Textbooks teach students the evolution of modern psychology in the seventeenth century starting from Sigismund Schlomo Freud and Carl Gustav Jung, ignoring the larger reality that it was ninth-century scholar Abu Zayd Ahmad ibn Sahl al-Balkhi who gave the world the fundamental principle of modern psychology, writes Azra Hussain
Abu Zayd Ahmad ibn Sahl al-Balkhi (850-934 CE) was one of the earliest thinkers to combine philosophical, psychological, and medical insights to study human well-being. His unique approach to understanding the human mind and emotions places him among the pioneers of psychology, particularly in the Islamic world. His work on mental health, contained entirely in his book Masalih al-Abdan wa al-Anfus (Sustenance for Bodies and Souls), provided one of the earliest comprehensive frameworks for the treatment and understanding of mental disorders.
The Scholar
Born in 850 CE in the city of Shamisitan, near Balkh (modern-day Afghanistan), Abu Zayd al-Balkhi lived during the height of the Islamic Golden Age, a period of flourishing intellectual and cultural achievements in the Islamic world. Balkh was a significant centre of learning at the time, and al-Balkhi was able to study under some of the greatest scholars of the era. His education was broad and encompassed fields such as medicine, philosophy, geography, literature, and theology. However, it was his synthesis of these disciplines that allowed him to contribute meaningfully to psychology.
Al-Balkhi’s intellectual career developed in the context of the Abbasid Caliphate, a period of great scientific, medical, and philosophical advancement. He was heavily influenced by the works of Greek philosophers such as Plato and Aristotle, which were being translated into Arabic at the time. The intellectual atmosphere in the Islamic world encouraged inquiry into various disciplines, allowing al-Balkhi to transcend traditional boundaries between medicine and philosophy. This unique environment fostered his interest in the health of both the body and the soul, or as he would call it, “the science of the self.”
The Works
His most famous work, Masalih al-Abdan wa al-Anfus, illustrates his holistic view of human well-being, linking the health of the body to the health of the soul. This work placed him among the first scholars to approach mental health as an essential component of overall human health, centuries before similar ideas would emerge in Europe.
The first part of the book deals with physical health, focusing on nutrition, exercise, hygiene, and the prevention of diseases. Al-Balkhi drew on the medical knowledge of his time, incorporating Greek, Persian, and Indian medical practices into his recommendations. He emphasised the importance of maintaining physical health to ensure that the soul could function properly, indicating that he understood the mind-body connection long before this became a mainstream concept in Western psychology.
However, it is the second part of the book, which deals with mental health that stands out as particularly innovative. Al-Balkhi discussed a variety of mental health issues that are still recognised today, such as anxiety, depression, and phobias. His ability to distinguish between different mental states and disorders, and his understanding of their effects on physical health, demonstrate his deep insight into the human psyche.
The Outcome
Abu Zayd al-Balkhi’s teachings offer valuable insights into the interconnectedness of mental and physical health, emphasising the importance of holistic well-being. His understanding of mental disorders, such as anxiety and depression, highlights the need to address both cognitive and emotional aspects for effective healing. His approach to cognitive therapy, self-discipline, and emotional regulation through mindfulness resonates with modern psychological practices. Additionally, his belief in balance – between body and soul, and in emotions – teaches the importance of moderation in achieving overall health. His work encourages a comprehensive, compassionate approach to mental health, relevant in today’s world.
Al-Balkhi emphasised the importance of self-awareness and understanding one’s own mental processes, and believed that recognising one’s thoughts and feelings is crucial for psychological well-being. He also identified what psychologists now call cognitive distortions – negative thought patterns that contribute to mental distress.
To prevent these distortions from taking root, Al-Balkhi proposed that individuals should learn to manage their emotions effectively. He believed that emotional disturbances often arise from misinterpretations of experiences and that altering these interpretations can lead to improved emotional health. His therapeutic methods included practical exercises aimed at challenging negative thoughts and promoting positive thinking. This is akin to the cognitive restructuring techniques used in contemporary cognitive therapy.
Disorder Classification
One of Abu Zayd al-Balkhi’s most significant contributions to psychology was his classification of emotional and mental disorders, which bears a striking resemblance to modern psychological concepts. He identified four primary emotional disturbances, which he believed were the result of an imbalance between body and soul, which included anxiety and fear (al-jaza’ wa al-khawf), sadness and depression (al-huzn wa al-gham), anger and aggression (al-ghadab), as well as obsessions and phobias (al-waswas wa al-khawatir).
Al-Balkhi described anxiety as a state of excessive worry about the future, leading to irrational fears and distress. He differentiated between natural fears, which arise from real dangers, and pathological fears, which are disproportionate to the actual threat. He also identified sadness as a natural response to loss or misfortune but noted that when it becomes excessive or prolonged, it leads to depression. He recognised both reactive depression, caused by external events, and endogenous depression, which arises without an apparent cause.
