Science blended with religion to help patients

By Prapti Widinugraheni

JAKARTA (JP): Frustration, disappointment and stress are a part of the everyday life many Jakartans lead.

They can build up slowly, harmlessly and even unnoticeably at first, but gradually becoming more and more uncomfortable, more unbearable and, finally, there is little choice but to let them all come out -- in some way or another.

"The everyday social, economic and political pressures in Jakarta need only a small, even unrelated incident, to trigger a major upheaval," said psychiatrist Prof. Dadang Hawari.

"If many individuals face the same problem, and if all of them are powerless, then what we have is a sick society," he added.

And dealing with a sick society is exactly what Dadang does.

Born in Pekalongan, Central Java, 56 years ago, Dadang decided to specialize in mental health while in his last year at the University of Indonesia's School of Medicine.

"To understand the human being, we need to know its physical aspects, its body. But I didn't want to stop at that, because I realized there is another aspect to a human being, the mental aspect," Dadang said by way of explaining his interest in psychiatry.

Many of his university colleagues, he said, disapproved of his choice, saying it was a "dry and unpopular" subject where "the only thing you deal with is crazy people".

But he was persistent, and after graduating from the University of Indonesia, he continued his studies in community and social psychiatry in England.

But still he was unsatisfied. Dadang, married with three children, knew there was something else besides physical, mental and social health which was crucial to a person's life.

"I was wondering where religion played a role," he said.

The answer came after he attended a number of international conferences on mental health and psychiatry, starting with a 1982 Asia Pacific conference on drug abuse and alcoholism in Canberra, Australia.

"During that conference, one presentation said that in every human being there is a basic spiritual need, no matter how secular that person is," said Dadang, who obtained his Ph.D. in psychiatry at the University of Indonesia in 1990.

Religion

The presentation went on to say that spirituality, or religion, played a role in preventing, treating and rehabilitating cases of drug abuse, addiction and alcoholism.

And in the following international conferences and seminars he attended, Dadang came to see that religion always had a place in psychiatric treatment.

"In 1984, the United Nations World Health Organization revised the definition of 'healthy', adding 'spiritual health' to the other three aspects -- physical, psychological and social health -- which used to be the only determinants of a person's health," he said.

From there, and from other international conferences, Dadang realized that religion was no longer a taboo subject that had to be avoided in scientific forums.

"I started adding 'religious background' as part of the diagnosis on my patients and I always asked about their religious commitment," said Dadang, whose father was a Moslem preacher.

Not everyone, however, agrees with Dadang's ways. Many fellow psychiatrists disapprove of his stance and some are even skeptical.

"Some people just don't like the idea of mixing up science with religion," he said.

Thus, a strong dichotomy still prevails, both in Indonesia and in international circles.

How does he apply "religious therapy" in practice?

"In every person there is a physical and mental capacity which is capable of fighting disease. But there is also a spiritual capacity which, I believe, must be explored to give the patient an additional sense of endurance," he said.

"I always tell my patients that doctors give the medicine, but it is God who heals," said Dadang, 1988-1992 and 1992-1996 chairman of the Association of Indonesian Psychiatrists.

He said many studies show that the stronger a person's religious commitment is, the less chance that person has of being affected by stress.

In suicide cases, the global figures are even more significant, as people with a weak religious commitment are four times more likely to commit suicide than those with a strong religious commitment.

But then again, depressed, frustrated patients lacking religious commitment are not the only ones that come to Dadang.

"Many of my patients are also those with religious delusions, believing they are sent to cleanse the world, or claiming they are a prophet," he said.

"In the end, I apply religious therapy both to increase the religious endurance of a person and to straighten wrong beliefs," he said.

Jakarta

What is his diagnosis for the distressed people of Jakarta, who live in a rapidly changing city which is often so big and unfriendly that the only ones who can thrive are the strong and brave-hearted?

"Social jealousy is heavy in the air, especially as most Jakartans have to face unfair competition everyday," he said.

"For example, not everybody has access to capital, or the right connection," he pointed out.

Legal uncertainty, eroding moral values, corruption, collusion and violence have become a part of the everyday life of most Jakartans. And the hardest hit by this spiraling situation is the city's lower-income group.

"I think we really need a system that protects the weak," Dadang said. But this does not seem to be the direction in which Indonesia is heading.

And instead of learning from past experiences of developed countries that have had to deal with problems caused by widening social-economic gaps, Indonesia is going headlong in the same direction, he said.

"The gap becomes accentuated and in the end, only a small trigger is needed to cause it to explode," Dadang said.

The July 27 riot in Jakarta, for example, shows how feelings of dissatisfaction, frustration and anxiety are released -- in a very harmful way.

The situation, Dadang said, can also trigger terrorism, an act where the helpless can feel a bit stronger and more capable of fighting against the social order which, they feel, has been cruel to them.

And who is to blame for the situation?

"All of this is happening because our leaders are not providing us with a role model. There is virtually nothing we can copy from them. Instead, they have created the conditions and the opportunities for such inequalities and deplorable situations to develop," he said.

The most likely to fall victim to the situation, Dadang said, is the country's younger generation.

Indonesia, he pointed out, has yet to fulfill the difficult task of setting up sound instruments to protect the younger generation from the negative impacts of globalization and change.

"Laws, regulations and intensive supervision are needed to anticipate the increasing trend of drug abuse, alcoholism, criminality, rape, narcotics and AIDS. Without such instruments, it will be hard to cope with the rapid changes that Indonesians must face in the near future," he said.

"Young people don't know the agony of modernization. All they see are the good things from outside and they adopt them in an unrestrained manner. All this is happening, and the system simply allows it," Dadang said.