Sex Therapy in an Islamic Context - Essay Example

Sex Therapy in an Islamic Context Sexual relations and sexual behaviour among Muslims is a that has not been studied in depth to a sufficient extent. Yet, for sex therapists this information is pertinent, because of the strong influence that religion has on the sexual relations and sexual behaviour among the followers of Islam. This paper attempts to provide a perspective of the impact of the religion of Islam on sexual relations and sexual behaviour among the followers of the faith and the challenges for sex therapy as a result of this impact. Sexual relationships in any form outside the institution of marriage are forbidden to Muslims by the religion. Marriage as such is an aspect of significant importance to the followers of Islam. Sex is an integral part of marriage sanctified by religion. However the bias of the religion towards the male gender may give cause for lack of sexual gratification. Sexual problems do lead to divorces in the Muslim world. Addressing the problems relating to sexual relations and sexual behaviour among Muslims, poses a challenge for sex therapists from the religion induced factors. For more successful approaches to addressing sexual relations and sexual behaviour issues among the followers of Islam an understanding of the individual and the impact of the dominant religious factors on the individual is essential in sex therapy. Sex Therapy in an Islamic Context Introduction: Sexual activity is essential to nearly all living beings, for it is through such activity that continuity of the species is ensured. Humans are not exempted from this. Thus one of the relationships that develop among humans of different sexes is sexual relationship. Such relationships are the most important of relationships among human beings and are the key to release of natural urges, namely sex. Sexual urges and requirements are normal to the human species, but are subjected to control of religious, moral and cultural codes. Thus there are restrictions to the development of sexual relationships according to total individual satisfaction. In restrictive societies the more is the curtailment in the development of free sexual relationships Sexual relationships in humans are often a long term commitment. Lack of individual satisfaction within the relationship is quite often the cause of the development of irritants within the relationship that could culminate in the termination of the relationship, which is to the detriment of the individuals and society. Intervention through sex and relationship therapy calls for a thorough understanding of the focal complex issues and the individuals involved in the relationship. Sexual Behaviour: Satisfactory sex is a pleasurable experience that enhances the relationship between individuals, as well as the physical and mental well being of individuals. Traditionally it was believed that more than the satisfaction derived through a pleasurable sexual experience for both partners, it was procreation that led to an increased physiological and psychological functioning of the individuals. Studies are emerging to show that procreation is a less important result and satisfaction, intimacy, trust, passion and love the more important facets in the relationship. This indicates that sexual relationship between individuals is dependent on several important facets involved in the sexual activity, with the influence of procreation being the minimal of them all (Costa & Brody, 2007). Sexual behaviour starts invariably with masturbation, but fulfilling sexual intercourse experiences reduces the reliance on masturbation. In the opinion of Costa and Brody (2007), penile-vaginal intercourse orgasms for both partners are dependent on the presence of intimacy, trust, passion and love in the relationship and the larger the frequency in satisfactory penile-vaginal intercourses the less is the reliance on masturbation. Sexual satisfaction was earlier the domain of male partner, while the female partner remained just the vessel for this satisfaction and procreation was the activity of satisfaction for the female partner. In modern times there is greater understanding of the requirements of the female partner in a sexual relationship. According to Leiblum and Chivers (2007,), "female sexual psychophysiology research suggests that women are capable of greater sexual responsiveness than previously thought" (p. 357). Such findings suggest that women seek and are as gratified through satisfactory sexual behaviour as men are and hence lack of this gratification in women in their sexual activity could be a harbinger for souring of sexual relationships. Yet sexual behaviour and sexuality in women is more complex than that of the male partner, for there is a greater impact of conditioning from socio-economic, cultural, political, relationship, psychological and medical roots (Johnson, 2003). Sexual behaviour though founded on natural urges is curbed by several factors, which include the religion and culture. These influences can have an inhibitory role on sexual behaviour and more so when the religion and culture have a strong influence on what is and what is not acceptable in the society, as is the case with Islam (Gray, 2004). Sex Therapy and its Relevance: There is a high rate of dissatisfaction in individuals with the sexual life. Lau, Kim and Tsui (2005), suggest that the prevalence of dissatisfaction could be as high as fifty percent in a given population, with almost fifty-one percent of