INTRODUCTION

Illness, both mental and physical, though based on universal physiological factors, is in its expression highly culturally patterned.
One becomes "sick" or "crazy" in a well defined culturally delimited way. Concepts of health and illness are based on a value system and they are culture-bound.
Every culture has a theory or theories of mental illness. Various forms of therapy are developed by every culture as well. These standards of behavior reflect the values of the group.
However, major categories of mental disorders may be universal. Schizophrenia, for instance, is now believed by many to be caused by some kind of biochemical imbalance.
Some Asian, Middle East and Near East societies provide therapy within a complex of what has been described by Westerners as magic or ritual. Such is the case of the Iranian culture which traces its lineage through 2500 years of Persian history to the most ancient Aryan peoples .
Psychotherapy and religious healing are very closely allied in Iran. More specifically, in the province of Kurdistan, there is a form of psychotherapy practiced by the native people that are directly related to the Islamic teachings.

Background of the Problem

The people who live in Kurdistan and other provinces in Iran depend on native "healers” for treatment of physical and mental disorders, as well as for spiritual guidance and counseling. There is at least one healer, accompanied by his helpers (morids), in every town or village.
The healer is usually at least forty years of age and must possess an adequate knowledge of herbal medicine, human anatomy and physiology, and knowledge of the spirit or "psyche," as it has been called. This knowledge is based for the most part on classical books and ancient religious and scientific writings. Unlike the majority of specialists in Western countries, these healers have a holistic approach in their treatment of disorders.
Every Thursday night the people of a particular town or village gather at the mosque or a room adjoining to it, to perform what they call Zekr (remembering God). This is no doubt a religious ceremony, but it is never­ the less their most common form of psychotherapy. The room where they sit is simply decorated with a few carpets to sit on. The participants sit in a circle and repeat phrases such as "La illaha illa'ala," (There is no God, but Allah) under the direction of the healer.
This chanting is supposed to increase their spiritual awareness and heighten their consciousness, which in turn helps them to worship Allah and reflect more deeply upon themselves and their lives. This meeting ends with a prayer and the people go home. But the healers function doesn't end here.
The healers help people with their per­sonal and family problems on a daily basis. For instance, a man may come to him claiming that he feels guilty for despising the poor. In response, the healer might advise him to actually play the role of a beggar for a short time so that he can learn to sympathize with poor people instead of disliking them. Or, a woman who is being abused by her husband might seek the healer's counsel. He would most likely try to help her and her spouse to improve their marital relationship, and if necessary include the intercession of relatives and/or friends.
The healer's helpers aide him for the most part by helping victims of disaster or misfortune in a material way. For instance, they may assist an orphan in finding a home, or provide temporary shelter to the poor or persons who have lost their homes by fire, flood or earthquake. It is the healer himself who takes care of their more specific emotional and behavioral problems. Together, this team of persons provides assistance to the people of their community.
The types of problems Iranians face who live in the larger cities and towns of Iran do not differ drastically from the problems that are common to the people living in the smaller towns and villages of Kurdistan. However, people living in larger communities may experience more problems due to the faster pace of life and other conditions associated with living in an urban industrial setting. In particular, they may encounter an increased number of family related problems that occur as family members spend less time at home and fall victim to outside influences. For example, a young man or woman: may get involved with drugs, underground politics or sexual experimentation and, thus, become social outcasts.
The healers of Kurdistan typically see a number of people suffering from stress and anxiety, including children, who live within a very competitive and restrictive social structure. Any deviation from cultural norms may promote guilt or anxiety in them. The loss of virginity, for instance, may contribute to hysterical reac­tions or obsessive-compulsive symptoms in some girls.
Very few of the people who live in the larger cities are familiar with the healers or the therapy they provide. However, it is the opinion of the author that they too could be helped by use of techniques similar to those used by the healers. In order to successfully treat his patients, the therapist with a practice in Iran might try to combine the new techniques and skills he has acquired with those the healers implement.

Statement of the Problem

Psychotherapy, the treatment of problems of mental health, can be defined as a series of contacts between a socially sanctioned healer and a patient who seeks relief; It is the treatment of personality disturbances by psychological means. Many different techniques of therapy are found scattered around the world; it is also true that they are not distributed evenly. Certain techniques occur much more often than others, and each culture appears to have its own preferences.
The reason is that techniques of therapy are intimately related to culture. They are related to the theories of causation of illness, the personality types valued, and the goals of therapy in the culture. The last is a reflection of more general cultural values.
The goals of therapy are also culture bound and are related to the basic ideals of the society. In the United States, for instance, personality characteristics held in high regard are achievement, independence, responsibility and rational thinking. Therefore, goals of therapy which are usually considered appropriate for a patient in this country include: improved insight, improved personal efficiency, and improved social efficiency, and the techni­ques of therapy which best achieve these goals are psychoanalysis, insight-oriented therapy, behavior therapy, drug therapy and occupational therapy.
In other cultures the values, goals and techniques are often different. An example of this is seen in Kurdistan (Iran), whose unique form of psychotherapy is the focus of this study.
In order to present an adequate description of psychotherapy as it is practiced in Kurdistan, the author has found it necessary to include a discussion of several aspects of psychotherapy found in Kurdistan and in Western cultures such as; the meaning of psychotherapy, the function of the psychotherapist, therapy techniques and the theories behind them.

Purpose of the Study

The intent of this study was to present the importance of the psychotherapeutic techniques used in Kurdistan within a coherent scientific framework.
Specifically, the purpose of the study was as follows:

1. To describe and characterize the healers of psychotherapy in Kurdistan.
2. To fully document and describe the theories and techniques of psychotherapy as practiced by healers in Kurdistan.
3. To determine whether the theories and techniques of psychotherapy as practiced in Kurdistan are bound by pre-Western scientific concepts.
4. To determine whether the theories of psychotherapy as practiced in Kurdistan bear any resemblance to those used in Western cultures.
5. To determine whether the techniques of psychotherapy as practiced in Kurdistan bear any resemblance to those in Western cultures.

Importance of the Study

The form of therapy that can be applied to all psychogenic disorders and is best suited to accommodate the people of Iran must be broad enough to sa­tisfy the needs of people who live both in cities and in rural areas. The counselor/therapist must utilize all possible sources new and old; traditional and progressive that could aide in the treatment of a variety of clients.
This would render flexibility and a basic commitment to help all people as essential characteristics of the professional with a practice in Iran.
It is relatively easy to familiarize oneself with Western psychotherapists and their theories and techniques. But there is a general lack of information and knowledge about psychotherapists and the practices in other cultures. This study is important because it introduces the "healers" of Kurdistan and their therapy and techniques as a valuable resource to Iranians and to people living in other countries as well. In addition, it is important because it provides a case study of cross-cultural comparison that can help to find out more about similarities and differences as human beings living in different societies.

Scope of the Study

This study was concerned with the description of the therapeutic techniques used by the indigenous healers in Kurdistan, and whether or not their practices were similar to those used in the West. The investigator made no attempt to evaluate the effectiveness of these techniques, however, because of problems such as setting the criteria to be used in judging effectiveness, and the difficulties associated with trying to set up a control group or observe participants over long periods of time.
The study was limited to:
1. The discussion of mental disorders and their treatment which are thought to be psychogenic in nature; such as anxiety-reactions, conver­sion reactions, phobic reactions or obsessive compulsive reactions.
2. Including only data that were felt to be relevant.
3. Observations made by the researcher; that is , the observations of others were not used.
4. The fact that the researcher was not able to observe the healers consistently, or their clients except when they were being treated. There is a need for a longitudinal study in this regard .

Assumptions

The study was conducted under the following assumptions:
1. The healers in Kurdistan provide valuable therapy for their clients.
2. The therapy which the healers provide has some bases in Islamic religion.
3. There are both similarities and differences exist between the psychotherapy used in Kurdistan and Western cultures.
4. The researcher was able to record data as the events occurred naturally.

