Tazkiya of the nafs through stations and states

1. Introduction

Version followed: the classical Sufi scheme of stations (maqāmāt) and states (aḥwāl) as first set out systematically by Abū Naṣr al-Sarrāj (10th century, Khurasan) in Kitāb al-Lumaʿ and taught today, for example, by the Golden Sufi Center (Llewellyn Vaughan-Lee's 2009 talks on Sarrāj's seven stations); the seven-station list as given by Encyclopaedia Britannica; al-Qushayrī's Risāla (partial English translation Principles of Sufism, trans. B. R. von Schlegell, Islamic Book Trust); and al-Ghazālī's Iḥyāʾ ʿulūm al-dīn, Book 38, On Vigilance and Self-Examination (trans. A. F. Shaker, Islamic Texts Society, 2015) for the practice of self-examination. The psychotherapist's side follows Traditional Islamically Integrated Psychotherapy (TIIP, Khalil Center; Keshavarzi, Khan, Ali & Awaad, Routledge) and Rothman's Islamic model of the soul (Cambridge Muslim College Papers No. 9).

Tazkiyat al-nafs means purification of the self or soul. In the tradition's own terms, the nafs is the part of the soul that inclines toward worldly desire; Rothman's informants describe it as a mirror that must be cleaned so that it reflects divine light [source: Rothman, CMC Paper 9]. The Sufi path (ṭarīqa) begins with repentance, rests on the religious law (sharīʿa) and leads toward reality (ḥaqīqa) [source: Britannica, Sufism: The path]. Along it the seeker passes through stations, which are relatively stable attainments reached through the seeker's own effort (mujāhada) under the guidance of a shaykh, and receives states, which the tradition holds are granted by God, come and go, and vary in intensity [source: Britannica, maqam; Britannica, Sufism: The path; Mukholik 2017]. In the tradition's account, change happens through disciplined effort on the self (struggle against the lower self, which is to be "tamed" rather than killed), constant remembrance of God, and divine grace, under a teacher's guidance [source: Britannica, Sufism: The path].

This is a religious path of self-cultivation, not a psychotherapy. A psychotherapist does not lead a client along it. The therapist's work is client-led: with consent, helping a Muslim or Sufi client draw on these concepts in their own tradition and language, recognising when distress is entangled with the practice (scrupulosity, harsh self-punishment, difficult contemplative experiences), and working alongside the client's shaykh, imam or scholar when the client wishes [synthesis; source: Khalil Center TIIP training outline]. Related entries: Domain VII (spiritually integrated psychotherapy, contemplative psychotherapy), Domain II (MBSR, MBCT, MSC, CFT) and Domain IV (trauma-sensitive yoga); other entries in this Islamic and Sufi family cover individual practices in more depth, notably 242 (muhasaba self-accounting), 239 (dhikr), 241 (muraqaba) and 243 (khalwa).

2. Framework

2a. The tradition's map (as its sources describe it)

Law, path, reality. The path (ṭarīqa) is built on the law (sharīʿa) and opens onto reality (ḥaqīqa). Legitimate teachers present the stations as resting on ordinary Islamic obligations, not replacing them [source: Britannica, Sufism: The path].
The seven stations (al-Sarrāj's order, as Britannica gives it). Britannica notes that the number and order of stations vary among Sufis but that most agree on seven [source: Britannica, maqam]:
1. Tawba, repentance: in the Sufi sense, not dwelling on sins but turning away from everything that distracts from love of God.
2. Waraʿ, rendered by Britannica as fear of the Lord (dread of being veiled from God) and elsewhere as abstinence or watchfulness (scrupulous avoidance of the doubtful) [source: Britannica, maqam; Britannica, Sufism: The path; Golden Sufi Center].
3. Zuhd, renunciation or detachment: a heart that is not acquisitive.
4. Faqr, poverty: needing God alone.
5. Ṣabr, patience: "the art of steadfastness" [source: Britannica, sabr].
6. Tawakkul, trust in and surrender to God, accepting hardship.
7. Riḍā, contentment or satisfaction with what God decrees.
The states. Britannica names pairs such as constraint and expansion (qabḍ and basṭ), fear and hope (khawf and rajāʾ), and longing and intimacy (shawq and uns) [source: Britannica, Sufism: The path]. A study of al-Sarrāj counts seven stations and nine states and describes the states as arising especially from intense remembrance (dhikr) [source: Mukholik 2017]. Lists of states differ between authors [uncertain: the full list in al-Lumaʿ not verified]. Al-Qushayrī's Risāla treats stations and states in a sequence of chapters that begins with repentance and ends with longing (shawq) [source: IBT, Principles of Sufism].
Culmination. The way culminates in gnosis (maʿrifa) or love (maḥabba), and in annihilation (fanāʾ), first understood ethically as effacing one's own qualities, followed by subsistence in God (baqāʾ), a "second sobriety" in which the person returns to ordinary life [source: Britannica, Sufism: The path]. These are religious goals as the tradition holds them; they are not therapy goals.
Levels of the nafs. Many teachers also describe the self moving from the commanding self (nafs al-ammāra), through the self-reproaching self (nafs al-lawwāma), where most of the work is done, to the self at peace (nafs al-muṭmaʾinna), which Rothman's informants said people "rarely cross into" and can fall back from [source: Rothman, CMC Paper 9].
Format in the tradition. A seeker usually takes a shaykh or pīr and becomes a disciple (murīd); the guide sets practices and formulas of remembrance [source: Britannica, Sufism: The path]. The tradition gives no fixed timetable: reaching gnosis "takes a long time" [source: Mukholik 2017]. Initiation and an order's specific litanies are given by the shaykh and are not described here.

