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Guide XIII-273

Yazidi pilgrimage to Lalish

Lalish, Iraqi Kurdistan
A 37 · L 46 · M 1713 interventions in the Trinity explorer
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[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the Feast of the Assembly at Lalish as described in Encyclopaedia Iranica (Khalil Jindy Rashow, "Jažn-ā Jamāʿiya", 2008, updated 2012), supplemented by the Yazidi community organisation Yezidis International, news reporting of the post-2014 survivor rite at the White Spring (Kanî Spî), and, for the therapist's work, Kizilhan's published clinical writing, the APA Cultural Formulation Interview supplementary modules and IOCDF guidance on scrupulosity.

What it is. Lalish is a valley in Iraqi Kurdistan, about 62 km northeast of Mosul, holding the main Yazidi sanctuary and the shrine of Sheikh ʿAdi [source: Encyclopaedia Iranica]. Yazidis visit its holy places and shrines (ziyaret, "pilgrimage") and, above all, gather there for the seven-day autumn Feast of the Assembly (Jamaiya, also called the great feast). Encyclopaedia Iranica dates it 23 September to 1 October by the Eastern calendar, which runs thirteen days behind the Gregorian; Yezidis International gives 6 to 13 October. Confirm each year's dates with the client [source: Encyclopaedia Iranica; Yezidis International]. A National Geographic report states that Yazidis should make the pilgrimage at least once in a lifetime if they can, and that those living in Iraq should go at least once a year [source: National Geographic 2014]. Yezidis International says Yazidis "attempt" the pilgrimage; Encyclopaedia Iranica does not call it obligatory [uncertain: sources differ on obligation].

Rites, as published. Evening samāʿ (sacred dance with tambourine and flute) in the courtyard of Sheikh ʿAdi's shrine, with hereditary hymn reciters (qawwals) singing hymns; a bull sacrifice at the shrine of Sheikh Shams, with the meat shared as sacred food; processions carrying a bier and cloths to the springs; and mor kirin ("sealing", roughly baptism) in the White Spring (Kanî Spî) or the Zamzam spring, which for first-time participants marks their initiation into the religion [source: Encyclopaedia Iranica; Yezidis International]. Visitors stand barefoot in the inner sanctuary, step over (not on) thresholds, kiss the stone archway, and tie knots in the cloth over Sheikh ʿAdi's tomb, each knot a prayer. Earth from Lalish mixed with spring water is used in marriage and death rites [source: National Geographic 2014].

Who leads and authorises. The Mir (Yazidi prince) supervises the bull rite; qawwals sing; Sheikhs, pirs and murids, the three hereditary castes, all take part in the dance; a custodian of Lalish prepares the sacred food [source: Encyclopaedia Iranica]. The Mir and the Baba Sheikh (the senior spiritual leader) meet community leaders during the feast [source: Yezidis International]. After the 2014 genocide, a decree by the Baba Sheikh (described by Kurdistan24 as issued with the Spiritual Council and the Mir) required that rescued Yazidi survivors be accepted back; survivors are taken to Lalish, baptised in the White Spring and returned to their families [source: VOA; Kurdistan24 2025; The World 2017].

Meaning, as the tradition holds it. Participants hold that during the feast the soul is close to God, to Tawûsê Melek (the Peacock Angel) and to other holy beings, and that the Seven Great Angels gather in a heavenly Lalish and bless those at the earthly one; the feast also renews community bonds and religious identity [source: Encyclopaedia Iranica; Yezidis International]. These are the tradition's beliefs, reported here without endorsement or dismissal.

The therapist's work and how change happens. The rite belongs to the community and its religious authorities; the psychotherapist does not lead, interpret or prescribe it. The therapist's task alongside it is to understand what Lalish means in the client's life; to remove obstacles (trauma, shame, displacement, scrupulosity, health or travel problems) that stand between the client and the belonging and identity the pilgrimage holds for them; and to support grief where the pilgrimage is impossible. Kizilhan argues that effective therapy for Yazidi survivors starts from the client's own cultural and religious coping resources and then adapts modern methods [source: Al Jazeera 2018; Kizilhan & Weigelt 2025]. The mechanism proposed here is meaning-making, restored belonging and reduced self-blame within the client's own frame [synthesis].

