InInshirahislamically integrated self-help
Areaanxiety
ThemeObsessions and compulsions
Time5 minutes
MomentAny
1The thing your obsession keeps circling is usually something you care about a great deal. Contamination worry sits on top of wanting people safe, and harm worry sits on top of never wanting to hurt anyone.
cbtObsessions and compulsions5 minutesQur'an 2:225

This is worth saying out loud, because most people carry these themes as proof that something is rotten in them. Read the other way round, the theme shows you where your care is, and the illness has taken that care and turned the volume up until it hurts. None of that makes the worry true. It changes who you think you are while you work on it.

Islamic evidence

He will not call you to account for oaths you have uttered unintentionally, but He will call you to account for what you mean in your hearts (Quran 2:225). What the heart means is the thing that counts, and your heart is plainly not the problem here.

He will not call you to account for oaths you have uttered unintentionally, but He will call you to account for what you mean in your hearts. God is most forgiving and forbearing

Qur'an 2:225

Psychological evidence

A narrative review of religion and obsessive-compulsive disorder found no sign that faith causes the disorder, but plenty that where the disorder is present it readily takes religious form, with reported rates varying hugely depending on how devout the community studied was. The disorder appears to reach for whatever a person holds most serious. This is a review of existing literature rather than a test of the idea, and it looked at religious content in particular.

Greenberg D, Huppert JD. (2010). Current psychiatry reports · doi

Review detail

Why it works. Shame makes people hide the thought, and a thought you are hiding is one you cannot work on.

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2What the thought is about matters far less than what happens next. Germs, illness, something too silly to say aloud: the machinery running underneath is the same in each case.
cbtObsessions and compulsions5 minutesQur'an 114:4

Chasing the content puts you in a game that cannot be won, because the moment one worry is settled the next turns up wearing different clothes. The useful question is not whether this one could really happen. It is what you do in the minute after it lands, and whether that doing buys ten minutes of calm at the price of the next round.

Islamic evidence

against the harm of the slinking whisperer (Quran 114:4). The whisperer is named by how it behaves, slinking in and slipping away, rather than by whatever it happens to be saying.

against the harm of the slinking whisperer––

Qur'an 114:4

Psychological evidence

In a brain imaging study, patients exposed to their own triggers showed habit-related circuitry taking over from the goal-directed kind, which fits the idea that a compulsion runs on ingrained urge more than on a plan to prevent something bad. If that holds, the specific fear is closer to the story told about the urge than to its cause. This was one experimental imaging study, so it supports the model rather than settling it.

Banca P, Voon V, Vestergaard MD, Philipiak G, Almeida I, Pocinho F, Relvas J, Castelo-Branco M. (2015). Brain : a journal of neurology · doi

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Why it works. Answering the content teaches your brain that the content was worth answering.

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3You can take someone's fear entirely seriously without walking through the frightening story with them. Say you can see how frightening it feels, and leave the plot alone.
cbtObsessions and compulsions5 minutesQur'an 50:16

It reads colder written down than it lands in the room. What the person needs is to feel believed. What they do not need is a second person weighing up whether the thing could happen. Put the warmth into the feeling and keep it out of the details, and if they press you for a verdict, you can say honestly that answering would help for a minute and cost them later.

Islamic evidence

We know what his soul whispers to him (Quran 50:16). Being fully known has never depended on anyone being told the details.

We created man––We know what his soul whispers to him: We are closer to him than his jugular vein––

Qur'an 50:16

Psychological evidence

In a survey of 353 adults without a diagnosis, unwillingness to sit with distressing thoughts and feelings predicted obsessive-compulsive symptoms over and above the beliefs people held about those thoughts. The struggle against the experience looks like part of the trouble, which is an argument for helping someone stay with a feeling rather than resolve a story. It was a one-off survey of a non-clinical sample, so it shows a link and not a cause.

Abramowitz JS, Lackey GR, Wheaton MG. (2009). Journal of anxiety disorders · doi

Review detail

Why it works. Being met in the feeling is what settles someone, while being answered on the content is what brings them back to ask again.

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4Notice how when one worry is finally settled, another takes its place. That pattern is the thing you are actually dealing with, more than whichever worry is currently in the chair.
cbtObsessions and compulsions5 minutesQur'an 17:36

Most people work this out for themselves long before anyone names it. Naming it still helps, because it gives you something to watch that is bigger than today's fear, and it takes the sting out of the line the next worry always uses, which is that this one is different and this one is real.

Islamic evidence

Do not follow blindly what you do not know to be true (Quran 17:36). Each new worry arrives insisting it is the real one, and you are allowed not to take that claim at its word.

Do not follow blindly what you do not know to be true: ears, eyes, and heart, you will be questioned about all these

Qur'an 17:36

Psychological evidence

A meta-analysis found that difficulty tolerating not knowing is reliably associated with obsessive-compulsive symptoms and also with worry, social anxiety, panic and depression. That points to a shared vulnerability sitting underneath rather than something that belongs to one worry or one diagnosis. These are associations pooled across studies, so they do not establish which way the influence runs.