Psychotherapy in Western Culture

There are more than a hundred specific psychotherapies practiced in Western cultures, each unique in some ways but each expressing one of the three general orientations:
1) Psychoanalysis and other directive approaches;
2) Phenomenological approaches; including client-centered therapy, role therapy and Gestalt therapy and.
3) Behavior therapy, or approaches emphasizing behavior modification such as operant conditioning or systematic desensitization.
In addition to these therapies there are also group therapy and family therapy.
"The basic function of psychotherapy is to provide a situation in which learning can take place. The patient comes to the therapist with a set of behavior that is ineffective and inadequate in dealing with his environment. The job of the therapist is to do something about it " (Lundin: 399).
In determining the specific goals of therapy, theorists typically have indicated a range of attitudes, values and behaviors which they see as deviant and needing to be modified or eliminated. In some instances (as in the case of the above quotation) the definition of the goals of psychotherapy is very simple; in others highly elaborate and descriptive.
One topic that has been widely debated among Western psychiatrists is whether or not the personality characteristics of the psychotherapist are necessarily important. At one end of the spectrum are those in the client-centered school who believe that the personality characteristics of the therapist constitute the most important components of the therapeutic relationship. At the other end are behavior therapists and psychoanalysts who maintain that therapy is primarily the application of techniques, and that the personality characteristics of the therapist are secondary or unimportant altogether.
However, studies seem to indicate that, since the therapist-patient relationship is by definition a personal one, the personality characteristics of the therapist are an important factor contributing to the successful treatment of the client or patient. In a study of vocational counseling, Seeman concluded that methods are not as important in accounting for differing client reactions as are the characteristics of "warmth, interest and understanding."
Friedler compared three differently oriented groups of therapists with three groups of relatively inexperienced therapists. He found that, among the experienced therapists, personality and experience, rather than different methods, accounted for differences in therapeutic outcomes. This view is also supported by Brammer and Shostrom who wrote that, "The counselor must be free to move naturally, quickly and easily in his thinking and feeling in order to adapt to the subtle nuances of client behavior. "

In most cases, emotional disturbances are temporary, surface phenomena that require no more than the help and care of family and/or friends .
However, if such disturbances occur repeatedly or are of a severe and more complex nature then expert help is called for. According to Hilgard, therapist is an expert whose resources of know­lege and experience are superior to that of the client. Typically then, the client relates his life's history and problems to the therapist so that the therapist can make appropriate recommendations. In this way, the therapists role may somewhat resemble that of an educator; he interpretes facts and imparts information to the client that can help him in an indirect or direct fashion.
Disturbed persons need the help of someone who understands the psychodynamics underlying maladjustment and one of the three specialists in personality disorders should be consulted; a psychiatrist, psychoanalyst or clinical psychologist.
Psychiatrists are physicians who specialize in the diagnosis and treatment of mental illness. They have been trained to differentiate between the organic and psychological causes of personality disorders. Psychiatrists recognize the fact that an illness that manifests itself primarily in physical symptoms, such as headache or fatigue, may be caused or aggravated by emotional stress. Or, on the other hand, a patient who is emotionally disturbed may appear to be so due to an organic cause such as brain damage or chemical imbalance. Psychiatrists who specialize in the function of the nervous system are called nueropsychiatrists , and those that have been specially trained to perform operations involving the central nervous system are called neurosurgeons. A psychoanalyst is also a psychiatrist; however, he has had more extensive training in psychoanalysis and/or other special methods of treating personality disorders.
The clinical psychologist currently practicing in America must have earned a Ph.D. in clinical psychology from an accredited university and completed at least one year internship in a mental hospital or clinic.
"Efforts are now being made in many states to obtain licensing for qualified clinical psychologists in order to guard against quacks infiltrating the proffession . . .  In recent years an increasing number of clinics have been set up that maintain teams trained people. The minimum staff of such a team consists of a clinical psychologist, psychiatrist, and a psychiatric social worker"(Lehner and Kube).

Psychotherapy in Other Cultures

Every society seems to have evolved some form of psychotherapy. Torrey divided therapists in other cultures into three categories the herbalist, diviner and healer, and said that they are roughly comparable to what we call a druggist, psychologist and psychiatrist; respectively. He also pointed out that mental illness everywhere is thought to be caused by one (or a combination ( of three things: biological events, experiential events or metaphysical events. In other words, the causes of mental illness 'may be attributed factors such as injury to the central nervous system, emotional shock, or as the results of supernatural intervention (eg. "Spirit possession”).
Different cultures classify disease in different ways. But in general, cultures other than American or European do so in a relatively simple and rational way; often on a purely functional base. For example Ozturk, who studied the people of Turkey, found that although there were many types of folk beliefs and ideas about mental illness, the most typical explanations were based on common sense. That is, the Turkish people from rural and industrialized areas believed that people went crazy because of lifes miseries, frustration, fatigue, or loss of a possesion and so on. At the same time, the remedies for mental illness were also quite simple in nature and included things like rest cures, good nourishment and marriage.
In all cultures the main function of the therapist is to treat illness. Therapists in Asian and Middle Eastern countries treat a wide range of problems, whether they stem from a physical, mental or social condition. Often the therapist is a religious figure as well. The method he uses in treating his patients has some connection to religious beliefs in this case. Examples of this type of therapist would include the Buddhist monks in Thailand, the hodjas in Turkey and also the healers of Kurdistan discussed in this paper. Soddy commented that metaphysical events like socery or angering a diety are used to explain mental illness in many parts of the non-Western world. This close association between the metaphysical and mental illness is how he explained the overlap in roles of religious figures and therapists commonly found in all areas of the globe including the West .
The relationship between the therapist and patient in other cultures is just as diverse as it is in the West. In British Ghana, the therapist does not accept very much responsibi­lity for his client. The client himself is responsible for his own recovery. On the other hand, in other places the client actually lives with the therapist for long periods of time if it is necessary, and the therapist constantly attends him until he is well again.
The therapist-patient relationship is in part determined by the fee paid for the therapist's services. In most cultures, the more successful a therapist is the more he costs. And, once a therapist has made a reputation for himself he can have the freedom to pick and choose his clients. But this is not always the case. Some therapists are interested in other things than money or prestige- like helping other people or because they seek their work as their "calling. " These therapists may actually live on small donations.
In regard to body contact in the therapist patient relationship, therapists in other cultures almost invariably use it more than Western therapists do. For instance, the Nigerian babalawa rubs the patient's body extensively, and carefully holds his head as he makes shallow cuts for the medicine (Prince). However, it might be added that as holistic medicine grows in popularity in the United States and European countries, this tendency may cease to exist.
In order to become a therapist in any culture, there is some minimal amount of training that is required. Zempleni wrote that even those who inherited their position as a therapist must still serve an apprenticeship for some time. In complex Western societies, of course, the therapist must have undergone extensive schooling and training. A psychiatrist, for example, must complete 4 years of college , 4 years of medical school, one year of internship, and finally 3 years of psychiatric residency training before he is considered qualified to work on his own. Prince pointed out that only a few cultures other than Western cultures actually have a formal examination at the end of training.
Kiev described how important culture is in defining illness, and in determining the recourse an ill person should take. Wittkower agreed with Kiev and pointed out that culture influences the content of mental symptoms. He found out for example, that delusions with a religious content (i.e . ) a person believing himself to be God) are much more prevelant in Christian societies as opposed to non-monotheistic ones. Kiev goes on to say that mental illness affects a person's entire being and involves the sufferer's world view, ethical values, self-image and his interactions with others. The therapist's role is, therefore, to be a mediator between society and the sick individual. His success depends not so much on his technique, but on his ability of his client to obtain the trust of his client and steer the faith of his client towards health
"The techniques of therapy all over the world are found to be the same. There is no technique used in Western therapy that is not also found in other cultures".
Some of the most common therapeutic techniques used by therapists all over the world include history taking, confession, suggestion, hypnosis and dream interpretation. History taking is particularly important in Morita therapy found in Japan. The patient is required to keep a daily dairy which is reviewd by the therapist and patient. Confession helps clients to share guilt and obtain emotional catharsis. The relieving of painful experiences by confession may also be therapeutic. Suggestion includes anything that is said to the client by the therapist, whether it is very direct or more subtle in nature (e.g. "you must do this to get well,” or "stop acting irresponsibly"). Hypnosis was reported to have been used in therapy in China 3,000 years ago, and it has been used by a group of Sufis in Afganistan to treat physical and mental disorders for quite some time as well. (Hallaji, 1964).
Dream interpretation is currently being used by native therapists in Turkey (Ozturk, 1965), Ghana (Jahoda, 1961), and the Phillippines (Stewart, 1955) to gain more knowledge of the patient's unconscious mind.
As it has already been mentioned, supernatural forces are most often believed to be the cause of mental illness. The Malays who tend to live in rural areas and are conservative in their life style believe in ghosts and spirits which are supernatural influences in their lives. Illness is thought to be caused by supernatural forces. Physical or mental afflictions may be due to the invasion of a spirit, loss of one's soul, or decrease in the soul's vitality. Traditional Malay "medicine” is almost magical and cures are effected by methods which control these supernatural forces (Kirk, 1970).
The Malay shaman, called a "bomoh ," cures mental illness by first identifying the bad spirit and then calling on a stronger spirit to drive the weaker one out of the victim (Winsted, 1961). Often in other parts of China a temple spirit is consulted for psychiatric patients. Spirit mediums are presumed to have direct access to gods and spirits. The spirit mediums are believed to be possessed by their guardian spirits through a state of trance and worship. Therefore, the patient is brought into first-hand contact with gods and spirits (Comber, 1958).
In an intensive study of the delusions of ten West Indian schizophrenics in English mental hospitals, Kiev found a predominance of religious and magical themes that were strongly related to the beliefs of normal West Indian immigrants who set high value on a fundamentalist approach to the Bible, believed in the phenomenon of charismatic personalities, and were conversant with and receptive to notions of obeah, ghosts, and religious healing (Kiev, 1963)
Pfister (1932), in an analysis of the symbolic processes, the breakdown of the patient's unconscious resistances, and the detection of ethological factors by the Shaman, demonstrated the close link between Navaho therapy and psychoanalysis. He maintained that the Indians penetrated to the unconscious motivation of the psychoneurotic disturbances under treatment and applied treatment individually.
Goldstein, et. ale (1980) wrote that theories of possession and witchcraft and the like are explanations of abnormal behavior, but they are not scientifically verifiable. Witchdoctors use mystical methods of therapy. Torrey in contrast to Goldstein wrote with regard to them:

“The techniques used by Western psychiatrists are, with few exceptions, on exactly the same scientific plane as the techniques used by witchdoctors. If one is magic, then so is the other”. Although there are numerous ethnographies describing the nature and function of African witch doctors, Indian shamen, and other primitive healers, few researchers have attempted to describe these persons from a psychological perspective. Torrey writes, "In contrast to the abundant anthropological literature, there are remarkably few psychiatric studies of therapists in other cultures." Furthermore, he mentions that most of the studies that were attempted concluded with remarks like, "It is difficult to fit mental disorders from that culture into Western diagnostic categories. "
And so, with this in mind, the author has set out to try and describe a people he has studied and the psychotherapy they practice in a way that can be understood by persons who are familiar with the terminology and general theories found in Western psychology.

Research Approach

There is currently little or no information available about psychotherapy as it is practiced in Kurdistan. However, the means which could gene­rate that information were accessible to the researcher. Therefore, the study involved a descriptive survey.
An application of the descriptive survey is to test whether a situation described by some theory exists in reality or not (Fox, 1969). A wide variety of statements are made by Asian and Middle Eastern scholars regarding the specific psychotherapy employed in those countries. One faces seve­ral research questions, such as: who are the psychotherapists in those countries, and are they comparable to those in the West? What are the similarities between the techniques these psychotherapists use in the Middle East and Asian countries and those used by psychotherapists in the Western countries? These questions lack answers and data, although research situations do exist. That is, there are accessible psychotherapeutic techniques in different Asian and Middle Eastern countries and there are research questions for which the descriptive survey is a perfectly appropriate research approach.
This research study was also past-oriented because it sought to illuminate the questions raised by an intensive study of material written by Muslim scholars from the beginning of Islam (A.D.620) in order to find the origins of the psychotherapy practiced in Kurdistan; to understand its bases in the past and relevancy to the present.
The research situation also involved direct observation. The healers and the healing process were observed as they occurred naturally and were recorded by the author. Local people, as well as skilled persons, helped with media production.
By directly observing the healers and being able to question them randomly, it was possible to formulate an adequate description of them and the techniques they used. For instance, answers to questions like, "how does the healer communicate with his clients?" or "do the healers use free association and dream analysis techniques?" became obvious.
Quite a number of observers accompanied the researcher. However, the researcher relied wholly on his own observations and discretion in compiling data relevant to the study. The data were obtained in a fashion such as would show the human interaction between healer and client (i.e. cause and effect; statement or question and reply).
In addition, it should be said that the author was familiar with the people and the healers of the particular area in which the study was conducted. This made it possible for him to attend special meetings not only as an observer but also as participant. Altogether, the study continued for six years, excluding the winter months.

Subjects

Fifty healers were interviewed by the author in a variety of situations. Each healer was interviewed two to three times a week for , approximately two hours at each sitting. The patients whom the author followed for a minimum of twelve months numbered seventy-five. All of these persons were suffering from neurotic disorders. The patients were interviewed two to three times; each time for about one hour.
The following table shows a breakdown of five categories of illness among the patients as categorized by the author.

Types of Neurotic Behavior Exhibited by Clients

Instrumentation

Instruments used for gathering data included unstructured interviews, filming, tape-recording and note-taking. The unstructured interview is a method of questioning in which questions are open and posed in a face to face situation. In this kind of interview, the questions and responses to them are spontaneous. At times, the author did rely on a list of questions, but he did not restrict himself to the list, omitting some questions and asking other additional questions that he thought of while conversing with the subjects. This allowed the maximum amount of freedom for all participants in expressing their thoughts. At the same time, using this method of questioning minimized the disturbances to the natural situation.

Data Collection

The data recorded represents only a portion of that which exists, and so it is not surprising that the author may have some concerns about the homogeneity of the conclusions he drew based on the information available to him. Data were randomly selected concerning the theoretical bases of the psychotherapy practiced in Kurdistan, primarily from literature and manuscripts of a historical nature.

Data Analysis

This part contains an account of the obs­ervations made by the author while he attended healing sessions performed by specific healers living in the towns and villages of Kurdistan. These observations provided answers to the research questions, as well as a detailed description of the healers and the techniques they employed. An attempt was made to present this information in a clear and objective way. Each of the research questions discussed and developed in the introduction was taken into consi­deration. Only data relevant to each of the questions were presented. Being able to review films and tapes of various events and interactions between the healers and clients, and those between both them and the author proved to be a useful method which allowed him to recall significant events and to see things as they happened in a different perspective.

Form and Basis of Psychotherapy in Kurdistan

Psychotherapy among the healers in Kurdistan is an old form of medical treatment based on a rational scientific foundation. The Holy scriptures by which the healers are in­fluenced are the Quran, the Gospel, the Torah, the Psalms and the Leaves of Abraham. However, of all the revealed books it is the Quran on which the healers depend most. The reason for the that is because Quran is the only Book which has not changed.
The other sources which the healers depend on are first the sayings of Prophet of Islam (peace be upon him) and then books and manuscripts left from Muslim scholars and thinkers such as AI-Farabi (950), AI-Razi (1029), Avecina (1037), Gazali (1111), Khayyam (1123), Rumi (1273), Sa'adi (1291) and Hafiz (1389). In general, the healers' psychological treatment is centered around the religion of Islam.
The healers practice a form of psychotherapy based on the science of psychodynamics. In other words, the psychotherapy used by the healers is based on an organized body of knowledge about the way the mind works. The libraries of the fifty healers to which the author had access have thousands of written materials and research studies regarding how to cure mental illness. Some of the materials are hand-written and as old as 2000 years. They are written in both Farsi and Arabic.

The Goals of Psychotherapy among the Healers

According to the healers and the books they rely on, psychotherapy encompasses rehabilitation of the patient, achievement of a constructive life, enabling the patient to recognize his assets and utilize them to better advantage, abling the patient to recognize and accept his limitations, to help the patient to become more self-reliant, to accept himself with his assets and liabilities, relief from anxiety, improvement of relationship with other people based on self-understanding and understanding of others, and the establishment of self-confidence .
If the patient already feels that he is able to be productive and to have satisfactory relationships, then further steps involve education rather than treatment. The healer's central task is learning to understand the patient; to help the patient see his own situation more clearly - to get new light. Sometimes a patient changes with only a little bit of psychotherapeutic help. And sometimes a longer period is needed.