2b. The psychotherapist's framework (client-led integration)

No source consulted gives session counts or a fixed number of phases for this work. The phases below are a working structure drawn from the TIIP training outline's topics (assessment, case conceptualisation, stages of change, cognitive, emotional and behavioural interventions, virtues and spiritual practices) [source: Khalil Center TIIP training outline], with the sequence itself as [synthesis].

Engagement and spiritual assessment. Goal: understand the client's tradition, affiliation (order, shaykh, local mosque, none), practices, and what tazkiya means to them; obtain explicit consent to bring religious material into therapy. Move on when the client has said in their own words how they want faith used (or not used) in treatment.
Formulation in two languages. Goal: a shared formulation that holds both the clinical picture (diagnosis, risk, maintaining cycles) and the client's own spiritual terms (for example, a struggle at the stage of the self-reproaching self). Move on when the client recognises themselves in it and the clinical problem is clearly separated from questions only a religious authority can answer.
Integration work. Goal: use the client's own concepts (stations such as patience, trust and repentance; self-examination; remembrance) to support clinical goals, alongside standard evidence-based methods. Move on when symptoms and functioning improve and the client reports that faith practice feels nourishing rather than threatening.
Consolidation, referral and ending. Goal: connect the client to ongoing spiritual guidance (shaykh, imam, scholar or community) for the religious path itself, and plan for relapse.

Scrupulosity, trauma, or difficult contemplative experiences can redirect phase 3 at any point (see sections 4 and 5).

3. Guiding principles

Tradition-derived principles are cited; how each applies in therapy is [synthesis] unless stated.

The client leads; the tradition defines the content. Practical meaning: use concepts only as the client and their tradition hold them; never redefine tawba or ṣabr to fit a technique.
The therapist is not the shaykh. The tradition places the seeker under a guide who sets practices [source: Britannica, Sufism: The path]; TIIP distinguishes the roles of murabbī, shaykh, muṣliḥ, ṭabīb, psychologist and faqīh [source: Khalil Center TIIP training outline]. Practical meaning: do not assign litanies, retreats, austerities or spiritual ranks; refer those questions.
Stations are earned, states are received. In the tradition's account stations come through effort and states are gifts [source: Mukholik 2017; Britannica]. Practical meaning: help the client with effort and habit; do not try to induce or interpret states, and do not treat their absence as failure.
The nafs is tamed, not destroyed. The lower soul is to be "tamed and used in the way of God" rather than killed [source: Britannica, Sufism: The path]. Practical meaning: frame self-work as training, never as self-hatred; challenge harsh self-punishment that goes beyond what the client's tradition asks.
The path rests on the law. [source: Britannica, Sufism: The path]. Practical meaning: questions of ritual validity or what is required belong to a qualified scholar, not to the therapist.
Uncertainty is part of worship. The IOCDF notes there is "no certainty or perfection" in religious practice and that scrupulosity "is not a faith problem; it is an OCD problem" [source: IOCDF, Islam and OCD]. Practical meaning: when self-examination becomes checking, treat it as OCD.
Discomfort in change is normal, but harm is not. Rothman's informants called the work "not ... an easy fix" and discomfort normal [source: Rothman, CMC Paper 9]. Practical meaning: expect struggle; monitor for deterioration, which is a reason to adjust, not to push.
Don't build identity around a diagnosis. One of Rothman's informants framed difficulties as "a passing state that has a known treatment" [source: Rothman, CMC Paper 9]. Practical meaning: present problems as workable and changeable.
Spiritual and religious competence. Most therapists receive little training in religious issues; Vieten et al. (2013) propose 16 basic competencies (attitudes, knowledge, skills) for all psychologists [source: Noetic, Vieten et al. 2013]. Practical meaning: assess religion routinely, know your limits, consult.
Even-handedness. Religious concepts (God, grace, states, the nafs) are described as the client's tradition holds them, neither endorsed nor dismissed [synthesis].
Self-disclosure and dual roles. Practical meaning: shared faith can help rapport but does not license acting as a religious guide; disclose your own commitments only when it serves the client; avoid joining the client's order or circle while treating them [synthesis].
No health claims. The stations are not a treatment for physical disease; health questions go to the client's doctor [synthesis].

