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Lecture to 2nd year medical students on 26th February 2000 at the Kulliyah of Medicine, International Islamic University, Kuantan by Professor Omar Hasan Kasule Sr.
OUTLINE
1.0 CONCEPTS
A. Human Emotions
B. Human Drives
C. Basis For Emotions:
D. Basis for Drives
E. Relation Between Drives And Emotions:
2.0 PLEASANT EMOTIONS
A. Love
B. Hope
C. Elation
D Tranquility
E. Empathy/kindness
3.0 UNPLEASANT EMOTIONS
A. Fear
B. Rage
C. Hatred, enmity, and aggression
D. Sadness, anxiety, despair, and laziness
E. Jealousy
4.0 STRESS
A. Qur’anic definition
B. Causes of stress
C. Stress pathway
D. Reaction to stress
E. Coping with stress
5.0 EMOTIONAL DISORDERS
A. Emotional immaturity
B. Schizoid affective disorders
C. Manic depressive affective disorders
D. Behavioral dysfunction
B. Social dysfunction
1.0 CONCEPTS
A. HUMAN EMOTIONS
Humans, like animals, have emotions. The emotions may be pleasant such as joy or unpleasant such as anger. Emotions involve both mental and physical aspects. The mental aspects involve the human intellect, the reception and interpretation of sensory signals and synthesis of all these into a resultant emotional state. Physical effects follow the emotional state. One of the physical effects in the way emotions are expressed. Humans have developed very sophisticated ways of expressing their emotions using the facial muscles, the eyes, a complex body language and least of all verbal expressions. Humans are also adept at hiding or even suppressing their emotions. They can also with some effort pretend to be in an emotional state that is not true; however the effort can not be sustained for any measurable length of time.
The Qur'an has described the changing emotional states of humans for example happiness, sarrai, and sadness, dharrai (p 1181 10:21, 22:11, 30:33, 30:36). The heart is the seat of emotions. The Qur'an has described several emotional states of the heart: inshiraah (p. 957 6:125, 20:25, 39:22-23, 94:1), taqwah (p. 957 22:32, 49:3), khusu'u (p. 957 57:16), dhiiq (p. 957 4:90, 6:125, 7;2, 10:88, 11:12, 15:97, 26:12-13, 39:45), tama'aninat (p. 957 2:260, 8:10-11, 11:120, 13:28, 18:14, 25:32, 28:10, 48:4, 48:18), qaswat (p. 957 2:74, 5:13, 6:43, 22:53, 39:22, 57:16), liin (p. 958 3:159, 39:23), and waswasat (p. 958 114:5). The heart can also experience various emotional reactions, infi'alat such as ulfat (p. 959 3:10, 8:63, 9:60), tanafur (p. 959 59:14), hasrat (p. 959 3:156), khawf (p. 959 3:151, 8:2, 8:12, 22:35, 23:60, 28:10, 33:10, 33:26, 40:18, 59:2, 59:13), ra'fat (p. 959 57:27), rahmat (p. 959 3:159, 57:27), riibat (p. 959 9:45, 9:110), zaygh (p. 959 3:7), and ghaldhat (p 959 3:159).
The Qur’an has mentioned that diseases of the heart underlie the following emotional expressions and consequences: lahw (p. 958 21:3), ghaflat (p. 958 18:28), ghill (p. 958 7:43, 15:47, 59:10), ghaidh (p. 958 3:118-119), kibr (p. 958 40:35, 40:56), and nifaaq (p. 958 2:8-10, 2:204, 3:167, 5:41, 9:8, 9:64, 9:75-77, 48;11).
