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Trauma Help From a Muslim Therapist
About Aisha Chaudhry
Aisha Chaudhry is an Aalimah and Muslim Therapist. She specializes in trauma which often looks like depression, anxiety including OCD, intrusive thoughts, health anxiety, and panic. She has a special interest in helping clients learn how to calm the body through a combination of neural informed therapies, Internal Family Systems, CBT, and Exposure-Response Prevention. For clients looking for integrated therapy, a holistic approach is available.
Table of Contents
Trauma Help from a Muslim Therapist
The information contained herein is to offer a comprehensive overview of trauma (not for treatment or diagnosis) with special emphasis on what trauma often looks like in some of the Muslim populations, particularly Muslim women I treat. It is important to get trauma help from a Muslim therapist, particularly, one who has studied Islam and who knows the Islamic rulings surrounding the issues clients seek treatment for. Getting help for anxiety from a Muslim therapist will be beneficial because:
- Therapeutic Alliance: It is important for the client to develop a good therapeutic relationship with the therapist. This can only happen if the client feels safe enough to discuss matters that they feel embarrassed about or fear they may be judged negatively due to them. Sometimes the themes related to the details are very difficult to communicate to anyone, which is one of the reasons for lack of seeking care at all. Additionally, to help the client feel comfortable with the treatment plan, the therapist should be comfortable with Islam and various Muslim cultures. The topics that often come up for Muslim populations are often related to what they value most, and often that is religious-oriented themes and contamination issues related Islam, culture, and legacy.
- Accurate Diagnosing. What trauma looks like among the Muslim population can significantly vary from other populations, which can cause a condition to either go undiagnosed or even misdiagnosed. Sometimes Muslims may seem to be more religious, have more piety (taqwa) or engage in more rituals to reduce anxiety. Behaviors may or may not reflect an accurate depiction.
What is Trauma?
Trauma is defined as an emotional response to a terrible event. This emotional response may include denial, shock, anger, and fear. Acute and chronic trauma can be differentiated based on the type of event experienced.
People’s response to trauma exists on a spectrum. Not everyone who experiences the same traumatic event will have the same response. Some people may go on to be diagnosed with post-traumatic stress disorder (PTSD), while others may be affected but for shorter periods of time or at a clinically undiagnosable level
Common Types of Trauma
Acute Trauma occurs when a person experiences one single traumatic event such as a death, natural disaster, assault, abuse, life-threatening incident, or accident.
Betrayal, infidelity, or a spouse taking another wife may also be included in this category. Being issued with divorce (talaq) can be an acute trauma. Failing a major exam or losing a job can be a trauma.
Basically, anything that happens to us that brings a shock to our system can be a trauma.
Chronic Trauma occurs when a person experiences multiple, long-term and/or prolonged traumatic events. Some examples include domestic violence, infidelity, betrayal, second or more marriages, bullying, addiction, sexual abuse, and long-term illness.
Complex Trauma is the result of multiple different traumatic experiences. Potential causes can include childhood abuse, domestic violence or civil unrest.
Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Not everyone who experiences traumatic events go on to develop PTSD. Having a healthy environment and support are factors that support the recovery of traumatic events.
Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.
Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.
Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.
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PTSD symptoms are generally grouped into four types:
- intrusive memories
- avoidance
- negative changes in thinking and mood
- changes in physical and emotional reactions
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Symptoms can vary over time or vary from person to person.
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Intrusive memories
Symptoms of intrusive memories may include:
- Recurrent, unwanted distressing memories of the traumatic event
- Reliving the traumatic event as if it were happening again (flashbacks)
- Upsetting dreams or nightmares about the traumatic event
- Severe emotional distress or physical reactions to something that reminds you of the traumatic event
Avoidance
Symptoms of avoidance may include:
- Trying to avoid thinking or talking about the traumatic event
- Avoiding places, activities or people that remind you of the traumatic event
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Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:
- Negative thoughts about yourself, other people or the world
- Hopelessness about the future
- Memory problems, including not remembering important aspects of the traumatic event
- Difficulty maintaining close relationships
- Feeling detached from family and friends
- Lack of interest in activities you once enjoyed
- Difficulty experiencing positive emotions
- Feeling emotionally numb
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Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:
- Being easily startled or frightened
- Always being on guard for danger
- Self-destructive behavior, such as drinking too much or driving too fast
- Trouble sleeping
- Trouble concentrating
- Irritability, angry outbursts or aggressive behavior
- Overwhelming guilt or shame
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For children 6 years old and younger, signs and symptoms may also include:
- Re-enacting the traumatic event or aspects of the traumatic event through play
- Frightening dreams that may or may not include aspects of the traumatic event
PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you’re stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a video, movie, or news report about an incident and feel overcome by memories of your own trauma.