McEvoy PM, Hyett MP, Shihata S, Price JE, Strachan L. (2019). Clinical psychology review · doi

Review detail

Why it works. Watching the pattern puts a little space between you and whichever worry is loudest right now.

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5Some worries are perfectly reasonable, and settling them still will not settle you. Someone living where the storms come can build the kit, check the kit, and find the worry has quietly moved on to something else.
cbtObsessions and compulsions5 minutesQur'an 23:98

This one is worth testing on yourself, because it removes the argument that you would be fine if only the fear were irrational. The probability was never the sticking point. The hard part is the scrap of not knowing that stays behind after every sensible precaution, and that scrap does not shrink by adding more precautions on top.

Islamic evidence

I seek refuge with you, Lord, so that they may not come near me (Quran 23:98). What is asked for is distance from the thing, not a guarantee about how it will turn out.

I seek refuge with you, Lord, so that they may not come near me.’

Qur'an 23:98

Psychological evidence

In one analogue study, people with high obsessive-compulsive symptoms were about as intolerant of uncertainty as people high in worry, which suggests the drive to be certain sits under both patterns. The sample was students rather than diagnosed patients and the design was a snapshot in time, so this is a clue about a shared driver and not a clinical finding.

Holaway RM, Heimberg RG, Coles ME. (2006). Journal of anxiety disorders · doi

Review detail

Why it works. No amount of preparing removes the last bit of uncertainty, so the search for it has no end.

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6Fears of doing something terrible, of hurting an animal or a person, are not treated by moving closer to the act. Nobody should be walking you up a ladder towards the thing you are terrified of doing.
cbtObsessions and compulsions5 minutesQur'an 33:5

These thoughts sit at the far end from wanting. They horrify you, which is exactly why they stick to you. The work goes on what you have decided the thought says about you, not on rehearsing the scene, and anyone treating you should draw that line clearly rather than handling it like a fear of lifts.

Islamic evidence

You will not be blamed if you make a mistake, only for what your hearts deliberately intend (Quran 33:5). What is weighed is the intention of the heart, and an unwanted thought is the opposite of intending.

Name your adopted sons after their real fathers: this is more equitable in God’s eyes––if you do not know who their fathers are [they are your] ‘brothers-in-religion’ and proteges. You will not be blamed if you make a mistake, only for what your hearts…

Qur'an 33:5

Psychological evidence

A review of thought-action fusion and related beliefs concluded that they overlap heavily across the anxiety disorders rather than each belonging to one condition, so treating a thought as though it were an act is a widely shared habit of mind. That is useful to know here: the belief is common and it is workable. The review pulls together existing work rather than testing a treatment.

Vladan Starčević; David Berle (2006). Depression and Anxiety · doi

Review detail

Why it works. The distress comes from the meaning you have given the thought, so the meaning is the part that has to move.

When not to. This is about thoughts that horrify you, and thoughts you find yourself wanting to act on are a different matter that needs saying out loud to someone today.

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7Plenty of people quietly believe that thinking about something bad makes it more likely to happen. It has a name, it is a known part of this condition, and having the belief does not make you dangerous.
cbtObsessions and compulsions5 minutesQur'an 114:5

Hearing that it is a documented feature tends to do more than any argument about probability, because arguing about odds is a game the doubt plays very well. The move is to reclassify the belief rather than debate it. Not evidence about your character, just a familiar way this particular problem thinks.

Islamic evidence

who whispers into the hearts of people (Quran 114:5). The whispering is described as something that arrives at the heart, not something the heart went and made.

who whispers into the hearts of people––

Qur'an 114:5

Psychological evidence

Following 83 outpatients through treatment, what most strongly predicted recovery was not the content of the obsession but a shift in what people believed about thoughts themselves, particularly how dangerous and how meaningful a thought was taken to be. That puts this belief near the centre of the work. It is a prospective study inside treatment rather than an experiment, so beliefs and recovery moved together without one being shown to drive the other.

Solem S, Håland AT, Vogel PA, Hansen B, Wells A. (2009). Behaviour research and therapy · doi

Review detail

Why it works. Once a thought is filed as a symptom, it stops being read as information about who you are.

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8If you are stuck on whether having a thought makes you a bad person, that question is a symptom and not a case waiting to be settled. Name it as scrupulosity and let it stand unanswered.
cbtObsessions and compulsions5 minutesQur'an 39:53

Debating your moral standing is where this gets its fuel, and every reassurance you win, from a friend, an imam, a search at midnight, buys less time than the one before. Saying the name out loud is the more useful move. Being young makes it harder still, because so much else is unfinished about what kind of person you are.

Islamic evidence

do not despair of God's mercy. God forgives all sins (Quran 39:53). It is addressed to people who went to excess against themselves, which is exactly the group a scrupulous mind is certain it belongs to.

Say, ‘[God says], My servants who have harmed yourselves by your own excess, do not despair of God’s mercy. God forgives all sins: He is truly the Most Forgiving, the Most Merciful

Qur'an 39:53

Psychological evidence

Work developing a measure of religious scrupulosity found it separates into two strands, fear of having sinned and fear of punishment from God, and that highly devout people score higher on both without that meaning they have a disorder. A separate comparison found highly religious Muslim participants in Turkey scored higher on religious obsessions and doubts about sin than comparable Christian participants in Canada. So devotion lifts the score by itself, and the shape scrupulosity takes follows the tradition a person practises. Both are questionnaire studies rather than trials of treatment.