B. HUMAN DRIVES
Humans, like animals, are motivated to take action by basic drives that are almost instinctual in essence. These drives are all related to the basic need of survival. The basic drives are hunger, thirst, sex, self-protection & security, sociability, and inner promptings of the nafs. The food and sex drives are the strongest and are necessary for the preservation of the species. The food drive is so strong that It is recommended to eat before prayer (KS p. 315). Surat Quraish placed food security before personal security. The sexual drive in its purely animal form is mere lust, shahwat (MB # 2110 p 989. The drive to protect oneself against danger is a basic human drive to ensure security. It includes ghiirat, shuhh, jubn, and bukhl. Ghiirat is natural that is why it is forbidden to combine 2 closely related women in marriage like step-daughter or sister of wife (Muslim #3268, 3412, 3413, MB Chapter 30). Ghiirat can be positive when used by a male to protect female members of the family from sexual exploitation. Covetousness, shuhhu (4:128, 59:9, 64:16), is the attribute of humans that makes them want to accumulate and keep material possessions and yet never get satisfied (Muslim #2282, 2283, 2284, 2286). The desire for material things may be a reflection of basic human insecurity. True wealth is contentment (Muslim 2287) and not having a lot of material possessions. Cowardness, jubn, is another manifestation of human self-preservation in which humans fear taking a stand for what they know is right for fear for their lives, property, or other personal interests. Niggardiliness, bukhl, (p. 187 3:180, 4:36-37, 17:29-30, 17:100, 25:67, 23:19, 47:36-37, 57:23-24, 59:9, 64:16) is refusal of humans to share their wealth because of the insecurity that it will be finished and they will have nothing left. Socialibility, ulfat, was mentioned in the Qur'an (3:10, 8:63, 9:60). Humans are social animals and they find human fulfilment in interacting with others. Reaching out to others is a result of very strong human drives. Loneliness is avoided as much as possible. Humans are also driven by evil promptings of the nafs described by the Qur’an as: shahwat al nafs, hiwa al nafs,and waswasat al nafs. Hiwa al nafs was mentioned in the Qur'an (79:40, 2:87, 5:7, 53:23) & (2:87, 5:70, 6:71, 6:119, 7:186, 18:28, 20:16, 23:71, 28:50, 30:29, 47:1, 47:16, 53:23, 54:3) and was condemned (KS p. 556). Hiwa blinds and deafens (KS p. 557). The Qur’an also described shahwat al nafs (21:102, 41:31, 43:71) that can be occult, shahwat khafiyyat (KS p. 557). People who follow their hiwa should be avoided (KS p. 537). Waswasat al qalb (5:30, 50:16, 114:5) is not a sin (MB#1142) unless accompanied by sinful behavior.
Humans have drives more and above the animal drives described above. These drives are higher and nobler; they are not only elicited by hope for reward or fear of punishment; they have loftier goals and objectives. The main lofty human drives are: honor, sharaf; altruism, iithhar (p 1250 59:9; p 171 12:91, 20:72, 59:9), faith, iman (p 1250 6:158, 10:100), consciousnes of Allah, taqwah (p 1253 91:7-8), seeking the pleasure of Allah, ridhallah (89:27-28); seeking knowledge, talab al ‘ilm; appreciation of esthetic beauty, and self-actualization. Honor, sharaf, is one of the higher drives that many humans do not have or do not value. A believer has a feeling of self-worth and self-respect, izzat (5:54, 63:8). Having self dignity is fulfillment of the honor that Allah gave humans. Animals have no sense of dignity. Honor is so important that death while protecting honor is martyrdom (Muslim #259).
There is disagreement whether the basic drives are innate or are external (elicited by rewards and incentives). Our preference is for the opinion that they are innate. It appears from many scientific observation that there is a biologic basis for some of the drives
C. BASIS FOR EMOTIONS:
Human emotions have a basis in both iman and organic factors. In practice the two interact and influence one another. Humans are distinctive from other creations of Allah in that they have emotions that they can control because of their iman and higher sense of moral rectitude.
Iman is the basis for consistent pleasant emotions. A believer is in emotional equilibrium with Allah, fellow humans, and the environment. Diseases of the heart underlie many of the unpleasant emotions.
Many human emotions can be explained on an organic basis. The limbic system is thought to be the seat of emotions. In humans this system can be over-ridden by the cerebral cortex thus making humans able to control their emotions. Rage and aggression are controlled by the hypothalamus and the limbic system.