Case Examples

In one case, a 35 year old man who was afraid that his drinking of alcohol was becoming habitual came to a healer for counseling. He was aware of his problem but didn't know how to solve it. After talking with the man, the healer discovered that his drinking behavior was encouraged by his peer group. Once the client became aware of this, he immediately broke ties with his old friends and made new ones who did not drink or tolerate it in others. After a few weeks, this man had been "cured. "
Another case involved a youth. The boy had long been the subject of neighborhood talk. He had developed a reputation at home and at school as a "troubled child." His teachers and schoolmates did not like him and so, not surprisingly, he did not do well in school and had fallen behind several grade levels. Finally, after he had run away from home, his parents decided to take him to a healer. The young man lived with the healer and participated in religious activities for about three months. He was treated kindly and learned to respond to people in new ways. He began to show keen interest in his studies because the teachers and people around him did not ostrasize him. After a while he was returned to his parents, but under the condition that they move to a new town and all make a new start.
Both of the previous examples have several things in common; in both cases the relationship of the therapist and his client was personal and direct, and at the same time the therapy involved changing the environment and habits of the two individuals voluntarily.
Not everyone who comes to the healer has a behavioral problem. In fact, many are interested in widening their religious experiences. Others who do have a specific problem are first treated for it before, or in addition to, parti­cipating in the various religious activities.
So, psychotherapy is considered to be a valuable supplement to religion. It enables the individual to have a deeper, more meaningful and more healthy kind of religion.

Becoming a Healer in Kurdistan

Healers have learned many theoretical approaches to the understanding of the human psyche. Their formal training teaches them about all psychic processes. They are trained in interviewing skills and in understanding the relationships of the patient with his family and his community. A healer is an expert in human disorders whose insights permit him to determine what is wrong with the individual and to decide what techniques can be most effective to produce changes in his client's maladaptive behavior.
The healer's students attend classes and the teaching hours are mixed with practicing. The classes begin in the very early morning and continue throughout the day. The training course includes such things as a memorization, both of a vast body of literature and healing tech­niques. Another aspect of the training of healers is the emphasis on self-control and self-knowledge.
The teaching classes contain instructions about the nature of the healing process. The mechanics of the techniques are taught to the students who want to become healer. There is no fee for learning. The students just pay Zakat (charity) to the healer if they wish.
What is taught is what has been handed down from teacher to teacher for centuries. There is at least a three-year healing residency requirement for a person who has finished formal learning. This is done under the supervision of a more experienced healer. This gives the new healer a chance to practice the things he has learned-various theories, how to control his thoughts and how to treat patients. If he makes any mistakes the older healer is there to help him.
The healers are generally between forty to eighty years of age. The author was impressed by one healer who was seventy-eight years old but who was in remarkable condition, both mentally and physically. He stood erect, was not overweight, did not show any signs of chronic disease like arthritis for instance, which is associated with old age. His hearing and sight were still intact and he had most of his teeth. His face was radiant and his eyes projected a deep sense of inner peace and thoughtfulness.
The healers usually encourage their child­ren to follow in their footsteps. Therefore, the training sons receive from their fathers discourages them from being attracted to city living. Knowledge is passed down from father to son. It is a common practice among the healers of Kurdistan to keep a family genealogy. Out of the fifty healers interviewed, two of them could trace their lineage back to the Prophet Muhammad (pbuh) Furthermore; all of their male ancestors had been healers. The following table shows how many previous generations of men, out of the remaining forty-eight healers, had also been healers.

Number of Healers and Their Past Generation

The father introduces his son to the public as a successor when he sees that he may die in the near future and the son takes his place. The son has already been practicing for years, but still it is necessary for him to be recognized publicly. So, on a certain prearranged day, the people of the town and surrounding villages gather in the house of the aged healer. During a very simple friendly and religious ceremony, the father gives his son his robe. If he has no son, the father gives his robe to his best and most knowledgeable student whom he has known for years.

Religious Techniques

Three religious techniques are used by healers. These are used as homework given to the patients to complete between therapy sessions.
1. The patients are told to call God. This, to the healers, enables the clients to put an end to all other thoughts and purify their minds without difficulty. The healing process is always started in the name of God and asking God for help. The patients practice what is called zekr "remembrance", the repetition of the holy words.
The patients sit in a circle and repeat phrases such as "La illaha illa'la," (There is no God, but Allah) under the direction of the healer. This chanting is supposed to increase their spiritual awareness and heighten their consciousness, which in turn helps them to worship God and reflect more deeply upon themselves and their lives. This meeting ends with a prayer and the clients go home.
This exercise, which is believed, can help to increase concentration and self-awareness is suggested to be repeated over and over when the patient is at home. Particular phrases from the Quran and Hadith are recommended by the healer to be repeated. This exercise is also suggested to be done during working and other times not just when the person is at home. Usually a handwritten copy is given to the patient as a guide for learning what sentences are more effective to repeat. This handwritten copy has sentences such as “God is the only one who can help me”, God is with those who are patient.
2. The patients who can fast are suggested to do so. It is believed that fasting enhances the feeling of inner peace, contentment and optimism. It teaches patience and preseverance and enhances the feeling of moral accomplishment. Fasting can be used to help a person learn to control excess behaviors, such as overeating too much sex and sleeping. .
A person who fasts must abstain from eating, drinking, smoking and engaing in sex from sun-up to sunset. He must also abstain during these hours from all vicious action, such as abusing, backbiting, anger, and jealousy.
3. The healers ask the patient to repent. Repentance of a publicly commited sin is done in public, and repentance of a secretly commited sin is done secretly. This is practiced during the free association technique, where the healer devotes total attention to the patient and listens both carefully and thoughtfully.
The healers consider Tauba (repentance (to be very important. So, it is necessary here to give a further explanation of its meaning and implications.
They define sin as breaking the laws of God stated in the Quran, as well as those deeds which generally harm society. Tauba actually means repentance for a sin by making promise not to do the same evil again and to return to good works. Repentance is considered to be the beginning of life for person who intends to walk in the normal way of life. It is the root of the fortune of those who are successful, the first step of a disciple, the key to guidance to the straight path. A principle in repentence is to turn away from sins, to know the major sins, to know man's progress and retrogression for virtues and vices, to know the causes of minor sins turning into sins, and to know the conditions of Tauba, search into past sins, expia­tion of sins and the classes of those who repent. Another principle to know the causes of making Tauba and the medicines for persons addicted to vices.

Group Therapy

Group therapy which has been practiced for about fifty years in Western culture was common among the healers for centuries. The healer for group therapy is very well trained. Assistant healers help in group therapy. To the healers, many people can be in the group, but the sexes are not mixed. Small group sessions are planned. Individuals present themselves for therapy with problems such as not communicating effectively with their spouces and with their peers, vague feelings of uneasi­ness about their goals or purpose in life, self-consciousness and lack of assertiveness. Intelligence and age of the patients are also factors which are considered by the healers in grouping the paitents. Poetry and music are both tools often used in group therapy.