Endogenous depression refers to forms of depression believed to originate from within the individual, often linked to biological or genetic factors. Al-Balkhi recognised that some individuals experience depression without any apparent external trigger. This perspective was revolutionary for his time, as it acknowledged the inherent complexities of mental health that could not simply be attributed to environmental factors.
Conversely, reactive depression arises in response to external events, such as loss, trauma, or stress. Al-Balkhi understood that human emotions and psychological states are influenced by circumstances, and thus, certain individuals may develop depressive symptoms as a direct reaction to significant life changes or challenges.
Al-Balkhi observed that anger could be a normal emotional response but could also become destructive if left unchecked. He discussed how chronic anger could lead to aggression and violence, both towards oneself and others. He also understood the physiological changes that accompany anger, such as an increase in heart rate and blood pressure.
Al-Balkhi identified obsessive thoughts and irrational fears, which he called “whispers” (waswas), as another form of emotional disturbance. He noted that these thoughts could dominate a person’s mind and prevent them from functioning normally, much like the modern understanding of obsessive-compulsive disorder and phobias.
The Prescriptions
Al-Balkhi was not content with merely describing mental health disorders; he also proposed treatments that resemble modern cognitive-behavioural therapy (CBT). He believed that emotional disturbances were often caused by distorted thinking and irrational beliefs. Therefore, treatment should involve correcting these cognitive distortions and helping individuals regain control over their thoughts and emotions.
One of his key therapeutic methods was what we might now call “cognitive restructuring”. He encouraged patients to challenge their irrational thoughts and replace them with more realistic, positive ones. For example, he suggested that individuals suffering from anxiety should confront their fears by examining the evidence behind their worries and recognising when their fears were unfounded.
In addition to cognitive restructuring, al-Balkhi advocated for the regulation of emotions through self-discipline and mindfulness. He believed that individuals could train themselves to manage their emotions by developing self-awareness and practising patience, moderation, and detachment from worldly concerns. His approach to emotional regulation bears a striking resemblance to modern mindfulness practices, which emphasise present-moment awareness and acceptance of one’s emotional state.
Lifestyle Impacts
Al-Balkhi was also ahead of his time in recognising the impact of environment and lifestyle on mental health. He believed that one’s surroundings, social relationships, and daily habits could either contribute to or alleviate mental health problems. This is another aspect of his work that aligns with modern psychological thought, which increasingly acknowledges the role of social and environmental factors in mental well-being.
Advising individuals to seek out peaceful and harmonious environments, avoid negative influences, and maintain positive relationships with others, he emphasised the importance of a balanced lifestyle, which included proper nutrition, exercise, and rest, as well as intellectual and spiritual pursuits. Al-Balkhi understood that a person’s mental state was not only a reflection of their internal thoughts and emotions but also the result of their external circumstances.
In his writings, al-Balkhi often referred to the concept of “the middle way” (wasat), a principle of moderation that he applied to both physical and mental health. This idea, which has roots in both Greek philosophy and Islamic teachings, emphasises balance and avoidance of extremes in all aspects of life. Al-Balkhi believed that mental health could be achieved by finding a balance between emotional extremes and by maintaining equilibrium between the needs of the body and the soul.
His focus on balance and moderation is similar to the concept of homeostasis in modern medicine, which refers to the body’s ability to maintain stable internal conditions in response to external changes. Al-Balkhi’s understanding of mental health as a state of equilibrium between body and soul is a precursor to modern bio-psychosocial models of health, which consider the interaction between biological, psychological, and social factors in determining well-being.
Cognitive Restructuring
One of the most striking parallels between al-Balkhi’s approach and modern cognitive therapy lies in the concept of cognitive restructuring. Al-Balkhi recognised that many mental health issues stem from irrational thoughts and cognitive distortions. He asserted the importance of identifying and challenging these negative thought patterns as a means to alleviate emotional distress.
In contemporary cognitive-behavioural therapy (CBT), cognitive restructuring is a core technique. Therapists guide clients to identify negative beliefs, challenge their validity, and replace them with more rational, positive thoughts. Both al-Balkhi and modern practitioners assert that altering thought patterns can significantly impact emotional well-being, illustrating a shared understanding of the mind’s influence on feelings and behaviours.
Al-Balkhi’s emphasis on emotional regulation mirrors modern therapeutic practices that focus on managing emotions effectively. He believed that individuals should cultivate self-awareness to recognise and regulate their emotions, thus preventing them from becoming overwhelming or destructive.
