One in four Americans suffers from mental illness. This means that in every Jewish community, it is likely that at least a quarter of our members are touched by mental illness. Nearly every Jewish family has been impacted by this disease. Research tells us what so many of us know first-hand from the privacy of our offices – nearly 60% of people with mental illness concerns turn to clergy first for spiritual support and referrals before reaching out to anyone else. We have a unique opportunity to make a difference.
Mental illness frequently raises specifically spiritual issues for individuals, families and communities that call for a spiritual care, as well as a mental health care response. Which means that in addition to being prepared to make mental health referrals we have an opportunity to offer pastoral care. Below are a few of the spiritual needs that may be present for individuals and families living with mental illness and some suggested responses.
1. Self worth and dignity (B’tzelem Elohim)
“God created the human being in God’s own image…” –Genesis 1:27
In today’s world mental illness is often surrounded by stigma and shame. Sadly, these societal attitudes can impact the inner sense of self of people who are touched by mental illness. This can lead to feelings of lack of self worth and a loss of dignity. Judaism has a myriad of sacred sources on the spiritual value of each person. In the Torah we are taught that each and every person is created “b’tzelem Elohim” in the image of God (Gen 1:27); in the Mishna we learn that when we save a single human life it is as if we saved an entire world (Mishna Sanhedrin). Individuals with low self worth benefit particularly strongly from belonging in community but may have difficulty reaching out and asking for help. We can affirm the value and worth of members of our communities living with mental illness through empathetic listening, bikkur cholim visits to home or hospital, publicly naming mental illness from the bimah and offering pastoral care that includes prayers and sacred texts that affirm the worth and dignity of all people
2. Guidance through grief and loss (Anninut)
“And the Israelites wailed out loud for Moses in the steppes of Moab for thirty days.” – Deuteronomy 34:8
The journey through mental illness is shaped by loss. Individuals and families may experience losses of physical or mental functions, relationships, employment, financial support, social status and spiritual beliefs. We can learn from Jewish mourning practices about the significance of ritually marking loss in Jewish tradition. The days after a death and before a funeral, the period of anninut, a time when everyday life is suspended for mourners, can be helpful here. After the funeral ritually marks the loss, mourners gradually return to daily life. This cycle of mourning, affirms the idea that loss must be marked before we can begin to heal. As spiritual care-givers we can guide people through the grief connected to mental illness by naming and validating physical, emotional and spiritual losses. These losses can be marked through empathetic listening and sanctified through innovative rituals or prayers. You may also consider adapting traditional rituals such as mikvah or birkat ha’gomel (the traditional blessing for surviving a life threatening experience).
3. Reconciliation in Relationships (Teshuva)
“Seeing your face is like seeing the face of God.” – Jacob speaking to his estranged brother Esav when they are reunited, Genesis 33:10
The symptoms of mental illness and the stigma that surrounds it can cause significant strains on all types of relationships. Individuals living with mental illness may have broken relationships to loved ones, to community and to Jewish tradition. Judaism is rich in sources on the sacred significance of rebuilding relationships through teshuva (repentance) and forgiveness. As clergy and spiritual care-givers we can support individuals in reconciliation thorough affirming the Jewish value of teshuva and forgiveness. We can also serve as a mirror to individuals, families and the community as a whole to reflect back the damage that has been done in relationships and lift our prophetic voices to highlight the need for repair.
4. Awe and Mystery (Yirah)
“Remove your sandals from your feet for the place on which you stand is holy.” – Exodus 3:5
Struggling with mental illness is usually extremely painful. It can also lead to shifts in identity and perspective that may provide certain individuals an opening to contemplate the mystery of the universe and the human mind. We should be careful never to suggest this approach as it can seem minimizing to the very real pain of illness or hint at theological rationales for mental distress and suffering. However, when people living with mental illness themselves wish to see their illness within a larger spiritual context, accompanying them in exploring awe and mystery can be profoundly healing. The concept of awe, yirah, is central to Jewish tradition. The place where those struggling with mental illness are standing is holy ground. We can acknowledge the sacredness inherent in the journey through mental distress toward healing through affirming awe when it is present for individuals, as well as offering prayer, meditation and text study that helps individuals connect their struggles to a larger spiritual context.
If you feel like someone in your community could use spiritual support, please call us at (415)750-4197. Our rabbis are able to provide spiritual care to those struggling with mental illness and their caregivers regardless of ability to pay. We would also be happy to provide support to clergy and congregational leaders as you explore the best ways to meet the needs of community members living with mental illness.