2. Framework

No treatment protocol exists for working alongside the Lalish pilgrimage. The phases below are a working structure built from the trauma-care phases described in Kizilhan's Baden-Württemberg project (stabilisation and orientation, then psychoeducation and psychotherapy) [source: APA Monitor 2016] and the Cultural Formulation Interview [source: APA CFI supplementary modules]. The ordering, goals and transition criteria are [synthesis]. No source gives session counts, so none are stated.

Phase A: Engagement and cultural assessment. Goal: understand the client's Yazidi identity, caste and community ties, relationship to Lalish (visited, never visited, cut off by displacement or exile), and current problems. Format: individual sessions, with a trained interpreter where needed; use the core CFI and the supplementary modules (see 4.2). Move on when the client's own account of Lalish and its place in their difficulties is clear and shared.

Phase B: Safety and stabilisation (trauma-exposed clients). Goal: housing, legal status, daily structure, medical care and symptom stabilisation, which Kizilhan and Weigelt treat as prerequisites for mental health care [source: Kizilhan & Weigelt 2025]. Move on when the client can talk about the past without sustained dysregulation and basic needs are met.

Phase C: Preparing for a visit or rite (when one is planned). Goal: client-led planning of a pilgrimage, feast attendance or survivor reintegration rite: meaning, hopes and fears, triggers, health and travel questions routed to the doctor, family dynamics. Move on when the client has a plan they own, including what to do if overwhelmed.

Phase D: Making meaning afterwards. Goal: integrate the experience: belonging, reconciliation, renewed identity, or disappointment and unfinished business. Move on when the client's story of the experience is coherent and its effects on daily life are clear.

Phase E: Ongoing work, grief and community. Goal: grief for the dead, for destroyed sites and for an inaccessible homeland; collective and transgenerational trauma; community roles; collaboration with religious or community leaders if the client wishes. Phases can be revisited, and many clients will move between B, D and E without ever travelling.

3. Guiding principles

  • The tradition's authorities define the rite. Practical meaning: describe rites as the Yazidi religious leadership and community publish them; send doctrinal and ritual questions to them, not to yourself [source: Encyclopaedia Iranica; Yezidis International].
  • Attribute, do not adjudicate, religious concepts. Practical meaning: say "in your faith, Tawûsê Melek…" rather than stating or doubting doctrine [synthesis].
  • Start from the client's cultural and religious resources. Practical meaning: ask first how prayer, recitation, ancestors' stories and the community already help, and build on them before adding Western techniques [source: Al Jazeera 2018; Kizilhan & Weigelt 2025].
  • Client-led, with consent. Practical meaning: religious material enters therapy only as far as the client wants; never set a pilgrimage or rite as a therapy goal the client has not chosen [synthesis].
  • Respect what is not shown to outsiders. Practical meaning: the sacred springs are not to be seen by non-Yazidis [source: National Geographic 2014]; do not ask for details the client indicates are not for outsiders, and accept partial accounts [synthesis].
  • Basic needs before deep work. Practical meaning: treat housing, food, documents and asylum stress as part of care, not a distraction from it [source: Kizilhan & Weigelt 2025; Kizilhan 2025].
  • Shame belongs to the perpetrator. Practical meaning: with survivors of sexual violence, question who lost honour, the perpetrator or the client, in a way the client can accept [source: Al Jazeera 2018].
  • Allow indirect disclosure. Practical meaning: let clients speak about "someone else" or in story form; do not press for explicit sexual detail [source: APA Monitor 2016].
  • Learn the client's idioms of distress. Practical meaning: expressions such as a "burning liver" may carry what a European client would put in the heart; ask what they mean [source: APA Monitor 2016].
  • Women's own decisions matter. Practical meaning: community rulings were made largely by men; support the client's own choices, especially mothers of children born in captivity [source: Free Yezidi Foundation 2019].
  • Collective and transgenerational frame. Practical meaning: expect the 2014 genocide to be experienced within a remembered history of persecutions (ferman); do not treat it as a single isolated event [source: Kizilhan 2025].
  • Integrate, do not replace, spiritual and communal healing. Practical meaning: offer to coordinate with religious or community leaders when the client wishes [source: Kizilhan & Weigelt 2025].
  • The therapist is not a religious authority. Practical meaning: do not rule on purity, caste, belonging or ritual correctness; avoid dual roles in the community [synthesis].
  • Competence and self-awareness. Practical meaning: Vieten et al. (2013) propose 16 basic spiritual and religious competencies (attitudes, knowledge, skills) for all psychologists; check your own attitudes to Yazidi religion and to the religious frames of the perpetrators [source: Vieten et al. 2013 abstract; synthesis].
  • Ethics code. Practical meaning: follow your professional code on competence, respect for religion and culture, and multiple relationships; check the code that governs your licence [synthesis] [uncertain: not verified].
  • Safety and practicality of travel. Practical meaning: a pilgrimage to northern Iraq may involve security, legal-status and health questions; the client decides, with their doctor and legal adviser where relevant [synthesis].