Poetry Therapy

A part of the total treatment of the emotionally ill in Kurdish psychotherapy is poetry therapy. Poetry therapy, according to the healers, can play an adjunctive role in healing. Poetry, to them guides patients to constructive adjustment. It helps patients make their emotional disorders easily, assists the process towards their recovery, and helps them to develop a philosophy of life that abets their adjustment to their mis­fortunes. Poetry encourages patients to explore their feelings, to feel more deeply, to extend their emotional range, yet to discover, also patterns of control and fulfillment. Poetry therapy helps patients to become more spontaneous and creative. Poetry is one of man's deepest expressions, and emotions are thereby released. Poetry can often help a patient to reach levels of emotional insight more adequately than con­ventional dialogue. It is utilized in reflecting the inner turbulent mental state experienced by the patient. It increases one's awareness and makes unconsciousness conscious. Poetry offers the individual a cultural solution to a situation. It offers something more than words and is akin to action. Poetry has more effect than discursive statements because of its bright images and strong phonetic order of harmony and rhytm. Patients with affective disorders may find a poem in sympathy with nearly any mood.
Poems that are close in feeling to the mood of the patient are found helpful. Depressed patients, for example, are helped by poems. By reading, studying, memorizing, reciting or creating poem, depressed patients come to feel that they are not alone in their depressions, that others are also depressed, that others have been depressed and recovered from their depressions. For them, crying precipitated by a poem is often therapeu­tically helpful.
Two things are important with regard to the poem. The meaning of the poem and the rhythm, rhyme and flow and symbols, of it. The poems su­ggested by the healers cover the meaning of daily life, and most of them are based on the Quran and the Hadith. Usually the poems are recited in groups. The healer and the patients sit around on the floor and cooperate in reading and describing poems. The states of ecstasy into which they fall vary according to the emotions which predominate in them - love, fear, desire, and repentance.
These states are the results not only of hearing the poems, especially those based on Quran and verses of Quran, but also erotic poetry. All the verses of the Quran are not adaptable  to stir the emotions such, as that which orders a widow must wait four months after the death of her husband before becoming espoused to another man. The nature which can be thrown into religious ecstacy by the recital of such verses are peculiary sensitive and very rare.
Ecstacy arises out of mental condition, which is of two kinds. One kind is Mokashafa, and Moshahada, which lead to unseen and unthinkable knowledge. Another kind leads to unthinkable change, fear, and repentance. Songs only awaken these conditions. If there is a change of open bodily limbs as a result of songs, it is called ecstacy or Wuzd. Another reason that the healers use poetry other than that of the Quran for healing is that people around them are so familiar with Quran, many even knowing it by heart, that the effect of it has been dulled by constant repetition. One cannot be always quoting new verses of Quran, as one can of poetry. Once, when some wild Arabs were hearing the Quran for the first time and were strongly moved by it, Abu Bakr said to them, "We were like you, but our hearts have grown hard," (AI-Bukhari) meaning that the Quran loses some of its effect on those familiar with it. For the same reason the Caliph Omar used to command the pilgrims to Mecca to leave it quickly: "For," he said, "I fear if you grow too familiar with the Holy City the awe of it will depart from your hearts" (AI-Bukhari).

Music Therapy

The healers believe that the heart of man has been so constituted by God that like a flint, it contains a hidden fire which is evoked by music and harmony. The harmonies are echoes of that, higher world of beauty which is called the world of spirits; they remind man of his relationship to that world, and produce in him an emotion so deep and strange that he himself is powerless to explain it. The effect of music and dancing is deeper in proportion as the natures on which they act are simple and prone to emotion; they fan into a flame whatever love is already dormant in the heart, whether it be earthly and sensual, or divine and spiritual.
In music therapy regard must be had to time and place, and spectators must not come from un­worthy motives. The patients should sit in silence, not looking at one another, but keeping their heads bent, as at prayer, and concentrating their minds on God. Each should watch for what­ever may be revealed to his own heart, and not make any movements from mere self-conscious impulse. But if anyone of them stands up in a state of genuine ecstacy all the rest should stand up with him.
The music therapy session takes from two to three hours. The music they play is very simple and contradictory to those practiced in the Western culture. The musical instruments are drum, tambourine and flute. These musical instruments are supposed to make music which stimulates spiritual emotion; otherwise they are forbidden to be used. The healers call music "sama" or spiritual concernts. They believe that instruments which are delicate and complex in their sounds and shapes usually have the power of evoking in men and women sexual passions, and they are looked upon by Islam with strong disapproval. The healers begin and end'the music with a verse of Quran. They play different kinds of musics and sing different kinds of songs. They have rules how to start and how to end the music. The rules are based on their opinions of the effectiveness of the sounds.

Drug Remedies

Drugs made from local herbs are also used frequently. The pharmacological armamentarium usually consists of mixtures and powders prepared from roots and leaves of plants and given to the patient. These are collected from the woods, mountains and fields by local inhabitants.
The healer has his own small laboratory and his own written formula verified from both the old and new medical knowledge. The healers were not willing to reveal the exact ingredients of their "home" remedies to the author, but they did tell what a few of the herbs were used for .
Galingate is used to harden teeth, wild sage to promote perspiration and prevent blood clotting (embolus); grains of the agnus cas­tus are used to relieve menstrual cramps, the leaves of the anemone raise blisters; dock leaves nuetralize acidity and stimulate appetite, while the flower of the white water lily cools heartburn and wormwood is good for the stomach as a tonic.
Castor-oil, derived from the castor plant is used to reduce colds and eliminate intestinal gas. In addition they admitted that some of their conconctions have no effect whatsoever and are used as a placebo.
The healers are not the only ones, however, who use herbal medicine. In fact some of the common people have been observed to use penicillin to reduce infection, and they have also developed their own kind of first aide. Wounds are often cauterized, the cautery being a mixture of salt, egg yolk, butter and honey applied to the wound at a boiling heat. For backache, after a fall from a horse, for instance, the hide of a freshly skinned goat is applied until it putrifies and effects the cure. It is hard to reason how treatment of the later type works, but the point is that it must; otherwise people would not continue to do it. Bois (1966:79) wrote that , "A French doctor, Dr. Marquios, has recorded that in 1948 he confirmed with his own eyes that in various places in Kurdistan some old women were clearly aware of the beneficial effects of the mould found on bread (penicillum glaucum) on certain wounds and diseases, thus anticipating penicillin ."
The therapeutic use of hypnosis which was first used by Franz Mesmer (1734-1815) in the eighteenth century has been used in Kurdistan by the healers as long as 1,400 years ago. Almost 1,200 years before Mesmer practiced hypnosis, it was being used by the healers of Kurdistan as an adjunctive treatment tool for facilitating their healing. They used hypnosis to facilitate memory, reduce anxiety and symptoms such as headache, neck back and shoulder pain. The technique they use is not exactly like Mesmers, but it is similair and has the same purposes.

Reasons for Maladjustment

According to the healers there are several reasons for maladjustment: the conflict between what an individual wishes to achieve and what he feels he can achieve, goals set too high, a degree of self-eva­luation that is too low, too great expectations of life and too little preparation for one's own contribution. Maladjustment is considered, in short, to be the consequence of distorted value concepts. They have to be corrected or even newly developed in the course of healing.
The healer's first assumption is that the disordered behavior for which people seek treatment is learned. Cognitive processes play an important role in problem solving behavior.  So, here one can see a similarity between the ideas of the healers and those of the phenomenological psychotherapists.
The healers recognize that there are physiological factors which may predispose one to certain types of disorders, and that certain chemical disorders, either internally or externally produced, will also result in behavioral change.
The healers also feel that there is a body of information which indicates that even organically based or genetically predisposing conditions can be in part compensated for or dealt with through psychological techniques, similar to what is known as behavior modification.
According to the healers, the major shapers of the person's behavior are his family during childhood, with the peer group and the institutions of the culture in which one lives providing later shaping and modification of established patterns. The development of behavior disorders occur when the individual undergoes recurring stress and arrives at inadequate solutions when attempting to terminate responses that he experiences as uncomfortable, painful, or anxiety-producing, or when he experiences any other kinds of unpleasant reactions .