4. Intervention inventory

Part A outlines the practices as the tradition publicly teaches them, so the therapist can understand what a client is doing and refer appropriately; the therapist does not teach them. Part B is the psychotherapist's own work. Example language throughout is illustrative wording, not quoted from any source.

Part A. The practice as the tradition teaches it

A1. Taking a guide and entering the path (public outline only)

Purpose and when relevant: In the classical account a seeker is accepted by a shaykh or pīr as a disciple, who then sets practices and formulas of remembrance [source: Britannica, Sufism: The path]. Relevant when a client is considering joining an order, has a shaykh, or is practising without one.
What it involves (outline): finding a recognised teacher within a lineage (silsila) and order; formal acceptance or initiation (bayʿa); receiving practices from the teacher; ongoing companionship and correction. Britannica also notes seekers without a living master (Uwaysī), said to be drawn by grace alone. Initiation content, an order's litanies and its secrets are restricted to the order and are not given here; the therapist should not encourage a client to bypass legitimate teachers [source: Britannica, Sufism: The path; synthesis].
Example language (illustrative): "It sounds like you're thinking about taking a teacher. What do you know about this order, and who could you talk to in your community about it?"
Watch for: the classical image of the disciple in the master's hands "like a corpse in the hand of the washer" [source: Britannica, Sufism: The path] describes a tradition of deep surrender; with a client, watch whether the relationship leaves room for their own judgement, health care, family and finances (see B11). Signs it is going well: the client describes the teacher as accountable, consistent with the law, and supportive of treatment.

A2. Repentance (tawba), the opening station

Purpose: The path begins with repentance [source: Britannica, Sufism: The path]. In the Sufi sense it is less about rehearsing past sins than turning away from whatever distracts from God [source: Britannica, maqam]. Qushayrī's Risāla opens its sequence with repentance [source: IBT, Principles of Sufism].
Publicly taught elements (in plain terms): recognising a wrong; turning back toward God; resolving not to return to it; making amends where others were wronged; then moving forward rather than dwelling [source: Britannica, maqam for the "not dwelling" emphasis; the other elements uncertain: not verified].
Example language (illustrative): "In your tradition, what does it mean to have turned back? How would you know your repentance is complete enough to move on?"
Watch for: repeated repentance for the same act, needing certainty of forgiveness, or ruminating on sins: these suggest scrupulosity rather than the station as the tradition describes it (see B6). Working: the client can name a wrong, take a concrete step of repair, and then let it rest.

A3. Watchfulness and renunciation (waraʿ, zuhd) and poverty (faqr)

Purpose: Waraʿ is scrupulous care toward God (Britannica: dread of being veiled from God; also translated abstinence or watchfulness); zuhd is detachment from possessions, a heart that is not acquisitive; faqr is need for God alone [source: Britannica, maqam; Britannica, Sufism: The path; Golden Sufi Center].
What it involves (outline): simplifying attachments, avoiding the doubtful, generosity, and inner detachment. Historically a shaykh might order strict ascetic practices [source: Britannica, Sufism: The path]. No austerity targets (fasting, sleep reduction, food rules) are given here; their effects are described qualitatively in section 5.
Example language (illustrative): "What does detachment look like for you day to day, and is it something your teacher has asked for, or something you've set for yourself?"
Watch for: self-starvation, sleep loss, neglect of dependants or medical care, or waraʿ turning into constant doubt about permissibility (a scrupulosity pattern; see B6). Health questions go to the client's doctor; questions of what is required go to a qualified scholar.