4. Intervention inventory

These are the psychotherapist's own interventions alongside the pilgrimage and feast; none of them is part of the rite itself. Each draws on the sources named; step sequences are [synthesis] unless tagged otherwise.

4.1 Exploring what Lalish means in the client's life

  • Purpose / when: At intake and whenever Lalish, the feast, baptism or Sheikh ʿAdi comes up; essential before any planning of a visit. Lalish may stand for faith, ancestry, community, home, a first initiation, a lost place, or a rite of return after captivity [source: Encyclopaedia Iranica; Kurdistan24 2025; synthesis].
  • Steps: (1) Ask open questions about the client's own experience: first visit, baptism, the feast, family memories. (2) Ask what the place means now, given displacement, exile or captivity. (3) Note emotions and body responses as they talk. (4) Reflect back in the client's words and terms (ziyaret, Jamaiya, Kanî Spî). (5) Ask how this meaning bears on the current problem: support, conflict, longing, guilt. (6) Record it in the formulation [synthesis].
  • Example language (illustrative): "Many Yazidi people I work with talk about Lalish. What has it meant for you, and has that changed since 2014?" / "You said you have never been. What is it like to carry that?"
  • Watch for: idealisation that masks grief; reluctance to describe what outsiders should not see (accept it); trauma cues when the conversation turns to 2014 or captivity. Working: the client brings Lalish into sessions spontaneously and links it to their own goals.

4.2 Cultural Formulation Interview with the spirituality, religion and moral traditions module

  • Purpose / when: Structured cultural assessment early in treatment and when religious themes seem to drive distress or coping [source: APA CFI supplementary modules].
  • Steps: (1) Administer the core CFI (the client's definition of the problem, cultural explanations, supports and stressors, cultural identity, help-seeking). (2) Add Module 5 (spirituality, religion and moral traditions), which covers: the traditions the person identifies with and their community ties; the tradition's role in daily and family life, practices at home and outside it; whether the tradition helps with the problem (talking with leaders, prayer, rituals); and whether tradition-related stresses, discrimination or conflicts contributed. (3) Put the client's own name for their faith (Yazidi, Ezidî) in place of a generic term, as the module directs. (4) Consider Module 11 (immigrants and refugees), Module 3 (social network), Module 6 (cultural identity) and Module 7 (coping and help-seeking). (5) Summarise the cultural formulation with the client. Paraphrase questions in your own words; do not read items mechanically [source: APA CFI supplementary modules, 2013 version; synthesis for step order].
  • Example language (illustrative): "Is your Yazidi faith part of how you cope with this, or part of what makes it harder, or both?" / "Are there people in your community, a sheikh or pir, or elders, you would turn to about this?"
  • Watch for: interpreter effects (a community interpreter may know the family; ask the client's preference); caste and gender issues the client may not raise in front of an interpreter; answers given to please. Working: you can state, in the client's words, how faith and community both help and burden them.

