Psychology and Mental Health Within Different Contexts Throughout Arab populations

By: Zainab Al-Dhurafy

Abstract

This paper explores the historical and contemporary contexts of Arabs and the psychology within those contexts. It begins by examining the Islamic Golden Age, a period in which education in psychology was thriving and psychoanalytic thought was being developed. The paper then shifts to the present-day experiences of Arabs who are immigrating or being displaced to different settings, and how their experiences with mental health and psychology differ from those in the Golden Age. Additionally exploring the impact of acculturation, discrimination, and societal stigmatization on mental health among Arabs. Through this analysis, the paper sheds light on the need for mental health support that considers the different stressors prior to and post-resettlement of refugees and immigrants. Highlighting the importance of understanding the historical and contemporary contexts in which these individuals live.

Keywords: McLuhan, anxiety, depression, acculturation, immigrants, Arabs, illness, refugees

Introduction

Psychology in and of itself is a fairly new concept, accepted as an official scientific discipline in only 1879. This, however, does not diminish the various studies and philosophies that were produced on the topic beforehand, whether by scientists, physicians, or philosophers themselves. During the rise of the Islamic Golden age (8th-14th century), key players at the time had acquired forward and innovative thinking and much of what is studied today is accredited to them. The concept of mental illness and those suffering from it were often stigmatized (Mitha, 2020). This brings up a vital point, that is, “The Medium is the Message”, a concept created by Canadian philosopher Marshall McLuhan in 1964, highlighting the importance of where the message is coming from as the crucial determinant of how it is portrayed and its effectiveness, sometimes playing a larger role than the message itself. This was precisely portrayed as the Golden Age of Islamic culture took a rise, and experts in the field introduced an educated light to psychology (Ansari, 2006). This created a more well-rounded community, dismantling common stigmas around mental illness and instead implementing antidotes for those battling mental health struggles. The medium was medical books written by well-known polymaths that held great influential powers. As McLuhan explains in his famous text, social consequences arise when a new form of influence like progressive technology takes place and strengthens a message (McLuhan, 1964). In this case, credible physicians and polymaths were the extensions of the population or the “medium”.

In the second cultural context where Arabs are not the majority, are immigrants, and in completely different historical times, the observation of their mental health and susceptibility to new knowledge is observed. In this context, pushing for mental health literacy through educational curriculums and the health care industry, such as family practitioners, to place careful emphasis on minorities' and immigrants’ mental health would be an effective medium to push for change. Studies on immigrants’ mental health and their means to seek help are limited and must be further explored in the future, taking advantage of new outlets, including social media, healthcare industries, and educational settings. In the latter research, immigrants whether young or older and acculturated or not, will be observed and their overall well-being and mental health will be brought forth through various credible studies. Aiming to bring light to the tribulations of minorities and expand progressive technologies to aid accordingly.

Background

With the Islamic Golden age ahead and the uprising of many well-known scholars even today, psychology was further delved into, and countless therapies and outlets were introduced by many scientists that will be mentioned throughout this research, such as Ibn Sina known as Avicenna, Al-Razi known as Rhazes, Al- Balkhi, and Al- Farkh, all of which play a pivotal role in shaping psychology and paving the path for those who battle mental illness. These scientists and experts in their field continued each other's work and greatly impacted psychological theories that still hold ground today. This essay will cover the context in which Arabs were thriving in their homeland and were within the majority. Polymath experts and their innovations created a progressive medium in which mental health and psychology overall were looked at in a new and enlightened way.

Rhazes is credited with creating the first terminology for various forms of psychological ailments as well as the earliest documented classification of mental illnesses. He wrote a great deal about the many psychological and emotional states that people experience, such as hysteria and melancholy. Rhazes was the first to acknowledge the significance of psychotherapy and its function in the treatment of mental diseases (Rassool & Luqman, 2022). He went on to create a book titled "Kitab Al Mansuri" that described therapies including cognitive-behavioral therapy and psychotherapy­­–With his outstanding literary work and medical certification. Based on behavioral observation and knowledge of the person's thoughts and feelings, he created a system to distinguish between normal and pathological mental states (“Kunnash al-Mansuri,” n.d.). After spending great lengths of his life writing books on philosophy and the intersection of science, he became the director of the first psychiatric wards in the world, in Baghdad hospital in Iraq. As Arshad Islam describes in the journal, Origin and development of Unani medicine: An analytical study, Rhazes believed in the importance of understanding the underlying causes of psychological disorders and emphasized the importance of the connection between the physician-patient and how the relationship between them affects the overall morale and effectiveness of treatments (Islam, 2018). Additionally, Rhazes made contributions to the understanding of the brain, including the concept of the “brain” as a separate organ from the heart. These contributions are significant in that they provided a foundation for the development of modern psychology and psychiatry.

