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Rabbinic Conceptions of Healing

“Be patient toward all that is unsolved in your heart and try to love the questions themselves, like locked rooms and like books that are now written in a very foreign tongue. Do not now seek the answers, which cannot be given you because you would not be able to live them. And the point is, to live everything. Live the questions now. Perhaps you will then gradually, without noticing it, live along some distant day into the answer.”  

-       Rainer Maria Rilke, Letters to a Young Poet, (Translated by Stephen Mitchell). First Vintage Books Edition [1903], 1982. P. 34.  

 

 

Rabbinic conceptions of healing

Henry Abramovitch, Jerusalem

IMPORTANCE OF QUESTIONS

           Traditionally, Jews believe the way toward the Divine is through studying and exploring His texts. Asking challenging questions and not taking things at face value has always been a Jewish preoccupation. Challenging authority and convention is a way of life. The first public act of a Jewish child, akin perhaps to first communion is to ask 4 questions at the Passover ritual "(seder") and then to be encouraged to ask more.  I often have compassion on those of you who learned catechism in which you were not allowed to ask questions but had to learn the answers by heart. For Rabbis, the best student is not the one who knows the answer, but one who can come up with a better question.  

Question:“Why does a Jew always answer a question with another question”?

Answer: “Why not?” 

Sometimes, the best intervention is not an interpretation, but an unexpected question that opens up new territory.

ACTIVE IMAGINATION

I want to begin with an active imagination. “Please put down your pens. Relax. Sink into your chair. Shut your eyes. Imagine you are at home, feeling emotionally low; you are all alone and there is no one to help you. You call out in your heart: “From the depth I call out…Listen to my cry for help! Listen with compassion…” (Pslam 130:1-2).  Then you receive an answer, “Something must be repaired.”

Now turn to the person next to you and share something of the active imagination.]

 Rabbinic healing is based on the concept of "tikkun" Hebrew for "repair".  At the center of Rabbinic concept of healing is the further notion of “tikkun olam” which literally means “repairing the world” or "cosmic repair". More specifically, it indicates that any individual healing must be linked to a cosmic repair, or tikkun olam. Such repairing the world is part of the ongoing task of humanity to restore the moral balance of the world. It is based on the idea that the world was not created, but is in the continuous process of being created. We each must play our part. Even minor acts of loving kindness ("hesed") may have profound impact. In Jungian terms we might say, following Answer to Job, that the ego has a moral obligation to repair the Self. Tikkun may involve a realignment; it may involve recovering the shards of the vessels shattering the process of creation which fell into dark side and appear to us as evil.  Perhaps you can now understand Jung’s line that everything he had tried to say had been said before by the great Hassidic preacher, Magid Mi-Mezeritch.

Rabbinic tradition mistrusts abstraction but uses examples and stories to explore  concepts and their implications. In this spirit, let us turn to our first text that comes from Babylonian Talmud which presents a case of tikkun olam based on a close reading of Genesis 1:16.

                                                                                                                        

Talmud Bavli, Holin, 70b:

Rabbi Shimon son of Pazi:

It is written (Genesis 1:16): God made the two great lights. [and then] it is written: the greater light…and the smaller light.

 

[Commentary: Rabbi Shimon discovers contradiction in Text between the creation of two great lights and then the sudden appearance of  "greater" and "smaller" lights. He will now tell a story or "midrash" about how this came about starting with the moon appearing before the Creator]

The moon spoke before the Holy One:

Master of the Universe, is it possible for two kings to make use of a single crown?

He said to her: Go and reduce yourself!

She said before Him: Master of the Universe, if I said something fair/decent, why should I reduce myself?

[ Commentary: Note how the moon is punished for asking a question. Authoritarian patriarchs like this Creator see questions as challenges to their authority; Moon responds in the Jewish tradition that encourages questioning]

He said to console her: You shall rule during the day and the night.

She said to him: What profit is there to be a candle at noon? What benefit is it?

