The American Journal of Islamic Social Sciences VoI. 8, No. 2 , 1991 n5 The Theoretical Foundations of Incorporating Islamic Beliefs in a Stress Inoculation Program for Muslims Ola Abdel-Kawi Little data are available about the nature of stress which Muslims in North America frequently endure. Muslim scholars have not attempted to define the major stressors these Muslims experience, nor have they furnished Muslims with an inocuIation program that integrates Islamic beliefs with cognitive techniques in order to change stress quality and quantity. The development of such a program, however, is not possible without theoretical foundations that employ the findings of stress research. On the other hand such a theory, if fuIly deveIoped, is not functional without empirical data to sustain its basic propositions. Hence, the purpose of this paper is to: a) develop the theoretical foundations of the interreIationship between stress cognition and Islamic beliefs; b) present a stress cognition paradigm that explains the moderation function of certain Islamic beliefs; and c) incorporate certain Islamic beliefs in the app€ication of the cognitive techniques of stress management. The Relationship between Stress Cognition and Religious Beliefs Stress is defined as the outcome of the cognitive process through which a person interprets and attaches meaning(s) to an event. Selye (1974) explains it as being the negative or positive cognitive appraisal that causes the individual to perceive an event as stressful. Based on the outcomes of the cognitive appraisal, Selye distinguishes between two types of stress: a) distress or pathogenic stress “which goes beyond people’s optimum arousal point so that performance and health deteriorate” (Savery 1986, 17), and b) eustress, which Ola Abdel-Kawi holds a B.D. and an M.B.A. from al Azhar University and is currently working on her doctorate in business administration at Nova University, Davie, Florida. 2l6 The American Journal of Islamic Social Sciences Vol. 8, No. 2, 1991 is the optimal amount the individual requires to stimulate physical and social functioning (Selye 1980). The individual may interpret a stressful event as an opportunity, a constraint, or a demand on hidher desires (Schuler 1980, 189). Thus the same event could be perceived as an opportunitY by one person or as a demand or constraint by another person depending on whether the appraisal is positive or negative. The determinant factor, however, is the individual's needs, values, and desires. While evaluating a stressor, the individual not only considers the objective environment but also predisposes other personality variables as inputs to information processing. Personality Constructs Beehr and Newman (1978, 678) defined personality variables associated with stress as "any characteristic of the human being that influences an individual's perception of stressful events, interpretation of events as stressful, and/or reaction to stress." Personality constructs, however, have two facets: cognitive and motivational. The cognitive countenance of the human personality represents the "characteristic properties of the individual's perception and thought processes, how the individual processes information" (Weiss and Adler 1984, 8). This faeet includes all perceptual constructs. The motivational countenance, on the other hand, incarnates "those stable individual differences in the why, when, where, and how behavior is energized and maintained" (ibid.). Thus the motivational facet hcorporates the individual's needs, motives, beliefs, 2nd values. While the cognitive facet embraces the thought processes the individual performs to interpret an event, the motivational facet embodies the implanted moral standards against which the individual evaluates any looming event. Both cognitive and motivational facets will affect individual differences in the cognitive construction of an event (Allen and Hyde 1981; Jenner 1986; Kelly 1955). Most of these individual differences are attributable to the person's belief system. The Individual's Belief System and the Impact of Religion The individual's belief system represents "all the beliefs, sets, expectations, or hypotheses, conscious and unconscious, that a person at a given time accepts as true of the world he lives in" (Rokeach 1960, 33). The beliefs one holds are a system because they are "an organization of parts" (ibid., 34). Normatively, Oh Abdel-Kawi Stress Inoculation Program 271 the parts of a belief system include religious, political, scientific, economic, social, and other elements. Religious beliefs have a powerful impact on various personality variables (Hanawalt 1963) and are frequently referred to as a “cognitive system” (Brown and Pallant 1962, 813) in itself. The function of this cognitive system is to interpret the “immediate experience by reference to the ultimate structure of the universe” (Meredith 1968, 1039). Any religion is defined as the inner experience accumulated by the individual while attaching meanings to both