A4. Patience, trust and contentment (ṣabr, tawakkul, riḍā)

Purpose: Ṣabr is steadfastness; at tawakkul the seeker "cannot be discouraged by hardships" and finds joy even in sorrow; riḍā is quiet contentment [source: Britannica, sabr; Britannica, maqam]. Consent at this level means accepting affliction with love; patience and gratitude belong to the higher stations [source: Britannica, Sufism: The path].
What it involves (outline): cultivating steadiness under trial, reliance on God alongside taking ordinary means, and acceptance of what cannot be changed. Llewellyn Vaughan-Lee's talks on Sarrāj relate the stations to contemporary life and to keeping the heart's attention turned toward God [source: Golden Sufi Center].
Example language (illustrative): "You've said trust in God helps you carry this. Does trust, for you, include seeing the doctor and asking for help, or does it feel like those are in tension?"
Watch for: use of patience or trust to justify staying in abuse, refusing treatment, or suppressing grief and anger (spiritual bypassing) [synthesis]. Working: the client describes acceptance alongside action, and grief is allowed.

A5. Remembrance (dhikr) (public outline only)

Purpose: grounded in the Qur'anic call to remember God often; the aim is that the whole being becomes remembrance [source: Britannica, Sufism: The path]. In the tradition's account, states arise especially through intense remembrance [source: Mukholik 2017].
What it involves (outline): repeating divine names, the name Allāh, or a formula such as the testimony of faith, sometimes with prayer beads of 99 or 33 [source: Britannica, Sufism: The path]. Orders give their own litanies (wird) through the shaykh; these, and any breath or body methods attached to them, are taught by the order and are not given here.
Example language (illustrative): "Would it help to talk about how your remembrance practice has been feeling lately: steadying, or harder than usual?"
Watch for: practice used compulsively to neutralise intrusive thoughts (see B6); intense or prolonged sessions followed by sleep loss, agitation, unusual perceptions or depersonalisation (see B9).

A6. Al-Ghazālī's cycle of steadfast commitment (murābaṭa): setting conditions, vigilance, self-examination

Purpose: al-Ghazālī's Book 38 presents steadfast commitment as six stations: mushāraṭa (agreeing conditions with the self), murāqaba (vigilance), muḥāsaba (self-examination), muʿāqaba (punishment of the self), mujāhada (renewed striving) and muʿātaba (censure or reproach), with vigilance and self-examination as the cornerstones [source: Fons Vitae and Islamic Texts Society pages for Shaker's translation]. The fuller treatment of self-examination is in 242 (muhasaba self-accounting).
Steps as publicly taught (in plain terms, following the six named stations; detail of al-Ghazālī's own instructions not verified): (1) at the start of the day, set intentions and conditions for one's conduct; (2) through the day, stay aware of God's watching and of one's own intentions; (3) at day's end, review conduct against the conditions; (4) respond to lapses; (5) renew effort; (6) admonish the self. [uncertain: the precise wording and content of each step in Book 38 not verified.]
Example language (illustrative): "When you do your evening self-accounting, what happens in you afterwards: do you feel clearer, or heavier and more anxious?"
Watch for: the punishment and censure stations can feed harsh self-criticism, self-harm or obsessive checking in vulnerable clients. A therapist should not prescribe self-punishment; explore what the client's teacher or scholar actually asks, and treat compulsive review as OCD (see B6) [synthesis]. Working: review leads to a concrete next step and then closure.

A7. States (aḥwāl): constraint and expansion, fear and hope, longing and intimacy

Purpose: in the tradition's account these are received, not produced, and fluctuate with the station [source: Britannica, Sufism: The path; Mukholik 2017].
What it involves: no technique; the seeker brings such experiences to the teacher for discernment.
Example language (illustrative): "You called this a time of qabḍ, of constriction. How does your tradition understand times like this, and who do you usually talk with about them?"
Watch for: a spiritual reading of constriction should not hide a depressive episode, and expansion should not hide mania; assess sleep, function, risk and duration (see B9). Britannica notes the tradition itself speaks of the majdhūb ("attracted"), people often regarded as more or less mentally deranged [source: Britannica, Sufism: The path] — a reminder that the tradition also distinguishes.

Part B. The psychotherapist's work

B1. Spiritual assessment and consent

Purpose and when to use: at intake and whenever religious material arises. TIIP training covers case conceptualisation, five assessment principles, stages of change and what it calls Prophetic empathy [source: Khalil Center TIIP training outline; content of the five principles not verified: uncertain]. Vieten et al. (2013) treat religious and spiritual assessment as a basic competency [source: Noetic, Vieten et al. 2013].
Steps: (1) ask whether faith matters to the client and how; (2) map affiliation: order, shaykh, mosque, scholar consulted, solitary practice; (3) list current practices (prayer, remembrance, self-accounting, any austerities or retreats) and their intensity; (4) ask how the client understands their distress in religious terms, if at all; (5) ask explicitly whether and how they want faith brought into therapy, and record consent; (6) agree on what belongs to therapy and what to a religious authority [synthesis].
Example language (illustrative): "Some people want their faith to be part of how we work, some prefer to keep it separate, and some want something in between. What would feel right to you?"
Watch for: the client deferring to the therapist as a religious authority; a therapist's own assumptions about "what Islam says". Working: the client is the one naming the concepts and the boundaries.