Avicenna, an Iranian philosopher, theologian, and physician born in 980 CE, significantly impacted the growth of knowledge at this time. He is regarded as one of the most influential individuals in the history of medicine and is most known for his work, "The Canon of Medicine," which was used extensively in the Islamic world before being translated into Latin and serving as Europe's primary medical textbook for many centuries (“Personalized healthcare at Avisena,” 2018). This literature covered a wide range of topics related to mental health and offered helpful guidance on how to identify and treat psychological problems like mania, depression, insomnia, and many others. In his "flying man" mental experiment, Avicenna attempted to explain the concept of self-awareness by imagining a man suddenly isolated from all external sensations (Mosavat et al., 2017). Avicenna was a forerunner in his awareness of the significance of the connection between physical and mental health. He was a firm believer in the value of spiritual well-being and its beneficial effects on mental health (Rassool & Luqman, 2022). Stressing the concept of moderation and the crucial role moderation in all aspects of life plays in one’s overall quality of life. Avicenna published writings on the concepts of association, memory, and imagination as well as on the significance of emotions in psychological health. Later philosophers such as Descartes and Hume, drew inspiration from Avicenna's teachings, and a plethora of their works showcase that (“Subjectivity and selfhood,” n.d.). In line with this, Avicenna wrote regarding things like the nature of the soul, the strength of dreams, and the value of education. The enormous psychological contributions made by Avicenna during the Islamic Golden Age had a significant impact, and his work continues to influence psychological study today. Avicenna's contributions to psychology and his comprehensive view of mental health inspired and informed many and acts as a guide amongst Arab communities (Mitha, 2020). Concludingly, Avicenna introduced the importance of internal health and how mental and physical health reflects the moderation placed within one’s life.Top of FormBottom of Form

Al Farkh and Al Balkhi were pioneers in psychological study, according to Ibn Khaldun, who wrote about them in his book Muqaddima. They created theories that served as the foundation for contemporary psychotherapy techniques. Studying subjects like the psychology of motivation, personality growth, emotion control, and mental health. The consequences of human conduct on people's physical and mental health were thoroughly discussed in writings by Al Farkh and Al Balkhi (Awaad et al., 2018). Their writings emphasized the value of self-awareness, self-control, and the necessity to build deep connections with others. They also highlighted the need for human cooperation for everyone to reach their full potential(“Arab science in the Golden Age”, n.d.). The psychosocial approach was founded by Al Balkhi, who was born in 850 CE, which emphasized the "sustenance of the Body and Soul." He later established cognitive therapy placing great value on the effects of external factors on ones well- being (Husain & Hodge, 2016). This was much like Avicenna’s thought in which he believed in the effects of external experiences as determinants of one’s trauma and mental health. Furthermore, Al Farkh and Al Balkhi both argued that the development of a strong ethical sense would help individuals to better understand their own emotions, behaviors, and thoughts. Their emphasis on relationships and a sense of community aligned with many of the population’s beliefs further strengthening their influence.

The Islamic Golden Age was one of the most important times for the advancement of knowledge in all fields including the development of Psychology under crucial players like Avicenna, Al Farkh, Rhazes, and Al Balkhi. During this era, intellectuality and critical thinking were amplified, paving the way for the creation of scientific theories, the growth of empirical research, and the conceptualization of concepts like motivation, learning, and intelligence. Moreover, introducing mental health to later Muslim generations. This background study acts as the foundation of exposure to mental health within the Middle East in a context where they are the majority. Later on in the research, the impact external factors have on Arab immigrants who are inevitably the minority contextually will be presented. The different factors that either increase or decrease their susceptibility to mental illness will be observed through modern research.

Literature Review

It is incredibly vital for any research paper to have a solid ground of sources having analyzed and depicted their effectiveness and credibility. To fully conceptualize whether or not a source would add value and quality to one’s research it must include relevant data and statistics while also having a great standing in accreditation. The following literature review will provide an overview of the sources’ overall effectiveness in all aspects and discusses what each text adds to the research; this paper will discuss sources regarding the impact of external factors on minority groups (Arab Immigrants) and the effects on their overall mental health. This topic is more prevalent than ever, as many people regardless of nationality have been displaced and forced to acclimate to new settings, especially after traumatic events where post-mental care is neglected.

