Coping with stress and anxiety: a spiritual and cultural perspective

Ever wondered how CBT fits with ideas about health and wellbeing from more spiritual perspectives?  A BABCP outreach event held in a local Glasgow mosque in Summer 2018 explored just this.  Saiqa Naz, Chair of the BABCP’s Equality and Culture SIG, Shayhk Abdul Aziz Ahmed and Dr Aman Durrani all speak to Dr Lucy Maddox. Show Notes and Transcript: If you want to know more, check out these resources... Articles Andrew Beck has written an article in the Sept 2016 edition of CBT Today, on page 14, available here: http://www.babcp.com/files/CBT-Today/cbt-today-september-2016.pdf on Helping To Deal With Racism As A Therapist. Saiqa Naz has written an article on p15 of this issue of CBT Today, available here: http://www.babcp.com/files/CBT-Today/cbt-today-february-2017.pdf on Working as a BME CBT Therapist. Books Badri, M. (2013). Abu Zayd al-Balkhi’s sustenance of the soul: The cognitive behavior therapy of a ninth century physician. International Institute of Islamic Thought (IIIT). Beck, A. (2016). Transcultural cognitive behaviour therapy for anxiety and depression: A practical guide. Routledge. Videos To watch the outreach event in full, you can access three videos here: 1) Coping with Stress and Anxiety 1/3: A spiritual and cultural perspective, Shaykh Abdul Aziz Ahmed https://www.youtube.com/watch?v=7i4I8AgIO30&list=PLDRvEQKwDiOGDndWynElDmzqUFo8Pa_vI&index=7&t=0s 2) Coping with Stress and Anxiety 2/3: A psychological perspective, Saiqa Naz https://www.youtube.com/watch?v=5FSWDWSJzXk&list=PLDRvEQKwDiOGDndWynElDmzqUFo8Pa_vI&index=9&t=0s 3) Coping with Stress and Anxiety 3/3: Q&A https://www.youtube.com/watch?v=NQpAiktShBc&list=PLDRvEQKwDiOGDndWynElDmzqUFo8Pa_vI&index=5 Website British Association for Behavioural and Cognitive Psychotherapies  https://www.babcp.com/ Transcript Lucy: Hello, and welcome to this bonus episode of Let’s Talk About CBT with Dr Lucy Maddox. In this episode, I’m going to introduce you to three people who put on a special outreach event in Glasgow back in July.   This free event was open to the general public but aimed to reach out specifically to the Islamic community in Glasgow where the BABCP conference was being held.   Data shows that Black, Asian and minority ethnic communities are under served by primary mental health services and are less likely than other groups to be referred for talking therapies like CBT. Research findings from Mind in conjunction with the Time to Talk coalition in 2017 highlighted a lack of culturally sensitive and tailored services to meet the diverse needs of many local populations. In addition, some significant cultural barriers can be present within communities which can prevent people seeking help or speaking up.   The event was held in an Islamic community space and it involved talks about mental health from different perspectives, from a CBT therapist, a psychiatrist and an Islamic scholar. Dr Aman Durrani, psychiatrist, introduced the event and Saiqa Naz, CBT therapist, and Shayhk Abdul Aziz Ahmed, Islamic scholar, spoke.   I spoke to Saiqa before the event. As well as being a CBT therapist, Saiqa is chair of the Equality and Culture Special Interest Group of the BABCP. I asked her to tell me more about why minority communities are not seeking mental health support.  Saiqa: We’ve been hearing about this for many years, that people from BME communities aren’t accessing support, so we’re just trying to hopefully challenge the stigma by educating them about what mental health is and what kind of support is available to them, and hopefully that will encourage them to seek help.   The whole idea, I guess, is to show people that psychology is at one with the faith and that might encourage people to seek help in the future.   They say, don’t they, that if you love your job it’s not work, it’s a passion, it’s a hobby, and that’s how I see it. I love connecting with people. I love meeting people. I love being out and about in the community getting to know people, and that’s who I learn from. So, there’s the learning I’ve taken from the community and trying to bring it back into the profession.   I’m really passionate about it because for me, CBT, I think everyone should be able to access it. You don’t have to be unwell to access it. I know services are set up in that way, but some of the tools that we use, and we teach people are really practical. I think that’s why I’m passionate, because you don’t have to be unwell to seek help.  Lucy: So, it’s something that anyone can benefit from?  Saiqa: Yeah, definitely, and that’s what I love about CBT. I always like to use the analogy of people being plumbers and just having extra tools in your toolkit to use when you need it.  Lucy: Saiqa wanted to encourage therapists to seek out her workshops and talk to the special interest groups about any problems that they’re having, and if you’re going to therapy, feedback to your therapist any cultural issues you think are important.   I spoke to Shayhk Abdul Aziz Ahmed before the event as well, about why he thought the event was important.  Abdul: I’m Abdul Aziz Ahmed.  Lucy: Just for people who might not know what the term ‘Shayhk’ means, would you mind explaining what it means?  Abdul: I think the way they’re using it in the context of tonight is somebody that’s learned in Islam, and I’m quite happy to use that title under certain circumstances because it gives credibility to the argument.  Lucy: Could you say a little bit about the event tonight?  Abdul: It’s quite an exciting event because hopefully it’s an opportunity to raise issues which are relevant to one of the minority communities here, the Muslim community in particular, who have their own cultural barriers which are stopping a lot of people from accessing services to support their mental health. And I think anything that can remove those barriers is a positive thing and so I’m quite excited to be part of that.  Lucy: Could you say a bit more about how somebody’s spirituality might present barriers to accessing mental health services?  Abdul: I think the main barrier is not so much their personal spirituality but the cultural interpretations of the community here. There’s a larger reliance on very traditional scholars who would interpret mental ill health in a way that it’s powers beyond our reach and would interpret them as the jinn or some supernatural forces. And because those people have important roles within the community it makes it very difficult for people who are facing challenges to challenge the community as well.   This hopefully will give an opportunity for people to really empower them, to be able to say, “Actually, I can find the sources. I can get out of this.” So, it’s not the individual spirituality that would be a problem; it’s more the cultural interpretation of that.  