B2. Cultural Formulation Interview

Purpose: a structured way to elicit the client's own explanation of the problem, cultural identity, sources of support and help-seeking, including spirituality, religion and moral traditions. DSM-5-TR includes the Cultural Formulation Interview with supplementary modules, one of which covers spirituality, religion and moral traditions [uncertain: not verified].
Steps: use the core interview early; add the spirituality module when faith is central; note whether the client sees their difficulty as a matter of the nafs, of unseen causes, of illness, or a mix; bring that explanation into the shared formulation [synthesis]. Do not reproduce or improvise items beyond the published instrument.
Example language (illustrative): "How would you describe what's been happening, in your own words, and how would people in your community describe it?"
Watch for: explanations that involve the unseen (for example, harm from jinn or the evil eye) are religious beliefs to be understood, not dismissed; referral for ruqya is covered elsewhere (Domain XI). Working: the client feels their explanation was heard.

B3. Formulation in two languages (nafs levels alongside clinical maintaining cycles)

Purpose: to let a client who thinks in terms of tazkiya see clinical work as compatible with it. Rothman's informants place most self-work at the self-reproaching stage (nafs al-lawwāma), describe a "constructive response to the discovery of faults", and see al-Ghazālī's vices and virtues as a programme of treatment [source: Rothman, CMC Paper 9].
Steps: (1) draw the clinical cycle (trigger, thought, feeling, behaviour, consequence); (2) ask the client how they would describe the same cycle in their own terms (for example, the commanding self pulling, the reproaching self fighting); (3) note where the two descriptions agree; (4) agree clinical goals that the client also sees as serving their spiritual aim; (5) mark anything that is a question of law or doctrine for referral [synthesis].
Example language (illustrative): "You described this as your nafs pulling you back. In therapy we'd call part of it an urge-and-relief cycle. Do those two ways of seeing it fit together for you?"
Watch for: the self-reproaching self becoming a voice of contempt; the client experiencing the clinical language as secularising. Working: the client uses both vocabularies freely.

B4. Client-led self-accounting (muḥāsaba) as compassionate structured reflection

Purpose: many clients already practise self-examination (A6). Used well, it can support behavioural change; used harshly, it fuels shame. TIIP training lists cognitive, emotional and behavioural "signature" interventions and a cognitive approach called the RIDA model [source: Khalil Center TIIP training outline; content of these not verified: uncertain]. The structure below is [synthesis], cross-referable to thought records and to compassion-focused work (Domain II: MSC, CFT).
Steps: (1) ask the client to describe their current practice; (2) together choose a brief daily review with three parts: something done well (gratitude), one lapse, one concrete step for tomorrow; (3) set a time limit and an end point (a closing prayer or phrase the client chooses); (4) review the effect in session: clarity versus rumination; (5) adjust, and check with the client's teacher if the practice was given by them.
Example language (illustrative): "What if your evening review ended with one step for tomorrow, and then you let it go until morning? Would that fit with how you understand self-accounting?"
Watch for: reviewing the same act repeatedly, needing certainty that it was acceptable, self-punishment, or worsened sleep. These point to scrupulosity or depression; move to B6 or reassess. Working: shorter reviews, less shame, more follow-through.

B5. Drawing on the stations as resources (patience, trust, contentment, repentance)

Purpose: to help clients facing loss, illness, injustice or guilt draw on meanings their tradition already offers, without overriding grief or action [synthesis].
Steps: (1) ask which teachings help the client in hardship; (2) explore how the client understands patience and trust (steadfastness and reliance, as in A4) and whether these include taking means such as treatment; (3) use the client's understanding to support acceptance work for the unchangeable and problem-solving for the changeable; (4) for guilt, distinguish repair and repentance (A2) from shame spirals; (5) invite consultation with their imam or teacher if they are unsure what their tradition asks.
Example language (illustrative): "You've said patience matters to you. Is patience, for you, the same as staying silent, or can it include speaking up and getting help?"
Watch for: spiritual bypassing (for example, contentment used to suppress anger at abuse); fatalism that blocks treatment; health claims for spiritual practice. No station is presented as a treatment for physical disease. Working: acceptance and action coexist.