He said to her: You will mark the days and the years for Israel [who use a lunar calendar]

She said to him: How else can they mark time as it is written "They shall be signs and set time for the festivals, for the days and for the New Year."

[He said:] Many great men ["Tzaddikim"] will be called for you:

 Yaakov the Small, Samuel the Little, Little David.

He saw that she was not satisfied.

The Holy One said: Bring atonement for me that I reduced the moon [during the ceremony of sanctification the new moon]!

[Commentary: Every month at the time of the New Moon, religious Jews go outside to bless the New Moon.]

Thus did Rabbi Shimon son of Lakish [say]: What is special about the offering for the New Moon? It is this offering which is atonement for the Holy One for reducing the moon.

 

In the ‘Prayer for the Sanctification of the New Moon’, which is said outdoors looking towards the new moon in the sky:….

“May it be Your will before You, my Lord and Lord of my Fathers, to heal the defect of the moon so that there should not be in her any reduction. May the light of the moon be as the light of the sun, as it was before its contraction in the seven days of creation, as it is said: the two great lights! ”

Commentary:

This story describes how the original unity of the world was fragmented into polarities of greater/smaller, feminine/masculine, lighter/darker etc. by the impulsive word of a Patriarch Creator. It created a consciousness which is fragmented and a world with injustice and hierarchy, which is in need a "tikkun". Creator's attempts to appease the Moon are all rejected since they do provide a cosmic repair. What does provide "healing" for the injured Moon is the recognition that the injury was done and the vision that the Moon will eventually be restored to her original glory. By saying the prayer, " May the light of the moon be as the light of the sun, as it was before its contraction" Jews join in the work of cosmic repair, just as when an act of recognition to a traumatized or wounded patient may help open up a vision of healing. We may not heal the person but when we participate in the work of little tikkun, the healing the person, we help to heal the world as well in  cosmic repair or "tikkun olam".

RABBINIC MODEL OF HEALING

Let now turn to a text that deals more directly with healing.

Talmud, Berakoth 5 b:

I

Rabbi Hiyya son of Abba fell ill, Rabbi Yochanan went to visit him and said to him: “Are your torments pleasing to you?” He replied: “Neither them nor their reward [in the world to come]”. He said to him: “Give me your hand.”  He gave him his hand and he raised him up.

II

One time Rabbi Yochanan fell ill. Rabbi Hanina went to visit him [and said:] “Are your torments pleasing to you?”

He replied: “Neither them nor their reward [in the world to come]”. He said to him: “Give me your hand.”  He gave him his hand and he raised him up. [Students asked:] “Why could not Rabbi Yochanan raise himself up?”

They answered: “The prisoner cannot free himself from jail.”

III

Rabbi Eleazar fell ill. Rabbi Yochanan went to visit him. He noticed that he was lying in a dark room and he bared his arm and light radiated from it. He then saw that Rabbi Eleazar was crying and he said to him:

“Why are you crying?

If it is because you did not study enough Torah, surely we have learned:

One who sacrifices much and one who sacrifices little have equal merit, so long as the heart is directed toward heaven.

Is it because of a lack of sustenance?

Not everyone has the privilege of enjoying two tables.

Is it because of lack of children?

[Look at] the bone of my tenth son!

Rabbi Eleazar answered him: “I am crying on account of this beauty which is going to rot in the ground.”

He said to him: “On that account you surely have a reason to weep.” And they wept together.

He said to him: “Are your torments pleasing to you?” He replied: “Neither them nor their reward [in the world to come]”. He said to him: “Give me your hand.”  He gave him his hand and he raised him up.

Commentary:

The story presents the Rabbinic paradigm for healing and analysis.