It is essential to have a safe space to share your story. Trauma help from a Muslim therapist may be just what your heart, body, and soul needs to heal and recover.
What Individuals With Trauma Say
Traumatic events can cause a wide variety of symptoms. The symptoms can appear soon after the event or later on in life. It is also possible to have body symptoms without remembering that a traumatic event has occurred.
Clients often say things like:
- I have this powerful inner critic that I feel is driving me crazy.
- I can’t forgive, forget, or move on. It’s like I’m stuck.
- I get attacks that feel like panic, intense anxiety, and sometimes nightmares.
- I avoid that place because of the memory attached to it.
- Since they did that to me, I feel like I am broken.
- Growing up I suffered so much abuse that I can’t manage as an adult.
- I can’t figure out boundaries and people walk all over me.
- I have a huge desire to save and help other people, and I often feel like it’s my job.
- Sometimes it feels like I’m right back there reliving that moment.
- My self-esteem is so poor.
- I have a lot of intrusive thoughts that won’t quieten.
- I am so worried about disappointing others that I work so hard, often unnecessarily.
- I feel like I am going to have a breakdown before meeting certain people or going to some places.
- I will almost do anything to drown out the feelings I have.
- I’ve just kept myself on automatic pilot to cope.
- I have a lot of fears so I am always checking to make sure I didn’t do or say something wrong.
- I have a need for perfectionism and people-pleasing.
- I don’t want to say no to people because of the disappointment or backlash.
Trauma is About the System
When women come in for care while experiencing a whole host of symptoms in any combination like depression, anxiety, OCD, and relationship struggles, usually it is because of an underlying story needing safe space to share and heal from. It is not necessary that a traumatic event causes PTSD, but most often I do see a whole host of broad spectrum symptoms. Our primary goal together is to help you learn how to calm your system so you can process what happened to you and heal.
Am I a Bad Muslim?
When clients ask me if they are a bad Muslim because they are afraid, a part of my heart breaks. Sometimes people believe they are bad Muslims because of having fear for things or people other than Allah swt. Sometimes Muslims are shamed and are told they are less of a Muslim because of what they are experiencing. Anxiety help from a Muslim therapist will be exponentially beneficial because of helping you understand anxiety from a broader perspective that doesn’t cause shame and actually brings relief in sha Allah.
Truth be told, Anxiety serves great purposes. It lets us know there is something to be careful about. It is by divine design that we have a fantastic way of staying safe! The brain has learned that it needs to sign off some alarms to keep you safe, and sometimes those alarms get paired with different situations, and sometimes there is a faulty connection but the goal is still to keep you safe. When the brain has a hard time deciphering between real and perceived threats, we develop symptoms even when there isn’t anything to be worried about.
For this reason, we have to take the whole person into consideration along with the thought and behavior processes. Trauma help from a Muslim therapist will help because as Muslims, we can decipher between excessiveness, rigidity, and what kinds of fear and how to resolve it in a holistic way you’re comfortable with.
Please keep in mind, that I usually get a lot of background information and then analyze it in totality to help you determine if you are a very pious person or if you are unfairly excessive in one area. I absolutely do not judge and wholeheartedly invite you to explore this.
Why Do Bad Things Happen?
A lot of clients ask me why do horrible things happen to people. They ask me if Allah swt is angry with them or wants to punish them. If Allah swt is so merciful, then why does He allow terrible things to happen to innocent people.
Questions like this loom in the minds of people who’ve been through painful tragedies. While I in no way can answer for Allah swt, we can explain according to Islamic texts like the Qur’an and Ahaadith and also Psychological principles that are well-grounded.
What we know about the world is that there are all kinds of people living amongst us who have full liberty to make choices. As Muslims, we do believe that people will be accountable for the wrongs they do, but only believing that may or may not relieve the anxiety, grief, sadness, or others that might be caused as a result of what people do.
We do know for sure that it’s not the event itself that is the problem, but more so, the meaning that is derived from the traumatic event. If for example, someone begins to believe they are truly unsafe, they may develop anxiety symptoms that can show a little or a lot. If a person believes what happened to them was because they were bad, they may develop anxiety, depression, OCD, and a variety of personality disorders depending on how much they believe they are bad.
Essentially how we process events leads to us altering our ‘core’ beliefs about ourselves and our world. In therapy, we will work together to help you restore safety and esteem.