males showing dissatisfaction and fifty-four percent of females demonstrating dissatisfaction in their sexual lives. Dissatisfaction with sexual life arises from sexual problems, many of which can be associated with issues related to the mind of the individual including inhibited sexual desires and sexual excitement. Dissatisfaction in sexual life could have a severe negative impact on physical and mental health of the individual and thereby the quality of life of the individual. Such dissatisfaction could lead to depression in individuals (Lau, Kim & Tsui, 2005). Emerging evidence suggests that depression has a greater detrimental effect on the health of the individual than chronic illnesses like heart diseases, arthritis, asthma and diabetes. Understanding the underlying causes for depression and moderating their impact become essential to improving the quality of life of the individual (Kahn, 2007). Sex therapy aims at addressing the causes behind sexual problems, dissatisfaction and dysfunction to provide a more meaningful and gratifying sexual relationship for individuals and through that enhance the quality of life of the individual. Sex therapy is also known as psychosexual therapy for it calls for not only an understanding of the physical sexual problems, but also the psychological issues that are associated with sexual functioning (Relationships, 2007). The challenges that sex therapy faces lies in understanding sexual behaviour and the development of sexual relationships. This is particularly relevant, as sexual behaviour is impacted on by religious, moral and social codes. In open societies such as in the Western world these codes permit overt sexual behaviour with limited constraints on sexual behaviour on the basis of their culture. This is far different from closed societies wherein sex and sexual behaviour remain covert subjects and within the domain of the individuals concerned and as shaped by their culture. Thus culture becomes a dominant factor in the determination of sexual behaviour. Societal values, way of life and thinking, customs and norms constitute the culture of any group of people. In many cultures, like Islamic culture, many of the components of culture are strongly influenced by religion. The degree of this influence may vary according to ethnicity and location, but the influence still remains strong. It is this aspect that makes understanding the impact of religion on the sexual behaviour of individuals an important factor in sex therapy (Dwairy, 2006). Religion and Sex Therapy: There are several religions, but each of these religions influence the sexual behaviour to varying degrees. This makes it important that counsellors and practitioners of sex therapy have a proper understanding of the religion of the concerned individuals and the influence that this religion could have on the sexual behaviour of the individual. The strength of the influence of religion on the individual makes the individual more prone to accept or reject the advised change in sexual behaviour. The stronger the religious influence and the more against the tenets of the religion, the advised change in sexual practices is the greater could be the resistance. The mix of sexuality and religion is a problem that can be posed in sex therapy. Where resistance is likely to be strong, a step by step approach, addressing religious concerns, provides greater chances of success in securing the required changed behaviour rather than a direct approach. Another aspect of individuals coming from strong influences of religion is that common aspects of sexuality may not be known to them or taboo to them. Getting these individuals to talk about their sexual needs requires patience and understanding (Gianotten, 1992). According to Simpson and Ramberg (1992), success in sex therapy hinges on therapists being sensitive to religious beliefs and the influence that these religious beliefs have on the individual, as religious beliefs are responsible for resistance to changes in sexual behaviour. Thus in understanding sex therapy from an Islamic context it becomes essential to understand Islam as a religion and its influences on the sexual behaviour of the followers of Islam. Overview of Islam: Islam is the youngest of the major religions of the world. Islam was born in harsh environment of Arabia in the seventh century of the Christian era, before spreading to other areas around the world. Dwairy, (2006), suggests that Islam was influenced by the harsh environment of its birth in Arabia and carried this influence into the non-Arab areas of its spread. Though the youngest of the major religions, it has grown to be present in many regions in the world and is the third largest religion in the world. It is also the fastest growing religion in the world. Kobeisy (2004) attributes the rapid growth of Islam to three factors. These three factors are immigration, high fertility rate and conversion. The factor of immigration is significant to this paper, as it is indicative of the presence of a growing number of the followers of Islam to areas of different cultures, wherein there may be a lack of understanding of Islam and the Muslim culture. Islam was founded by Prophet Muhammad on the basis of his claim that he was the chosen one of God to spread the word of his absolute oneness, submission to God and repentance. To Prophet Muhammad, Islam was not a new religion, but a purer version of the traditions of Jews and Christians. However, Islam has grown to be a religion in its own