The Rabbi As Therapist

...there is too much civic violence compared to most civilized countries...

...But question science...

...Rites of passage are events shared with a community, and they are things enacted, not believed...

...It is in these connections that the contributions of Jewish ideologues could be most valuable...

...For many, a good alternative to grand purpose or grueling effort comes from having meaningful routines of activity and expectation, enriching life by its rhythms...

...The way science helps solve problems is by feeding technology...

...Two currently prominent themes in American culture and in the prescriptive tendencies of psychotherapists illustrate issues where rabbis might be expected to have something special, and important, to say...

...This existential need, I think, is what sends them, first and foremost among all comers, to every psychotherapy and quasitherapy that comes along, as it sends so many of their children to deviant evangelical sects and causes...

...Most people do not want grand purposes, or welcome any long term need for valiant struggle...

...Their persons, like their possessions, are well cared for, well presented...

...All that people in mental health and the behavioral sciences can say, or ever really could say with any confidence, is a few things about how people ought not to live...

...The reason, I think, is that religion is no longer an encompassing event in people's lives, no longer a source either of incentive or of threat...

...Scientists and experts in mental health cannot speak to what is good for people in an ethical sense with any more certainty than clergymen can...

...They will not ask the clergyman to help them because he is not in the health business...

...More and more of the contemporary problems for which psychotherapy is sought are of the existential kind, concerned with what life means and how one ought to live it...

...For many of these miseries, people turn to psychotherapists for help...

...Psychotherapists rationalize their prescriptions of what is "good for you" in terms of mental health and rabbis in terms of moral health...

...For Jews, bar mitzvah is a confirmation party, religious holidays are not much observed (Sabbath and Chanukah candles expected...

...What is true of people's perceptions and expectations of science becomes willy-nilly true of their ideas about psychology...

...They add value to the meanings which personal ambitions give to life because they are shared experience, independent of the individual's choice and free of the threat of failure...

...Some of them reinforce each other, but some compete in their implications for how people ought to conduct themselves in order to achieve "the good life...

...I grow up...

...The question at issue is whether a very easy life can be a very good one in the first place and whether, in the second, self-impiovement technologies, however useful, can fill the spiritual vacuum left in some people by lives which lack delineation, definition, and purpose...

...Hardly...

...People with endless leisure and money may seek diversion by moving from pleasure to pleasure...

...The gap makes the pain of unhappy Americans more poignant, and their anxiety more noticeable...

...But they do require a sense of meaningful-ness about their lives, or else the tenuous quality of their relationship to the world becomes too threatening to bear...

...The Shift of Faith to Science Why have so many educated people chosen psychotherapists over clergymen to talk to about their problems of living...

...Indeed, most people lack self-consciousness about the underlying beliefs involved...

...Their troubles, like their successes, are representative of American psychotherapy seekers...

...The ideological themes that underlie psychotherapy, on the other hand, are not all irrelevant to those of Judaism...

...And such a vision is no one's professional property...

...Aerobics versus Weltanschauung The second topic involves broader issues, but arises currently from a technical question connected with the growing repertory of treatment methods...

...Experts in these fields do not always know it themselves and, because they have so many good techniques for relieving suffering, make the same kind of logical error, concluding that they know a lot about its obverse, how people ought to behave to find health and well being...

...Science training has the same status in mass education today that the three Rs had a century ago and the classics before that—it is to be taught not as something merely instrumental but as part of the general intellectual equipment of a modern educated person...

...The Jewish tradition may offer a forceful case for the communal orientation, and the actual experience of rabbis with the familial problems of American Jews should, I think, provide them with plenty of grist for that mill...

...Indeed, they may not be certain what business the clergyman is in, or whether that business is at all important to their lives...

...A fair proportion of the unhappy families I encounter in the consulting room whom rabbis must likewise see in their studies, are disconnected from the rest of the world, lack the social support systems which could give them sustenance in their quarrels and wisdom in their efforts with each other, and are thus blind to the healing possibilities for their own lives that could be derived from involvement in their neighbors' struggles...

...Recent opinion surveys now confirm the dominance of what Tom Wolfe some years ago labeled "the me generation" of educated Americans...