D. BASIS FOR DRIVES
Sex behavior is controlled by the cortex, the limbic system, the hypothalamus, and the endocrine glands. Hunger controlled by the satiety and feeding centers. The thirst center controls drinking.
E. RELATION BETWEEN DRIVES AND EMOTIONS:
Drives are inside and emotions are their external manifestations. There is a close relation between the two. Drives lead to and control emotions. Satisfaction of drives is associated with pleasant emotions. Dissatisfaction of drives is associated with unpleasant emotions. Many unpleasant emotions may result from conflict between drives. Unpleasant emotions can also occur when the drive is unattainable or it is in conflict with results of logical intellectual analysis. A drive could be satisfied in more than one way. For example the sex drive could be satisfied through legal marriage (Muslim # 3242) or through illegal sexual intercourse, zina. The purpose of religion is to direct humans to correct control of their drives. It is wrong to deny that drives exist or to try to suppress them. Suppression will be successful for only a short time. It is better to direct and channel the drives in a positive direction.
Actions are based on and follow intentions. There are many ambivalent situations when two contradictory drives are present at the same time. Humans differ from animals in that they are above to control their drives. This control is not always perfect. It depends on the individual and the circumstances. Humans are rewarded according to how well they control these drives. Rewards are given for suppressing negative drives or redirecting them such that they become positive and useful. Punishment is given when positive drives are not nurtured or are expressed in the wrong context. In His mercy to humans, Allah rewards them for good intentions and does not punish them for bad intentions. There is punishment only if a negative intention is actually translated into a negative action (Muslim #230, 231, 233, 234, 235, 236, 237).
2.0 PLEASANT EMOTIONS
A. LOVE, hubb
Love is the most pleasant of human emotions. Love of Allah is the highest level of love (2:165, 3:31, 5:54, 9:24). Human love for Allah is reciprocated by Allah's love for humans. Love of Allah and by Allah is associated with many positive behaviours: excellence, ihsan (2:195, 3:134, 3:148, 5:13), reform, islah (2:205, 5:64, 28:77); trust, amanah (4:107, 8:58, 22:38); charity, infaq (2:177, 86:8); consciousness of Allah, taqwah (3:86, 9:4, 9:7); humility, tawadh'u (4:36, 5:54, 16:23, 28:76, 31:18, 58:23); repentance, tawbat (2:222); patience, sabr (3:146); obedience, ta'a (3:31-32); reliance on Allah, tawakkul (3:159); purity, taharat (2:222, 9:108); good word, taib al kalaam (4:148); justice, 'adl (2:190, 3:57, 3:140, 5:42, 5:87, 7;55, 42:40, 49:9, 60:8); not wasting, 'adam al israaf 6:141, 7:31); and unity, wahdat (61:4). Allah's love is denied to non-believers (2:276, 3:32, 22:38, 30:45). Love of the Prophet Muhammad (PBUH) comes next to the love of Allah (Muslim #70, 71). Love of Allah and His messenger are part of faith, iman, (KS p. 179). There is love for blood relatives (9:24), children (12:8), and the erotic love for spouses (30:12). Sexual love can be a disease if excessive and for the wrong reasons. It could be positive such as the Prophet’s love for his wife Aisha and negative such as the love of Aziz’s wife for Yusuf (12:30). Excessive uncontrolled sexual love/passion, ‘ishq, can be a disease treated by marriage or fasting. Love is also possible for unrelated people and friends. The Prophet loved Usamah Ibn Zayd (KS p.74). Love of others should be for the sake of Allah (KS p. 179). When one loves a brother he should tell him so (KS p. 179). Love of the material possessions of the earth, hubb al duniya, is the opposite of the love of Allah (2:165, 2:216, 3:14, 3:92, 3;152, 3:188, 9:24, 14:3, 16:107, 38:31-32, 41:17, 75:20, 76:27, 89:20, 100:8).