reality and the transcendent (Clark 1963,128). This implies that the individual subjects any event to some degree of religious evaluation while perceptually processing information about it. The Islamic belief system not only dominates the other parts of a Muslim’s belief system, but is also the fundamental impetus which molds them. Based on this universally accepted regulatory function of the Islamic belief system, this paper proposes that the employment of these beliefs in a stress cognition paradigm can inoculate Muslims’ stress. A Paradigm for Stress Affecting Muslims Due to a lack of empirical data about the nature of stress affe&ng Muslims, the conceptual foundations of the following stress cognition and inoculation paradigm are drawn from the Qur’an and scholarly literature on human stress. The proposed paradigm (see figure 1) posits that the sources of stress are to be found in the individual, the environment, or the interaction between the two. Internally generated stressors are pressures which the individual experiences as a result of “being ambitious, materialistic, competitive, and aggressive” (Yates 1979, 19). These internal stressors “have a far more intense effect than do the external stressors” (ibid.). The Qur’an is replete with references to internal sources of human stress (i.e., 3:14; 89:20; 100:8) and associates them with the individual’s beliefs and motives. External sources of stress are usually such life events as retirement, death of a spouse, marriage, childbirth, loss of one’s job, and other similar occurrences. The individual strives to maintain a desired equilibrium between hidher internal needs and motives and the environmental supply of these motives (Harrison 1980). Any discrepancies between internal demand and environmental supply are expected to disturb the individual‘s equilibrium. In such cases, the individual is inclined to interpret this lack of fulfillment as a threat (i.e., a stressor). The assimilation of Muslims into American society (Hashem 1991) is a visible example of Muslim social disequilibrium. The cognitive process is stimulated when the external event enters the Figure 1: A Cognitive Paradigm For Muslims’ Stress Individual Environment Interaction 4- Cognitive Processes Perception Activation of the belief system Cognitive appraisal Prediction r------ * I I Moderators I Understanding Cognitive Techniques of Stress Management Social engineering Cognitive reappraisal Personality engineering Meditation Selective awareness - 1 + Behavioral Outcomes Inoculation Perceived Stress Lack of motivation Lack of satisfaction Dysfmctioning Ola Abdel-Kawi Stress Inoculation Program 279 cognitive system through the perception channel. The perception of a stressor activates the belief system in a fashion that makes it function as a frame of r e f h n c e used by the individual to filter the information he/she has acquired about the pemeived stressor. During cognitive appraisal, the individual classifies the perceived stressor. "Here, labels are attached to perceptions, such as good or bad; dangerous or harmless; pleasant, adversive, or benign" (Allen and Hyde 1981, xii). If the individual concludes that the event is a constraint on hidher goals or motives, the psychological and physiological strains will be more intense and will thus cause undesirable behavioral outcomes, the most common of which are lack of satisfaction, lack of motivation, and dysfunctioning. The cognitive paradigm as such proposes that the employment of the Islamic belief system could play a multifaceted function in altering stress. First, scrupulous reference to these beliefs can assist in predicting and understanding the stress which affects Muslims. Second, these beliefs can moderate the cognition-behavior relationship and thereby inoculate a perceived stressor. The Moderation Function of Islamic Beliefs Gibson, Ivancevich, and Donnelly (1988, 24) defined a moderator as "a condition, behavior, or characteristic that qualifies the relationship between two variables. The effect may be to intensify or weaken the relationship." There are two types of stress moderators: personality and situational moderators (Beehr 1976, 35). The proposed paradigm employs two Islamic beliefs to moderate the cognition-stress relationship: a) belief in Allah as one creator- sustainer God, and b) belief in the rewards in the life hereafter. The Belief in One Creator-Sustainer God The witness to the oneness of God is a total conviction that requires both submission and commitment. There are several implications of this belief. First, a Muslim should seek knowledge to reach this conviction. A1 FBniqi (1976,522) noted that a "man is not a convinced Muslim unless he has reasoned out his religion, known it in person, and become personally convinced of its truth and validity." Second, a Muslim should reach this conviction as a result of hidher own volition and free will. Third, a Muslim is motivated merely by hidher knowledge of Allah, not by a desire for power or a drive 280 The American