The first source found is by Catherina Francina, published in 2021, titled, The mental health and wellbeing of asylum-seeking and refugee populations in high-income countries: A capabilities approach. This was a dissertation authorized by the University of Liverpool that discusses the mental health of refugees in high-income countries, in this case, the UK. The setting of this research provides limitations as some of the results are limited to the UK, but even then, with the results found, one can argue that this could be used to make assumptions for further countries and the data would still be somewhat consistent. This source discusses the integration and placements of refugees and the effects those have on their well-being. It was made obvious that the authors had the refugees’ best interest in mind as their contribution was to improve and provide emphasis on mental health. The article discusses the meta-analysis of refugees' post-resettlement mental health in high-income countries. The data exemplifies that the lack of support one receives after psychological trauma is the key determinant of whether or not mental illness will be severe and a lifelong battle. Utilizing many statistics and conclusions from a wide variety of studies provided prominence on how people have been impacted by the lack of spotlight on mental health among immigrant Arabs and people of color in general. Overall, this thesis helps in providing a true perspective on the gravity of the effects of displacement on refugees. Throughout this dissertation, one can see that all sources used and all data that was found/ cited were found through scholarly and credible sources.

Secondly, a Journal of general internal medicine analyzed a California Health Interview Survey, in an article titled, Worse mental health among more acculturated and younger immigrants experiencing discrimination: California health interview survey by Altaf Saadi and Ninez Ponce published in 2020 highlights the worse mental health among acculturated and younger immigrants who experience an added external factor, discrimination. This source helps provide a clear picture of the experiences of younger refugees who might visibly stand out from the general population, whether by race, language, or beliefs. In the article, it states “Our analysis yielded three major findings: (1) more frequent self-perceived discrimination was associated with increased odds of mental illness, across racial/ethnic groups; (2) acculturation did not mediate the effect of discrimination and mental illness; and (3) the perceived discrimination and mental illness relationship was more profound among those with higher acculturation and younger age” (Altaf & Ponce, 2020). Further highlighting the strong link between discrimination and mental illness among youth immigrants and those with increased acculturation. This changes and places emphasis on youth immigrants’ mental health and their higher susceptibility to mental illness including how that should change medical practitioners’ focus moving forward. Once again, this study and survey were conducted in California making these results somewhat exclusive to its population.

In the Canadian Journal of Psychiatry an article titled, Mental health literacy: Past, present, and future, Stan Kutcher, MD, Yifeng Wei, MA, and Connie Coniglio, Ph.D. Discuss the evolution of Mental Health literacy, detailing the long-term effects of mental illness on one's physical health. This article stresses the importance of mental health literacy among everyone, as poor health literacy can be related to decreased use of health services and overall poorer mental health. Stressing the importance that implementing educational curriculums in an educational setting to teach the younger generation mental health literacy to further improve wellness later on, stating, “… MHL interventions addressing adolescents should not only frame MHL constructs in appropriate lifespan domains but should be delivered within educational settings (such as schools) using intervention strategies that are known to enhance literacy competencies, are pedagogically familiar to educators and students alike, and that use modern electronic delivery platforms. In this context, MHL delivery methods could also be designed to concurrently impact the MHL needs of teachers and students within a common curriculum framework” (Kutcher et al., 2016, para. 13). This article was published in 2016 implying that the overall population’s mental health literacy might have changed due to recent exposure through social media and so on, but this source continues to hold value in that educating on matters like mental health should be just as important as over physical health as both can work concurrently.

A dissertation submitted by Sara Abubotain as part of the partial fulfillment of requirements for a Ph.D. in Health Sciences titled, Between two worlds: Acculturation impact on the mental health status of Arab Americans delves into the impact of acculturation on mental health among Arab Americans. Abubotain states Studies and literature on the psychological problems Arab Americans endure and their connection to suicide are relatively limited. More cases of anxiety were reported by first-generation immigrants than by second-generation Arab Americans (Abubotain, 2020). Furthermore, in terms of how first and second-generation Arab Americans view and seek out professional mental health services, the study found a considerable disparity between them. The study's findings identified some differences and some unique findings as well as supporting some findings from earlier studies. The study focused on the value of educating mental health practitioners about Arab culture and the ways that different generations view and use mental health care. It is crucial to educate Arab Americans and licensed mental health professionals as long as Arabs are immigrating to the United States. It is critical to conduct more research in other regions with sizable Arab populations. This paper was reviewed by a team of dissertation committee with Ph.Ds. in the field further proving the credibility of the information and the prevalence with the date being 2020.

