Reader for the Orthodox Jewish Psychotherapist: Issues, Case Studies and Contemporary Responsa

Copyright

Golden Sky

New York

Golden Sky is an imprint of Mondial.

Seymour Hoffman, Ph. D. (Editor):

Reader for the Orthodox Jewish Psychotherapist:

Issues, Case Studies and Contemporary Responsa

© 2014 Mondial (Golden Sky) and Seymour Hoffman

This book or parts thereof may not be reproduced in any form, stored in a retrieval system, or transmitted in any form by any means —electronic, mechanical, photocopy, recording, or otherwise — without the prior written permission of the publisher or the author, except as provided by United States of America copyright law.

ISBN 9781595692795 (Paperback version)

ISBN 9781595692979 (eBook version

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www.goldenskybooks.com

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Acknowledgements

The editor thanks the authors of the informative and insightful articles, Betty Hoffman for proofreading the manuscript, Rabbi Gershon Hoffman for his aid in translation, Dr. Shlomo Sklarz for the book cover design and Dr. Richard and Marcia (Rothstein) Kashnow for their generous financial support in advancing mental health education in Israel, especially in the dati/haredi community, by sponsoring Nefesh Israel publications and lectures.

Dedication

This book is dedicated to the founders and co-chairpersons, Judith Guedalia, Ph. D. and Leah Abramowitz, M. S. W., and to the administrator, Elana Wahlhaus, of Atem Nefesh Israel, Network of Orthodox Mental Health Professionals, in appreciation of their tireless efforts in behalf of the organization.

Preface

Whether psychotherapy as a discipline is seen as threatening or beneficial to Torah life may depend on whether psychotherapy is seen as a liberal philosophy based on secular values, or whether it is seen primarily as a form of treatment for psychological problems. A prominent Torah-observant American psychiatrist and psychoanalyst, Dr. Nachum Klafter, articulated his understanding of how psychotherapy treatment should be conceptualized as separate from and therefore not conflicting with Torah beliefs and observance of halacha.

"Torah study and Torah observance are not treatments for psychopathology. They are the path given to us by G-d and our sages to refine ourselves for the purpose of greater awareness of and service toward our Creator. Individuals suffering from personality disorders, mood disorders, severe anxiety disorders, psychotic disorders, and other significant psychopathology are impaired in their ability to serve G-d and study Torah. This may be because of straightforward cognitive limitations or behavioral problems. Or, more likely, it may be due to impaired ability to engage in meaningful interpersonal relationships. Relationship problems, in turn, severely impair a person’s ability to take advice, benefit from spiritual direction, make friends, work or hold jobs, get married, provide effective parenting for their children, and participate in community responsibilities. Such patients will not benefit from a mussar schmooze (ethics talk) or a humra (strict interpretation). Such patients need treatment. After they have received successful treatment, they will be more capable of pursuing Torah and mitsvot, if they wish to. After they have received successful treatment, they will be more likely to benefit from mussar. In other words, their free choice is limited by their psychological difficulties. With successful treatment, their free choice is expanded.

As a psychiatrist, psychotherapist, and psychoanalyst, it is not my role to bring Gentiles closer to the seven Noahide mitsvot or Jews to the 613 commandments. Enacting that role would sabotage my ability to help restore mental health. I am licensed as an expert in treating psychopathology. No matter how great a scholar I might be, I am not licensed to teach Torah or bring back stray souls. Torah and mitsvot are not mental health treatments…Torah study and strict adherence to the halacha do not automatically protect us from leading lives that are unbalanced, unhappy, and unfulfilled. …"

During the last half dozen years I have been employed as a supervising psychologist in a mental health clinic in Israel under haredi auspices where the professional staff consists exclusively of dati and haredi practitioners-psychiatrists, psychologists and social workers, and where the overwhelming majority of patients are from the haredi community. Over the years, questions were raised in supervisory and staff meetings about how to relate to and treat haredi and religious patients and also lively and interesting discussions took place regarding issues concerning halacha (Jewish law) and psychological treatment. This monograph contains a selection of interesting, pertinent and relevant articles for religious practitioners, authored by orthodox rabbis and psychotherapists, that deal with a variety of significant topics that include issues dealing with the relationship between clergy and clinician, special considerations in treating the haredi patient, attitude towards and treatment of homosexuals, and responsa by prominent contemporary rabbis regarding the issue of halachic (Jewish law) constraints and treatment options, among others.

The latter contains anecdotal examples of conflicts and dilemmas that religious therapists encountered in their work that were presented by the editor to various prominent rabbis for their halachic rulings. Among the questions raised included: Is the therapist permitted to encourage a patient to express his negative feelings towards his/her parents?; Can a therapist continue doing marital therapy after learning that the husband is a Cohen and his wife is a divorcee?; Is crossgender therapy permissible?; Is it permissible to do couple therapy with a homosexual couple where there exists a serious suicidal risk?, amongst others.

The editor believes that religious therapists, dati and haredi (ultraorthodox) as well as rabbis and laymen, will find the book stimulating, informative and a pleasant and worthwhile read.

Rabbis and Psychologists

Rabbi David Mescheloff, Ph. D.