Journal of Islamic Wid Sciences Vol. 8, No. 2, 1991 for money, because ”both [are] notorious for their vulnerability to the vicissitudes of frustration and to too prolonged examination, particularly at the end of the individual‘s life” (Clark 1%3, GO). This motivation based on the knowledge of Allah cream a sensed state of freedom from materialistic values, although the latter is not completely denied as a motivator, in which an individual Muslim is in control of hidher desires and needs. Finally, the belief in Allah as one’s sustainer and acceptance of His divine help provides a Muslim with the assurance that he/& is never left without guidance and assistance. Therefore, “such men fear neither poverty nor humiliation in this world because religious certitude is the greatest wealth and greatest glory” (Al F a q i W6, 527). We cannot overlook the psychological ramifications of this belief. Since it is based on knowledge reached by logic, reason, and inner experience, it is not an illusion. There are two expected behavioral modifications brought about by this belief. First, because this belief demands the cognitive evaluation of one’s motives and goals, it creates an inner urge for self-correction. To motivate the individual to overcome the predicted difficulties, the Qur’an has honored the self that seeks correction: “And I do call to witness the self-reproaching spirit” (752). While striving for righteousness, virtue, and piety, a Muslim achieves self-actualization. Second, the exercise of freedom of choice and free will can fulfill a Muslim’s need for self-esteem. Research has found that “at the highest level of the need hierarchy a reversal occurs in the satisfaction- importance relationshqf (Bedian 1986,438). Thus, increased satisfaction as regards self-esteem and self-actualization will lead to increased rather than decreased motivation. Both outcomes can reduce the discrepancies between inner motives and the external supply of motives. The Belief in Rewards in the Life Hereafter Sharfuddin (1987, 232) noted that work in Islam is “considered one of the external manifestations of faith.” The Qur’an asserts that an individual‘s work will be warded and witnessed by Allah, His prophet, and the believers. The q d i t y of behavioral choices will also be rewarded, for “Man acquires nothing but what he himself has earned; none of his deeds is lost and each will count on the Day of Judgment” (Qur’an 53:3941). A Muslim’s goal, then, is to “seek with that which God has bestowed on you, the home of the hereafter. Nor forget your portion in this world” (Qur‘an 28:77). Therefore the purpose of life and death is “that you may prove who of you is better in deed” (Qur‘an 672). For this pursuit the moral precepts are clearly defined, and they should be observed not as recommendations to be admired Ola Abdel-Kawi Stress Inoculation Program 281 occasionally but as commandments to be honored, enforced, and effected in all facets of a Muslim’s life. The instrumentality of this belief in a Muslim’s life is inferred from several contextual propositions, since it a) encompasses an unmistakable sense of direction, b) delineates a certain structure of the reward system in the Islamic theory of human behavior, c) says that free will is the essence of a Muslim’s responsibility to hidher Creator (Spilka [1970, 1751 noted that “the doctrine of free will embodies the idea of action in its fullest sense”), and d) implies that the afterlife is far more important than one’s earthly life: “What is the life of this world but play and amusement? But best is the home in the hereafter, for those who are righteous. Will ye not then understand?” (Qur7an 6:32). Conceptually spealung, there are two behavioral implications of this belief: a) a Muslim should be engaged in a continual process of self-evaluation and behavior modification, and b) a Muslim is expected to exert self-leadership. In other words, he/she should be in command of hidher desires and in control of hidher needs. If this is the case, one could then predict that reference to this belief could reduce stress in two ways: a) the expected rewards could cognitively supplement the lack of motives in the environment, and b) a cognitive reappraisal of stressful events could alter the perception of their magnitude. Paradoxically, research findings indicate that religious beliefs do not perform their presumed function. For example, Hanawalt (1963, 352) found that religion alone did not hold enough strength to cause a “differentiating effect [on] the measures of self-esteem and security.” Hepburn (1971, 174) also found that “whereas 95% of teenagers polled indicated belief in God, less than 40% were willing to entrust their lives to God.” It therefore seems that there are other personality variables inhibiting religious beliefs from performing their functions. The paradigm presented here argues that the hypothesized moderation effect of the Islamic belief system on the cognition-stress relationship is contingent on two personality variables: a) a Muslim’s degree of certitude towards certain beliefs, and b) the religious outlook used by a Muslim to effect the belief system. The Degree of Certitude As individuals do not hold the same assurance about their beliefs, including their religious beliefs, their beliefs vary according to their degree of certainty (Schiebe 1970). According to Lewinsohn (1961, 26), “the highest degree is complete certainty, next is belief, then suspicion, and finally doubt.” Sharif 282 The American Journal of Islamic Social Sciences Vol. 8, No. 2, 1991 (1963, 146) suggested that there are three degrees of knowledge in the “ascending scale of certitude”: a) knowledge by inference (Flm a1 yaqin), b) knowledge by perception, reporting, or observation (by al yaqin), and c) knowledge by experience or intuition ( b q q a1 yaqin). Kerlinger (lm, 5-6) also identified four ways of knowing or “fixing [a] belief”: a) method of tenacity, b) method of authority, c) intuition or a priori method, and d) scientific method. There is consensus in the literature on the conceptual relationship between variations in the degree of certitude and the source of knowledge about the belief (Schiebe 1970; Sharif 1963). For example, while Sharif (1963, 147) referred to these sources as inference, observation, and intuition, Schiebe (1970, 36) identified them as induction, construction, analogy, and authority. The degree of certitude is an outcome of the cognitive interaction between the belief, its source, and the believer’s personality variables. This cognitive interaction may be subject to chance errors or deficiency in the believer’s cognitive and reasoning skills. Schiebe (1970, 28) explained further that the two sources which may cause uncertainty are “distal” (i.e., attributed to chance errors) and “proximal” (i.e., attributed to errors in cognitive skills). Schiebe’s explanation of variations in degree of certitude is congruent with Sharifs (1963) explanation of sources of errors as being: a) errors of reasoning, b) errors of intuition, and c) errors of observation. The first two are skills deficiency errors and the third is a chance error. This explanation is relevant because it determines the individual’s predispositions to act on certain assumptions. Moreover, it indicates that “a person’s willingness to pursue a course of action depends to a great extent [on] his confidence of success” (Schiebe 1970, 27). The Religious Outlook Maududi (1977, 68) argued that there are two types of Muslims: a) those who “accept Islam as their religion but treat this religion merely as a part of a section of their whole life,” and b) those who “completely merge into Islam their full personality and entire existence.” Although there are no empirical data to support his argument, the review of research on other religions lends some support to his observation. Allport (1960, 257), for example, in his investigation of religious practice found that there are two types of religious outlooks adopted according to an individual‘s motives: extrinsic and intrinsic. He defined the extrinsic religion as a “self-protective form of religious outlook which provides the believers with comfort and salvation at the expense of outergroups,” while the intrinsic religious outlook “marks the life that has interiorized the total creed of his faith without reservation.” According to Ola Abdel-Kawi Stress Inoculation Program 283 him, an individual‘s master motive under the first type is self-interest, where he/she uses religion and makes it serve himlher. Under the second type, however, an individual serves hidher religion and lives it in every detail of life. It is interesting to note the similarities between the two religious outlooks explained by both authors. However, we can neither accept Maududi’s observation without empirical evidence nor can we generalize Allport’s findings to the Islamic personality without further investigation. An Inoculation Program for Muslims Affected by Stress The word ”inoculation” implies the implanting of powerful “psychological antibodies” (Meichenbaum 1986, 21) to increase the ability of a Muslim’s cognitive system to prevent and cope with stress. The proposed stress management training uses cognitive techniques to a) develop awareness of the internal sources of stress, b) use the Islamic beliefs as implanted measures to alter the quality of the perceived stressor, and c) develop the Muslim’s ability for self-leadership. Although only five cognitive techniques are discussed, this does not imply the inapplicability of other stress management techniques. The following techniques are selected based on Allen and Hyde’s (1981, xii) rationale that “some forms of stress control will actually alter slightly the way in which [our] sense organs feed information to the brain.” Social Engineering. This technique involves two steps: a) identifying internal sources of stress, and b) restructuring a goal-oriented behavior such that the internally initiated needs and wants are met, but with less stress. The