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

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