Rabbis are just like psychologists. A crosssection of each group will reveal a tremendous variety of views on any given topic. Thus different psychologists have different perspectives concerning rabbis and the nature of their profession. Similarly, different rabbis have different perspectives concerning psychologists and the nature of their profession.

Indeed, to complicate matters still further, since human perceptions are dynamic, any given member of each group may hold different views about the other group at different times. Furthermore, just as psychologists may view other psychologists in a different light, and rabbis’ views of other rabbis come in a great variety, so may any given member of each group hold different views about different members of the other group.

Thus one psychologist may hold that all rabbis are incompetent in matters psychological, while another may see some rabbis as competent while they think that other rabbis are charlatans. Similarly, one rabbi may hold that all psychologists aim to convince their clients that sin is normal and legitimate, another may hold that all psychological techniques violate Jewish law and ethics, while yet another rabbi may acknowledge that only some psychologists are antagonistic to religion while others are authentically, deeply religious.

All this makes it very difficult to generalize or to deal objectively with the question of the relationship between psychologists and rabbis, and between psychological disciplines and techniques and the study and teaching of the Torah way of Jewish life.

Indeed, there is a great variety of psychological theories, techniques, and practitioners. Similarly, there is a great, varied wealth of Jewish literary source material, belief, practice, practitioners, and rabbis. Thus, rabbis who have serious reservations about the psychological professions, whatever the reason may be, can prove their case by pointing to the fundamental principles of certain psychological schools or to the actions of certain psychologists and by quoting certain Jewish sources. On the other hand, psychologists who oppose or have reservations about the religious Jewish way of life taught by rabbis, whatever their reason may be, can prove their case by pointing to certain religious Jewish doctrines, or certain Jewish laws, or the behavior of certain religious Jews and rabbis.

Against this background, at the risk of overgeneralizing, it seems to me that among the rabbinic groups most open to respecting psychologists and the contemporary psychological disciplines are the American modern Orthodox rabbis, and, in Israel, the religious Zionist rabbis. I belong to both groups.

This does not mean there is a love affair between these groups of rabbis and psychology. To the contrary, not a few of my rabbinic colleagues openly dislike modern psychology as a discipline, its techniques, and its practitioners. Some rabbis point to the discipline’s preoccupation with personal, individual happiness, encouraging egotism at the expense of commitment to others – including parents, spouses, and children – and at the expense of the willing self-sacrifice necessary for advancing communal, social, and national Jewish ideals. Other rabbis object to techniques that include bringing to the surface unpleasant memories and past traumatic experiences – some call it wallowing in filth - thus reviving the traumas and creating rifts in family and community relationships. Other rabbis object to techniques that include acceptance or even encouragement of sins of various types, ranging from disrespecting parents, masturbation, homosexuality, and adultery. Psychologists’ neutrality is seen in this way as destructive. Yet other rabbis object to non-Jewish or Jewish non-religious practitioners, who may use their influence, openly or unconsciously, to lead a religious Jewish patient away from his Orthodox Jewish belief and way of life. Finally, some, while acknowledging that genuinely ill people may need the help of medical and psychological professionals, feel that normal people with psychological distress should be able to find the strengths that they need to deal with their distress within themselves, on their own, or with G-d’s help, or with the guidance of Jewish religious source material, or with a rabbi, but not with a psychologist.

I rather suspect that not a few mainstream psychologists would agree with at least some of these criticisms. I agree with some, in some measure. Yet, in the large, it seems to me that each of the criticisms reflects a mistaken overgeneralization, or a certain misunderstanding, or limited understanding, either of psychology – which has changed a good deal since the discipline began on its path almost a century and a half ago - or of Judaism and Jewish law, which allow for a more dynamic understanding of human development than is often realized. Let me elaborate a little.

A religious psychologist summed up his views regarding his profession’s goals: Mental health practitioners’ purpose and function is first, to give the troubled person relief from suffering and then to equip him better to live in peace, affection and stable equilibrium with himself and the people around him. Psychotherapy is anthropocentric; its goal and measuring rod is man’s psychological well-being (however defined by the mental health expert)".

As a rabbi, I do not find any of that objectionable. First of all, under the headings of such Jewish halakhic imperatives as Love your neighbor as yourself and acts of loving-kindness … have no upper limit, but are one of the three pillars on which the world stands, I can only be thrilled that we live in a world in which people can find relief from their psychological distresses.

Furthermore, I have no interest in people being driven to live their Jewish lives on account of distress. It would bring no blessing to Jewish living if it were to be characterized as founded on psychological imbalance. If that were the case, no one would be drawn to Judaism and the numerous lessons of faith and value, justice and righteousness that we wish to bring to the world. Moreover, I have every reason to prefer that the individuals for whose spiritual growth I work and pray will be free to do so undisturbed by internal disquiet. Indeed, the most fundamental prerequisite for Torah study and mitzvah observance to bear any value is that they be chosen by a healthy, free-willed person. Psychological distress and illness restrict one’s free choice. Psychotherapy expands freedom, and makes it possible to create a whole, integrated life.

A Torah way of life is to be lived with joy in the heart of the person living it! (1) R. Avaraham Yitzhak HaCohen Kook wrote about this: "Many have seen in