The fact that most people do not have extreme reactions to traumatic events, it means that other measures to help that person feel safe must have been in place to quickly restore homeostasis and wellbeing. Those measures would look like having a secure attachment to others and having safety and other needs met.
If we are struggling because of a traumatic event, it really means most likely there is something else which is an issue: the negative, limiting core beliefs developed during our childhood.
Now, when children are raised under continual stressors and abuse, it does not necessarily mean they are doomed to struggle. A major factor like having at least one adult in their life they could talk to or derive inspiration from is absolutely enough to help that person be alright.
Events that happen in our lives aren’t supposed to roll us over. What is ideally supposed to be in place is good, secure relationships. This is the underlying issue and the factor that builds resilience – the ability to bounce back after adversity.
So if we really hone into the problem now, most issues like abuse for example aren’t from Allah swt directly, but rather from people who used their freedom to decide and act to carry out that abuse.
It stands to reason that if we were to work on our individual and community health, we would improve as an Ummah and as a world.
In the meantime, we can absolutely work on building resilience and rewriting the meaning made from the stories you’ve lived which cause you pain. in sha Allah.
Trauma help from a Muslim therapist will help you keep all views inline and help you get some answers that may be circulating in your mind.
PTSD in Men vs. Women
Mental health experts agree that women can sometimes experience PTSD in different ways than men. For example, women with PTSD are more likely to feel depressed and anxious, as well as have trouble feeling or dealing with their emotions. They also tend to avoid activities and things that remind them of whatever traumatic event they suffered through. And while men with PTSD have a higher probability of turning to alcohol or drugs to mask their trauma, women are less likely to do so.
According to the nonprofit organization Solace for Mothers, some women who have a difficult time in the delivery room also suffer from a type of PTSD, and if left untreated, it can stay with them through their journey as a parent. It may also explain why some women do not want to go through childbirth again and may decide to stop having more children. This is very different from postpartum depression. Solace for Mothers seeks to support women who have been traumatized and prevent birth trauma.
When people are educated about how PTSD can affect women they have a better understanding of the fact that the disorder is not only a real medical problem, it is also highly treatable.
“Sometimes women will feel the need to be perfect, and admitting to something they perceive as a weakness may feel like the last thing on earth they want to do,” says Dr. Cira. “Women are constantly sent the message that they need to do it all, and do it all very well, which, of course, isn’t possible. But it does not change the fact that they still feel that way and live with that kind of pressure.”
Some of the psychological treatments that have proved to be effective in helping women cope with the symptoms of PTSD include Cognitive-Behavioral therapy (CBT), which helps someone put the emphasis on how they evaluate and respond to certain feelings, thoughts, and memories. Another type of treatment is Exposure Therapy, which is more of a behavioral treatment for PTSD. It can help someone reduce their fear and anxiety by having them confront the problems that caused them to be traumatized.
The first part of any true trauma treatment is normalizing the symptoms and experiences of someone who is struggling with PTSD. What does “normalizing” look like?
- Recognize that physical pain may be part of the process. For some people who struggle with PTSD they can have severe migraines, pain in the backs or even stomach and digestive issues.
- Be aware that “flashbacks and/or nightmares” can occur in anyone who has experienced a traumatic event. Often times they can be triggered by sounds, smells or a phrase that someone says.
This will help somewhat with the guilt, but making peace with a difficult past is a long process and dealing with the guilt is no exception. But with the right therapist, there is absolutely hope, especially when you find a therapist who understands how PTSD impacts a person’s thoughts, feelings, behaviors, relationships, and self-image
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Diagnosing Trauma
Diagnosing that someone has experienced trauma comes as a result of symptoms reported and questionnaires that report how much various symptoms are being expressed. I often use the PCL-5 to measure those symptoms, and then we can know if we’re improving in therapy by reassessing over time.
Symptoms are as previously mentioned and often look like a cluster of disorders or struggles like anxiety, depression, OCD, and various personality disorders.
Treating Trauma
Clients with symptoms of trauma who seek treatment will often experience improvements in their quality of life across all domains. For example, people who were lacking in focus, losing relationships, avoiding events, people, and memories associated with the traumatic event, feel hypervigilant, have flashbacks, struggling in relationships etc may notice they improve their functioning and are able to reengage in areas of life they value and improve relationships with people and relationships to ideologies that often help them even improve their spirituality and relationship with Allah swt.
Several types of therapies may be used to help clients with Anxiety. As a Muslim therapist dealing with Muslim clients, per my client’s comfort levels, I offer an integrated therapy helping them with Islamic principles and values that most find liberating. Please note that clients absolutely have the option of electing therapy without Islamic principles and values.