...Mental Health Themes and Judaism It is easy to be misled into thinking that because psychotherapy has always been a profession loaded with Jews, it is, in some cultural or religious sense, Jewish...

...a surfeit of ice cream soon dulls the taste for ice cream and finally disdains it...

...But in America, the gap between being happy and living in manifestly pleasant circumstances is more apparent than it is elsewhere...

...They have made some important contributions in this connection...

...Perry London is Professor of Psychology, Psychiatry and Behavior Science at the University of Southern California and Lecturer in Psychology at Harvard Medical School...

...As psychology has become a science, it has benefited from this cultural development...

...are peculiarly American refrains...

...Even when not spoken plainly, these kinds of questions are reflected in some of the social trends for which Americans have become pace setters for Western civilization—in some aspects of the Women's Movement, for instance, or in the growing instability of personal and romantic relationships, or in the steady increase in career switching that goes on in the United States, or even in the fantastic preoccupation with health, more visible in America than elsewhere...

...The most basic problems people want solved appear in nature, starting with problems of food, water, shelter, and health...

...Indeed, psychotherapy is under constant attack in that connection as too costly, cumbersome, and even ineffective...

...So the need for dialogue does not concern the techniques themselves, but only the size and significance of their role in people's lives...

...In America, more than anywhere, what's new in heart prevention, cancer cures, or smoking campaigns, makes headlines...

...it is combating pain or suffering or symptoms...

...Psychotherapists of all kinds, on the other hand, are in the repair business—not so much telling people how to live as how to be less sick and in less pain...

...Most people know, of course, of guns, as of atom bombs, that they are not good things...

...Little is kept of the old culture, little borrowed of the new...

...At least, they are more vocal about it: "Who am I?" "What do I want to be when (or if...

...A scientific ethic emerges when efficient technical solutions creep into our minds as ethical solutions—"good" in the sense of efficient becomes synonymous with moral good because it is associated with the relief of something which is so plainly unwanted...

...Wise physicians know intuitively that "health" is a Platonic Idea, for which the real world has no illustration, and that they are more in the illness-fighting than the health-dispensing business...

...Now, an ethic develops to promote the goals of a culture...

...With all of this, Jews are still marginal enough in American society, if barely so, that they may be foremost among Americans in hungering for purpose, rhythm, and community all at once...

...Self-improvement and self-help, like self-seeking, are long established virtues in Anglo-Saxon tradition...

...The theories, the motifs, the methods, and the goals of psychotherapy have no deliberate connections with Judaism, ideologically or institutionally, and the Jews who are involved in psychotherapy (on both sides of the counter) and are also connected with Jewish institutions have rarely been propelled to either by the other...

...therefore it is good to find the means to alleviate sickness and delay death...

...So too, by and large, are their minds and manners...

...but implicit in each message is the belief that, faithfully carried out, adherence to the prescription will make people's lives more fulfilling...

...Nor are most psychotherapists so eager to preempt the role of arbiters of such questions once they realize their breadth...

...One of these emerged from the discovery of functional disorders—ailments whose physical basis is not apparent...

...If so, it is a pity, for the failing robs them first of moral authority and then of credibility...

...Medical people almost cannot help thinking about the nature of health, but they have no special edge on understanding it...

...Above all else, Americans seem terribly anxious about aging, as if getting old were shameful or in bad taste...

...This differs sharply from the classical Jewish view that "life is with people" in a broader sense, a view which promotes a broad network of relationships and one that demands a sense of functional responsibility for other people's welfare as well as kindly sentiment towards them...

...Too much ease, it may be argued, produces restlessness, discomfort, boredom and depression...

...There are still poor Jews in America, and ready-to-be persecuted Jews, and unkempt and uncouth Jews—but most of them do not go to Friday evening services, belong to suburban synagogues, or seek psychotherapy...

...It is generally true in the history of the healings arts that the more specific the response the more effective it is—and each of these techniques is demonstrably valuable...

...But most forms of psychotherapy are simply not equipped to address such needs, and those which are tend to address them in ways which, in traditional Jewish view, foster egocentric, narcissistic, and finally barren styles of life...

...Their children, like them, are well cared for and, like them, well educated and urbane...

...there are none for describing health...

...Thanksgiving Day and Fourth of July are not much to get worked up over and still less are Christmas and Easter, though both have been largely detoxified for Jews...