The Nature of Man

The healers believe that man is created by God as a being composed of a soul, which is known by spiritual insight, and of a body. The soul is the core of man. The body depends on the soul for its existence, and not vice versa. The soul belongs to the world of the spirit, while body pertains to the material world. Since the characteristics of a material object are not to be found in the soul , it cannot be the subject of the question "how" or "what"; the answer to the question of "what the soul is like" or "how it exists" is that the soul is not the subject of howness or whatness .
The reason for the soul's coming to the body is not to suffer punishment. Christianity teaches that Adam fell from paradise because of his sin, and that this fall was designed as a punishment for him; owing to his sin, there is a taint of sin in every individual whose place on earth is caused by this sin. Such ideas are not to be found among the healers.
The healers state that what caused Adam to fall was something accidental and foreign to his soul, i.e . , an act of disobedience; this made him unfit for living near God. In order to enable him to acquire that fitness, or deserve it through guidance, Allah (God) sent him down to this world. Every soul's fitness is not owing to Adam's faults, but because it is created imperfect. This concept of the acquisition of provision and perfection is a Quranic idea. The healers elaborate it in accordance with their theory of the basic natural disposition or basic nature of the souls since the soul is divine in nature, inclination toward good and aversion to evil are innate in it. This corresponds with the assumption in humanistic psychologies that human beings have a natural tendency to be "good "
The soul is the core of man and the body is merely its instrument for acquiring "provision " and perfection; the body is very necessary for the soul, and care must be taken of it. The soul uses the body as its vehicle. Although a separate substance, it is united with the body through the physical heart. Everything in the body is the assis­tant of the soul. Some of these assistance are visible, e.g. the hands, the legs, and all other external and internal parts. Others are invisible and are three in number:
a) that which is the source of motive and impulse; motive to attain what is use­ful is called "amyal" (desire), and motive to repel what is harmful is named "dusdee badan" (anger).
b) That power or "qudrat" which moves the limbs toward the objects of desire, or against the objects of aversion; it is diffused in all the limbs, particularly in muscles and nerves,and c) that which perceives. This has two divisions, one consisting of the five senses and the other of the five powers which are centralized in the five parts of the brain. These powers are imagination (i.e. representation), retention, reflection, remembrance and the common senses. Besides this relationship between soul and body, the healers believe that soul and body are distinct entities; they affect each other and determine their courses mutually. Every act produces an effect on the soul, and this effect forms the quality of the soul. After an act has been repeated for some time, its effect on the soul becomes established. This idea parallels learning theory.
An act performed without conscious deliberation cannot create any effect on the soul. This is the reason why involuntary action has no relevance to others. As bodily action influences the soul, so the soul influences the body; if a quality is est­ablished in the soul, relevant bodily action necessarily proceeds from it. Willingness or reluctance in the execution of an act depends on the strength or weak­ness of the quality. A deed creates some effect on the soul; this effect causes the body to repeat the same deed; this deed again produces some effect on the soul; this effect is added to the previous effect, which is now strengthened. The circular process goes on indefinitely. This necessity of the soul and body to be in unity and balance in order to promote wellness of each individual roughly corresponds to the idea of the Gestalt Psychotherapy. The healers apply this theory (e.g. getting rid of vices by means of opposite deeds, acquisition of virtues through habit formation, and so on). It is repressed in those who were created with only a moderate degree of desire and anger.
(Avecina (1037), who has shown the intimate relations exist between psychology and medicine, has described various psychical states such as anger, anxiety, joy, grief and other feelings and their effects upon the functioning of the heart, the constituents of blood and different remedies, and has given details of how they affect the heart as well as proper occasions for their use. He has tried to persuade his readers to the belief that moral qualities are based on the functioning of the "heart" in combination with the "spirit." In the third volume of his famous book Qanun, under heart diseases, moral qualities are treated as diagnostical signs of a cardiac constitution. Avecina claimed that it is possible for therapeutic measures to control human feelings such as envy, malice, courage, miserliness, generosity, joy, grief, and anger,which can be increased, decreased or altered.
The healers believe that personality is divided into three interconnected parts, each of which has its own functions and properties. They approach the problems of conflicting ten­dencies within the individual by dealing with the concepts of nafs: amareh, lavameh and motmaenah. The nafs amareh is the depository of the innate instinctual drives (sexual, aggressive), which in their bald form seek immediate expression when aroused. If unbridled, the nafs amareh would always seek immediate gratification of primitive, irrational, pleasure-seeking impulses.
Nafs amareh is present at birth and necessary for survival. All the insticts are included in the nafs amareh. It is the aspect that is in closest touch with the inner world of the individual.
The healers see the nafs amarah as unorganized, unreasonable, and illogical in nature. It is entirely unconscious, having no contact with reality except through the nafs lavamah. They liken the nafs amarah to the primitive or animal nature of man.
The nafs of lavamah is considered the executive of personality. It is partly conscious and partly unconscious. It is practical and discharges the nafs amarah energy in a way that is sensible and in keeping with the religious and moral nature of the society. It discovers a way, a plan of action which reduces the tension and keeps the personality out of trouble.
The nafs lavamah, however, is an organized portion of the nafs amarah. It is dedicated to forwarding the aims of the nafs amareh to frustrating them. At times it may have to divert an impulse or delay its gratification, but essentially it exists to serve the nafs amarah by mediating between its impulses, and the demands and limitations of the environment.
The nafs motmaenah is the moral branch of the personality. It represents a person's moral code, being developed through the child's assimilation of his parents' standards of proper conduct. In a highly moralistic person, the nafs motmaenah has taken over control and the nafs lavamah is subservient to it. Conflict often arises between the nafs motmaenah and the the nafs amarah via the nafs lavamah. The nafs lavamah may try to satisfy the impulses of the nafs amarah but it is then punished by the nafs motmaenah for so doing.
The nafs motmaenah comes into existence through identification with parents, who reward certain actions and punish others. The presen­tation of the nafs motmaenah serves to limit all future actions of the nafs lavamah.
Gazali (1111) is responsible for the idea of the nafs, which preceded Freud’s concept of the id, ego, and superego, and even the "libido", by about 1,100 years. He based his ideas on the Quran, utilizing passages as the following to describe the concept of nafs by about 1100 years. He based his ideas on the Quran, utilizing passages as the following to describe the concept of nafs .
Nafs Ammarah: "Nor do I absolve my own self (of blame). The human soul is certainly prone to evil, unless my Lord do bestow His mercy" (XII 53).
Nafs Lavamah: "And I do call to witness the self-reproaching spirit (Eschew Evil)" (LXXV 2 (
Nafs Motmaenah: (To the righteous soul will be said :) "0 (thou) soul, in (complete) rest And Satisfaction!" (LXXXIX. 27)
The following is a short description of nafs amarah, nafs lavamah and nafs motmaenah by Gazali (1111):
Nafs has two meanings, Passion or baser and lower self. Passion is a comprehensive word consisting of greed, anger and other evil attri­butes. The second meaning of nafs is soul. When Nafs assumes calmness and has removed passion, it is then termed nafs motmaenah. When the calm nature of nafs does not become perfect, it is called nafs lavamah or self-accusing soul, as such a soul rebukes one for neglect in divine duties. If soul gives up protests and surrenders itself to the devil, it is called nafs ammarah or passion addicted to evils.

Development of Reason

Reason begins to appear at the age of discrimination (sometimes during adolescence), gradually develops at the age of maturity (young adulthood), and becomes perfect at forty, when man becomes fully man. Reason has no power to prevent passions from exceeding their limits. When it develops in man at the time of his maturity, it finds passions very strong in the soul, since they developed much earlier and are strengthened by their repeated satisfaction. Since they are completely irrational they themselves cannot be amenable to reason. Since reason is not present in children and the insane, they do not know good and evil and cannot control their passions, so they are incapable of refraining from evil. (Gazali, 1111). That is why the healers use only a direct therapy approach in treating these cases.

The control of desire and anger, or "amyal" under the commands of reason is strongly urged because the control of desire and anger by reason is considered by the healers as the central characteristic of a normal, virtuous man.

Classifying Abnormal Behavior and Behavior Modification Theory

The healers believe that it is possible to change behavior through effort and appropriate moral training. Men differ in the speed of change in their dispositions. Some people do not distinguish truth from falsehood or good from evil; they lack conviction, and have lacked it since their birth. Their central desires are not strengthened since they have not indulged in them. The character of any person of this type may become "good" normal in a short time.
At the second level are those who know well enough the "badness" of what is "bad", but do not shun it because they find their bad deeds enjoyable. The correction of their disposition is more difficult than for those at the first level.
Those in the third stage believe their evil dispositions to be right and good and so pursue evil ways whole heartedly. It is almost impossible for these men to be cured of their vices; there is no hope for their correction except in rare instances.
The fourth groups are those who, in addition to their corrupt beliefs and practices, see excellence in their very excess of evil. In this they vie with one another, and think that they gain fame by the amount of evil they accom­plish. They are the most recalcitrant of the four levels .
The first two groups in this classifi­cation of abnormal behavior are equal to what the Western psychotherapists label neurotic, and the last two groups are equal to psychotic. As it was explained before, the healers do not make classifications of behavior pathology in the same manner as the Western psychotherapists. They basically con­sider classification artificial, useless, unre­liable and misdirecting. They reject classification for these reasons and rely on the simple classifi­cation of four above groups.
The usual way of achieving good charac­ter is by mortification and self-training (i.e. performing those actions which proceed from good character until they become habitual and pleasant).
Thus to acquire the character-trait of generosity, a man needs to take pains to engage in generous actions, such as giving away some particular po­ssession; he should preserve in this generous action until it becomes a kind of second nature to him. An action will be considered to have become his nature and habit if he feels pleasure in performing it.
Good and normal character may also be achieved by observing good people and associating with them. Man is by nature imitative; one's nature can unconsciously acquire both good and bad from the nature of another. This is the basic principle of training children in good character, for they are more imitative than adults. Imitation is defined by Western psychologists such as Skinner as a conditioned behavior. Studies done by Bandura, and Ross, have suggested that exposing children to either live or filmed aggressive models increases the probability that they will imitate the aggre­ssive behavior they see.
According to the healers, the first step in correcting evil character, or maladptive be­havior, is to increase one’s self-awareness (which is important in any kind of therapy). There are three methods suggested by the healers in this respect.
1. The first is to keep company with a spiritual guide (healer). The guide will closely observe one and tell one about one's defects.
2. The second is to ask a friend who is truthful, pious, and has insight. This friend should be urged to watch one's states and con­ditions closely and to tell one of one's manifest and hidden defects.
3. The third method is to gain knowledge of one's defects from an enemy.