Islamic behavioral theory recognizes the moral jihad (lit. : effort, struggle) as a life-long effort to modify a believer’s internal needs and goals and then reform them within the Islamic context. For this purpose, Allah offered his assistance: “And if My servants ask you of Me, tell them that I am near and that I respond to the caller who calls upon Me. Tell them then to pray to Me, to believe in Me. That is the way to wisdom” (Qur’an 2:186). Cognitive Reappmisal. This method focuses on eliminating “subsequent, maladaptive arousal” (Allen and Hyde 1981, 104) by converting a potential distress into eustress. This is achieved by directing the focus of attention “to interpretations [of a stressor] that promote resolution and growth rather than those that promote damage and disease.” The Qur’an (i.e., 94:5-8) emphasizes the power of positive thinking: “Verily, with every hardship comes ease! Hence, when thou art freed [from distress], remain steadfast, and unto thy Sustainer turn with love.” This particular verse urges each Muslim to 284 The American Journal of Islamic Social Sciences Vol. 8, No. 2, 1991 reevaluate any stressor and to focus hidher mind on the positive facets of a given event. Personality Engineering. “Hans Sayle said that by adopting the right attitude toward life, one can turn harmful distress into positive stress. He argued that this may be the most powerful stress reduction technique in existence” (quoted in Girdano and Everly 1986, 133). The proposed stress management program develops self-correction skills which will enable a Muslim to change the negative aspects in hidher personality that may cause stress. Meditation. Allen and Hyde (1981, 113) defined meditation as “any activity which attempts to focus and maintain attention on unchanging or repetitive stimulus.” Its function is ”to alter cognitive functioning and access a spiritually aware state of consciousness” (ibid.). The main characteristics of meditation according to Allen and Hyde are: a) a quiet environment, b) posture, c) a meditation object, d) a passive attitude toward any mind driftmg, and e) regular practice. The proposed program emphasizes the importance of a Muslim’s daily prayers not only as a required ’ib@h but also as a meditation tool. These prayers satisfy those meditation characteristics described by Girdano and Everly (1986,211) as “the ability to maintain a passive concentration state in which alertness and control are maintained, but in such a way as not to be tension producing.” The Qur’an emphasizes the instrumentality of daily prayers: “Seek further assistance by patience and prayer. The latter overtaxes none but the irreverent and the proud. It is a force for genuine assistance for those who know that they will someday confront their Lord and that to Him they shall finally return” (Qur’an 2:45-6). Selective Awureness. Allen and Hyde (1981, 131) defined this technique as “exercising . . . power of choice over stimuli, ideas, or images presented to the mind.” The proposed stress management program uses one of the interesting elements of the selective awareness theory: “regadless of our innate design, we have a choice as to where to place our attention” (ibid., 13). This implies that the individual has the ability to freely choose one thought over another by controlling hidher focus of attention. Implications for Further Research The w g m of stress cognition and inoculation presented above integrates the cognitive appraisal of a stressor with the Islamic belief system. As such, it proposed that this integration would inoculate stress. It also explained that while research provides enough evidence that internally generated stressors produce the most strain, most Muslims tend to search outside themselves Ola Abdel-Kawi Stress Inoculation Program 285 for sources of stress. Moreover, they are not aware of the moderation function of Islamic beliefs. This conceptual framework proposes several implications. First, Muslim scholars should test this paradigm in an empirical manner. It should be used as a departure point for the further collection of data on stress affecting Muslims, Second, Islamic institutions could develop a stress management program for Muslims based on this model. Third, reference to the Islamic reward system to change a Muslim’s expectations will reduce the amount of stress generated from a lack of motives in the environment. Conclusion The tendency to avoid empirical research with Islamic implications may lead to the spurious conclusion that there is a separation between Islam and science, and that Islamic knowledge is an approach which cannot be scientifically investigated. In some areas, such as the subject of this paper, the lack of theory to guide empirical investigation has inhibited the systematic development of an applied research agenda. There are methodological difficulties in observing and measuring the extent to which a Muslim integrates the Islamic belief system into hidher daily life. 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