World Mental Health Day 2021 – A Jewish approach

In the Talmud, Berachot 5b, we read a series of stories of the sages and their illnesses. First we are told of Rabbi Yochanan’s student, Rabbi Hiyya bar Abba, who falls ill. “Rabbi Yochanan entered to visit him, and said to him: Is your suffering dear to you? Do you desire to be ill and afflicted? Rabbi Hiyya said to him: I welcome neither this suffering nor its reward, as one who welcomes this suffering with love is rewarded. Rabbi Yochanan said to him: Give me your hand. Rabbi Hiyya bar Abba gave him his hand, and Rabbi Yochanan stood him up and restored him to health.

Similarly, Rabbi Yochanan fell ill. Rabbi Ḥanina entered to visit him, and said to him: Is your suffering dear to you? Rabbi Yochanan said to him: I welcome neither this suffering nor its reward. Rabbi Ḥanina said to him: Give me your hand. He gave him his hand, and Rabbi Ḥanina stood him up and restored him to health.

The Gemara asks: Why did Rabbi Yochanan wait for Rabbi Ḥanina to restore him to health? If he was able to heal his student, let Rabbi Yochanan stand himself up. The Gemara answers itself “A prisoner cannot generally free himself from prison, but depends on others to release him from his shackles.”

I read these stories as being a very clear statement of the repudiation of pain or suffering being “good for the soul” – or that accepting any pain or suffering is a gateway to divine mercy. Rather, the rabbis reject the idea that suffering is necessary for achieving closeness to God, or for salvation of the soul, or indeed for anything beneficial to the sufferer, in this world or the next.

Threaded through the narratives of the Hebrew bible are the stories of individuals who protest suffering – their own or that of the people around them.

Moses calls out to God to free him from the burden of leadership of a fractious people (Numbers 11:14-15), adding “And if You deal thus with me, kill me, I pray, out of hand, if I have found favour in Your sight; and let me not look upon my wretchedness.” – Moses would rather die than continue in his mental distress and the loneliness of his position.

In 1Kings 19:4ff we see Elijah, having shown courage and confidence against the Baal worshippers only the chapter before, now frightened and depressed at his situation “He went a day’s journey into the wilderness, and came and sat down under a broom-tree; and he requested for himself that he might die; and said: ‘It is enough; now, O Eternal God, take away my life; for I am not better than my fathers.”

We see King Saul, the first King of Israel,  repeatedly demonstrating disturbed behaviour and showing emotional and mental distress: shortly after he is anointed King by Samuel he has an episode where he joins a band of wandering prophets and falls into some kind of ecstatic prophetic frenzy, (1Sam 10:10) leading to the proverb “Is Saul also among the prophets?”;  and again he appears to have an episode much later when chasing David (1Sam 19:23f) whom he knows will now be king in his place “And he went to Naiot in Ramah and the spirit of God came upon him also, and he went and prophesised until he came to Naiot in Ramah. And he stripped off his clothes and prophesised before Samuel and lay naked all that day and all that night. Wherefore they say “Is Saul also among the prophets”

More frequently however Saul is described in what today we would understand to be deep depression and anxiety– described as “an evil spirit from God”, and could be soothed only by David playing the lyre before him (1Sam 16:23).

The Psalmist repeatedly writes of emotional and mental distress, of feeling alone and abandoned, of the anxiety of living with the knowledge that there are those who seek to harm them. The language used is very much bodily oriented – feelings are experienced in heart and belly and bowels, and this reinforces the Jewish teaching of Maimonides – “the body is the home of the soul and the soul guides the body. This means that the body and the soul are one unit”

Maimonides also wrote that “”When one is overpowered by imagination, prolonged meditation and avoidance of social contact, which he never exhibited before, or when one avoids pleasant experiences which were in him before, the physician should do nothing before he improves the soul by removing the extreme emotions.”  He believed that mental health was as important as physical health, earning him the distinction of being the father of psychosomatic medicine. He emphasised the prevention of illness of all kinds, mental or physical, since they interfered with the person’s ability to serve God. (Koenig: Faith and Mental Health: Religious Resources for Healing, p34)

 His understanding that before addressing a person’s physical needs, physicians must first attend to the patient’s emotional and mental needs, was a powerful innovation for his time (12th Century) and led to him being appointed as court physician, as well as being described by Ibn Abi Ozeibia (1203–1270), the famous physician and historian of Cairo as a “healer of the body and the mind.”

In the traditional community prayer for healing, the “Mi Sheberach” prayer read in the morning service when the Torah is read, we pray for a r’fuah shleimah, a complete recovery, which includes both r’fuat hanefesh ur’fuat haguf, a healing of the soul and the body. This ancient formula which asks for “complete healing”, specifies that both the body and the soul are often in need of help, that we are human beings who experience distress and pain in both the physical and spiritual parts of our being. Judaism acknowledges a that both mental and physical ill- health exists, and our tradition treats them on equally, knowing that for a human being to be “shalem” complete and whole,  there should be good health in both the physical and spiritual aspects.

Somewhere this understanding that we are made up of body and spirit, that everyone from the highest social status to the lowest can be subjected to distress of both mind and body, and that prioritising physical health over mental distress can never successfully alleviate either – somewhere this knowledge has diminished.

  • According to MIND 1 in 4 people will experience a mental health problem of some kind each year in England  
  • 1 in 6 people report experiencing a common mental health problem (like anxiety and depression) in any given week in England

https://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems/

In any given week in England people suffer:    Mixed anxiety and depression: 8 in 100 people

  Generalised anxiety disorder (GAD): 6 in 100 people

  Post-traumatic stress disorder (PTSD): 4 in 100 people

  Depression: 3 in 100 people

  Phobias: 2 in 100 people

  Obsessive-compulsive disorder (OCD): 1 in 100 people

  Panic disorder: fewer than 1 in 100 people.

