Rabbis, be cautious with your advice and pronouncements

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Advice (photo credit: GOT CREDIT/ FLICKER)
Advice
(photo credit: GOT CREDIT/ FLICKER)
Below is a limited list of involvements of rabbis that came to the attention of the writer in his capacity of supervising psychologist at a clinic under haredi auspices, who lacked psychological sensitivity and knowledge and unwittingly caused tragic outcomes to those that sought their advice :
1.    A middle-aged woman with a diagnosis of schizophrenia, and who was hospitalized numerous times, consulted a known rabbi and mystic while she was being treated in a mental health clinic. He explained to her that the voices she heard was the voice of an angel who was punishing her for her transgressions, and therefore she had to repent. This advice was counter to the efforts of the therapist, who attempted to strengthen her reality testing and diminish her pathological feelings of guilt, depression and suicidal inclinations.
2.    A 22-year-old yeshiva student shared with his rabbi his doubts and worries regarding his fiancée who was demonstrating compulsive behavior regarding cleanliness. She spent a great deal of time washing her hands, avoided touching things that were on the floor, etc. The rabbi reassured him that this behavior will disappear after she gets married. A month after the wedding, his wife was hospitalized in a psychiatric hospital and they divorced a half year later.
3.    A 23-year-old recently engaged yeshiva student sought psychological treatment so that “he will be able to discontinue taking psychiatric medication before his marriage,” which was scheduled to take place in several weeks. His rabbi had cautioned him not to reveal that he was receiving psychiatric and psychological treatment to his fiancée and dismissed several of his concerns and reservations regarding marrying his intended as insignificant. Unbeknown to him, his fiancée was also being treated at the clinic, which he discovered two weeks prior to the wedding when he saw her entering the clinic. He asked his therapist to tell him whether his betrothed was a patient at the clinic and about her psychiatric diagnosis. The therapist explained that he was not at liberty to provide this information due to professional ethics and suggested that he “come clean” with her regarding his psychiatric condition, inform her that he saw her at the clinic and request her to “come clean” with him, so they could begin their marriage on the “right foot” with openness, honesty and trust between them. Unfortunately, the patient did not act on his therapist’s suggestion. A month later, the couple separated.
   (In contrast to the attitude and behavior of the rabbi referred to above, Rabbi Dr. Abraham Twerski, a prominent Torah scholar and psychiatrist, wrote in the ultra-Orthodox magazine Hamodia (January 29, 2009) a response to a woman who sought his advice after finding herself in a similar situation as the young husband mentioned above: “I have repeatedly pleaded with people not to withhold important information precisely because of situations like this. Your husband’s parents felt that if they revealed that he was taking medication, that would ruin his chances of finding a wife, so they withheld the information ‘for his sake.’ But did they help him despite their intentions? Parents! I plead to you. Have pity on your children. Do not cause them suffering by withholding information. As you see it can cause them misery rather than happiness.”)
4.    A young yeshiva student sought help at a mental health clinic because of his attraction to another student with whom he had sexual relations. In one of the sessions, the patient informed his therapist that he consulted with his rabbi regarding his problem and the rabbi advised him to continue the process of shidduchim (matchmaking) and reassured him that after he marries, these feelings and impulses will disappear. The therapist, after hearing this, instructed the patient to inform his rabbi that he was in the beginning stages of treatment and that getting married will only intensify his problems and sabotage treatment. Fortunately, after hearing this, the rabbi recanted and encouraged his student to continue his therapy.
5.    Rabbi Moses Sternbuch, a highly respected haredi arbiter, wrote:
“Even the best therapists have nothing to offer those whose sins have brought them to depression or sadness, for the help they need is from those knowledgeable in Torah, who are the real healers of souls... Psychologists and psychiatrists steal a lot of money from the patient and let him imagine that he will be healed.” (Tshuvot VeHanhagot, 1:465).
   (Recently Rabbi Shternbuch was asked by a haredi psychiatrist whether religious patients can seek treatment from religious mental health practitioners who are guided by Halacha in their professional undertakings, in view of his previous halachic ruling.
The rabbi’s response was, “I spoke in general, but surely there are individuals who are Torah observant that treat according to Halacha, and with them it is appropriate and a mitzvah to be treated by them.”)
   Unfortunately, many years passed by before the rabbi modified his strict prohibition to seek psychiatric and psychological help, which prevented many haredim from receiving appropriate treatment.
AS SHOWN above, amateur dabbling in treating and advising in the area of psychopathology can cause serious negative outcomes. Before telling people with phobias, depression and obsessive-compulsive disorders to consult rabbis and not psychologists, success rates for rabbis for particular conditions should be objectively assessed.
Clergymen and clinicians have something of value to offer to each other to enhance the quality of their assistance to the people they serve. Therefore it is important that both professions recognize the limits of their professional competence and consider the benefits of working and consulting with each other.
Rabbi Shlomo Wolbe, z”l, a prominent haredi rabbi, author and educator, wrote (Psychiatry and Religion, “In the Pathways of Medicine,” 5 Sivan, 5749): “There is an urgent need to organize courses for practicing rabbis and educators, in order to disseminate basic knowledge of the symptoms of neurosis and psychosis and their treatment, in order that they will know to refer mentally ill people immediately to the psychiatrist. Basic knowledge will remove many prejudices.”
Bi-directional programs of education and collaboration should be developed and offered to clergymen and clinicians. By providing clergy with some basic knowledge and exposure to psychopathology and psychiatric and psychological treatment, they will develop a greater appreciation for the complexity of the human mind and psychotherapy, and will be in a better position to make more appropriate referrals and provide supportive counseling to their emotionally disordered and distressed parishioners. Likewise, a basic knowledge of religious laws, customs, values and rituals will enable psychotherapists to better appreciate the benefits of religious belief and conduct to mental health and make more effective and appropriate diagnoses, referrals and interventions in their clinical work.
The writer is a senior clinical psychologist who recently published Scrupulosity: Rabbinical Views, Treatment and Case Studies.