right and at loggerheads with Jews and Christians. Within a brief period of a hundred years Islam spread across the Atlantic Ocean in the west, to Central Asia in the East and from there into Africa and the rest of Asia. The spread of Islam in these areas essentially can be attributed to conquests and forced conversions of the conquered populations. As is seen with other religions, growth of the religion leads to divisions, and so too is it with Islam, where the schism resulted from disagreements over the political and religious leadership of the Muslims. Two major groups within the followers of Islam are the Sunnis and the Shiites. The essential part of the religious faith remains the same in both groups. The fundamental religious book Islam is the Qu'ran and consists of recitations of Prophet Muhammad. The Qur'an remains the basis of the faith of the religion and the guidance to the way of life among the followers of Islam (Muslim History, 2007). Religious Aspects of Islam: Islam from its Arabic derivative means submission to God and the acceptance of God. This acceptance and submission to God is demonstrated through the worship of God and the strict following of the commands and guidance as handed down by God. Such commands and guidance are provided in the recitations of Prophet Muhammad which make up the central religious text the Qur'an. To any Muslim the Qur'an is the literal word of God. Hence the Qur'an is free from error. The 6,236 poetic verses that make up the 114 chapters of the Qur'an are in essence moral guidance and as such the Qur'an is considered to be the embodiment of principles and values of Islam. (Islam, 2007). Examples of the life of Prophet Muhammad are called the Sunnah and are preserved in the traditions called Hadith. The Hadith is a collection of the words, actions and personal characteristics of Prophet Muhammad and Muslims are encouraged to follow these examples of the actions of Prophet Muhammad in their daily lives. There is some controversy over some parts of the Hadith, as a section of Muslims tend to blame these parts of the Hadith for any of the ills seen in the Islamic way of life. (Kalifa, 2000). The Sunnah and Hadith assist in the interpretation of the Qur'an as a source of guidance to the Muslims. (Islam: Introduction, Part 1, 2007). There are five religious practices that constitute the pillars of Islam. The first and primary is the shahadah. The shahadah is the basic tenet of Islam and is the basis of all the other religious practices. It consists of the acceptance of God and His messenger Muhammad and is to be repeated in prayer. The second religious practice is the salah, which is the ritual that needs to be offered fives a time day by a follower of Islam. The third is zakat, which is the practice of giving of alms based on the capacity of the individual. Sawm is the fourth and is the traditional fasting from sunrise to sunset during the month of Ramadan. The fifth and final religious practice is the hajj. Hajj is the pilgrimage to the holy city of Mecca during the Islamic month of Dhu al-Hijjah, which every able-bodied Muslim, male or female, is expected to undertake at least once in their life time (Islam, 2007). Multiculturalism in Islam: Islam began as a small community of followers in the seventh century, and spread rapidly to become one of the major religions of the world. This spread of Islam meant that Islam became a religion not of just the harsh culture of the community it was born in, but was to become the religion of many communities in from the Iberian Peninsula to the China in the Far East and the continent of Africa. This spread has caused the religion of Islam to be influenced by the cultures of the other communities. Thus the practice of Islam is not monolithic or identical in all parts of the world due to the influence of other cultures (Voll, 1988). This is significant, as the harshness of the religion as practiced among the Arabs, as suggested by Dwairy, (2006), may not be applicable in all parts of the world where Islam is practiced. Arabs constitute only twenty percent of all the people that practice Islam. In each of the South Asian and South-East Asian countries like Indonesia, Pakistan, Bangladesh and India there are more than a hundred million followers. In the Middle-East Turkey and Iran, which are non-Arab countries, constitute the largest Muslim majority countries. In Egypt and Nigeria in Africa followers of Islam are the majority of the population. In several of the European countries Islam has grown to be the second largest religion after Christianity. In each of these non-Arab countries, the local culture has had an influence on the practice of Islam and so the practice of religious codes around the world is not the same (Islam, 2007). This dilution in the submission to the harsh requirements of Islam can be seen in the dress code practised among Muslims around the world. These words found in the Koran "And tell the believing women to lower their gaze, and to display of their adornment only that which is apparent, and to draw their veils over their bosoms, and not to reveal their adornment save their own husbands or fathers or husbands' fathers, or their sons or their husbands' sons, or their brothers or their brothers' sons or sisters' sons, or their women, or their slaves, or male attendants who lack vigour, or children who know naught of women's nakedness (SURAH XXIV. 31, p. 360), is the reason for the strict dress code of hijab, which virtually covers every part of Muslim