Lastly, in the research article, Critical history of the acculturation psychology of assimilation, separation, integration, and marginalization by Floyd Rudmin, from the Psychology Department, University of Tromso, in Tromso, Norway from 2003. The research explains the history of the acculturation psychology of assimilation. Explaining that those from two different cultural backgrounds do not just enable them to choose when culture to be associated with and to assimilate most to, stating, “...2 cultures in contact logically allow 16 types of acculturation, not just 4…incompatible acculturative attitudes can be positively correlated, and why bicultural integration and marginalization are confounded constructs” (Rudmin, 2003). Concluding that there isn’t any solidified evidence that proves those with a variety of cultural backgrounds to be most adaptive and with the ability to assimilate most. This article will help add to the conversation of acculturation by exemplifying that this research is not limited to those with one background as the effects of assimilation and marginalization hold ground regardless.

Researching and breaking apart research sources is an essential part of writing as it ensures one’s credibility throughout and the quality of their information having considered each aspect of the research sources and affirming their quality. Overall, all the research articles chosen are in line with the claims and the overall contexts that aimed to be discussed. They vividly highlight the importance and prevalence of mental health among Arab immigrants and the gravity that it withholds. Credibility and overall current facts were not compromised and were seen consistently throughout all the mentioned articles creating solid grounds for the intended research, with limitations considered and addressed. The following part of the paper will bring in the information addressed and synthesize it while delving deeper into the susceptibility minorities are to mental illness and the change that needs to take place to create a new effective medium to the message, mental health support for underrepresented individuals.

Summary

Mental illness takes rise among individuals who abruptly change settings such as immigrants or any displaced individuals. The social and cultural shift deeply affects these individuals, and this is seen throughout the research. Many refugees or asylum-seeking immigrants are seeking refuge from unsafe circumstances, where post-mental care is needed, but unfortunately neglected. It is repeatedly proven that PTSD, anxiety, and depression can be mitigated if support and community are found immediately; unfortunately, those support outlets are rarely received.

The impact cultural shock has on immigrants is evident and can be observed through various research. The dissertation studying the acculturation impact on mental health status, states that first-generation immigrants often report a higher level of anxiety compared to those who are second-generation (Aboubatain, 2020). There are key factors that differentiate first-generation from second-generation immigrants in terms of mental illness susceptibility; key factors being, the effect of harsh circumstances from their native country and the lived experience that comes with that, hence why many experience PTSD, the second factor being the accessibility to new and progressive information and lesser shock to cultural differences and displacement as those are not a second generation’s lived experience. Each refugee’s experience differs; meaning that those who had suffered prior trauma due to war exposure or traumatic experiences as a whole have a generally higher exposure to developing PTSD (post-traumatic stress disorder). In 2021 a dissertation by Catherina Francina van der Boor found that a recent systemic review and meta-analysis looking at the post-resettlement mental health of refugees in high-income countries discovered that 13% were diagnosed with anxiety disorders, 30% with depressive disorders, and 29% with PTSD (van der Boor, 2021). The research goes on to address that there is a lack of comparative research that emphasizes the quality of life within displaced populations. This further proves the impact lack of support and life circumstances before migrating has on recent refugees in countries like the UK or the US. These statistics should be a call to action in placing greater and much-needed prominence on mental health support for refugees and immigrants as they experience similar cultural shocks while the circumstances each party undergoes are subjective, generally, mental health support should be stressed as it can manifest into physical symptoms.

With the evident social media rise and the higher rates of reported mental health crises, younger individuals whether first- or second-generation immigrants have an increased chance of exposure to awareness of mental health and the resources to utilize (Aboubatain, 2020). This information should provide an incentive for medical practitioners to further delve into the mental health of their immigrant or minority patients and ensure that they are aware of the resources that can help aid them in recovery or at least help aid them to mitigate their trauma. As previously mentioned, a push for further mental health literacy is crucial and can enable many to seek help. As McLuhan explained, a message can be portrayed through a plethora of different mediums, in this context, social media, educational curriculums, or family practitioners can all help educate and enforce mental health awareness and the available resources for treatment. In the Canadian journal of psychiatry, experts discuss the imperativeness that mental health literacy holds and the importance of providing literacy within educational settings, leading to the benefit of both students and teachers; further proposing that education on such topics can be done through modern platforms to increase engagement and effectiveness (Kutcher et al., 2016). This provides a prime example of how to combat mental illness through exposure and literacy from a young age and for students impacted by external factors like but not limited to displacement, acculturation, and discrimination. To see a positive change in younger generations regarding mental health which can already be noticed, it is fundamental to continue to push for awareness and to acknowledge the generational trauma that can impact a student’s success or even a teacher's. Utilizing the medium of the educational curriculum can help educate teachers and their students facilitating both positionalities.