Techniques for emotional regulation, such as mindfulness and distress tolerance, are integral to many modern therapies, including dialectical behaviour therapy (DBT). These methods teach individuals how to observe their emotions without judgment and to implement coping strategies to manage intense feelings. The foundational idea that understanding and managing emotions is crucial for mental health is a common thread between al-Balkhi’s work and contemporary practices.
Al-Balkhi’s therapeutic approach is distinctly holistic, considering the interplay between psychological, physical, and spiritual aspects of well-being. He recognised that mental health cannot be viewed in isolation and emphasised the need to address all facets of a person’s life.
Modern therapy, especially in integrative and holistic approaches, echoes this sentiment. Therapists today often consider clients’ lifestyles, including physical health, relationships, and spiritual beliefs, when developing treatment plans. The biopsychosocial model, which views mental health through biological, psychological, and social lenses, aligns closely with al-Balkhi’s comprehensive understanding of human health.
Physical Health
In Sustenance of the Soul, al-Balkhi stressed the importance of lifestyle choices – such as diet, exercise, and sleep – in maintaining mental health. He believed that physical health significantly influences psychological well-being, advocating for a balanced lifestyle to promote emotional stability.
This perspective is mirrored in contemporary therapeutic practices, where self-care and lifestyle modifications are often recommended as part of treatment. Modern therapists recognise that nutrition, physical activity, and sleep hygiene play critical roles in mental health. For instance, cognitive-behavioural interventions may include strategies for improving sleep patterns or incorporating regular exercise into a client’s routine, reflecting al-Balkhi’s holistic emphasis on lifestyle factors.
Social Support
Al-Balkhi acknowledged the impact of environmental and social factors on mental health, asserting that an individual’s surroundings, relationships, and cultural context could significantly influence their psychological state. He recognised that social support and community engagement are vital for mental well-being.
This understanding aligns with the contemporary emphasis on the importance of social support systems in therapeutic contexts. Therapists today often encourage clients to strengthen their social networks and engage in community activities as part of the healing process. The recognition that relationships and environmental factors are integral to mental health is a shared principle between al-Balkhi’s teachings and modern therapeutic practices.
Al-Balkhi integrated ethical and moral considerations into his therapeutic approach, suggesting that living a virtuous life contributes to psychological well-being. He believed that moral behaviour and personal integrity foster a sense of purpose and fulfilment, which are essential for mental health.
While modern therapy typically focuses on individual experiences and mental processes, many practitioners also acknowledge the role of personal values and ethics in shaping a person’s mental health. Approaches such as values-based therapy encourage clients to explore their core values and align their actions with these principles, promoting a sense of meaning and coherence in their lives. This alignment with personal values reflects al-Balkhi’s emphasis on the moral dimensions of well-being.
Awareness
A critical component of al-Balkhi’s therapeutic approach is the encouragement of self-reflection and awareness. He believed that individuals should actively engage in introspection to understand their thoughts, emotions, and behaviours better.
This principle is foundational in many modern therapeutic modalities, including mindfulness-based therapies. Therapists often encourage clients to practice self-reflection through journaling, meditation, or guided self-assessments. The aim is to foster greater self-awareness and insight, which are essential for personal growth and healing. Both al-Balkhi and contemporary therapists recognise that self-reflection is crucial for facilitating change.
Al-Balkhi’s approach included various therapeutic techniques that can be seen as early forms of integrative practices, combining different modalities to suit individual needs. His methods encompassed cognitive, emotional, behavioural, and even spiritual elements, promoting a comprehensive approach to treatment.
Today, integrative therapy has gained popularity, where practitioners combine different therapeutic techniques tailored to the client’s unique circumstances. This may include elements from cognitive-behavioural therapy, psychodynamic approaches, mindfulness practices, and more. The flexibility and adaptability of treatment modalities in both al-Balkhi and modern therapy highlight a shared commitment to personalised care.
The Self
Al-Balkhi viewed the nafs, or the self, as a central concept in understanding human psychology. He delineated different states of the nafs, notably the nafs al-ammara (the commanding self), which drives individuals toward base desires and impulsive actions, and the nafs al-mutmainnah (the tranquil self), characterised by inner peace and contentment. This duality reflects a profound understanding of human motivation and emotional states, echoing modern psychological concepts of self-regulation and self-awareness.
His perspective suggested that achieving a balance between these states is crucial for psychological health. He advocated for personal development through spiritual and ethical practices, arguing that nurturing the nafs could lead to enhanced mental well-being. This approach not only emphasised individual responsibility but also aligned with the broader Islamic ethical framework, which encourages self-improvement and accountability.
