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Muslim Stages of Change (Stage 3: Ambivalence)

(This is the third of a series of 6 posts)


Encouraging 'Muhasabah'

With Awareness, the second stage of change, the worker then engages the Muslim client towards muhasabah.


Muhasabah ( Arabic: محاسبة .IPA [ muḥāsabah] ) means calculating or counting (Al-Ghazali (1988). The religious context of muhasabah is concerned with the evaluation of one's actions (Jamaluddin 2015, as cited by Arsad, 2018). Without going into the details of its categorizations (Ibnu Qayyim (2004), Ahmad Farid (2014), as cited by Arsad, 2018), I am proposing this term to refer to the process of introspection and retrospection.


Abdullahi Barise (2005), places muhasabah as the last process of his proposed Islamic social work model. He states that 'muhasabah helps the social worker and the client to determine the extent to which the chosen strategies have been successfully applied to reach the specified goals' (Barise, A, 2005) as providing a feedback loop. Although he also suggested that muhasabah is both a formative and summative evaluation process, I believe that this should be highlighted within the cycle of the change process.


In muhasabah, the client looks retrospectively at what has happened, the lessons learned, and perhaps, the spiritual meaning behind the event. Introspectively, the client may contemplate their own strengths and weaknesses that led to the event happening and how these warrant an acknowledgment that change may be necessary.




The Third Stage - Ambivalence

Figure 1: Muslim Stages of Change


Muhasabah allows for movement toward the next stage of change: Ambivalence. In the Muslim worldview, ambivalence is not a pleasant state of being. Central to the state of ambivalence is 'waswas', consisting of 'intrusive thoughts that cause cognitive dissonance (mental distress due to contradictory beliefs, values, or thoughts), and poses a risk to a person's spiritual and psychological homeostasis.' ( Awad, Najwa (2023)).


Waswas, especially in dealing with life issues is believed to be a ploy and whispers of the devil ( syaitan ) to keep a person in a state of uncertainty, and from the remembering of Allah. Extreme waswas is associated with obsessive-compulsive disorder (OCD) (Rahman, Izyan & Mustapha, 2021)


Hence, the Muslim individual strives to regain spiritual and psychological homeostasis by seeking certainty. The spiritually inclined seeks God's guidance as a way to hold a position of certainty. This is usually done through a special prayer, called istikharah, and supplications.

Istikharah ( Arabic: الاستخارة. IPA [ɪstɪkhɹə] ) means seeking guidance for what is good ( Al-Jawziyyah, n.d, as cited in Barise,A.(2005) ).



Certainty Takes Time

When a Muslim client is in a state of uncertainty to proceed with a change, seeking Divine Guidance through istikharah and supplications is a way of finding the path to the next steps to take.


Certainty, however, takes time. Aside from safety concerns and high-risk situations that require immediate intervention, social workers should refrain from insisting on decisions during interview sessions when their Muslim clients are in a state of ambivalence. Using techniques like listing the pros and cons of certain decisions, scaling questions, or the use of the miracle question should remain as tools to give clarity, not to push for a decision that the client might regret post-session, resulting in non-adherence to tasks agreed upon during sessions. Practicing Muslims would want to be sure that their decision is the best for their current life, and their hereafter, with blessings from the All-Knowing.


However, not all Muslim clients practice the religion with piety. Some, may not even know the procedures of the istikharah. I have found that certainty for such a group of clients could be achieved through quiet contemplation, done outside of the interview session. One client who I had helped, openly shared that she was not a religious Muslim.



Case Example 3

Madam Q sought counselling because she suspected her husband was having an affair. She did not have any evidence of the alleged tryst. When she confronted her husband about the matter, he denied it and brushed it aside as unwarranted jealousy. She was contemplating making a complaint to the Syariah Court but was unsure if she should proceed. We talked about her ambivalence. I used circular questioning to elicit her thoughts about the situation. We also went through the pros and cons of proceeding with the complaint. However, at the end of the session, I remained mindful that Madam Q would need some time to gain certainty about what she needed to do. The conversation led to how she made decisions in the past. Being Muslim, albeit a non-practicing one, she said she looked to God to help her decide. She said that from time-to-time, she sought solace by speaking to God before she sleeps.


In this particular case, she made the decision to remain in the marriage after 'talking to God, and surrendering to His plans'. When she returned for a subsequent session, she said she was at peace with her decision and began to see that her suspicions were exaggerated and learned to be more trusting of her husband. Their relationship improved, and she shared that she had begun to resume practicing her prayers again.



Assessment

Assessment for the stage of Ambivalence focuses on identifying if the client expresses uncertainties about the situation they are in and if action needs to be taken. The client might express anxiety about being in the situation but at the same time, equally anxious about doing something about it.


The client might say " I don't know what I should do right now. I am torn between making choices, or maybe, not making them at all."


Clients at this stage might look upon the social worker to provide answers and direction as an easier way out. Hence, workers need to be mindful of taking over the solutioning, as well as pressuring clients into making premature decisions about what to do next.



Intervention

To move the client into the next stage, Decision Making, social workers could help the client by clarifying their thoughts through the use of paraphrasing, reflecting feelings, reflecting meaning, reframing, use of scaling questions, etc. Similar to the previous stage (Awareness), the worker helps the client to review the circumstances, and the consequences of action and inaction.


However, this time, the worker encourages the client to take some time to contemplate and seek divine guidance if they believe this to be helpful in gaining certainty. The worker demonstrates patience, empathy, acceptance of the ambivalence, and offers unconditional positive regard.


I shall discuss the fourth stage, Decision-Making, in my next post.











References & Readings


Al-Ghazali. (1988). Ihya’ Ulumuddin. (I. Yakub, Trans.) (8th ed.). Victory Agensi.


Awad, Najwa (2023). Clinicians, imams, and the whispering of Satan. Yaqeen Institute. https://yaqeeninstitute.org/read/paper/clinicians-imams-and-the-whisperings-of-satan


Barise, Abdullahi (2005). Social work with Muslims: Insights from the teachings of Islam. Critical Social Work, 6(2), 73-89. https://ojs.uwindsor.ca/index.php/csw/article/download/5660/4627?inline=1


Rahman, Mohd., Izyan, Shah., Mustapha, Ahmad. (2021). The term waswas and Obsessive-Compulsive Disorder (OCD) in Islamic perceptivity. Al Hikmah International Journal of Islamic Studies and Human Sciences, 4 (3), 452-469. https://doi.org/:10.46722/hkmh.4.3.21s


Siti Suhaila Arsad, Nik Rosila Nik Yaacob, Mohamad Hashim Othman.(2018). Integration of muhasabah and scaling question technique in counselling. Malayan Journal of Social Sciences and Humanities (MJSSH). 3 (4), 23-29. https://media.neliti.com/media/publications/322563-integration-of-muhasabah-concept-and-sca-92833247.pdf





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