We know that people who suffer from mental health challenges are not only having to deal with their illness, but that society will often stigmatise them and exclude them. People with a visible illness may attract empathy and concern, yet often people with an invisible illness or disability will find themselves ridiculed or dismissed, ignored or even feared.

Today is World Mental Health Day. A day for us to stop and recognise that each of us has a risk of mental ill-health in our lifetime, just as we have the risk of physical ill-health. A day for us to see the people whose suffering is often invisible to us; a day to give space and time to those who may be struggling, a day to tell others of our own distress and struggle. A day to remember that we are each made up of body and soul, and both can become out of sorts, both need to be in balance for our well-being.

 Mi she-bei-rach a-vo-tei-nu, Av-ra-ham, Yitz-chak, v’Ya-a-kov, v’i-mo-tei-nu Sa-rah, Riv-kah, Ra-chel, v’Le-ah, Hu yi-va-rech vi-ra-pei et ha-cho-leh/ha-cho-lah ____ ben/bat ____ Ha-Ka-dosh Ba-ruch Hu yi-ma-lei ra-cha-mim a-lav/a-lei-hah, l’ha-cha-li-mo/l’ha-cha-li-mah u-l’rap-o-to/u-l’rap-o-tah, l’ha-cha-zi-ko/ l’ha-cha-zi-kah u-l’ha-cha-yo-to/u-l’ha-cha-yo-tah V’yish-lach lo/lah bim-hei-ra r’fu-ah sh’lei-mah, r’fu-at ha-ne-fesh u-r’fu-at ha-guf, b’toch sh’ar cho-lei Yis-ra-el, hash-tah ba-a-ga-lah u-viz-man ka-riv, v’no-mar, Am-en!

May the One who blessed our ancestors Abraham, Isaac and Jacob, Sarah, Rebecca, Rachel and Leah, bless and heal the one who is ill: ____ son/daughter of ____. May the Holy One, the fount of blessings, shower abundant mercies upon him/her, fulfilling his/her dreams of healing, strengthening him/her with the power of life.

Merciful one, restore him/her, heal him/her, strengthen him/her, enliven him/her. Send him/her a complete healing from the heavenly realm, a healing of body and a healing of soul, together with all who are ill soon, speedily, without delay; and let us say: Amen! Translation by National Center for Jewish Healing

https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/five-steps-to-mental-wellbeing/

https://www.ageuk.org.uk/information-advice/health-wellbeing/conditions-illnesses/depression-anxiety/

https://www.mentalhealth.org.uk/campaigns/world-mental-health-day

A Key on the Seder Plate: Remembering those who are detained indefinitely while their applications for asylum are being processed.

keysforfreedomImagine the fear of being subject to indefinite detention. No way of knowing how long you will be there,” feeling like you have been put into some sort of human storage facility” (Ajay from Freed Voices).  Imagine trying to keep your sense of self, already damaged by the treatment you have received earlier in your own country, the torture and abuse you have fled, leaving behind family and home in an attempt to save yourself.  Imagine the dangerous journey to freedom, the cold and the heat, the hunger and the insecurity, the anxiety for those you have left behind, the fear of what the future will hold.

Imagine then arriving at a country of sanctuary, hopeful, grateful, ready to work hard to create a new home and make new relationships, to build a good future. And then imagine the bureaucracy, the suspicion, the black hole you fall into as you try to do all the things that will bring a new start. Imagine the xenophobia, the misery, the violence of those who are losing all hope. Imagine that your innocence is questioned, that being locked up without any time structure is seen as normal. Imagine the limbo you find yourself in, no end in sight, nothing to hold on to. In 2015, 255 people had been detained for between one and two years, 41 for over two years.  But these figures exclude the many people who are held in prisons under immigration powers, so the true figure is likely to be significantly higher.  Detention is justified as a way to deport people, but the majority of people detained for more than a year are not ultimately deported.

There is no clarity or transparency in the process. It just grinds on slowly – at least you hope it is grinding on – how would you know if you are not forgotten?  How do you hold on to your humanity when others see you only as a statistic, and a hostile statistic at that?

As one detained asylum seeker said:    “In prison you count the days down to your release, but in detention you count the days up and up” (Suleymane from Freed Voices”)

In 2015 official figures report that almost three thousand people were placed on suicide watch, eleven of them children.  And the figures for suicide attempts inside these centres is going up. The mental health of detained asylum seekers becomes further fractured by the fear, the lack of any clear process or time structure, the prison conditions in which they are held.

As Richard Fuller MP said at an interfaith event hosted by Tzelem and Rene Cassin in the House of Commons yesterday (20th April 2016) “the system is costly, it is inefficient, and it is unjust”. It costs £70 thousand a year to hold someone in detention in Colnbrook detention centre – money that could be used for their rehabilitation and to facilitate their entry into society.

The UK is the only European country with indefinite detention for asylum seekers. The immigration bill is coming back to the Commons with many amendments from the Lords, one of which is to set a time limit of 28 days. As we go into Pesach, our festival of freedom, let’s do all we can to remember and to hold in our hearts and minds the frightened people held in indefinite detention in our own country. Put a key on your Seder plate and pledge to work for the freedom of all people to live in security and peace, to work for the ordinary and common desire we all share to be able to get on with our lives without fear.