Trauma is painful. It not only alters how people interact with others but also how they understand or misunderstand themselves. It can lead to anxiety, self-harm, substance abuse, personality disorders, PTSD — the list goes on and on. The sooner a patient can access trauma-informed treatment, the sooner they can start to heal.
Trauma-focused therapy works with clients to help them understand their trauma and address their symptoms and problems in healthier ways.
Below are some (but not all) potential benefits of trauma therapy:
- Reduce or improve trauma-related symptoms
- Empower personal growth
- Manage regulation of the nervous system (e.g. heart palpitations, shaking, etc.)
- Refocus the present over the past
- Overcome addictions
- Eliminate or reduce self-harm
- Recognize hereditary trauma
- Implement healthier coping skills
- Improve self-worth and self-esteem
Trauma Focused Cognitive behavioral therapy (TF-CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness that stem from traumatic events.
Numerous research studies suggest that TF-CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications. Anxiety help from a Muslim therapist will be exponentially beneficial because of we’ll be able to reframe your experiences in ways that really make sense to you!
EMDR therapy is a phased, focused approach to treating trauma and other symptoms by reconnecting the traumatized person in a safe and measured way to the images, self-thoughts, emotions, and body sensations associated with the trauma, and allowing the natural healing powers of the brain to move toward adaptive resolution.
It is based on the idea that symptoms occur when trauma and other negative or challenging experiences overwhelm the brain’s natural ability to heal, and that the healing process can be facilitated and completed through bilateral stimulation while the client is re-experiencing the trauma in the context of the safe environment of the therapist’s office (dual awareness).
Through EMDR, individuals safely reprocess traumatic information until it is no longer psychologically disruptive to their lives. Over time, exposure to traumatic memories will no longer induce negative feelings and distressing symptoms.
EMDR has eight phases of treatment:2
- History taking
- Client preparation
- Assessment
- Desensitization
- Installation
- Body scan
- Closure
- Reevaluation of treatment effect
During EMDR, the person being treated focuses on a disruptive memory and identifies the belief they hold about themselves. If it is connected to a negative memory the technique teaches the person to change their view of themselves by learning to associate it with a positive belief instead.
For example, it is common for victims of abuse to feel they “deserved” the abuse. EMDR helps the person to see that as self-destructive thinking. So “I deserved it” becomes “I am a worthwhile and good person in control of my life.”
All the sensations and emotions associated with the memory are identified. The individual then reviews the memory while focusing on an external stimulus that creates rapid (or bilateral) eye movement. Typically this is done by watching the therapist move two fingers. After each set of bilateral movements (usually involving both eyes), the individual is asked how they feel.
This process continues until the trauma has been processed and the memory is no longer disturbing to the individual. The selected positive belief is then “installed”, via bilateral movement, to replace the negative belief.
Sessions typically last for an hour. It is theorized that EMDR works because the “bilateral stimulation” bypasses the area of the brain that processes memories and has become stuck due to the trauma. When a difficult/traumatizing memory is stuck, it prevents the brain from properly processing and storing the memory.
During EMDR, individuals process the memory safely and that leads to a peaceful resolution. The experience results in increased insight regarding both previously disturbing events and the negative thoughts about themselves that have grown out of the original traumatic event.
Internal Family Systems Therapy (IFS) is by far one of my favorite therapies for all-around well-being and transformational healing. IFS focuses on understanding where your emotions have sprung up from and what are their roles in your life. Most often they are to protect you from something. With IFS therapy, we work to negotiate with your emotions to help them stay on your side as your friend rather than taking you over like a boss. You will be empowered to be the driver of your life, not the driven. Then, we focus on identifying what you need to move toward safety and forward in wellness.
I often combine IFS with other modalities such as EMDR or alternative means of bilateral stimulation.
Understanding the neurobiology of trauma can be very helpful for individuals struggling with PTSD and trauma-related difficulties, such as anxiety and depression.
The limbic system is the part of the brain that lights up and becomes activated when an individual is experiencing a perceived threat. This activates the stress responses in the body, including fight, flight, or freeze.
When that threat is perceived, the brain releases adrenocorticotropic hormone, which tells your body to release cortisol. The amygdala also tells your adrenal glands also produce adrenaline, which helps you fight or run away during a threatening situation.
The amygdala can assist in learning; however, cortisol shuts down the way that the hippocampus primarily functions. So while you may be able to survive a traumatic event, it has not been properly encoded into your brain as a memory due to the hippocampus being shut down.
This is why individuals with Post Traumatic Stress Disorder (PTSD) experience flashbacks, intrusive thoughts and behavioral reenactments. Because their brains think that the event is still happening.