4.3 Accommodation in scheduling and treatment

  • Purpose / when: When the client plans to attend the Feast of the Assembly or another visit, or observes Yazidi holy days [source: Encyclopaedia Iranica; Yezidis International].
  • Steps: (1) Ask each year for the feast dates the client follows (sources give different Gregorian dates). (2) Plan breaks, telehealth or extra sessions around travel. (3) Agree a plan for a pause in treatment, including crisis contacts abroad. (4) Ask about preferences on therapist and interpreter gender, and on discussing sexuality, which survivors may find hard to raise [source: APA Monitor 2016]. (5) Adapt homework and exposure tasks so they do not clash with religious practice [synthesis].
  • Example language (illustrative): "When is the Feast of the Assembly for you this year? Let's plan our sessions around it."
  • Watch for: the client not mentioning plans for fear of seeming non-compliant; travel used to avoid therapy (explore gently, without assuming). Working: no unplanned drop-outs around the feast; the client sees therapy as compatible with their faith.

4.4 Health, travel and practical preparation, coordinated with the doctor

  • Purpose / when: When a visit is planned and the client has physical or mental health conditions, pregnancy, mobility limits, or is in a fragile phase of trauma treatment.
  • Steps: (1) Ask which parts of the visit the client expects to join (crowds, evening dance, standing barefoot in the sanctuary, processions to the springs, immersion) [source: Encyclopaedia Iranica; National Geographic 2014]. (2) Ask about long travel, heat, sleep disruption and crowds. (3) Route medical questions, including medication during travel and fitness for immersion, to the client's doctor; do not advise on medicines yourself. (4) Discuss legal-status and safety questions (for example, travel for people with protection status) as matters for a legal adviser. (5) Agree a plan for mental health support during the trip. Clinical sources on health at Lalish are lacking; this guidance is [synthesis] [uncertain: not verified].
  • Example language (illustrative): "Before you go, it would help to check with your doctor about the travel and your medicines. Shall we write down what to ask?"
  • Watch for: health worries dismissed out of religious commitment; panic or flashbacks in crowded or enclosed spaces; return to the region where the genocide happened acting as a trauma trigger. Working: the client goes (or decides not to) with a clear plan and medical advice.

4.5 Supporting a survivor's reintegration rite at the White Spring

  • Purpose / when: For survivors of ISIS captivity considering, preparing for or reflecting on the rite by which rescued Yazidis are baptised again at Kanî Spî and returned to their families. The community describes it as unconditional acceptance; women interviewed have described the community as supportive and respectful [source: Kurdistan24 2025; The World 2017]. Reports describe a religious leader pouring water over the head, tying three knots in cloth with three wishes, prayer, washing the face in the spring water, and lighting candles; the rite was traditionally for young children and was extended to adult women [source: The World 2017]. The rite is led by Yazidi religious authorities, not the therapist.
  • Steps: (1) Ask what the client knows of the rite and what they want from it. (2) Explore hopes (acceptance, cleansing, return) and fears (judgement, family reactions, reminders of captivity). (3) Separate the client's worth from any rite: acceptance was decreed for all survivors, and therapy does not depend on it [source: VOA; synthesis]. (4) Prepare for triggers: water poured over the head, crowds, public visibility, journalists. (5) After the rite, explore what changed and what did not; shame or intrusions may persist and are not a sign of spiritual failure [synthesis].
  • Example language (illustrative): "What would it mean for you to go to the White Spring?" / "If some of the heaviness is still there afterwards, that does not mean the rite failed or that you did. Healing can take different paths."
  • Watch for: the rite felt as a demand to be "made clean", deepening shame; family pressure; avoidance or dissociation during preparation; disappointment afterwards. Working: the client describes the rite in terms of belonging and dignity, and self-blame decreases.