women. Such a strict code is seen essentially among Arab women. The less restrictive niqab is more common among non-Arab Muslim women. In less conservative non-Arab Muslim countries and in Muslim migrants to the Western world, a head scarf is all that remains of the dress code for Muslim women (Niqab, 2007). The influence of multiculturalism has been to tone down the harshness of the impact of Islam among the different cultures it spread to and this may provide the perception that Islam is not monolithic in its practice. However the influence of Islam has been strong on the way of life of the followers of Islam in these lands. The cultures of these lands reflect this strong impact of Islam (Habeeb, 2006). Islam and Sexual Behaviour: Just as most other religions have instructions on the most important of human relationship, namely sexual relationships, so too does Islam. In Islam the extent of religious guidance on sexual behaviour is in great depth. Such a consideration comes from the belief that Allah in all his greatness created human beings, as the most unique and distinguished of all his creations. The main distinguishing feature of humans, is the ability to think and through this faculty, the ability to control behaviour. Sexual relationship in all other creations is an act in the process of reproduction and continuation of the species. It is only humans that indulge in sexual activities for personal gratification. Thus it becomes necessary for religion to enforce regulations on sex, so that it does not become an activity to the detriment of the individual and to the society as a whole (Bennett, 2005). From an Islamic perspective the Qu'ran is the guiding light in the regulation of sexual relationships and behaviour. The Qu'ran makes it clear, as to what are acceptable sexual behaviours and relationships and makes these regulations on zina or illicit sex applicable to both men and women equally. Any and all sexual relationships outside of heterosexual marriage are considered to be illicit sexual relations and are punishable according to shariah or Islamic Law. This makes pre-marital sex, marital infidelity homosexual sex, sex with prostitutes, incest and rape illicit sexual relationships and unacceptable according to the Islamic moral code. Hence for the followers of Islam heterosexual marriage is the only means to sexual relationship and gratification of sexual needs has to be modified to satisfaction received within the relationship of marriage. Similar religious regulations on sexual behaviour are a part of other religions, but are not enforced as strongly as in Islam, where total submission to God and religious tenets are an integral part of the faith. However, quite often it is seen that women are the focal point of maintaining the moral code of Islam and holding their sexual desires in check to prevent the occurrence of zina or illicit sexual relationships. Thus sexual relationships outside of marriage are forbidden to the Muslims. This means that sexual gratification needs to be found only within the relationship of marriage (Bennett, 2005). Marriage in Islam: Marriage is an important aspect on the life of a Muslim, the essence of which differs from many of the practices of the developed world. The Koran encourages marriages, or rather makes it mandatory on all followers of Islam. Marriage and submission to Allah are the two components essential in the life of a Muslim (Shah, 2002). This stress on the requirement for marriage in Islam is to prevent immorality in Muslim societies. These words from the Koran amplify it. "And so are the virtuous women of the believers and the virtuous women of those who received the Scriptures before you (lawful for you) when ye give them their marriage portions and live with them in honour, not in fornication, nor taking them to as secret concubines. Whoso denieth the faith, his work is in vain and he will be among the losers hereafter (SURAH V.5, p.119). Marriage in Islam is thus a shield against immoral acts like promiscuity, adultery, fornication and homosexuality. The Koran also provides the guidelines in all the aspects of marriage, thereby giving religion a strong influence in marriage. From a sexual behaviour perspective it is necessary to explore whether the Koran and the religion have an influence on sexual behaviour within a marriage in Islam. The Koran clearly provides the obligations and rights of the partners in marriage. According to Shah (2002), the obligations of a woman to her partner in marriage from the Koran are "she must be faithful, trustworthy, and loyal; she must not entertain strange men without her husband's consent; she can not let other men have her husband's rights (especially to sex); she can't be alone without her husband or with strange males; she must avoid jealousy, suspicion, and gossip; she must believe that the husband's possession is her trust; she can not throw away his belongings without warning him; she must make herself sexually attractive and be responsive to his advances; and she can't refuse her husband sexually because that could cause him to commit adultery" and those of man as "he must sustain high maintenance by being financially responsible, providing assured security, lodging, clothing, food, and general care; if his wife is not physically able to be a maid, then he must be able to afford one; he must provide marriage gift that is her own (mahr) for marriage is not valid without it; and he must treat his wife with respect, equity, kindness, and