The first point is that psychotherapy and analysis fulfills the commandment of visiting the sick. Visiting the sick is a religious duty in all spiritual traditions, but in the case of psychotherapy or analysis the visiting is symbolic. We do not actually visit the house of the sick as Rabbi Yochanan did, but in symbolic terms we must go into their “house” and not expect them to come to us. One of the reasons, a Freudian analysis did not suit me when I went to one as a young man, was because the analyst expected me to adapt myself to him; any deviation, any silence, was interpreted as resistance [and that reminds me of the joke about two candidates on their way to their analysis in the metro when it breaks down, one says I am going to a Classical analyst, he will say coming late is resistance and I will say "No"  so that the whole session, even the whole analysis is being destroyed at this moment; the other says, "I am going to a Kleinian. She will start without me!"]. Even though patients come to us physically, we must go to them symbolically.

The second task necessary to create a therapeutic alliance is for the patient to reject the secondary gains that the illness provides – hence the odd question “Are your torments pleasing to you?”  Theologically, the Rabbis at that time, but not contemporary Jews, believed that suffering in this world, gave you a discount in the world to come. Secondary gains can be the sense of being a victim, being helpless, blaming one’s parents etc. They can be very comforting and not easier to renounce.

Once secondary gains are rejected then a true alliance may be created but only if the patient gives his hand; once that happens the analyst may raise the person up out of their depression or illness. Usually when we discuss psychotherapy or analysis, we focus on the interpretation, but this text highlights the importance of therapeutic performance. It shows that true healing requires excellent timing and knowledge of when to be passive and when to be active, when to speak and when to be silent, when to challenge and when to be supportive.

In the second story, we see how the analyst cannot treat himself but must be a patient like all others. Of course, all analysts undergo analysis, but when we become senior analysts it is much more difficult to decide you need help and to find someone who can treat you.

Six years ago, I was diagnosed with lymphoma, cancer of the lymph.  In my training the issue of the ill or disabled analyst never arose. I understood I had to return to analysis and especially supervision and discover how to help myself while trying to help my patients. I now understand that it is crucial to confront our own illness and mortality before we get sick, otherwise impact on the patients we so care about will be terrible.

In the third part, we see again the metaphor of visiting the sick but now we are dealing with a more difficult case, in which no diagnosis is apparent – The analyst cannot “see” the patient since they are surrounded by defensive darkness indicated by the darkened room. R. Yochanan had a magically arm from which light radiated which he normally kept covered. This I understand as an illuminating syntonic counter-transference – to look into the suffering of Eleazar.

What do we say to someone who is in despair? Martin Buber, the Hebrew Humanist who gave a series of lectures on psychotherapy wrote that what is needed is a presence whereby it is shown that nevertheless there is meaning.  Yochanan takes a tack that might follow from Cognitive therapy trying to counter and challenge the negative thoughts and misjudgments that are burdening Eleazar’s self esteem and allow him to come to terms with failed dreams. He mentions Torah learning which would have been all important to a Torah Scholar where feelings of inadequacy were common. For example, as a child I was taught that I could never make up for a lost hour of study. Since if I studied twice as much the next day I should have done so anyway and the missed hour remained an eternal loss; economics – not everyone can afford two tables and infertility – Yochanan lived in a time when secondary burial was practiced. Bodies were buried in caves and when the fleshed decomposed, the bones were transferred to sarcophagus. Yochanan had ten sons, all of whom died from illness/plague. He takes out the bones of the tenth and last child to have perished. He does not say one of the standard greeting of comfort to mourners such as “May you find comfort from above” but shows that one can find a way to live even in the depth of the childless winter. In Wittgenstein’s terms, he does not tell but shows consolation.

 Jung taught us that when we hear a dream we should take the attitude that we have not go the slightest notion of what the dream is trying to say. As in my Kleinian joke, we must never start without the patient but always allow dreams to tell us something new. Yochanan misses the mark. But the empathy that Yochanan has shown is enough to stimulate Eleazar to speak – as Winnicott wrote, “I must make wrong interpretations to know when I am right.”  Eleazar’s response which I have translated as “I am crying on account of this beauty which is going to rot in the ground” is ambiguous even in the original.

