Breaking the Silence: Shame, Secrecy, and Mental Health in Arab Communities

In Arab communities, concepts like al-‘ayb (shame) and haram (religious prohibition) play a powerful role in shaping attitudes toward mental health. Al-‘ayb refers to societal disapproval for behaviours seen as socially inappropriate or shameful (1), often applied to women for laughing too loud, staying out past dark, or even pursuing certain careers (1). Haram, on the other hand, refers to actions explicitly prohibited in Islam – such as drinking alcohol (2). Over time, some actions, like driving or voicing differing opinions, have shifted from being viewed as haram to ‘ayb (2), reflecting changing values but still carrying sense of shame with potential familial or societal reprimands.

In this sense, maintaining family reputation is central, and mental health struggles are often hidden to avoid stigma. Publicly addressing mental health can be seen as damaging to family reputation, particularly for women whose actions reflect on the family and may subject male relatives to blame (1,3). In some cases, fear of reputation loss can even escalate to emotional or physical responses (1).

These cultural dynamics illustrate the need for culturally informed mental health care that not only understands these family values, but also respects them – while also prioritising individual wellbeing, addressing the deep-rooted stigma in Arab communities surrounding mental health support.

The cultural weight of shame and family reputation

In Arab culture, family reputation often supersedes personal aspirations and satisfaction (3). Decisions typically reflect the interests of the family as a unit, emphasising collective values over individual desires (3). Fathers traditionally play the pivotal role in instilling cultural, religious, and social values within the family (3). Even marriage decisions often prioritise family reputation, where family names can signify respect, status, and reputation (3). In the MENA region, families with high social visibility face even greater pressure to maintain a flawless public image, as wealth and influence often hinge on maintaining this “perfect” family reputation.

The influence of societal expectations also means that mental health struggles are frequently hidden to protect family reputation. The act of seeking therapy, still sometimes seen as ‘ayb (2), can be associated with potential damage to family reputation. In high-profile families, where reputation may shape public perception and even business success, the fear of judgment creates two difficult options for those affected: keep treatment secret – something feared and mistrusted – or suppress their struggles, avoiding help altogether.

This internalised stigma becomes a significant barrier, pushing individuals to rely on secrecy as a protective measure.

Secrecy as a coping mechanism

For many individuals in Arab communities, secrecy acts as a protective strategy – a way to uphold appearances and avoid al-‘ayb. Despite prevalence of mental health conditions in Arab populations, there remains a significant stigma around receiving a psychiatric diagnosis and seeking mental health support, rooted in negative perceptions towards psychological services (4-7). Research highlights that Arab individuals are less likely to seek psychiatric help compared to other ethnicities (2,4), largely due to these cultural perceptions and psychocultural barriers (5-7).

Social pressures around privacy further complicate this issue. Personal struggles are rarely discussed outside the family, a reflection of the high value placed on privacy in Arab culture (8). This is especially true for high-profile families, where any admission of mental health struggles could jeopardise their public image. This culture of concealment often limits conversations around mental health, leaving many issues unaddressed and untreated.

However, culturally sensitive, judgment-free spaces can help to counteract these barriers, offering Arab clients a trusted environment to open up without fear of societal reprisal.

The role of culturally informed care in breaking the cycle

Culturally sensitive mental health care is vital in Arab communities, where the weight of shame and secrecy often hinders individuals from seeking help. This approach acknowledges cultural factors like the importance of family reputation, offering non-judgmental support that aligns with family dynamics and cultural values.

Harbor’s approach, rooted in cultural understanding, respects these pressures, creating safe, judgment-free spaces where Arab clients feel truly understood. Prioritising trust, utter discretion, and cultural sensitivity enables clients to explore their mental health challenges authentically. Importantly, involving family members – when appropriate – can reinforce a better informed, more supportive foundation that still respects the individual’s recovery journey within their family structure.

This culturally informed model doesn’t just promote individual healing; it helps break the cycle of silence around mental health, opening paths to recovery that supports both personal and cultural needs.

Find out more about Harbor’s dedicated Arab services, or get in touch with the team today.

References

1. https://www.womensrepublic.net/ayb-the-arabic-word-used-to-shame-women-into-propriety/
2. https://postscriptmagazine.org/content/2019/06/03/living-between-the-haram-and-aayb-women-in-gulf-societies
3. https://aada.commons.gc.cuny.edu/home-life-and-education/
4. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-04827-4
5. https://www.mdpi.com/2076-0760/7/10/196
6. https://www.eurekaselect.com/article/73765
7. https://journals.lww.com/co-psychiatry/abstract/2005/09000/mental_health_practice_in_arab_countries.19.aspx
8. https://diversitybch.ucsf.edu/sites/g/files/tkssra5176/f/Arab%20Culture%20and%20Traditions.pdf