This is a main­stream is­sue now — let’s keep push­ing

The Jewish Chronicle - - NEWS - FIRST PER­SON BY JUDY COOPER

OVER 100 com­mu­ni­ties are ex­pected to take part in the Men­tal Health Shab­bat. This is an amaz­ing demon­stra­tion of how much at­ti­tudes to men­tal health have moved on, even over the 40-plus years that I have prac­tised as a psy­chother­a­pist.

Work­ing in north-west London, where there is no short­age of ther­a­pists and no short­age of de­mand, I can see how con­cerns about emo­tional and psy­chi­atric symp­toms have evolved. Men­tal health, which was on the mar­gins un­til re­cently, has now moved into the main­stream thanks to more open­ness and tol­er­ance.

Men­tal tor­ment has been known to Jews since the Bi­ble. The text re­fers to var­i­ous char­ac­ters suffering from mis­ery, an­guish and tur­moil. For in­stance, we are told that King David played the harp to soothe Saul’s nerves when he was de­pressed and para­noid. In the Psalms, David him­self cried out, “Why are you down­cast, O my soul? Why so dis­turbed within me?” More­over, what could be more heart-rend­ing than Job’s ve­he­ment outburst, “I loathe my very life, there­fore I will give free rein to my com­plaint and speak out in the bit­ter­ness of my soul”. Of course, through­out the ages peo­ple have coped with men­tal dis­tress by prayer and later, by con­fid­ing in their rabbi.

Since the advent of Sig­mund Freud, Jews have been par­tic­u­larly in­stru­men­tal in the cre­ation of new ther­a­pies. Freud, how­ever, wor­ried that his cir­cle would be seen merely as a Jewish group, wished to find a gen­tile dis­ci­ple in or­der to make his the­o­ries more univer­sally ac­cept­able. Many of the sub­se­quent hu­man­is­tic and be­havioural off­shoots from Freud’s think­ing were for­mu­lated by Jews. For ex­am­ple, the more im­me­di­ate ap­proach of Fritz and Laura Perls’ Gestalt ther­apy.

There was also Joseph Wolpe’s Be­hav­iour Psy­chother­apy, the fore­run­ner of the pop­u­lar up­surge of Cog­ni­tive Be­havioural Ther­apy (CBT), widely prac­tised in hos­pi­tals and clin­ics to­day. One of the most fa­mous Jewish ther­a­pists, a sur­vivor of Auschwitz, Vik­tor Frankl. His Lo­gother­apy stresses the im­por­tance of find­ing mean­ing in one’s life and in in­vest­ing en­ergy in a hope­ful fu­ture rather than Freud’s em­pha­sis on un­cov­er­ing the past.

On a more in­for­mal level, there have been nu­mer­ous well-known Jewish agony aunts. To name a few, I used to reg­u­larly read Mary Grant’s prob­lem page in Woman’s Own; Mar­jorie Proops was well-known for her col­umn in the Daily Mir­ror; and Dr Wendy Green­gross an­swered lis­tener’s prob­lems on the ra­dio. Fur­ther­more, there were many doc­tors who were in­no­va­tors in the field of psy­chi­atric med­i­ca­tion and ad­vance­ment; Dr Willy Mayer-Gross, for ex­am­ple, treated schizophre­nia with in­sulin. Also, Isaac Sut­ton mod­ernised treat­ment of pa­tients in Bar­net by open­ing locked wards and in­tro­duc­ing new won­der drugs.

Over the decades I have no­ticed that so­ci­ety has changed very fast and, in many ways, is un­recog­nis­able from when I started out in clin­i­cal prac­tice. In the cur­rent cli­mate, there is no time to re­flect. Re­sponses need to be in­stan­ta­neous and may be erased im­me­di­ately. Lit­tle seems to be sus­tained or durable, rush­ing to the next event seems more im­por­tant than stay­ing with the present mo­ment. So­cial me­dia en­cour­ages in­su­lar­ity and vir­tual re­al­ity. With the break­down of fam­ily and reli­gious af­fil­i­a­tion, and the stress on com­pe­ti­tion and per­sonal ful­fil­ment, any time and effort in­volved in de­vel­op­ing per­sonal re­la­tion­ships is at a premium.

