Spirituality and Psychotherapy

“Nachas Ruach”: Jewish Spirituality and Psychotherapy, Part 1

I was working at a government-run drug rehabilitation clinic in Israel when I first began recognizing the role of Jewish values and spirituality in my patients’ lives. I began working there shortly after making aliyah from Philadelphia to Jerusalem in 1984 with my family. My clients at that time were almost exclusively long-term heroin addicts from Israeli families. Most had retained a strong sense of Jewish tradition, even if they did not define themselves as religious.

Most of my clients at the time did not dress in a way that would readily identify them as religious Jews, such as wearing skullcaps and ritual fringes (kippahs and tzitzis) for men and modest skirts for women, but their mode of speech was sometimes difficult to distinguish from that of their counterparts who were stricter in their religious observance. A common refrain among those seeking treatment was “God willing” (b’ezras Hashem), not only when speaking about ending their addiction, but even when setting our next appointment. Sometimes they would say they wanted to “make a vow or neder to God” that they would stop taking drugs, or they would talk about how reciting Psalms or personal prayers gave them more strength to cope better with their addiction and move toward full recovery. They would often kiss the mezuzah on the door when leaving my office.

As a recent oleh (new immigrant to Israel), I wasn’t used to hearing such expressions used so freely or with such intensity. My experience in the United States had been that even if someone might make use of such a phrase at home, he would generally censor himself when in the presence of outsiders, including mental health professionals.

In addition, even phrases like “God willing” can become second nature and be expressed as a “positive habit,” somewhat like saying “Have a nice day.” In contrast, clients coming for therapy were continuing to maintain their natural way of speaking, despite being in the presence of a professional. I sensed that these clients were not using phrases like “God willing” superficially but as an expression of a deep, genuine hope and belief.

There are several possible reactions that a professional therapist could have when a client invokes Divine assistance. These responses may or may not be vocalized immediately or at all, but they are likely to play a role in how the therapist understands and interacts with the patient. Such reactions include:

1. Why are you asking God for help? You have to be mature enough to take responsibility for your own life.

2. I don’t think God has anything to do with this, but I’ll just ignore the comment and take it to be a phrase that you picked up in childhood.

3. I agree that we need Hashem’s assistance, but I  can’t talk about it because that would require bringing my personal religious views into our professional relationship, which is not appropriate.

Many mental health professionals — particularly until the end of the 1960s, when many established ideas began to be challenged in Western culture — typically not only failed to see that organized religion could help heal patients, but considered reliance on a Higher Power to be a dysfunctional way of coping, because they thought it enabled people to avoid taking responsibility for their own lives. Such an attitude, which viewed religion as the “opiate of the masses,” has long been part of the mainstream Western, liberal, secular worldview, though its predominance has diminished somewhat in recent decades.

In my experience, the third reaction (“I agree that we need Hashem’s assistance, but I can’t talk about it because that would require bringing my personal religious views into our professional relationship”) is typical of many Orthodox therapists. Even though they may basically share the religious beliefs and commitments of their patients, they are reluctant to let those beliefs play an active role in the treatment, having learned that to be accepted in a profession dominated by secular skepticism and a stated adherence to a “value free” ideology, it is necessary to create a bifurcation, or split, between their personal/religious selves and their professional role.

Even when mental health professionals see the potential therapeutic benefits of incorporating religious-based values in treatment, they are still faced with the difficult challenge of figuring out whether, when, and how to integrate Torah concepts into the therapy process in a way that is congruent with professional standards and ethics.

Joining the Client

While many therapists have been antagonistic, indifferent, or not sure how to integrate Torah concepts and psychotherapy, I have seen the importance of “joining” the clients “where they are” — that is, in understanding and accepting the religious, social, and cultural context of their life experiences, with the goal of utilizing that framework to treat them as effectively as possible. My own background, with the changes in lifestyle that I chose, led to an interest both personal and professional to seriously attempt to integrate Torah perspectives within the framework of psychotherapy. Over time, I understood this goal to be more and more part of my own personal mission.

Working in Israel since 1984, I have discovered that there is great readiness amongst many clients to receive help from a psycho-therapeutic model that clearly incorporates Torah perspectives.

The professional religious therapist will convey that he is “joining” the client, through the ambiance of his office. Seeing a Sefer Tehillim (Psalms) or other sifrei kodesh ( Torah classics) on the therapist’s desk, as well as pictures on the wall of well-known rabbis, gedolei Yisrael, serves to help the religious client feel more comfortable, safe, and less inhibited.

I often tell clients that they should recognize that they have been walking around holding in tremendous pressure, “like a kettle that had no way to release the steam,” and now they have a safe opportunity to release that steam.

King Solomon was aware of the healthy need to ventilate when he taught: “When there is worry in a person’s heart, he should discuss it with others” (Yoma 75a).

Torah Perspectives on Joining

Finally, Rebbe Nachman’s well-known parable entitled “The Turkey Prince” gives an insightful example of “joining”, within a counseling relationship: A royal prince once became mad and thought that he was a turkey. He felt compelled to sit under the table, pecking at bones and pieces of bread like a turkey. The royal physicians all gave up hope of ever curing him of his madness, and the king suffered tremendous grief. A sage then came and said, I will undertake to cure him. The sage sat under the table next to the prince and also began picking crumbs and bones.

“Who are you? What are you doing here?” asked the prince.

“And you? What are you doing here?” replied the sage.

“I am a turkey,” said the prince.

“I am also a turkey,” answered the sage. [In our understanding, at this point the sage is now “joining the prince.”]

They sat together for a long time like this until they became good friends. One day the sage signaled the king’s servant to throw him shirts. He said to the prince, “What makes you think that a turkey can’t wear a shirt? You can wear a shirt and still be a turkey.”

This same process continued with clothes and food being thrown down to the prince.

“What makes you think that you will stop being a turkey if you wear clean clothes and eat good food?”

Finally the sage said, “What makes you think a turkey must sit under the table. Even a turkey can sit at the table.”

The sage continued in this manner until the prince was completely cured.

To be continued.

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The above essay is an excerpt from Nachas Ruach, by Dr. Naftali Zvi Fish

Dr. Naftali Zvi Fish is a licensed clinical psychologist and hypnotherapist in Israel. After completing Doctorate in 1984 he made Aliyah from Philadelphia with his family, living in Jerusalem. During this time Dr. Fish has become a leading authority in the treatment of addictions, healing the “inner wounded child” and the enhancement of self-esteem which often underlies clinical issues. In the mid-nineties he founded and administered the first full-time Rehab program designed for Jewish addicts with the support of Rav Dr Abraham Twerski. Based on extensive experience Dr. Fish has developed and implemented the Nachas Ruach Treatment Model, a new and unique Paradigm to facilitate psycho-social and spiritual growth and healing. It utilizes and effectively integrates Torah perspectives and values, “openly bringing Hashem into the room,” within the context of professional Psychotherapy and Hypnotherapy. Dr. Fish has a full time private practice and has been teaching various courses in Psychology at Touro College – Israel since1993.