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Refuat HaNefesh: Perspectives on Mental Health in the Orthodox Community

Nearly 1 in 5 Americans suffers from a mental illness each year. And no, that’s not just a general statistic; those numbers apply to our communities as well. Mental illness exists in our shuls, in our schools, in our homes. Thankfully, mental health awareness seems to be on the rise in the Orthodox community. More personal articles are being written on the matter, more mental health panels are being organized, more community leaders are promoting mental health awareness, more people are advocating for programs that educate about and provide preventative services. These developments are enlightening, exciting, and empowering.

But are we being forward thinking in speaking about mental health, or are we lagging behind the rest of the world? What distinguishes our perceptions of mental health from non-Orthodox or secular communities?

To be frank, I don’t have the answers, nor do I think that the comparison is particularly meaningful. I don’t know how to measure just how open we are, how educated we are, or how sensitive we are to mental health issues. What I do find particularly meaningful, however, is exploring how mental health issues are manifested uniquely within the orthodox population, and what we can do as a community to support those affected.

OCD (Obsessive Compulsive Disorder) and Religious Observance:  When someone davens (prays) for a long time, we commend them for their concentration. When someone checks lettuce (to ensure it is bug-free and thus kosher) for a long time, we compliment how frum (observant) they are. When someone can recite chunks of the shulchan aruch, we are impressed by his or her memory. However, what we might not realize, is that our positive reinforcement might be encouraging and maintaining their obsessive and compulsive tendencies. In other words, the cultural approval and admiration of attention to detail can perpetuate a serious psychological condition.

Stigma: Orthodox communities are, by design, very close knit. For better or for worse, everyone seems to know everyone else’s business. The communal involvement can be extremely beneficial in some scenarios, such as the outpouring of support in the case of a death or a serious physical illness, yet also has the potential to be harmful and detrimental. Imagine that you have a deep dark secret that impacts you every day, but instead of telling a few friends about it to get it off of your chest, you swallow it by yourself. You are worried that other people will find out. You are worried that other people will see you as different. You are worried that people will know you aren’t perfect. You are worried that people will see you walking into a therapist’s office and see you as crazy. Sometimes, the stigma hurts even more than the diagnosable disease.  

Emunah: When someone is struggling with a psychological condition, emunah (faith/belief) can factor into both their mental health and their religious observance. In some circumstances, emunah can be a protective factor. For example, some may feel comforted knowing that everything is in Hashem (G-d)’s control, others may stop self-harming because they don’t want to damage the body that Hashem gave to them, others may need the chiyuv (requirement) of davening to get them out of bed in the morning. However, there are also ways that the concept of faith becomes more of a challenge than a comfort. People may feel angry that Hashem gave them a specific condition; others may feel alienated from the community due to their doubts. Additionally, we are taught from a young age that everything happens for a reason. However, when people use that idea as an attempt to comfort people in acute pain, it can often be received as dismissive. Though often well intentioned, comments such “stop worrying, it’ll all be fine” or “at the end of the day, Gd will take care of it, no need to freak out” can feel very invalidating. Not only will offering G-d as a band aid to mental health issues be ineffective, but it will probably discourage them from reaching out for help again.

What can we do?

Educate yourself. Learn the signs of specific conditions. Support people when they seek professional help. Check in on someone if you know they’ve had a hard week. Enhance your emotional vocabulary. Respect the subjective nature of life. Legitimize emotions instead of explaining them away. Bring a Shabbos meal for a family that is struggling. Encourage openness. Understand that emotional pain is real pain. Ask what you can do to help. Listen intently without offering advice. Validate. Empathize.

Resources to learn more – 

TED Talks:

Bene Brown: The power of vulnerability

Guy Winch: Why we all need to practice psychological first aid

Kevin Briggs, The Bridge Between Suicide and Life

Temple Grandin: The World Needs All Kinds of Minds

Kevin Breel: Confessions of a Depressed Comic

JD Schramm: Break the Silence for Suicide Attempt Survivors

Books:

Darkness Visible: A Memoir of Madness, by William Styron

My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind, by Scott Stossel

The Center Cannot Hold: My Journey Through Madness, by Elyn R. Saks

An Unquiet Mind: A Memoir of Moods and Madness, by Kay Redfield Jamison

Down Came the Rain: My Journey Through Postpartum Depression, by Brooke Shields

Curious Incident of the Dog in the Night-Time, by Mark Haddon

Man’s Search for Meaning, by Victor Frankl

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