4.6 Working with shame, honour and moral injury

  • Purpose / when: When survivors (especially of sexual violence, forced conversion or enslavement) feel defiled, dishonoured or unworthy of Lalish or the community; when clients carry guilt about pretending to convert, about those they could not save, or about surviving. Kizilhan reports that survivors often believe they lost their honour through rape, and links this to patriarchal values [source: Al Jazeera 2018]. Kizilhan and Weigelt describe exclusion of women tied to honour and shame, and "religiously led recognition rituals" that can reduce self-blame and restore dignity [source: Kizilhan & Weigelt 2025].
  • Steps: (1) Name shame as a common response to atrocity, not a verdict. (2) Explore the client's own moral reasoning; identify where responsibility is being placed. (3) Use guided questioning to relocate responsibility to the perpetrators, as Kizilhan describes [source: Al Jazeera 2018]. (4) Bring in the community's own statements of acceptance, if the client finds them meaningful (the 2014 decree; the 2019 council statement accepting all survivors and that what happened "was out of their control") [source: VOA]. (5) For forced conversion, explore inner faithfulness; one survivor told reporters she outwardly pretended to convert while praying inwardly [source: The World 2017]. (6) Where moral injury is present (acts done or witnessed under coercion), use moral-injury approaches you are trained in, keeping religious rulings for the religious authorities [synthesis].
  • Example language (illustrative): "You keep saying you are no longer clean. Who did the dirty thing here?" / "Your community's leaders said what happened was out of your control. How does that sit with you?"
  • Watch for: reassurance that feels empty to the client; collapse into silence; suicidal thinking linked to shame (assess risk following current standards). Working: self-blame statements decrease; the client allows themselves contact with community and holy places.

4.7 Scrupulosity about purity and ritual correctness

  • Purpose / when: When concern about purity, baptism, correct ritual, contact with outsiders or caste and marriage rules becomes repetitive, fear-driven and time-consuming (for example, repeated washing, repeated requests for reassurance that a rite was valid, intrusive blasphemous thoughts about holy beings). Scrupulosity is the IOCDF's term for OCD focused on faith or morals; compulsions can look like religious practice [source: IOCDF].
  • Steps: (1) Assess for OCD, distinguishing value-based practice from fear-driven ritual: OCD is ego-dystonic, healthy practice ego-syntonic [source: IOCDF]. (2) Explain that treatment does not ask the client to oppose their religion [source: IOCDF]. (3) With consent, consult a religious authority the client trusts about what the tradition actually requires, so that exposures target the OCD and not genuine obligations [source: IOCDF on clinician–clergy collaboration; synthesis for Yazidi application]. (4) Build an ERP hierarchy (for example, tolerating doubt that a baptism "counted" without re-seeking reassurance), with contraindications and safety checked: postpone ERP in acute PTSD or crisis, obtain informed consent, agree a stop signal [synthesis]. (5) Practise response prevention for reassurance-seeking from family and clergy.
  • Example language (illustrative): "Your faith comes from what you value. This checking comes from fear. Let's work on the fear and keep your faith."
  • Watch for: confusing trauma-related contamination feelings after sexual violence with OCD (assess both); clergy who unknowingly provide reassurance. Working: less time spent on rituals; the client reports religious practice feeling like faith again rather than fear.

4.8 Grief, collective trauma, ritual and community support

  • Purpose / when: Grief for the killed and missing, for destroyed religious sites and lost homeland, and for a pilgrimage made impossible by exile. Kizilhan describes trauma framed through a remembered history of persecutions (ferman, with community narratives of 74 genocides), "double or multiple traumatization", destroyed religious sites and transgenerational transmission [source: Kizilhan 2025]. In 2014 some 450 displaced families were sheltering in Lalish itself [source: National Geographic 2014].
  • Steps: (1) Map losses: people, places, practices, community roles. (2) Ask which rites the client could or could not perform (marriage and death rites using earth from Lalish, the feast, baptism) [source: National Geographic 2014]. (3) Explore what substitute or partial practices the client and community find valid; let the client and religious authorities decide what counts [synthesis]. (4) Connect the client to diaspora community gatherings if they wish. (5) Use the community's narratives of endurance as a resource while allowing anger and doubt [source: Kizilhan & Weigelt 2025; Al Jazeera 2018].
  • Example language (illustrative): "You have not been able to go to Lalish for the feast since you left. What do you miss most?" / "Your grandparents' generation also lived through a ferman. What helped them?"
  • Watch for: prolonged grief; survivor guilt; collective narratives that leave no space for personal loss. Working: the client can hold both grief and connection, and finds community contact.