consideration, especially if he has other wives". Thus sexual relationship and behaviour within marriage for a woman is constrained to the requirements of the man, and in addition a man may have more wives in Islam, if he can meet the financial and other needs of the additional wives he chooses to have. Within the Koran lies the reason for this favour to the male gender. "Men are in charge of women, because Allah hath made the one of them to excel the other, and because they spend of their property (for the support of women). So good women are obedient, guarding in secret that which Allah hath guarded" (SURAH IV.34, p.97). Sexual relations and sexual gratification for a follower of Islam is founded in the institution of marriage. Physical intimacy and sex between husband and wife is a part of the Islamic faith. However, the relationship of marriage among Muslims is weighted in favor of the male (Engineer, 1992). This leads to the assumption that any issues of sexual relations and sexual gratification are likely to be more among the women in Islam rather than among men. Women do not express their sexual problems easily, as the issue of sex and sexual relations is a subject that is not open for discussion among Muslims. This has caused issues of sex and sexual relationships among women like submission to the sexual demands of husbands and sexual excitement in unmarried women, under wraps. There has been little social research into this aspect to throw more light on the issues of sex and sexual relationships in the Muslim world. However anecdotal evidence suggests that many of the divorces seen among the followers of Islam are due to sexual problems (Fam, 2006). Challenges in Sex Therapy for Islamic Clients: Sexuality and religion are inter-related entities. Sexuality has its impact religion, just as religion has its influence on sexual expression. The religious influence can be permissive or restrictive depending on the religious rules. In the case of Islam it can be seen that the rules influencing sexuality are restrictive and give rise to sexual problems (Vandermeersch, 1992). The restrictive influence of Islam has a positive impact in that sexually transmitted diseases are less frequent among Muslims, and sex problems may not be a result of such physical issues (Gray, 2004). On the other hand the negative influence of religion may be the cause of sexual problems resident in the mind. Physical tests do not offer a solution for a proper diagnosis, which calls for a eliciting the nature of the problem from the client through the cooperation of the client. A stumbling block immediately looms as cooperation and willingness to talk may not be there, as Islam forbids discussion of sexual issues outside of marriage. Cooperation of the client thus becomes the first challenge faced by sex therapists (Kobeisy, 2004). Securing this cooperation calls for understanding the influence of Islam on its followers and utilizing this knowledge to arrive at skills required in securing the necessary cooperation for the diagnosis of sexual problems of the client. Kotb, 2004, points out that the seemingly restrictive influence Islam stems from the requirement to prevent an over expression of natural desires for sexual activity. Thus a misconception that sexual problems among Muslims have its origins in the restrictive nature of Islam alone has arisen. Misconception of the influence of religion and the discontent it leads to among Muslims, particularly women, dominate in the Western world. The example of confinement to the home for Muslim women, with outings only allowed properly attired in purdah and accompanied are taken as restrictive in the Western world. Yet, Bedouin women have expressed satisfaction in this practice, as they are content with the autonomy and humour, warmth, and affection within the home setting (Siann, 1994). Hence understanding also calls for an open mind without any preconceived blinkers. Discussion with the client is necessary in coming to grips with the sexual problems experienced. Islam prohibits not just the discussion of issues related to sex, but also prohibits any interaction with a male for a Muslim female outside the family. The extent of the implication of this prohibition are at times taken to extremes by their husbands, as can be seen from this example, where a man divorced his wife, just because she watched a television program presented by a male alone and in the absence of her husband (Deemed immoral, divorced). Hence it would be better for female sex therapists to interact with female Muslims and male sex therapists to interact with male Muslims, to make the interaction more meaningful in diagnosing the sex problems (Dwairy, 2006). An open mind, knowledge of the influence of Islam, and the willingness to accept the influence of Islam on Islam are the key to overcoming the challenges that are faced by sex therapists in sex therapy for Islamic clients. Literary References Bennett, L. R. (2005). WOMEN, ISLAM AND MODERNITY: Single women, sexuality and reproductive health in contemporary Indonesia. London: Routledge Curzon. Costa, R. M. & Brody, S. (2007). Women's Relationship Quality is Associated with Specifically Penile-Vaginal Intercourse Orgasm and Frequency. Journal of Sex & Marital Therapy, 33(4), 319-327. Deemed immoral, divorced. (2007). AFP. THE HINDU, September 30, 2007. p. 12. Dwairy, M. A. (2006). COUNSELLING AND PYSCHOTHERAPY WITH ARABS AND MUSLIMS: A Culturally Sensitive Approach. 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