I used to be able to con­duct an as­sess­ment con­sul­ta­tion rel­a­tively straight­for­wardly. To­day, more of­ten than not, fam­ily trees may be so com­pli­cated that it takes some effort to un­tan­gle the net­work. Here, per­haps, the Jewish world strives to of­fer some­thing more struc­tured and sta­ble with its em­pha­sis on fam­ily and com­mu­nity val­ues. As one of my non-Jewish pa­tients com­mented wist­fully, “You Jews take the trou­ble to look af­ter your own peo­ple”.

Across the board, peo­ple come to ther­apy be­cause of prob­lems in their re­la­tion­ships, feel­ing stuck in un­sat­is­fac­tory pat­terns of be­hav­iour. As one woman re­cently told me, “I know what I have to do, but I’m not ready to do it”. Feel­ings of alien­ation, low self-es­teem, de­pres­sion and lack of pur­pose are all ev­i­dent in one’s con­sult­ing room.

There is no doubt that fam­ily re­la­tion­ships have be­come in­creas­ingly com­pli­cated, with ris­ing di­vorce rates, var­i­ous part­ner­ship com­bi­na­tions, blended fam­i­lies, and a cultural cli­mate en­dors­ing sex­ual free­dom. There is also a con­fu­sion over gen­der iden­tity, giv­ing rise to an evolv­ing vo­cab­u­lary, for ex­am­ple “trans” and “bi­nary”.

In­creas­ingly there are de­mands for help in ar­eas such as cou­ple ther­apy, ad­dic­tion, self-harm and eat­ing dis­or­ders, as well as the men­tal prob­lems of mid-life and old age.

It is note­wor­thy that Freud stated psy­cho­anal­y­sis would not ben­e­fit any­one over the age of 50 whilst, to­day, the ma­jor­ity of my cases are over 50.

One may won­der why so many Jews are drawn to psy­cho­anal­y­sis. Per­haps, as the group an­a­lyst John Sch­lapober­sky sug­gests, Jews have been so dis­persed they are used to trans­form­ing “long­ing into be­long­ing” and “mak­ing a home amongst strangers”. So, is it prefer­able for a Jewish per­son to have a Jewish ther­a­pist? Not nec­es­sar­ily. Some peo­ple ac­tu­ally pre­fer some­one com­pletely out­side the com­mu­nity, al­though oth­ers, like Nini Her­man in her book My Kleinian Home felt re­lieved that her an­a­lyst, Sid­ney Klein, ac­knowl­edged that it was im­por­tant for her that he was Jewish.

The govern­ment is cur­rently putting more money into men­tal health re­ha­bil­i­ta­tion. If this is done in tan­dem with Jewish or­gan­i­sa­tions, such as the im­pres­sive Jami, it will be a big step to­wards erad­i­cat­ing the stigma at­tached to psy­cho­log­i­cal vul­ner­a­bil­ity. Rab­bis, com­mu­nity lead­ers and schools also have a key role, par­tic­u­larly in en­cour­ag­ing an open di­a­logue on men­tal health. Men­tal ill­ness and suffering are in­creas­ingly be­ing ac­knowl­edged in the Jewish world rather than de­nied or swept un­der the car­pet as they so fre­quently have been.

Men­tal tor­ment has been known to Jews since the Bi­ble In the cur­rent cli­mate, there is no time to re­flect

Judy Cooper has been a psy­cho­an­a­lytic psy­chother­a­pist for 45 years and is the au­thor and edi­tor of six books on psy­cho­an­a­lytic the­ory and prac­tice

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