Lucy: So, there’s room, in a way, for both?  Abdul: Absolutely. And I think anyone that understands how to deliver services to any community will know that if they’re culturally sensitive, they will work because people will accept them, because it relates to them as individuals. And therefore the two things need to work together, which is the psychology profession and those who are supporting mental health in general and the community to make sure that those misconceptions within the community are removed. And hopefully we’ll be able to do that this evening, or contribute to that this evening.  Lucy: Is this something that you think would be helpful for other communities around the UK to be doing?  Abdul: Absolutely. I’ve done similar events in a couple of places and I’ve always found that the response was tremendous. I think that based on those responses, hopefully what will happen tonight is that we will see that this is something that really needs to be rolled out. And the more this is done, the more access people will have to mental health services, and that can only be good for the minority communities.  Lucy: I know you’ve been travelling recently. Is there anything you wanted to say about the work that you’ve been doing abroad at all?  Abdul: Yeah, I was in Malaysia and Singapore. Each community that I go to has different kinds of issues. One of the things that I was addressing in Singapore is about pressure, the pressure to succeed, and how that affects young people in particular. Each community has its own manifestation of this, so we do need to be sensitive to what each community needs.   I think the most important thing for the community, all communities that are scared and there’s fear of the authorities and mechanisms, is just to try and put that behind you and make that first step. Because once you’ve made that first step to recognise that, “I need help and there are people to help me”, it’s all going to get better. We have to help people make that first step – and that’s for everybody: therapists, GPs and community leaders.  Lucy: Lastly, I spoke to Dr Durrani about his hopes for the event.  Aman: My name is Dr Aman Durrani and I’m a consultant psychiatrist based here in Glasgow. The event today is a good balance where we have the spiritual element from an Islamic scholar who can very much give the theological perspective, but also a trained therapist as well who can give a very practical method of how you can understand what’s going on in your body and your emotions and your thoughts and also what you can do about it.   Glasgow has a majority Pakistani and Muslim background population and so there are many cultural issues, ranging from the earlier generations where language might be an issue, for example. But I think even second, third and fourth generation where they maybe think, if there’s something wrong mentally, what are the ramifications if I get help, both for myself and my family, for marriage prospects, for career prospects.   Perhaps there are also issues in relation to, could this be something to do with cultural and religious issues such as possession from spirits, could it be black magic, could it be these other aspects. In my experience, people then will go and seek help from their religious leader, the imam, or community figures rather than going to their GP, for example, to seek help.   So, I think there are these issues of where that understanding is. And I think the important thing I guess I’m hoping from events like today is very much making people understand that these are common mental disorders, these are things that there’s treatment and there’s help available. But the starting point is understanding that there’s an issue and what might be going on and then where you can go for help.  Lucy: Is there anything you’d like to add for people listening who might be therapists or who might be people who are thinking about approaching their GP for help, anything you would like to say?  Aman: I think in my experience always is getting help sooner rather than later is important. I think it’s also important to be optimistic that help is available – sometimes it takes times, sometimes it means trying different things, but at the end of the day there’s lots that can be done for a lot of these mental health issues, particularly anxiety and stress.  Lucy: I was interested in recording this event because I think it’s really important that we do try and put on more outreach events that involve the public in the therapy that we’re offering them, and so that we can learn from them about what they best want or most need so that it’s really a two-way conversation rather than just explaining what CBT is to people.   I learned a lot about how Islamic culture might be misinterpreted but also how some of the literature is very supportive of seeking out a psychological approach.   These three people were speaking from quite different contexts that they were coming from, so psychiatric, psychological and more spiritual, but actually all of them were recommending that people seek help and were able to talk about how they feel. And all of them were talking about links between the mind and body and how those links can kind of go both ways.   I guess the message for the audience was that they don’t have to feel that they can’t seek psychological support because of their faith, which I think is a very important message to get across.   I think for therapists it’s particularly useful because maybe it might be quite tricky for a therapist who doesn’t necessarily have a great knowledge of Islamic literature to be able to reassure somebody that it’s totally all right to be seeking psychological support, but actually there’s a lot in the text that the Shayhk was talking about which would support somebody seeking help and that’s really reassuring.   That’s it from me in this special bonus episode of Let’s Talk About CBT. This podcast has been brought to you by the British Association for Behavioural and Cognitive Psychotherapies or BABCP. For more information, check out BABCP.com and also the show notes.   Thanks to Gabe Stubbing for the music, Eliza Lomas for editing consultation and Saiqa Naz, Shayhk Abdul Aziz Ahmed and Dr Durrani for their interviews.   If you have ideas for future CBT-related topics you’d like covered by this podcast, please email me at [email protected].  END OF AUDIO 

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Let's Talk About CBT is a podcast about cognitive behavioural therapy: what it is, what it's not and how it can be useful. Dr Lucy Maddox interviews experts in the field including people who have experienced CBT for themselves.  A mix of interviews, myth-busting and CBT jargon explained, this accessible podcast is brought to you by the British Association of Behavioural and Cognitive Psychotherapies. www.babcp.com