that in such designs “… groups are formed ‘after the
fact’ of their already existing subject characteristics” (p. 215).
Participants and Setting
A purposive sampling technique was used, which resulted in a sample of 87 psychiatric patients (38% male patients and 62% female) who were hospitalised during a
period of 7 months (February–August 2005), in the psychiatry departments of
different public hospitals in Lahore City. Lahore is Pakistan’s largest city. The
hospitals included the Services, Mayo and Jinnah Hospitals. Purposive sampling was
used because of convenience, economy of time, and money (Goodwin, 2003). A
probability sampling strategy could not be used due to the lack of a sampling frame
applicable to Pakistani public hospitals and the high risk of attrition due to the
stigma attached to psychiatric disorders in Pakistan.
The inclusion criteria for the participants were adult psychiatric patients, treatment by a psychiatrist at a public hospital in Lahore city at the time of this study,
and those who volunteered to participate in the project.
Pakistani Traditional Healing Practices
407
All of the patients had been diagnosed for affective disorders, schizophrenia, anxiety, somatoform, or personality/conduct disorders by their treating psychiatrists.
However, at the time of interview the patients’ psychiatric symptoms were in remission. Details of the demographic characteristics of the sample (from selected items of
the Case History Interview Schedule (see Instrument) are presented in Table 1.
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Instrument
A Case History Interview Schedule (in Urdu) and hospital records (in English) were
used to gather a range of information (see Appendix). However, in this article only
the information about demographic data, the type of traditional healing practices/
methods sought, and the number of times each traditional healer had been visited
per week prior to receiving the psychiatric treatment are presented. The interview
was conducted in Urdu, which is the local language and was well understood by the
patients. It is the language used in Pakistani’s public hospitals. (Appendix is a translation of the Case History Interview Schedule.)
Shaugnessy, Zeichmeister, and Zeichmester (2003) argued that “case histories are
a source of hypotheses and ideas about normal and abnormal behavior” (p. 290).
However, observer bias and biases in data collected through case history interview
can lead to incorrect interpretations of case history outcomes. To control for this
bias in the current research, hospital medical/psychiatric records were used to verify
the data in relationship to diagnosis collected by Case History Interview Schedule.
The hospital records were accessed by the author to verify the diagnosis and demographic data of the patients. Written notes were made to record the diagnosis.
The responses regarding the number of visits were classified into three categories
as follows: 0–1 visits per week = Few; 2–4 visits per week = Many; and 5–7 visits per
Table 1.
Descriptive characteristics of the sample (N = 87)
Characteristic
Gender
Male
Female
Diagnosis
Affective disorders
Schizophrenia
Anxiety disorders
Somatoform disorders
personality/conduct disorders
Age
Income (monthly) (Pakistani Rupees)
Years of schooling/education
Socio-Economic Status
Frequency
Percentage
33
54
38
62
35
17
13
11
11
40
19
15
13
13
Range = 18–70 years
Range = Rs. 300–10,000
Range = 0–14
Low and low-middle class
408 Y. N. Farooqi
week = Almost Always. Numeric values of 0, 1, and 2 were then assigned for Few,
Many, and Almost Always, respectively.
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Procedure
The researcher sought official written permission from the administration of the
aforementioned hospitals to include their hospitalised patients in the study. The
interviewers sought verbal informed consent (in Urdu) from each of the patients.
Verbal consent was sought because most of the patients had very little education and
would have felt more comfortable with this mode of communication.
The patients were interviewed by three Masters-level students of applied
psychology with specialisation in the field of clinical psychology from the
University of the Punjab, Lahore. The interviews took place at the patients’
bedsides in the wards and private rooms in various hospitals during a 1- to 2-week
period. Uniform questions based on the Case History Interview Schedule were
asked and the interviewers wrote the patients’ responses verbatim on to the Interview Schedules.
Data Analysis
The Statistical Package for the Social Sciences, Version 12 (SPSS 12.0) was used to
analyse the data. The responses of the patients were tallied as per their options for
the six types of responses related to the traditional healing practices (Homoeopathy,
Tibb, Islamic Faith Healing, Sorcery, Multiple Traditional Healing Practices, and
None). The nominal values of 1, 2, 3, 4, and 5 were used to dummy code Homeopathy, Tibb, Islamic Faith Healing, Sorcery, and Multiple Traditional Healing Practices. Bar diagrams were plotted to examine gender differences in the type of
traditional healing practices sought and the number of visits per week to the
healer(s). Differences in the treatment choices of different psychiatric groups and of
male and female patients were established.