B. HOPE
Hope, raja / amal (p. 482 2:218, 4:104, 10:7, 10:11, 10:15, 11:62, 17:28, 17:57, 18:110, 24:60, 25:21, 25:40, 29:5, 28:86, 29:36, 33:21, 35:29, 39:9, 45:14, 60:6, 71:13, 78:27, MB # 2106 p 988). Hope has to do with good feekings about the future. Tomorrow is better than today. Only those with iman can have a sense of hope. This is because they have a larger picture and see a larger reality. Hope is from Allah (Muslim #6875, 6877, 6878, 6880).
C. ELATION
Elation, suruur / farah: The Qur'an has mentioned happiness as suruur (p. 572 2:69, 3;120, 3;170, 3;188, 6:44, 9;50, 9:81, 10:22, 40:58, 11:10, 13:36, 19:26, 20:40, 23:53, 25:74, 27:19, 27:36, 28:9, 28:13, 28;76, 30:4, 30:32, 30:36, 33:17, 33:51, 40:75, 40:83, 42:48, 57:23, 76:11, 80:38-37, 84:9). Happiness has also been described as sa'adat (p 573 5:119, 9:100, 11:105, 11:108, 13:28, 16:106, 16:112, 20:130, 22:11, 22:59, 58:22, 69:21, 89:27-28, 92:21, 93:5, 98:8, 101:7). Laughter can be a sign of happiness (p. 725 9:82, 11:71, 23:110, 27:19, 43:47, 53:43, 53:60, 80:39, 83:29, 83:34). Happiness is a state of good feeling that is temporary because the challenges of daily life for adults preclude continuous elation. Elation could be due to material or even non-material things.
D TRANQUILITY
Tranquility is a state of emotional equilibrium. Tranquility has been mentioned in the Qur'an as itm'inan (89:27, 2:260, 8:10-11, 11:120, 13:28, 18:14, 25:32, 28:10, 48:4, 48:18) as tama'iniinat (2:260, 3:126, 4:103, 5:113, 8:10, 13:28, 16:106, 16:112, 17:95, 19:26, 20:40, 22;11, 28:13, 33:51, 89:27), and as sakiinat (2:248, 7:189, 9:20, 9:40, 9:103, 30:21, 48:4, 48:18, 48:26). A sense of tranquility is felt after prayer, reciting Qur'an (Muslim #1739, 1740, 1742), and accomplishing a good act. Satisfaction of basic physical and psychological needs is a pre-requisite for tranquility. Recitation of the Qur’an leads to tranquility. Children can be a source of tranquility, qurrat 'ayn (p 939 19:26, 20:40, 25:74, 28:9, 28:13, 32:17, 33:51).
E. EMPATHY/KINDNESS
Mercifulness, rahmat: 3:159, 57:27. A kind predisposition toward self and others is a reassurance of our basic humanity. Empathy, hulm: p. 345 9:114, 11:75, 11:87, 37:101.
3.0 UNPLEASANT EMOTIONS
A. FEAR, khawf
Fear is a negative emotional state due to real or imaginary fears. The Qur'an discussed khawf (p. 405 2:114, 2:155, 2:182, 2:229, 3:151, 4:3, 4:9, 4:34-35, 4:83, 4:128, 8:12, 9:28, 9:56, 11:70, 11:74, 16:112, 19:5, 20:21, 20:68, 24:50, 24:55, 27:10, 28:31, 29:33, 33:19, 33:26, 38:22, 39:26, 40:26, 51:28, 59:2, 106:4). The term faza'u has also been used by the Qur'an to mean fear (p. 895 21:103, 27:87, 27:89, 34:23, 34:51, 38:22). Fear was also mentioned in the hadith (MB # 2106 p 988).