...the one is fast, the other looks easy...

...there is a saddening increase in psychological depression (one scholar has labeled it "the common cold of psycho-pathology...

...We have become a culture of science and technology...

...Nor does it matter whether they are easy or hard to fulfill, but only that they are well marked...

...This view leans more in the direction of social interest, as Adlerians or as Wilhelm Reich would have seen it, than towards self actualization of the kind that Abraham Maslow or Frederick Perls would have advocated...

...This may account in part for the current popularity of therapeutic programs such as est and biofeedback...

...To what extent, in other words, is it useful to seek specific methods for feeling good, for staying healthy, and for finding peace of mind, without trying to organize or view one's life in some totality, with beginning and end, with broad goals, and with seasons, rhythms, and rituals to shape it...

...It is the majority who do who are of interest here...

...There are worse signs of un-happiness in things for which statistics are collected: there is too much divorce (beyond that which is corrective for what were, to begin with, bad marriages...

...If I am willing, as a congregant, to encounter him in that connection, and he can respond with no other thoughtful intelligence than I can get from psychotherapists, he makes himself and his spiritual tradition counterfeit and, thereby, diminishes both himself and me...

...The question here concerns the relative value of tactical devices for self-improvement as opposed to a strategic perspective on one's life...

...The teaching of science and technology, their growth and transmission to future generations, are major concerns of our society...

...Americans jog more, eat health food more, buy more books on diet and self-improvement and more beepers to warn them of heart attacks than other people, more than they themselves did last year...

...The practical faith of sophisticates, if any, is that science is good—and that if they feel bad, they have a health problem, mental or physical, for which a doctor or a psychotherapist will help them...

...Some interesting scholarship, moreover, has traced the intellectual roots of psychotherapeutic methods and goals to early Jewish philosophical and religious writing...

...Gentiles also give and get psychotherapy, of course, but the most dependable traffic has been largely Jewish...

...I would like to believe of my rabbi that his concern is with the totality of my life and what I wish and fear to do with it...

...Implicit in this belief is an ethical statement: science and technology are good for people...

...American rabbis are dealing with a community of people many of whom have found relative material ease but feel that something else important is missing from their lives, some sense of purpose...

...Everyone knows it is bad to be sick, to suffer, to die...

...How to respond to these conflicts and miseries are partly questions of ideology, and the repository of experience expressed in Jewish lore and tradition has as much claim to wisdom here as do the prescriptions therapists spin off from their theories of personality...

...Certainly, divorce and discontent and fear of failure, misery in love, in family, in one's career, are nothing like the hysterical blindness and paralysis and other "neuroses" which psychoanalysts and others eloquently described and elegantly attacked almost a century ago (though there are still plenty of those around, and by now a tradition of treating them with psychotherapy...

...Ethics is the study of how people ought to live, that is, what is good for people morally...

...The question here is one of the extent to which people can fulfill themselves in pursuit of nonsocial goals and of a small network of entirely personal relationships, based on feelings of friendship, a tendency now commonplace in America...

...It may seem easy to derive what one should do from the knowledge of what one should not do, but that is to leap to existential conclusions from frothy psychological premises...

...Today's congregational rabbis seem indisposed to do so...

...He lives in Israel and teaches at the University of Tel A viv and the Hebrew University in Jerusalem...

...The thrust of the contemporary psychotherapeutic enterprise is to view only primary relationships as central to self actualization and, even in them, to value positively a high level of emotional independence...

...Americans appear more anxious about their personal identity than other people do...

...sacred rituals of passage are markers of its course...

...It is easy to form a habit of thinking that science is ethically good because a lot of good things are done with it, just as it is easy for people who protect themselves by bearing arms to think that guns are morally good because, in their experience, they are life-saving...

...This is useful knowledge, and useful means of treatment, including psychotherapy, result from it...

...In America, the virtues of expedition have been added to them, perhaps as a by-product of the American appreciation of economic efficiency...

...Dealing with illness is not prescribing health...

...There is, first, the importance of social interest in self actualization, and second, the value of global perspectives in organizing one's life...

...American pluralism, other directedness, and perhaps technology, together have diminished, rather than multiplied, the tendencies of ethnic subgroups to celebrate holidays or elaborate rites of passage or to take them very seriously if they do...