B6. Scrupulosity (waswās): ERP adapted with scholarly consultation

Purpose: self-examination, repentance, watchfulness and ritual purity can become the content of OCD. The IOCDF describes presentations such as repeating prayer or ablution until it feels "just right", repeating Qur'anic recitation, avoiding food for fear it is not halal, repeatedly asking scholars or family about rulings, self-shaming, and hypervigilance about offending God [source: IOCDF, Islam and OCD].
Steps (following the IOCDF account): (1) assess for OCD and explain that doubt is the core problem; (2) build a hierarchy of triggers from least to most distressing; (3) design exposures that stay within Islamic law while provoking doubt (for example, performing the required parts of ablution without checking every area); (4) response prevention: time limits on ablution, stopping reassurance-seeking from scholars, reducing mental replaying of prayers; (5) expect self-shaming to rise as compulsions fall and name it as expected; (6) the clinician may consult an Islamic scholar to ensure exposures respect the law [source: IOCDF, Islam and OCD]. Get consent for exposure, explain discomfort is expected, start low, and do not use exposures that the client's scholar judges impermissible [synthesis]. TIIP also uses a waswasa workbook [source: Khalil Center TIIP training outline; content not verified].
Example language (illustrative): "Your scholar has said your ablution is valid once you've washed each part once. The urge to check will come; the exercise is to notice it, finish, and go to prayer anyway."
Watch for: the therapist becoming a new source of reassurance; scholar consultations turning into reassurance for the client rather than guidance for the clinician. Working: shorter rituals, less checking, tolerance of uncertainty, worship described as less tormented.

B7. Remembrance and contemplative practice in or alongside sessions (client-led)

Purpose: TIIP training includes guided imagery, breathing exercises, murāqaba and dhikr, and integration of Sufi practices among its spiritual practices [source: Khalil Center TIIP training outline; how these are used in TIIP not verified: uncertain]. Secular counterparts are in Domain II (MBSR, MBCT, MSC, CFT).
Steps: (1) only at the client's request and in their own form of practice; (2) let the client lead any recitation, or practise outside session and discuss it; (3) keep it brief and eyes-open optional; (4) check effect afterwards; (5) for teaching or deepening the practice, refer to the client's teacher [synthesis]. No breath-retention or rapid-breathing methods are used.
Example language (illustrative): "Would you like to begin with a short remembrance of your choosing before we start? You lead it, and we'll stop whenever you like."
Watch for: the therapist drifting into the teacher role; agitation or dissociation during practice (see B8, B9). Working: practice steadies the client and supports the session.

B8. Trauma-sensitive adaptation

Purpose: clients with trauma may find inward attention, self-accounting, or teachings about patience under affliction destabilising or shaming. Treleaven's trauma-sensitive mindfulness (2018) is a published adaptation for meditation; its specific recommendations are not verified here [uncertain: not verified]. Domain IV (trauma-sensitive yoga) and Domain II carry related adaptations.
Steps: (1) ask about trauma before introducing any reflective or contemplative element; (2) offer choice and control: eyes open, shorter periods, external anchors such as sound or the feel of prayer beads; (3) keep self-accounting focused on present choices rather than reliving past events; (4) separate the client's responsibility from what was done to them, especially where teachings on patience or repentance have been used against them; (5) titrate and stop if arousal rises [synthesis].
Example language (illustrative): "Patience in your tradition was never meant to mean accepting harm from someone else. What happened to you was not something you need to repent of." (Check this framing with the client's own understanding, and with a scholar if they wish.)
Watch for: flashbacks, numbing or dissociation during practice; shame about not being "patient enough". Working: the client can practise with a sense of choice and stays within a tolerable range.

B9. Screening for and responding to difficult contemplative experiences

Purpose: remembrance, retreat and intensive self-work can be followed by difficult experiences. The Varieties of Contemplative Experience study (Lindahl et al. 2017, PLOS ONE; Buddhist practitioners) described more than 50 kinds of experience across somatic, affective, cognitive, perceptual, conative, sense-of-self and social domains, and over 20 factors grouped as risk factors, remedies and interpretations [source: Britton lab project page]. A systematic review of 83 studies found adverse events in 8.3% pooled, most often anxiety, depression and cognitive anomalies, including in people with no prior mental-health history [source: Farias et al. 2020, Acta Psychiatrica Scandinavica]. Neither study focused on Sufi practice; transfer to dhikr and retreat is [synthesis]. Cheetah House offers resources on meditation-related difficulties [source: Britton lab project page].
Steps: (1) before intensive retreat (khalwa) or extended practice, screen for history of psychosis, bipolar disorder, recent trauma, severe depression, dissociation, eating disorder and current sleep problems; (2) when difficulties arise, reduce intensity and duration of practice in consultation with the client and, if they wish, their teacher; (3) use grounding: ordinary activity, eating regularly, sleep, physical movement, time with others; (4) assess for psychosis, mania, depression or dissociation by duration, functional decline, risk, sleep and others' observations, without pathologising a meaningful state or missing illness; (5) DSM-5-TR lists a religious or spiritual problem as a focus of clinical attention, code Z65.8, which can be used when the focus of care is a spiritual matter; (6) refer urgently for psychiatric assessment where indicated [synthesis].
Example language (illustrative): "What you're describing could be part of the path as your teacher understands it, and it could also be your nervous system under strain. We can take both seriously. For now, would you be willing to ease back on the practice and get some sleep?"
Watch for: sleeplessness, grandiosity, voices, fear of persecution, loss of self-care, or loss of the ability to step back from the experience. Working: symptoms settle with reduced practice and grounding, and the client keeps meaning without being overwhelmed.