All of the recommended therapies include neural informed components. Some forms or severity of anxiety will not be managed by merely talking about it and reframing. So it is important to include body work as a part of learning to regulate the body response to stressors. Some of this work includes:
- Breathing exercises
- Polyvagal exercises
- Visualization
- Meditation
- Grounding
- EMDR
As a Muslim therapist and Aalimah, I had the pleasure of identifying special practices we can do which are found in the Quran, Sunnah, and are in line with grounded science that can reduce symptoms associated with various anxieties.
I have created an Islamic Based Mindfulness Stress Reduction Program which is a program you can follow at your own pace. During individual sessions, I do integrate these practices per the client’s comfort and desired level.
I take therapeutic interventions like grounding and integrate them Islamically for the holistic nourishment of the heart, body, and soul. The very same principles from science that have powerful effects on the nervous system are used which highlight and encourage your own identity.
Anxiety help from a Muslim therapist will be exponentially beneficial because of helping you do what you already are doing, but in a way that will bring further relief in sha Allah.
When treating depression, several drugs are available. Some of the most commonly used include:
- Selective serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa), escitalopram oxalate (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine HRI (Paxil), and sertraline (Zoloft).
- Selective serotonin & norepinephrine inhibitors (SNRIs), such as desvenlafaxine (Khedezla), desvenlafaxine succinate (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor).
- Vortioxetine (Trintellix formerly Brintellix) and vilazodone (Viibryd) are newer medicines that both acts as SSRIs and also affect other serotonin receptors.
- Tetracyclic antidepressants that are noradrenergic and specific serotonergic antidepressants (NaSSAs), such as Remeron.
- Older tricyclic antidepressants, such as Elavil, imipramine (Tofranil), nortriptyline (Pamelor), and Sinequan.
- Drugs with unique mechanisms such as bupropion (Wellbutrin).
- Monoamine oxidase inhibitors (MAOIs), such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (EMSAM), and tranylcypromine (Parnate).
- N-methyl-D-aspartate (NMDA) Receptor Antagonist, such as esketamine (Spravato)
- While not technically considered a medication by the FDA, l-methylfolate (Deplin) has proven successful in treating depression. It is categorized as a medical food or nutraceutical, requires a prescription and is the active form of a B-vitamin called folate. L-methylfolate helps regulate the neurotransmitters that control moods.
Your health care provider can determine which drug is right for you. Remember that medications usually take four to eight weeks to become fully effective. And if one medication does not work, there are many others to try.
In some cases, a combination of antidepressants may be necessary. Sometimes an antidepressant combined with a second antidepressant from a different class, or a different type of medication altogether, such as a mood stabilizer (like lithium) or atypical antipsychotic (like aripiprazole [Abilify], brexpiprazole [Rexulti] or quetiapine [Seroquel]) can boost the effect of an antidepressant alone.
Side effects vary, depending on what type of medication you are taking, and may improve once your body adjusts to the medication.
If you decide to stop taking your antidepressants, it is important that you gradually reduce the dose over a period of time recommended by your doctor. Quitting antidepressants abruptly can cause discontinuation symptoms such as headache or dizziness or increase the chance that symptoms will return. It is important to discuss tapering off (or changing) medications with your health care provider first.
When treating anxiety disorders, antidepressants, particularly the SSRIs and some SNRIs (serotonin-norepinephrine reuptake inhibitors), have been shown to be effective.
Other anti-anxiety drugs include the benzodiazepines, such as as alprazolam (Xanax), diazepam (Valium), buspirone (Buspar), and lorazepam (Ativan). These drugs do carry a risk of addiction or tolerance (meaning that higher and higher doses become necessary to achieve the same effect), so they are not as desirable for long-term use. Other possible side effects include drowsiness, poor concentration, and irritability. Some anticonvulsant drugs (such as gabapentin [Neurontin] or pregabalin [Lyrica]), some blood pressure medications (such as propranolol), and some atypical antipsychotics (such as aripiprazole or quetiapine or Seroquel) are also occasionally used “off label” to treat anxiety symptoms or disorders.
As a therapist, if you feel you need medication or are not improving in therapy, I may suggest that you see a Psychiatrist. While I do have full diagnostic and therapeutic treatment rights, I do not prescribe or suggest the use of medications. A Psychiatrist will determine if or which medication may be useful for you, and you may decide if medication is something you would like to use to improve.
Disclaimer
None of the information on this website is intended to diagnose or treat any condition. This information is for educational use only. Please get treatment if you feel you are struggling with different symptoms.