Finding a Healer

When an individual becomes aware of the evil traits which are present in him, he should hasten to remove them. He should seek the help of a spiritual guide (healer), just as he seeks the guidance of a medical man in curing his bodily diseases .
A true guide is the one who is gnostic, intelligent, a seer of the soul's diseases, kind­-hearted, admonishes others in religion, has com­pletely purified his own soul from evil charac­ter-traits, and is eager to assist others in their efforts for purification.
Common men do not know the diseases of the soul, which are very obscure and subtle nor do they know their secret causes and the specific ways and subtle techniques for their removal, and hence they need guidance.
"Know that the evils of the soul are their diseases, and the cleaning of souls from disease is through remedy... For every disease of the soul there is a remedy commensurate with the smallness or greatness of the disease. Apply, then, a remedy for the disease wherever it attack you, by introducing the anti­dote of the disease, or by cutting off its roots”.  (Al-makki: 129).
The guide (healer) should first diagnose the disciple's (client's) disease and determine its causes, and also decide upon the form of self-training he will be able to undergo with good intention, according to age, bodily health and temperament.
After a through examination of all these, the guide (healer) will prescribe a particular form of cure (just as Western psychologists first collect data to form a patient history in order to diagnose and treat mental illness).
If an evil trait is so strong that the dis­ciple (client) is unable to remove it by prac­ticing its opposite, the guide should devise a technique by which the disciple's habit in that trait may be defected to a less evil trait, and this should then be removed by its opposite (in other words, the healer uses shaping to change an initial behavior) .

Self-Actualizing

Some examples of traits that the healers see as bad include gluttony, strong anger, and delusion. Gluttony, in particular, is one vice that they believe can be remedied by performing those acts which are opposite to it (in this case moderation). For example, desire for food is natural in man, and its aim is to ensure bodily health. It is only the moderate satis­faction of this desire that is useful to this end. Excess and deficiency in it are both harmful. Hunger occupies the mind with the thought of food; but the man who takes a moderate quantity of food feels free from hunger and heaviness of stomach - he forgets his stomach; and can think about other things besides eating. So, when a person who is very obese, or on the other hand suffereing from a disorder like anorexia nervosa, the healer would try to help that person achieve a balance by applying the opposite behavior, or "extinguishing" overeating or undereating.
In short, the healers define a self-actualizing person to be one who tries to acquire virtuous or "good" qualities such as hope (optimism), intention (goal-setting pur­pose), unity (self-integration), and other qualities that will enable him to function successfully in a human society, such as patience, trust and love. Love is regarded as the highest station of virtue, and other qualities, such as intimacy and satisfaction, are said to be its by-products.

Psychotherapeutic Techniques in Kurdistan

Healing procedures vary greatly depending upon the nature of maladaptive behavior. It may involve biological, psychological, or sociocul­tural (sociological) approaches, or any combi­nation of these.

Physical Therapy

            Here also, treatment is directed toward the correction of organic pathology. The psy­chotherapeutic drugs include the simple use of the local herbs, as explained before and using the hot springs around the country and drinking holy water, called Zamzam, brought from Mecca. These alleviate anxiety and tension and widely used in the treatment of depression. However, these drugs do not resolve inner conflicts or other life stress or modify faulty assumptions or inadequate competencies. They mostly are used to facilitate communication with patients who have mental blocks because of their prompter action, to enable person to em­bark upon healing, to decrease pressure of impul­ses, to promote a tightening of thought process, to interfere with secondary gains and to assist in the management of depressions, as well as for their oral significance as a variety of placebo. The pla­cebo is considered a very powerful therapeutic technique. Factors such as attention, interest, con­cern,  trust, belief, faith and expectation are re­cognized as placebo effects in the healing of phy­sical disorders and psychological disturbances .

Deap Breathing

            Practicing deep breathing is recommended by the healers as a technique. Deep breathing proper­ly requires the following physical movements:
a. First, intention (determination) is made to do so.
b. Second the air in the lungs is exhaled slowly. For complete exhaling, the individual needs to bend half-way to the front. In performing exhalation the mouth should be completely closed.
c. Then the individual makes a space between his teeth while his mouth is closed and begins inhaling until he is standing straight.
d. The individual keeps the air for as long as he can (based on practicing) and then he lets the air out slowly.
This is a complete exhale and inhale, which the healers teach to their patients. There is a need for a usual breath in between to avoid hy­perventilating. This technique is supposed to help reduce anxiety by increasing levels of oxygen in the bloodstream. Most people have a tendency to hold their breath unconsciously or breathe insufficiently when they are anxious or angry. The consequent lack of oxygen (actually the build up of carbon dioxide) may then cause additional body pain or increased tension, which the healers be­lieve can be prevented by using this technique.
Purification "Taharah "
The healers ask their clients to take care of the purity of both the heart and soul as well as the body and material aspects of life. This is based on many of the Quran injunctions which call upon man to be pure and clean:
"For Allah loves those who turn to Him constantly And He loves those who keep themselves pure and clean" (AI-Bagara, 222).
Patients are asked to perform ablution before prayers, to trim their nails, to remove their hair under­neath the armpit and from around the genitals, to trim their moustaches. This ordinance of cleanliness includes both men and women.
1.  Body washing "Total Ablution”
            a. Body washing upon ceremonial impurity due to sexual contact with one's wife. Both men and women are required to wash their whole bodies.
b. Body washing after mense and puerperium. After the bleeding of menses and puerperium stops women are required to wash their whole bodies.
2.  Purification of the private parts of the body after defecation and urination. Water is used to purify polluted organs of the body after answering the call of nature. If water is not availabe paper is used.
3.  Ablution "Wudou " Ablution is prescribed as a key to prayer and it is absolutely necessary before performing prayers. In ablution the individual washes his hands first, then he rinses his mouth, then he throws water up his nostrils. He then washes his right hand and arms up to elbows, then washes his left hand and arm. Afterwards, he wipes his wetted hand over the upper part of his head. After that he puts the tips of his forefingers wetted with water into his ears and twists them around, passing his thumb at the same time around the back of the ears. Lastly, he washes his feet, up to the ankles and passes his fingers between the toes, en­suring thereby their cleanliness. Each organ is washed three times except wiping the head and ears which should be made only once.
4.  Complete Body Washing "Total Ablution" The washing of the whole body to absolve it from uncleaniness and to prepare it for the exercise of prayer is absolutely necessary after the following acts: noctural emission, menses, costus, and puerperium.
In general, the recommendation by the healer to practice this ritual of cleanliness has its effects on the mind, since it is done while repeating verses of the Quran and senten­ses such as "I seek refuge in God from the temp­ tation of Satan" or "I intend to clean my body as a symbol of cleaning my soul.”