B10. Referral and collaboration with shaykh, imam or scholar

Purpose: the therapist is not a religious authority. TIIP training distinguishes practitioner roles (murabbī, shaykh, muṣliḥ, ṭabīb, psychologist, faqīh) and their training requirements [source: Khalil Center TIIP training outline].
Steps: (1) identify questions only a religious authority can answer (ritual validity, obligations, how to read a spiritual state); (2) ask whether the client wants you to speak with their teacher or imam, and obtain written consent specifying what will be shared; (3) keep contact focused: share the clinical concern and ask how the tradition views it; (4) agree a joint plan where possible (for example, practice reduced during a crisis); (5) if the client has no teacher and wants one, help them think about how their community identifies qualified, accountable teachers, without recommending one yourself [synthesis].
Example language (illustrative): "This sounds like a question about what your practice requires, and that's for your shaykh or a scholar you trust. Would it help if I spoke with them, with your permission?"
Watch for: splitting between therapist and teacher; a religious adviser discouraging treatment. Working: consistent messages and the client feels supported by both.

B11. The teacher relationship, power and high-control dynamics

Purpose: the classical model asks deep surrender to a master [source: Britannica, Sufism: The path]. Most teacher relationships are healthy, but surrender can be exploited. Independent investigations of misconduct in a specific Sufi order: none found in the sources consulted.
Steps: (1) ask the client how decisions are made in the relationship and what happens if they disagree; (2) watch for signs of coercive control: isolation from family, control of money, sexual approaches, demands to stop medical or psychological treatment, secrecy, punishment for questions, threats of spiritual ruin if they leave [synthesis]; (3) affirm the client's right to consult other scholars; (4) if harm or abuse is disclosed, follow safeguarding and reporting duties; (5) support clients who leave a group, attending to grief, loss of community, fear of divine punishment, and religious trauma, while respecting any continuing faith [synthesis].
Example language (illustrative): "In your tradition, is a student allowed to ask another scholar for a second opinion? What would happen if you did?"
Watch for: the therapist taking sides against the client's faith as a whole. Working: the client can think freely about the relationship and keep their faith on their own terms.

B12. Austerities and health: routing to the doctor

Purpose: some paths involve reduced food, reduced sleep, long vigils or retreats ordered by a teacher [source: Britannica, Sufism: The path]. No targets are given here.
Steps: (1) ask what the client is doing and who set it; (2) for any health condition, pregnancy, eating disorder, diabetes, medication use or mental illness, coordinate with the client's doctor; (3) ask whether their teacher or scholar grants exemptions for illness, as Islamic law does for obligatory fasting [uncertain: specific rulings not verified here]; (4) watch for eating-disorder or self-harm patterns presented as discipline [synthesis].
Example language (illustrative): "Before you go into retreat, would you be willing to check it with your doctor, and ask your teacher what allowances they make for health?"
Watch for: weight loss, dizziness, sleep collapse, mood change. Working: practice adjusted to health, with the teacher's blessing.

5. Handling problems

The sources here address few of these problems directly; responses are [synthesis] unless cited.