A Pioneer
Al-Balkhi was ahead of his time in recognising mental health as a critical aspect of overall well-being. He argued that psychological ailments should be treated with the same seriousness as physical illnesses, an assertion that resonates with contemporary views on mental health. His holistic approach considered various influences on mental health, including spiritual, social, and environmental factors.
The ninth-century scholar believed that neglecting mental health could lead to significant societal issues, advocating for awareness and education about psychological conditions. His work laid the groundwork for future Islamic scholars to explore mental health further, emphasising the need for a compassionate and informed approach to psychological care.
One of al-Balkhi’s significant contributions was his belief in the therapeutic potential of spiritual practices. He posited that engaging in prayer, meditation, and reflection could serve as effective tools for achieving mental clarity and emotional stability. This perspective parallels modern psychological practices that highlight mindfulness and meditation as means to enhance mental health.
Al-Balkhi emphasised that spiritual practices help individuals connect with their inner selves and cultivate a sense of purpose. He argued that such practices could mitigate anxiety and depression by fostering a deeper understanding of one’s relationship with the divine and with oneself. By integrating spirituality into psychological well-being, he provided a framework that recognises the importance of the soul in emotional health.
A Concerned Community
Al-Balkhi also acknowledged the critical role of the community in promoting mental health. He argued that social support systems are essential for individual psychological resilience. His emphasis on community aligns with Islamic teachings that stress the importance of ummah (community) and mutual support among individuals.
He proposed that a nurturing community could provide the emotional support necessary for individuals facing psychological challenges. Al-Balkhi’s insights anticipate modern theories in social psychology, which recognize that social interactions significantly influence individual behaviour and mental states. He advocated for creating environments where individuals could thrive emotionally and psychologically, underscoring the collective responsibility of society to foster mental health.
His writings indicate recognition of the need for a nuanced understanding of the human condition that transcends simplistic explanations. By integrating spiritual, ethical, and psychological dimensions, al-Balkhi contributed to a more profound comprehension of what it means to be human in an Islamic context.
An Ignored Contribution
Western scholarship has historically overlooked or misrepresented the contributions of Abu Zayd al-Balkhi and other Islamic scholars in the development of psychology. Despite his groundbreaking work on mental health, al-Balkhi’s contributions have been overshadowed by the Eurocentric focus on figures such as Sigismund Schlomo Freud, Carl Gustav Jung or even earlier Greek thinkers like Hippocrates and Galen. This misrepresentation stems from the long-standing tendency in Western academia to marginalise non-Western intellectual traditions, especially during the colonial era, which often framed Islamic and Eastern thought as inferior or derivative.
Al-Balkhi’s sophisticated understanding of mental health disorders and treatments – concepts such as cognitive therapy, emotional regulation, and the psychosomatic relationship – was centuries ahead of its time. Yet, this pioneering work is rarely acknowledged in Western histories of psychology, where the development of the field is often portrayed as exclusively Western, emerging only in the nineteenth century. By failing to recognise figures like al-Balkhi, the West not only distorts the historical timeline of psychology’s evolution but also perpetuates a biased narrative that under-appreciates the rich intellectual legacy of the Islamic world. This oversight underscores the need for a more inclusive, global approach to the history of science and medicine.
The neglect of al-Balkhi’s contributions has significant implications for the field of psychology. First, it limits the breadth of knowledge available to practitioners and scholars. The exclusion of non-Western perspectives can lead to a narrow understanding of human behaviour, potentially resulting in culturally insensitive practices and theories. By integrating insights from diverse traditions, psychologists can develop a more comprehensive understanding of mental health that is sensitive to cultural variations.
Besides, the dismissal of al-Balkhi’s work undermines the rich intellectual heritage of the Islamic world. Recognising his contributions is crucial not only for a more inclusive history of psychology but also for fostering a greater appreciation of the diversity of human thought. In a globalised world where cross-cultural interactions are increasingly common, embracing a pluralistic approach to psychology can enhance the field’s relevance and efficacy.
Abu Zayd al-Balkhi’s contributions to psychology represent a critical, yet underappreciated, chapter in the history of mental health. His holistic approach, emphasis on community, and early classification of mental disorders offer valuable insights that resonate with contemporary understandings of psychology. To fully appreciate the field’s evolution, it is essential to recognise and incorporate the diverse intellectual traditions that have shaped our understanding of the human mind. By reclaiming al-Balkhi’s legacy, we not only honour his contributions but also enrich the tapestry of psychological knowledge, making it more inclusive and reflective of the human experience.
As the field of psychology continues to evolve, the principles articulated by al-Balkhi serve as a reminder of the enduring relevance of a holistic, integrative approach to mental health. By recognising the interconnectedness of thoughts, emotions, behaviours, and broader life contexts, both al-Balkhi and modern therapists emphasise the importance of treating the whole person in the pursuit of mental well-being.