Sociological Approaches to Therapy

Sociocultural approaches to treatment are concerned with alleviating poverty (such as the healers' attempts at gathering money or finding job for their clients), group prejudice and discrimi­nation (healers' attempt in explaining the brother­ hood and equality among the Muslims), and other pathogenic community and social conditions. The use of the social milieu is especially considered important in the treatment of identity crises in the adolescent. The healers help the adolescent to take full advantage of the normal societal processes available to him, usually relationships with peers and discussions with them of mutual problems.
Participation of the patients in the re­tuals and ceremonies usually has the most impact upon the modification of the patients' social behavior. The rituals are as follow:

Friday Prayer

All the believers in the community have to participate in the Friday prayer according to the Quran. Friday prayer is a congregational prayer only and cannot be offered alone. Consequently, an Imam (i.e., Leader and usually the healer of the community) leads the prayer. He first delivers a Khutba (sermone) in two parts consisting moral, usual, present day situations, showing the people the means of their elevation and dwelling upon their national praise to God and Prayers of Ble­ssing for the Holy Prophet, and communal welfare and some admonition to the congregation. He then prays to God for the welfare of all those who have given submission to God. After that he leads two Rokat of Friday and all the others follow him as usual in congregational prayers.
The Imam stands in front of the congregation facing the direction of the Kaba, and all the other worshipers stand in lines behind him and follow his lead, i.e., they stand when he stands,  perform Ruku when he does it, and so on . To prepare oneself for Friday prayer, one should take a shower or bath in the morning, put on clean clothes, and abstain from eating foods which leave an offensive odor on the breath, such as onions or garlic.
There is no better way of bringing about the noble feeling of social and unity and brother­hood than conducting such a collective or group prayer. The rich and the poor, the white and the colored, the high in society and the low stand side by side as true brothers, saying the same words, doing the same actions and feeling the same reverence and devotion. This certainly drows their souls nearer to each other.
As Friday is the day of collective worship for Muslims, its observance may seem to resemble the Sabbath or Sunday in Judiasim or Christianity.
The similarity, however, is apparent rather than real. The basis of the Sabbath observances in these religions orginated from the idea that as God the Creator "rested" on the seventh day after six days of "labor" at completing the creation of the heavens and the earth, so man should also rest in honor and observance of the Creator's "rest" (see Exodus 20:8-11). This idea is fundamentally contrary to the teaching of Islam, as the omnipotent God does not become weary and requires no rest from His "work." There is no Sabbath in this sense in Islam. Muslims can carry on their usual activities and business before and after the Friday prayer. God has said in Quran:
“O you who believe!
When the call is proclaimed for prayer on Friday, hasten earnestly to the remembrance of God, and leave off business; that is better for you but know. And when the prayer is finished, then you may disperse through the land and seek the bounty of God; and celebrate the praises of God often, that you may prosper” .
 Eid-al-Fitr (The Festival of Fast Breaking) Eid means a recurring happiness or festi­vity. When the Prophet arrived in Medina, he found that the people of that city celebrated many festivals. He abolished these pagan observances and told the Muslims that God has prescribed only two festivals for them - the Eid-al-Fitr (The Festival of Fast-Breaking) and Eid-al Adha (The Festival of Sacrifice).
The Eid-al-Fitr is celebrated on the first day of Arabic lunar month (Shawwal) following the month of fasting, Ramadan.
 Eid-al-Adha (The Festival of Sacrifice) This Eid is celebrated on the 10th of Dhul-Hijja, following the course of Hajj (pil­grimage to Mecca).
The Eids are days of thanksgiving and rejoicing for every Muslim, as well as for the community of Muslims as a whole. While the Eids are occasions, for joy and happiness, they are certainly not occasions for frivolity, over­eating or the pursuit of pleasure. The joy on Eid is the spritual joy of fullfillment-fullfilment of God's command of discipline, piety and collective worship.
Each of the Eid days begins with prayer and is spent in alms-giving, visiting friends and relatives, and exchanging greeting and gifts.
The spirit of Eid is the spirit of peace and forgiveness, for at these times one should forget all grudges and ill-feeling toward one's fellow men if he has not already done so. On Eid one makes fresh start in his relations with others in a brotherly spirit.
After the Arabs destroyed the strong Iranian Empire with the help of Islam in Seventh century, Kurdish people as well as Persians accep­ted Islam faithfully. Hundreds of maktabs, madre­ses (schools) and colleges were built. Islam uprooted the earlier integrated policies and practices and eased the past. Persians modi­fied the new practices willingly and integrated them into their own way of life. During Safavia Dynasty in fourteenth century, many pegan prac­tices of the old Persians were put into action. Such is the celebration of “Nowruz” the new year of the old Persian calender. But the Kurdish and the ten millions of Sunnis in Iran kept the pure Islamic practices. This is a proof to the idea that there is no pre-Islamic aspect in the Kurdish life as well as in the practices in psychotherapy.

Advice-giving

This technique impies the direct, unmi­tigated offering of a course of action to patient. It is an activity on the part of the healer and oftentime authoritarian, and he advises the patient directly concerning the handling of symptoms.

Confession (catrarsis)

This technique is considered to be effec­tive in reduction of guilt and related tensions.

Environmental Manipulation

The patient's environment is adapted to better meet his needs. More radically, the pa­tient's personality is modified to make him more compatible with his environment. The healers help the patient separate from exacerbating situation as a tactic of environmental manipulation and place him in an atmosphere more suitable to his needs as another. The healers recommend a variety of manipulations, such as the use of family and friends, job training and proper job placement to increase self esteem, body mechanics, and par­ticipating in the rituals. They also recommend travel and vacation as a manipulation that enables the patient to achieve a distance between him­ self and his conflict. In some cases, the patient is recommended to spend alone in nature (such as mountain areas) for two or three weeks. The author had the chance to practice such a technique for ten days. He was also encouraged not to use any watch or o'clock in order to be away from the anxiety which is usually caused by paying too much attention to the passing of time. The only way the author could arrange his time with was the sun. The healers use mani­pulation of the environment to improve the patient's feelings of support, particularly when his relation­ ship to his world needs improvement.

Family Therapy

The healers are concerned with the problems arising from a patient's interactions with members of his family. Where these interactions are patho­logical, the patient may be imprisoned, and indeed may be the person in the family who least needs psychological help. Where the difficulty in the patient's life arises from pathological interactions among members of the family, the healers bring the family together for a group discussion of insight into and resolution of their joint problems.
The healers consider the family therapy a viable technique for extending psychodynamic aid to the large masses of people. To them, this technique is particularly applicable in the treatment of children, where the child's pathology cannot be separated from the families. Different members of the family are also seen separately. One healer treats the entire family.

Home Visits

The healers extend healing to emotionally disturbed people in their homes.

Group Therapy

This technique is used widely. The healers are available to the group only as a group, not to any individuals.

Support

The healers support adolescents in making their own decisions. However, these decisions do not involve actions which would seriously hinder the achievement of an identity solution, such as passive submission to authority, leaving school, withdrawing from interpersonal contact and other behavior extremes. Supportive techniques are considered important especially in emergency treatment of children, where they know that they can rely upon the healers.

Concept Control

This is used to enable the patient to control either the formation or the frequency of occurance of certain idea. Patients are encouraged to adopt to behavior common in society.

Hypnosis

The healers use hypnosis to facilitate communication and to abreviate the healing process. They also teach auto-hypnosis for achieving muscle relaxation .

Self-Esteem Reconstruction

Among the patients referred to the healers was a frequent concomitant of depression, lowered self-esteem. The self-esteem of the patient is increased through insight, and this result from the learning of new and better coping and problem solving behavior.

Desensitization

This technique employs a physiological state that is incompatible with the existence of anxiety, in order, first, to inhibit a weak anxiety response to a stimulus. The stimulus is repeated until the waek anxiety response is eliminated com­pletely. Following this, stimuli of increasingly stronger degrees are introduced and progressively eliminated. The essential steps are (1) training in deep-muscle relaxation; (2) construction of intensity-hierarchies of anxiety-producing sti­muli; (3) opposition of relaxation-arousing and anxiety-arousing stimuli from the hierarchies.

Re-Conditioning

This is one of the basic procedures of healing. New desired behaviors are rewarded, while undesired behavior is either consistently not rewarded or punished.

Interpretation

The healing employs interpretation as a technique for achieving amelioration or cure by conveying insight to the individual concerning the nature and causes of his fear, his impulses, his defenses against them and his motivations that are beyond the level of awareness. They use interpretation to connect present with past events.

Educative Techniques

Teaching the patient a skill or mastery which the healer perceives as important to affecting stabilization. The healers educate patient as to the origins of neurotic fears and they make an effort to instruct the patients in the use of insight as a corrective force in the patient's life, and so help him to apply the insight to real life situations; in this respect the educative technique is adjunctive to the insight-imparting process. They teach patients problem-solving techniques; they advocate educative techniques to enable patients to reach new solutions.