Many decades ago, one of my doctoral students researched a novel topic under my direction which became her dissertation: Could a person who has been in therapy ever win the presidential election? The study explored the biases and stigmas associated with a range of mental conditions requiring treatment, and also examined people’s perception of those who seek and need help.

In our circles, there is a significant change in the attitude regarding mental health counseling or psychotherapy. More Jewish schools have in-house counselors and more graduate schools attract religious men and women seeking a degree that can lead to a career as a therapist. Nary a convention or yom tov program lacks a mental health professional of some sort as a speaker these days. In much of the Western Orthodox world, there is a greater acceptance of the concept that a trained mental health professional can be well-grounded in his or her hashkafos and adhere knowledgeably to halacha.

Something I have promoted in my own work over the years is the concept of “mental hygiene,” which looks at tools and fundamentals that promote stability, wellness, and some type of insulation from stress. It’s a model and a perspective on human functioning that involves self-care, empathy for others, and consistency of thought, feeling, and behavior. Still, there are some conditions that run through our Jewish bloodlines, genetic loading, and social structure that defy efforts to contain them, and most definitely leave some individuals unable to escape or avoid them. Therein lies the petri dish for the development of a stigma.

Human beings can develop conditions which impair them. For some, it can show up as disturbed thinking or deterioration of thought. There is a difference between, say, schizophrenia, which involves disturbed thinking, and dementia, which involved a deterioration of the thought capacity. But both manifest as different forms of cognitive disarray. Chazal were sensitive to both forms of impairment in their use of the term shoteh, which can characterize both distorted and abnormal perceptions and thoughts, as well as subnormal or diminished-capacity of thought.

Some disturbances manifest as atypical emotional energy. This can involve extreme changes of mood or intense irrational fears or severely debilitating anxiety. Other conditions show up as maladaptive behavior, whether impulsive, addictive, compulsive, or endangering. Still others are displayed as strange-seeming preoccupations with physical sensations or ailments. Whether we utilize the term mental illness, disorder, condition, syndrome, deviation, disturbance, abnormality, or dysfunction, severe and extreme ongoing problems in adapting to routine life and adjusting to life’s demands and stresses usually characterize a condition which the person afflicted may not wish to disclose freely, and whose family may wish to keep private or even under wraps.

Back in the 1950s, my late father a’h, a pioneer in child psychology, worked with parents who kept their impaired children locked in a closet for fear others would learn that they had a “problem” in the family which could possibly “shteir shidduchim.” Others gave up their children for adoption or other more drastic steps.

The more we learn about genetics, culture, psychopharmacology, parenting styles, and the data generated by credible neuroscience, social science, and behavioral science, the better our understanding of the human condition becomes, and perhaps the more objective we can be in knowing when professional intervention can not only save face, but save a life. The more we appreciate the role that social support can reduce the perception of social stress, the more we might open the door to help-seeking. The more we see the negative impact of rejection, teasing, bullying, alienation, and hatred on those we stigmatize, the more we can create ways to protect and prevent the fault-lines which can undermine individual, family, and community cohesiveness.

If someone you care about is in distress, seek consultation. Obtain reliable information. Identify qualified licensed clinicians for them, whatever the cost. Most mental health conditions are treatable, some with medication and most through establishing a therapeutic relationship with a skilled clinician competent to treat the properly diagnosed condition. But seek expert input. We can learn to avoid stigmatization, but not to the degree that we fail to recognize that atypical thoughts, emotions, and behaviors require conventional treatment. n


Rabbi Dr. Dovid Fox is a forensic and clinical psychologist, and director of Chai Lifeline Crisis Services. To contact Chai Lifeline’s 24-hour crisis helpline, call 855-3-CRISIS or email Learn more at



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