Abramowitz JS, Huppert JD, Cohen AB, Tolin DF, Cahill SP. (2002). Behaviour research and therapy · doi

Inozu M, Clark DA, Karanci AN. (2012). Behavior therapy · doi

Review detail

Why it works. Answering the question is itself the compulsion, which is why no answer ever holds.

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9It can help to give the parts of your brain jobs. The front of your head is the manager, the memory system is the librarian, and the alarm is a security guard who is good at his work and far too keen on it.
cbtObsessions and compulsions5 minutesQur'an 70:19

The point is not accuracy, it is having language you can reach for quickly. Saying the guard is overreacting again gets you further than trying to describe a feeling, and it puts the reaction slightly outside you, where you can look at it. Young people tend to take to it, and it gives a family a shared shorthand for the week between sessions.

Islamic evidence

Man was truly created anxious (Quran 70:19). The alarm is part of how a person is made, so an alarm set too sensitively is a fault of tuning rather than of character.

Man was truly created anxious

Qur'an 70:19

Psychological evidence

In a study scanning patients before and after four weeks of intensive exposure-based therapy, brain metabolism shifted alongside their symptoms, showing that behavioural work changes brain function and not only what people report. That is a fair basis for talking about these systems as changeable rather than fixed. The guards and librarians are a teaching device, not anything those images show.

Saxena S, Gorbis E, O'Neill J, Baker SK, Mandelkern MA, Maidment KM, Chang S, Salamon N, Brody AL, Schwartz JM, London ED. (2009). Molecular psychiatry · doi

Review detail

Why it works. Naming the part that is firing turns a state you are stuck inside into something you can point at.

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10If stopping the ritual is out of reach for now, do it differently every time. Different order, different hand, different room, as long as it is never the same twice.
cbtObsessions and compulsions5 minutesQur'an 17:110

Compulsions take a lot of their grip from exactness, and disturbing the shape loosens that grip while you are still allowed to do the thing. It also leaves you in charge, which matters if you have already said no to stopping outright. Think of it as a way in rather than the place you are heading.

Islamic evidence

do not be too loud in your prayer, or too quiet, but seek a middle way (Quran 17:110). A middle way is offered inside the act of worship itself, so exactness was never the measure of a thing done well.

Say [to them], ‘Call on God, or on the Lord of Mercy- whatever names you call Him, the best names belong to Him.’ [Prophet], do not be too loud in your prayer, or too quiet, but seek a middle way

Qur'an 17:110

Psychological evidence

A review of experimental work suggests compulsions may be over-learned habits running largely on their own rather than considered attempts to prevent a feared outcome, which would make the obsession something closer to an explanation added afterwards. If the urge is habit, breaking its exact form is a sensible thing to aim at. That is a reading of laboratory studies, not a trial of this particular technique.

Gillan CM, Robbins TW. (2014). Philosophical transactions of the Royal Society of London. Series B, Biological sciences · doi

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Why it works. A habit that is never performed the same way twice becomes harder to run on automatic.

When not to. This is a step towards stopping, and if the varied version quietly hardens into a new fixed routine it has stopped doing its job.

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11Offer choices rather than instructions. With a problem that runs on control, being told what to do gives that control somewhere to dig in.
cbtObsessions and compulsions5 minutesQur'an 22:78

Two or three real options, the trade-offs said plainly, and then the pick is genuinely theirs. That holds for the big decisions too, like moving to a more intensive programme. People who go in having chosen tend to stay, and people who go in having been told tend to leave, and the leaving usually gets called resistance when it was mostly about who decided.

Islamic evidence

He has chosen you and placed no hardship in your religion (Quran 22:78). What is asked of a person is not pitched at the maximum, so taking the lighter route first is not taking a lesser one.

Strive hard for God as is His due: He has chosen you and placed no hardship in your religion, the faith of your forefather Abraham. God has called you Muslims––both in the past and in this [message]––so that the Messenger can bear witness about you and so…

Qur'an 22:78

Psychological evidence

There is a real menu to offer here. A meta-analysis found therapy delivered by phone, computer or internet outperformed control conditions and was not clearly worse than face to face, though the trials were few. In a trial with 152 young people, starting online and stepping up to in-person sessions only when needed worked about as well as in-person from the outset, while using far less clinician time. Neither study tested whether letting the person choose changes anything.

Dèttore D, Pozza A, Andersson G. (2015). Cognitive behaviour therapy · doi

Aspvall K, Andersson E, Melin K, Norlin L, Eriksson V, Vigerland S, Jolstedt M, Silverberg-Mörse M, Wallin L, Sampaio F, Feldman I, Bottai M, Lenhard F, Mataix-Cols D, Serlachius E. (2021). JAMA · doi

Review detail

Why it works. Nobody fights a plan they picked themselves.

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