Client asks the therapist to rule on religious matters ("Is my prayer valid?", "Which station am I at?"). Response: name the limit of your role and refer to a scholar or their teacher; offer to help them prepare the question. With scrupulosity, repeated questions are reassurance-seeking and are handled within ERP [source: IOCDF, Islam and OCD].
Stuck in the self-reproaching stage. The client feels endlessly at fault and never "purified". Response: normalise that, in their teachers' description, most work happens at this level and the peaceful self is an ideal few reach [source: Rothman, CMC Paper 9]; then shift from judging to concrete next steps (B4); assess for depression.
Self-examination becomes OCD. Response: move to ERP (B6); explain that, as the IOCDF puts it, scrupulosity "is not a faith problem" [source: IOCDF, Islam and OCD]; consult a scholar on exposures.
Self-punishment. The client applies the punishment station to themselves harshly or hurts themselves. Response: risk assessment following current standards; safety planning; explore with the client and, with consent, their scholar what the tradition actually permits; no therapist endorsement of self-punishment.
Resistance to therapy as "secular" or lacking faith. Response: return to consent (B1); show how the work serves their own aims (B3); offer collaboration with their religious authority (B10); TIIP-trained or faith-matched therapists may be an option.
Resistance to referral to clergy. Some clients fear judgement from their community. Respect this; referral is never required.
Overwhelm or destabilisation after intensive practice or retreat. Response: reduce intensity, ground, assess for psychosis, mania, depression or dissociation, coordinate with the teacher if the client wishes (B9). Adverse events can occur without prior mental-health history [source: Farias et al. 2020, Acta Psychiatrica Scandinavica].
Spiritual bypassing. Patience, trust or contentment used to avoid grief, anger or necessary action. Response: gently explore what the client's tradition says about taking means and about grief (B5); invite consultation with their imam.
Non-adherence to clinical tasks that conflict with prayer times, fasting or retreat. Response: accommodate scheduling; agree tasks that fit religious practice; never set practice and therapy against each other.
Rupture over values. The client feels judged by the therapist's view of religion, or the therapist feels uneasy about a practice. Response: name it, repair, use supervision; consider referral to a faith-matched or TIIP-trained colleague if the rupture persists. Disclose your own commitments only when it serves the client.
Harmful teacher relationship. Response: B11; safeguarding where there is abuse; support for leaving and for religious trauma without attacking faith.
Health risks from austerities. Response: B12; coordinate with the doctor; ask the client to seek their teacher's or scholar's view on exemptions.
Client wants the therapist to induce spiritual states. Response: in the tradition's account states are given, not produced [source: Mukholik 2017]; the therapist does not offer techniques for this and refers to the teacher.
Differing versions. Clients may hold different lists of stations and states from different orders or authors (Britannica notes that order and number vary [source: Britannica, maqam]). Response: use the client's version; do not correct it.

Sources

Web sources:

Works cited (details as given on the pages above):

al-Ghazālī. Al-Ghazali on Vigilance and Self-Examination (Iḥyāʾ Book 38). Trans. A. F. Shaker. Islamic Texts Society, 2015.
al-Qushayrī. Principles of Sufism. Trans. B. R. von Schlegell, intro. H. Algar. Islamic Book Trust.
Mukholik, A. (2017). Human spirituality phases in Sufism: the study of Abu Nasr al-Sarraj in the Book of al-Luma'. Teosofia, 6(1), 21–32. doi:10.21580/tos.v6i1.1699.
Keshavarzi, H., & Haque, A. (2013). Outlining a psychotherapy model for enhancing Muslim mental health within an Islamic context. International Journal for the Psychology of Religion, 23(3), 230–249. doi:10.1080/10508619.2012.712000.
Keshavarzi, H., Khan, F., Ali, B., & Awaad, R. (Eds.). Applying Islamic Principles to Clinical Mental Health Care: Introducing Traditional Islamically Integrated Psychotherapy. Routledge.
Lindahl, J. R., Fisher, N. E., Cooper, D. J., Rosen, R. K., & Britton, W. B. (2017). The varieties of contemplative experience: a mixed-methods study of meditation-related challenges in Western Buddhists. PLoS ONE, 12(5). doi:10.1371/journal.pone.0176239.
Farias, M., Maraldi, E., Lucchetti, G., & Wallenkampf, K. (2020). Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatrica Scandinavica, 142(5), 374–393. doi:10.1111/acps.13225.
Vieten, C., Scammell, S., Pilato, R., Ammondson, I., Pargament, K. I., & Lukoff, D. (2013). Spiritual and religious competencies for psychologists. Psychology of Religion and Spirituality, 5(3), 129–144.
Treleaven, D. (2018). Trauma-Sensitive Mindfulness [uncertain: not verified].
American Psychiatric Association. DSM-5-TR (Cultural Formulation Interview; religious or spiritual problem, Z65.8).
Al-Sarrāj. Kitāb al-Lumaʿ [uncertain: not verified].
ICD-10-CM Z65.8, Other specified problems related to psychosocial circumstances (includes 'Religious or spiritual problem'), https://www.unboundmedicine.com/icd/view/ICD-10-CM/945432/all/Z65_8___Other_specified_problems_related_to_psychosocial_circumstances

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