...But the surfeit even of pleasures produces first satiation, then indifference, then distaste...

...Whether rabbis are ready to take on such roles, or even undertake such dialogues, is another question...

...Thoughtful students can agree that there are many good models for describing illness...

...As much misery too, I think, can be said to come from people's pridefully nurturing independence of each other as from languishing in resentful dependencies...

...Since the rhythms involved are externally ordained, the only "thinking about" they require, perhaps, is how to fulfill them...

...The result, in any case, is that "fast" and "easy" have become coupled with self-improvement as American motifs...

...Nothing could be plainer, in the pluralistic intellectual community of modern times, than that no one has the edge on knowing much about how people ought to live...

...Health is not quite the business solely of doctors, not just the domain of medicine...

...The authors of Pirkei Avot did just that, as have long lines of their intellectual and spiritual disciples...

...Social Interest in the Me Generation The first issue arises in connection with the growing trend of Americans to be individually self centered in their life goals, unconcerned with broad social matters...

...In agricultural and tradition bound societies, those rhythms are contained in cycles of changing seasons and rituals for acknowledging them...

...And these are the questions which people earlier would have addressed to their teachers, priests and pastors more than to their doctors...

...there is an astonishing amount of alcoholism (to which Jews are rapidly succumbing almost as much as others...

...Since these are "natural" problems, solutions to them are seen as "naturally good...

...Out of that discovery came the message that repressing feelings (instead of being consciously aware of them) can damage people's ability to function intelligently, even to recognize their own needs...

...Knowing how to live requires a more positive vision of life and of the compass of life...

...Success in doing so blurs the inherent difficulty of defining health and may also turn the competent reliever of suffering into an inadvertent and incompetent expert on ethics...

...So also, we are learning from the study of psychosomatic disorders, now called behavioral medicine, about the physical consequences of things like driving oneself too hard, excessive arousal, anxiety, frustration, stress, too easy and too much anger too often, and grief—how all these can damage the heart, can give rise to itches and boils and asthma and ulcers and other ailments...

...This is especially true of medical problems, because illness, pain, infirmity, and death offer what seem to be natural standards by which one can judge what is bad...

...They have the quick affability of other Americans, and the social presence of the affluent and unpersecuted...

...They reassure people that life has some dependability, that it is "la ronde de la vie...

...In an insidious way, scientific excellence promotes ethical pretensions...

...The preoccupation with remaining young has moved hair transplant ads from the classifieds up to the second and third pages of the daily paper and up next to hotel and car rental ads in the airline magazines...

...It is a principle of sensory psycho-physiology which may apply to ever-thing else in human experience as it does to elementary body processes—the feel of clothing touching one's body disappears as one gets used to it...

...But none of these things really say much about how people ought to live, how they ought to set the patterns of their lives...

...Americans are no more obviously happy or unhappy than are free and well fed people anywhere...

...Perhaps one's purposes cannot be significant if they are too easily obtained or too independent of ideals, things, and people outside oneself...

...It is not because of the success of psychotherapy in treating mental illness or neurosis...

...Even so, it is not a "Jewish" enterprise except in this sociological or casually historical sense...

...Most people do not know, on the other hand, that medicine and mental health are not automatically good...

...Their cars, like their synagogues, are big, clean, abundant and new—well tended in their early years and replaced in their prime, before they age too much...

...Most of the first therapists were Jews, it is true, as were most of their customers, and it has been a somewhat in-group business ever since...

...At least they come at the ethical problems of living, to begin with, as people whose primary concern is ethics...

...Rabbis, in general, have more right to opine about such things than psychotherapists...

...But most are not problems that can be strictly spoken of as mental illnesses or behavior disorders or whatever voguish term mental health professionals use to name the ailments that they treat...

...Our culture has evolved a scientific-technological ethic because science has proved so useful in solving practical problems...

...The current therapeutic disposition (seen most among behavior therapists and some behavioral medicine enthusiasts rather than psychoanalysts or humanists) is to advocate very specific techniques—assertiveness training for the cowed or shy, sex therapy for the fearful and inept in bed, dieting and jogging for cosmetics and for health of heart and feelings of well being, yoga and meditation for peace of mind...