4.9 Mothers of children born in captivity: community rulings and personal choice

  • Purpose / when: When a client is a mother of a child fathered by an ISIS member, or a relative of one. In April 2019 the Yazidi Supreme Spiritual Council stated it would accept all survivors; days later it clarified that the ruling covered children of two Yazidi parents and not children born of rape [source: VOA; WION 2019]. Under tradition a child is generally counted as Yazidi only if both parents are Yazidi; the Free Yezidi Foundation describes mothers forced to choose between their children and the community, and holds that the mothers alone have the right to decide [source: Free Yezidi Foundation 2019].
  • Steps: (1) Provide a safe, non-judgemental space to explore the dilemma; the therapist does not decide. (2) Separate religious, family, legal and resettlement questions, and refer to legal advice. (3) Support the client's decision-making and grief whatever she chooses. (4) Explore whether, and how, Lalish and the community can remain part of her life. (5) Assess safety, risk and child welfare under safeguarding standards [synthesis].
  • Example language (illustrative): "This is your decision, and it is one of the hardest anyone can face. What matters most to you as you think about it?"
  • Watch for: pressure from family or interpreter; acute grief after separation from a child; the therapist's own values leaking into advice. Working: the client experiences the choice as hers and feels supported regardless.

4.10 Resource-oriented narrative work using Yazidi oral tradition

  • Purpose / when: In the processing phase, to help the client build a coherent life story that includes Lalish, faith and community. Kizilhan uses religious recitation and stories of ancestors' survival to build resilience [source: Al Jazeera 2018]. Kizilhan and Weigelt propose adapting Narrative Exposure Therapy to Yazidi oral traditions and strengthening identity through spiritual values and family roles [source: Kizilhan & Weigelt 2025]. Storytelling is central to Yazidi culture, and indirect disclosure is allowed [source: APA Monitor 2016].
  • Steps: (1) Construct a life timeline including joyful moments such as a first visit to Lalish or the feast. (2) Process traumatic events using a narrative trauma method you are trained in, after stabilisation. (3) Weave in the client's own religious resources (hymns, prayers, ancestors' stories) where the client wishes. (4) Encourage intergenerational dialogue in the family where safe [source: Kizilhan & Weigelt 2025; synthesis for step order].
  • Example language (illustrative): "Let's put the good memories on your life line too. Tell me about your first time at Lalish."
  • Watch for: overwhelm or dissociation during trauma narration (slow down, ground); sacred material shared that the client later regrets; idealised narratives that bypass loss. Working: a coherent story the client recognises as their own.

4.11 Collaboration with religious and community leaders

  • Purpose / when: When the client wishes, to clarify religious questions, gain recognition, support reintegration or mediate family conflict. Kizilhan and Weigelt call for integrating "spiritual leaders, communal practices, and justice narratives" into care [source: Kizilhan & Weigelt 2025]; Kizilhan names Yazidi community leaders as partners [source: Kizilhan 2025].
  • Steps: (1) Obtain explicit, specific consent for what will be shared and with whom. (2) Let the client choose the contact (a sheikh or pir connected to their family, a community organisation, a diaspora association). (3) Clarify roles: religious questions go to the leader, clinical decisions stay with the therapist and client. (4) Keep confidentiality about trauma details the client has not authorised [synthesis].
  • Example language (illustrative): "Would it help to speak with a religious leader about this? You decide who, and what I would share."
  • Watch for: community gossip risks; leaders' positions that conflict with the client's wishes (especially on women's choices); caste dynamics. Working: the client feels supported by both therapy and faith community.

4.12 Role clarity and the therapist's own stance

  • Purpose / when: Throughout, especially when the client asks the therapist's view on doctrine, purity or community rulings, or when the therapist belongs to the community or to a faith associated with the perpetrators.
  • Steps: (1) State that you are not a religious authority. (2) Reflect on your own religious commitments and reactions to Yazidi religion; consider self-disclosure only when it serves the client. (3) Avoid dual relationships in small diaspora communities. (4) Seek consultation or training in spiritual and religious competencies [source: Vieten et al. 2013 abstract; synthesis].
  • Example language (illustrative): "I can't rule on religious questions; your religious leaders can. What I can do is help you think through what this means for you."
  • Watch for: the client deferring to you as an authority; mistrust if your faith resembles the perpetrators'. Working: questions about doctrine are routed appropriately and the alliance holds.