B. RAGE, ghadhab
The Qur'an described human anger, ghadhab al insan/sakhat al insan (p 569 9:58, 21:87, 7:154, 42:37, KS 415). A person should be angry only for Allah (p. 869 7:150, 7:154, 20:86). Rage and aggression are related to drives and emotions. Rage is natural (Muslim #6319) and can not be avoided. What is needed is self-control to avoid negative consequences (KS p. 68, Muslim #6311, 6313, 6314, 6316, 6317). Anger can be calmed down, taskiin al ghadhab (p 869 7:154, 42:37). Quarelling, usually associated with rage, is discouraged (MB#1107). Other ways of controlling rage are fasting (Muslim #2563) and recitation of the Qur'an (KS p. 397).
C. HATRED, ENMITY, AND AGGRESSION
AGGRESSION, 'udwaan:
The Qur'an described aggression in several verses (p. 795-796 2:61, 2:65, 2:85, 2:178, 3:112, 4:14, 4:30, 5:78, 50:24-25).
ENMITY, adawat:
The Qur’an described enmity in many verses (p. 785 3:103, 4:45, 5:14, 5:64, 5:82, 5:91, 7:150, 9:83, 20:80, 26:77, 28:8, 28:15, 28:19, 43:67, 46:6, 60:2, 60:4, 60:7, 64:14).
HATE, kurh:
Humans can hate for various reasons most of the time related to self-interest or one of the diseases of the heart. It is unfortunate that the emotions of love and hate are closely related. Humans normally hate those they loved before such as spouses (4:19) or those they are supposed to love such as children (16:57-59, 16:62, 43:17-18).
D. SADNESS, ANXIETY, DESPAIR, AND LAZINESS
HAMM
Hamm was mentioned in the Qur’an (p. 1293 3:154, 12:83, 16:58, 40:18, 43:17, 68:48)
GHAMM
Ghamm was mentioned in the Qur’an (p. 873 3:153-154, 10:71, 20:40, 21:88, 22:22-23, 80:40. KS 78).
SADNESS
The Qur'an gas described sadness as huzn (3:139, 3:153, 9:40, 9:92, 1;24, 28:8, 29:3, 33:51, 58:10) and as kadhm (3:154, 12:84, 16:58, 40:18, 43:17, 68:48). Expression of sad emotions is by crying and other facial expressions (p 910 5:83, 9:92, MB # 662 p 329 & # 663 p 330). There are many causes of sadness one of them being separated from loved ones, al huzn ala al firaaq (p 333 12:13, 12:84, 12:86, 20:40, 28:7, 28:13). The Qur'an has told us that there will be no sadness in paradise (p 333 2:38, 2:62, 2:112, 2:262, 2:27, 2:277, 3:170, 5:69, 6:48, 7:35, 7:49, 10:62, 35:34, 39:61, 41:30, 46:13).
DESPAIR
The Qur'an has decribed despair as wahn (3:146, 8:18, 19:4, 29:41, 31:14) and also as ya'as (p 1326 2:282, 5:3, 11:9, 12:80, 12:110, 13:31, 17:83, 41:38, 41:49). Wishing for for death, an act of despair, is forbidden MB # 2210 p 1027, MB # 2211 p 1027
LAZINESS
Laziness, kasl (KS p. 78, p. 999 4:142, 9:54) is a result of despair and giving up. It is lack of drive to achieve.
JAHD AL BALA & DARAK AL SHAQA KS P. 78
E. JEALOUSY
Envy, hasad: Hasad (2:109, 4:32, 4:32, 4:54, 48:15, 113:5, MB # 2112 p 990). Jealousy, hatred, hostility: Muslim #6205, 6209. Jealousy and turning away from one another were forbidden (KS 68).
4.0 STRESS
A. QUR’ANIC DEFINITION
The Qur'an has described stress as tightness of the chest, dhiiq al sadr (p. 670 6:125, 11:12, 15:97, 26:13, 29:33). It also has described stressful life as maishat dhankat (p. 735 20:124). The oppposite of stress is inshiraah al sadr (p. 69 6:125, 10:57, 16:106, 20:25, 94:1). Stress involves psychological stress, dhiiq nafsi (p. 736 6:125, 9:25, 9:118, 11:12, 11:77, 15:97, 16:12, 18:6, 26:3, 27:70, 29:33, 35:8, 65:6).