Results
All the patients indicated they had sought some type of traditional healing practices
prior to seeking their current treatment. Female patients outnumbered male patients
in the use of Multiple Traditional Healing Practices. The results in Table 2 indicate
that more men than women sought Homeopathy (5% versus 2%). This is an interesting finding given that Homeopathy is considered relatively more advanced and a
more expensive mode of treatment for psychiatric patients than Tibb, Islamic Faith
Healing, or Sorcery. Indeed, more women than men sought Tibb (7% versus 1%),
Islamic Faith Healing (7% versus 2%), Sorcery (9% versus 1%), and Multiple
Traditional Healing Practices (37% versus 29%) for their psychiatric disorders.
Table 3 presents the differences in the choice of treatment by type of illness. The
findings suggest that 73% of both those with Somatoform and Personality/Conduct
Pakistani Traditional Healing Practices
Table 2.
409
Gender differences in type of traditional healing practices
Type of traditional healing practices (%)
Gender (N = 87)
Homeopathy
Tibb
Islamic Faith
Healing
Sorcery
Multiple Healing
Practices
5
2
1
6
2
6
1
9
25
32
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Male patients (N = 33)
Female patients (N = 54)
Disorders were likely to seek Multiple Traditional Healing Methods. The likelihood
of opting for more than one traditional healing method showed a gradual decline for
those with Schizophrenia (70%), Affective Disorders (68%), and Anxiety Disorders
(55%) in this sample. Unfortunately, Anxiety Disorders are the most under-diagnosed and under-treated of the mental illness in Pakistani society because they are
perceived to be an outcome of the patients’ “weak will-power”. This may be why
those with Anxiety Disorders were least likely to seek multiple traditional healing
methods.
With respect to the question of frequency of visits to healers per week, the data
shown in Figure 1 indicate that the male patients visited the healers more frequently
than their female counterparts. This may be due to men’s mobility and economic
autonomy within the patriarchal society of Pakistan.
Figure 1. Gender difference in traditional healing treatment choices
Discussion
This study explored type of traditional healing practices sought by Muslim psychiatric patients being treated at the time of the study in public hospitals in Lahore
City, Pakistan. It further investigated gender differences and differences among
various sorts of psychiatric patients in the type of healing methods and in the
number of visits they made per week to traditional healer(s) prior to their hospital
treatment.
The findings of this study suggest that traditional healing practices are prevalent
among Pakistani psychiatric patients. Ironically, most of these traditional healing
Table 3.
Type of traditional healing practices by diagnosis
Type of traditional healing practices (%)
Gender (N = 87)
Affective disorders (N = 35)
Schizophrenia (N = 17)
Anxiety disorders (N = 13)
Somatoform disorders (N = 11)
Personality/conduct disorders
(N = 11)
Homeopathy Tibb
9
0
15
0
9
3
0
15
0
9
Islamic Faith
Healing
Sorcery
Multiple Healing
Practices
9
18
0
18
0
11
12
15
9
9
68
70
55
73
73
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410 Y. N. Farooqi
Figure 1.
Gender differences in traditional healing treatment choices
methods were utilised more frequently by the female patients who are the most
under-privileged, uneducated, vulnerable, and suggestible group in Pakistan, probably due to the patriarchal system, poverty, and illiteracy. The male patients reported
more frequent visits to traditional healers. This is probably because Pakistani men
are more mobile, educated, economically independent, and secure when compared
with Pakistani women. Another reason may be that all traditional healers are men,
and Pakistani women may be too shy and inhibited to consult these men for their
personal and psychiatric problems.
There are stigmas and taboos attached to female patients consulting male traditional healer(s). Consequently, traditional conservative Pakistani women would be
inhibited in visiting them for treatment of their psychiatric disorders. Another reason
may be that Pakistani Muslim women are dependent upon their male relatives to
escort them to male traditional healer(s). Often, these male relatives are reluctant to
take their female family members to male healers, mainly due to shame, embarrassment, and taboos attached to female patients’ mental illnesses. Consequently, in this
study, fewer female patients received treatment from multiple healers, and made fewer
visits per week compared with their male counterparts. In contrast, more male patients
sought treatment from homeopathic practitioners probably because of the male
patients’ freedom in their mobility, choice of treatment, and economic autonomy
The findings of this study are consistent with the prior research (e.g., Hassan,
1991) that suggested most Pakistani psychiatric patients, especially the female
patients, opted for Multiple Traditional Healing Practices. Such treatment choices
seem to be closer to the patients’ religious and cultural traditions concerning mental
health and mental disorders (Ghouri, 2004; Hasan, 2002; Hassan, 1991; Majid,
2001; Mazhar, 2000; Qidwai, 2003; Raja, 2004; Rizvi, 1989). This may be the
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Pakistani Traditional Healing Practices
411
reason why these researchers have advocated an integrated health care approach,
which would lead to a more consistent, religiously and culturally sensitive health
care system in Pakistan.