4.13 Children and families at the rite

  • Purpose / when: Children are baptised at the White Spring during the feast [source: Yezidis International]; child survivors are also brought for the reintegration rite [source: Kurdistan24 2025].
  • Steps: (1) Prepare children in age-appropriate language with their carers. (2) Seek the child's assent as well as carers' consent for any related therapeutic work. (3) For child survivors, watch for triggers in crowds and water rites. (4) Follow local safeguarding procedures if any concern arises [synthesis].
  • Example language (illustrative, to a carer): "How do you want to explain to your child what will happen at the spring?"
  • Watch for: distress the child cannot verbalise; family pressure on adolescents. Working: the child experiences the visit as safe and welcoming.

5. Handling problems

Sources address few of these directly; responses are [synthesis] unless tagged.

  • Client distrusts therapy or rates professional help as unhelpful. Kizilhan and Weigelt found professional help rated among the least helpful coping strategies, and prayer and belief in personal strength the most helpful [source: Kizilhan & Weigelt 2025]. Response: lead with the client's own coping (prayer, community, ancestors' stories), offer practical help with basic needs, and present therapy as supporting rather than replacing faith.
  • Stuck: the client says nothing will help until they can go to Lalish. Response: honour the longing; explore what going would give them (belonging, blessing, return) and which parts of that are reachable now (community gatherings, contact with religious leaders, home practices the client considers valid). Do not promise the visit will heal.
  • Overwhelm before or during a visit or rite. Response: rehearse grounding the client can use discreetly in crowds; agree that stepping back from a part of the rite is the client's choice, guided by religious leaders on what is permissible; plan contact with family or a trusted person on site; schedule a session soon after return.
  • Disappointment or worsening after the rite. Response: normalise mixed outcomes; separate spiritual meaning from symptom change; continue trauma treatment; avoid implying the rite or the client failed.
  • Non-adherence around the feast or travel. Response: plan ahead (4.3); treat missed sessions as information about competing obligations, not resistance; agree how to resume.
  • Rupture: the client feels the therapist doubts or exoticises their faith. Response: acknowledge it directly, ask what felt disrespectful, repair, and return to the client's own terms. Avoid curiosity-driven questions about sacred matters that do not serve treatment.
  • Rupture: the therapist's faith or ethnicity resembles the perpetrators'. Response: name the possibility early, invite the client to say if it matters, and offer a referral if the client prefers.
  • Interpreter problems. Response: ask the client's preference on the interpreter's gender, community ties and caste; brief interpreters on confidentiality and on not adding religious opinions; switch interpreters if the client is guarded.
  • Conflict between community rulings and the client's wishes (survivors, mothers, marriage). Response: the therapist does not adjudicate; support the client's own decision-making, provide information on legal and support organisations, and assess safety (risk of family violence, self-harm) following current standards [source: Free Yezidi Foundation 2019; synthesis].
  • Scrupulosity mistaken for devotion, or devotion mistaken for OCD. Response: use the value-versus-fear distinction and, with consent, consult a religious authority before designing exposures [source: IOCDF].
  • Unusual experiences at the shrine (visions, feeling blessed or punished). Response: explore their meaning in the client's tradition before pathologising; screen for psychosis, mania, severe depression or dissociation if accompanied by functional decline, sleep loss, or distress out of keeping with the client's community's understanding; DSM-5-TR provides a code for a religious or spiritual problem (Z65.8).
  • Suicidal thinking linked to shame, exclusion or loss of a child. Response: assess and manage risk following current standards; involve supports the client trusts; address shame directly (4.6).
  • Pressure from family to attend or to stay away. Response: explore the client's own wish; problem-solve conversations with family; the decision remains the client's.
  • Health or legal risks of travel. Response: route to the doctor and legal adviser (4.4); help the client weigh their advice against the religious meaning of the visit.
  • The therapist's own limits. Response: seek consultation in cultural and religious competence and trauma care; refer when the work exceeds competence [source: Vieten et al. 2013 abstract; synthesis].

Sources

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