B. CAUSES OF STRESS
Stressful events are traumatic, uncontrollable, and unpredictable. Examples are: trauma, temperature, emotions. Travel is stress (KS p. 280). It is part of human nature to be inpatient, al ajalat fitrat insaniyat (p 784 17:11, 21:37, 7:20, 76:27). Thus when confronted by a problem that can not be resolved quickly they become stressed. Life is full of difficulties, ‘usr (p. 810 9:91-92, 19:73, 25:26, 54:8, 65:6, 74:9, 92:10). Allah helps those in difficulty (p 810 2:280, 9:60). He causes difficulty to be removed by ease, zawal al usr bi al yusr (p. 810 2:185, 2:280, 65:7, 94:5-6). Each difficulty, ‘usr, is accompanied by what makes it easy, yusr (p. 1332 2:185, 2:280, 65:7, 74:9-10, 92:10, 94:5-6). Patience is called for in moments of difficulty (p. 810). However many people when in trouble forget this and fall into stress.
C. STRESS PATHWAY
The environmental stress ir relayed to the CNS by the sensory pathways. The CNS relays it to the hypothalamus through the limbic system. The hypothalamus releases beta-LTH, ACTH, and beta-endomorphin. ACTH acts on the adrenal cortex to release cortisol which causes systemic effects. Beta endomorphin causes release of GH and prolactin which act on the liver to lead to hyperglycemia.
D. REACTION TO STRESS
Psychological reactions to stress: anxiety, anger & aggression, apathey and depression, cognitive impairement
Physiological reaction to stress:
Effects of stress on health
E. COPING WITH STRESS
Coping with stress: denial, projection, repress, rationalise, reaction-formation
Personality and stress: type A & B
5.0 EMOTIONAL DISORDERS
A. EMOTIONAL IMMATURITY
Emotional immaturity is basically refusal to accept and deal with emotions in a balanced way
B. SCHIZOID AFFECTIVE DISORDERS
C. MANIC DEPRESSIVE AFFECTIVE DISORDERS
D. BEHAVIORAL DYSFUNCTION
Human behavior in the default state of fitra will be perfect. The human has both the good and bad drives. In the natural state the good will dominate over the bad. However humans do not always live in a natural state. Their upbringing and environment affects the balance between the bad and the good. The environment can suppress or reinforce either the bad or the bad.
Control of animal drives: MB # 661 p 329. Fasting controls sexual urges MB # 927 p 440
Control of emotions:
Patience (sabr): 18:28, KS p. 302. Fasting is one half of patience (KS p. 324). Sustenance from patience (2:45, 2:153)
Channeling/directing drives:
C. SOCIAL DYSFUNCTION
It is natural for humans to be with others. Social isolation is not normal. The Qur'an talked about social company, suhbat (p. 666 2:254, 4:1, 4:36, 4:69, 6:7, 7:184, 9:40, 9:70, 12:39, 12:41, 15:78, 15:80, 17:73, 18:9, 18:34, 18:37, 18:76, 20:135, 21:43, 24:61, 25:28, 25:38, 26:61, 26:101, 26:176, 29:15, 31:15, 34:46, 36:13, 38:13, 40:18, 41:34, 43:67, 50:12, 50:14, 51:59, 53:2, 54:29, 60:13, 68:48, 70:10, 69:35, 70:12, 74:31, 80:36, 81:22, 85:4, 105:1). Humans hate loneliness. Prophet Zakariyah prayed to Allah not to be left alone (p. 888 21:89). One of the calamities of the last day is that every human will be alone (p 888 6:94, 19:80, 19:95). The Qur'an condemns separation, al furqat (p 894 2:102, 3:105, 6:153, 6:159, 7:107, 11:17, 18:21, 19:37, 42:14, 98:4). The Qur'an goes further to forbid separation, nahy al furqat (p 894 3:103, 3:105, 30:31-32, 42:13). Emotions and the resultant behavior could help or hinder social interactions.