Assimilation and acculturation are often added stressors for individuals of a minority. While acculturated individuals are often thought to be less prone to discrimination: self-perceived discrimination and internal conflicts disprove that statement. The journal of general internal medicine analyzing a California health survey in 2020 by Altaf Saadi and Ninez Ponce, analyses mental health among acculturated younger refugees and immigrants. Overall, the study found that self-perceived discrimination increased the likelihood of mental illness, and even those who either have acculturated or acculturation occurred as a result of being second-generation did not alleviate vulnerability to discrimination and mental illness. The most thought-provoking result was that the relationship between discrimination and mental illness was greater among youths with amplified acculturation (Altaf & Ponce, 2020). Reinforcing the importance of mental health resources for younger individuals as they face both the internal and external struggles that arise as they navigate acculturation in a foreign setting. Floyd Rudmin’s research explains that individuals of mixed backgrounds are not automatically at an upper hand concerning assimilation, he goes on to explain that “…bicultural integration and marginalization are confounded constructs” (Rudmin, 2003). Essentially, introducing that the ability to assimilate or even the inherent ability to does not mitigate the external factor of discrimination and the mental health battle that comes with that.

The external stressors that occur prior to or post-resettlement are ultimately the deciding factors for battling mental illness. A cross-sectional study observing the mental health outcomes of Arab refugees, immigrants, and U.S.-born Arab-Americans done in 2018, indicated that the level of depression and anxiety symptoms reported by the group of Arab Americans observed is extremely high. In particular, Arab-origin refugees and immigrants who have relocated to the U.S. to escape political violence or religious persecution exhibit higher levels of depression and anxiety compared to those migrating for other reasons (Pampati et al., 2018). This study confirms the pivotal role lived trauma and underlying reasons for immigration play in one's mental well-being. It is vital that weight is placed on identifying the stressors that occurred throughout resettlement to combat the possible mental health struggles that arise. Ultimately, awareness of the life experiences of refugees and immigrants helps to increase the well-roundedness of mental support provided through medical professionals and credible mental health assistance.

Acculturation, tribulations before and after resettlement, and resettlement contexts either refugees or immigrants, all play a pivotal role in the overall well-being of individuals. It is imperative that new mediums to push for mental health literacy and support are explored and implemented as the lifelong mental health battles are detrimental to minorities’ health and overall well-being. Only targeting younger individuals to educate on mental health is not enough and mental health literacy should in fact be enforced in medical, job, and educational settings alike. Many turn a blind eye to their mental health as the stressors of displacement can be far greater and priorities like finding a job and adjusting to language barriers play a role in distracting from the importance of mental health check-ins and the detrimental life-long impact that can occur as a result of neglecting that. Concludingly, exploring new mediums to educate and support the mental health of these individuals should become a priority as the disparity the statistics show are apparent and should not be ignored.

Conclusion

The research starts by exploring the ancient development of psychology among the Arab population, exploring an entirely different context overall. With this, one is able to observe the development of psychology and the social shift in regard to mental health, this historical and social context, while very different from the latter time that is subsequently explored, provides a gauge of what psychology looked like in the context where Arabs are the majority. Consequently, a differing context within the mental health of Arabs is researched. In this context, Arabs are the minority, experiencing resettlement or displacement from their home countries due to different circumstances such as war and unsafe factors. On the contrary context, the detriment resettlement has on one’s mental health is observed, and the two different contexts can be compared, although the intention was instead to see the difference in mediums utilized and the shift between these different frameworks. While in the background section of the paper, it was suggested that the medium in the concept by McLuhan “The Medium is the Message” is exemplified through the influential people that are experts in their field, these individuals named, Rhazes, Avicenna, Al-Farkh, and Al- Balkhi. In the latter research, the medium to help improve the mental states of immigrants and refugees was to implement support and education among lifestyle things such as within family medicine, educational, and job settings. A major gap that occurred is the timeline between the Islamic Golden Age and the “now” of the Arab population in a more prevalent light and a dissimilar positionality. The latter research covers solely, the modern statistic of this century, so with that, there is a major gap, but it creates the ability to compare contexts, gain understanding, and differentiate between the mediums that are utilized throughout the different timelines; one utilizing the modern technology of then and the extensions of the population’s themselves like McLuhan suggested and comparatively the different timeline of immigration now, one can see that the mediums are utilizing modern platforms, technology, and the ease of implementing the message within already-used spaces to boost the effectiveness of mental health education and support.

References

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