The current study was limited to the psychiatric patients from public hospitals of
Lahore City. Thus, the results cannot be generalised to the whole of Pakistani society or to its Muslim population in general. Future research must be carried out with
larger samples of patients from public and private hospitals, with different religious
and ethnic backgrounds, and from rural and urban communities in other provinces
of Pakistan.
Pakistani Muslims share common cultural elements with Muslim people of many
developing South Asian countries who generally do not discuss their personal, physical, or mental problems with any one outside their family. Shame and guilt often are
used to enforce norms in the family, which may lead to anxiety and depression. An
individual’s emotional problems often bring shame and guilt to the family, and these
in turn prevent family members from reporting psychological problems to licensed
mental health professionals. Under such circumstances, traditional healers may be
the best choice for the treatment of mental disorders in a religiously conservative
country like Pakistan.
In my clinical practice I have found that anxiety and affective disorders are the
most under-diagnosed and under-treated mental disorders. Usually, patients with
anxiety and depression are blamed for being weak-willed or guilty of violating
Islamic religious traditions and cultural norms. However, in the cases of schizophrenia, somatoform, and personality/conduct disorders, the course of these illnesses is
usually more chronic and the level of impairment in terms of the global functioning
is so pervasive and threatening that families seek a variety of traditional healing
methods for their family members.
Conclusions
An understanding of the religio-cultural background of patients with a mental
illness and the strengths and weaknesses of the traditional healing practices should
be known to all health care professionals in Pakistan so that they could treat the
patient with less resistance from the patients and their relatives. Interestingly
enough, most Pakistani traditional healers treat their patients tactfully in their religio-cultural context, at a very affordable cost. Consequently, patients prefer to seek
help/counselling from these traditional healers rather than seeking timely, but
costly, treatment from the well-trained and qualified psychiatrists. These traditional
healers regularly advertise in newspapers and in the form of graffiti without any
check from the Pakistani law enforcement agencies. Thus, further research work is
recommended to find out exactly why patients prefer to seek treatment from traditional healers, especially from spiritual healers and sorcerers, for the treatment of
their mental disorders
Some questions remain regarding how Pakistani traditional healing practices
would fare in comparison with modern psychotherapeutic and pharmacological
412 Y. N. Farooqi
interventions in an era of evidence-based medicine (Raja, 2004). Moreover, it is
debatable whether seeking treatment from spiritual/traditional healers would delay
patients in receiving diagnoses and appropriate treatment via modern western medicine and psychiatry. Perhaps, in an age of information technology, there is a need for
cooperation between spiritual healers and westernised health care workers. A positive interaction between the two health care systems could improve the mental
health and well-being of people in the East and the West.
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Appendix. Case History Interview Schedule (English translation)
Name:
Age:
Education:
Occupation:
Monthly Income:
Any other Income:
Marital Status:
Dependents in Family:
Hospital:
Diagnosis given:
Q1.
What brought you here?
Q2.
Who brought you to this hospital and why?
Q3.
How long you have been here?
Q4.
Do you have any past history of this illness?
Q5.
What treatment was given for it in the past?
Q6.
During the last one year, which type of traditional healing method/s have been
sought by you for the treatment of your current illness?
a. Homeopathy
b. Tibb
c. Islamic Faith Healing Practices
d. Sorcery
e. Multiple Traditional Healing Practices (more than one of a, b, c, or d)
f.
None.
Pakistani Traditional Healing Practices
Q7.
How frequently have you visited the healer/s per week during the last one
year?
a. 0–1 visits
b. 2–4 visits
c. 5–7 visits
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415
Q8.
How did you come to know about this healing practice/s?
Q9.
Has it helped you?
Q10. Is there anything else you would like to share with me?
Thanks for your cooperation!