I wonder what you think it means.

I believe Eleazar was suffering from existential despair about the meaninglessness of everything since even the most beautiful things will end up rotting. If we will all rot,  “What is the point?” This time R. Yochanan responds spontaneously and with feeling. He validates Eleazar’s feelings: “On that account you surely have a reason to weep.”  Then in what Daniel Stern calls the “now moment”. They cry together.

 I recall a most unusual autobiography of a Catholic therapist who suffered a debilitating depressive illness in Undercurrents: A Therapist’s Reckoning with her own Depression by Martha Manning (HarperColins 1994) . She was eventually hospitalized and while there, she was called to the bedside of a patient in the hospice, who was dying. Her patient says, “You were so terrific!”

Wondering what penetrating interpretation, she had given, the patient spoke, “Yes, when the results came back bad, you said, “That stinks!”

Crying together, patient and analyst are together in the alchemical bath, crying their hearts out. I wonder how many of you have cried with your patient and or saw your analyst cry with you – and whether you told your supervisor!

If the analyst experiences the deep, bitter inner world of the patient, then mourning can begin. Mourning is not something you can do by yourself; it is inherently dialogical. You have to have someone to be with you when you lose a valued person, to experience concretely that there is something left despite the loss.

Once the relation has been restored, then the usual paradigm may be followed. Are your torments pleasing?  Give me your hand and he raised him up.

Here is the Rabbinic view of healing: visiting the sick, rejecting secondary gains, asking existential questions, weeping together, forming a bond by giving your hand and being raised up.

Turkey Prince

I want to end with one more parable, taken from Rabbi Nachman of Bratzlav, the great-grandson of the founder of Hassidism who wrote a series of famous stories and parables.

 

A prince once became mad and thought that he was a turkey. He felt compelled to sit naked under the table, pecking at bones and pieces of bread, like a turkey. All the royal physicians gave up hope of curing him of this madness. The king grieved tremendously.

A sage arrived and said, “I will undertake to cure him.” The sage undressed and sat naked under the table, next to the prince, picking crumbs and bones. “Who are you?” asked the prince. “What are you doing here?” “And you?” replied the sage. “What are you doing here?” “I am a turkey,” said the prince. “I’m also a turkey,” answered the sage. They sat together like this for some time, until they became good friends. One day, the sage signaled the king’s servants to throw him shirts. He said to the prince, “What makes you think that a turkey can’t wear a shirt? You can wear a shirt and still be a turkey.” With that, the two of them put on shirts. After a while, the sage again signaled and they threw him pants. As before, he asked, “What makes you think that you can’t be a turkey if you wear pants?”

The sage continued in this manner until they were both completely dressed. The sage continued in this manner until the prince returned to society.

This wonderful story continues the theme of visiting the sick, stripping off the persona and entering into the underworld beneath the table. To make contact and establish therapeutic alliance, one often needs to do things which are odd or even crazy when seen from outside. It is reminiscent of Rosarium, in which patient and analyst must strip off their clothes and their persona, and enter together into the “bath”. In one sense, it touches on how we must enter deeply into the world of our patients in order to bring them back; to give up all pretense and persona. Even To allow ourselves to appear crazy in service of the Self.

Let me give you a personal example, (Abramovitch 2002). When we meet people with painful stories, we are often insulated because we have heard worse. This patient had lost her family three times – once in holocaust, one to illness and finally to a traffic accident. She was a galmuda – a person without living relatives, which in Jewish life is considered the worst possible of fates. . As you can imagine, it not easy for her to give me her hand; or for me to raise her up. But gradually trust was built up. When I went for my break, she was certain I would never return and reacted as if to undo all the hard work we had done together of building an alliance. I felt my leaving would damage her irreparably. I did not know what to do as she refused to see someone in my absence. Then she asked who would water my plants in my absence and intuitively I asked if she was interested in doing so. She replied that she was happy to care for them and when I left I gave her the key to my office. She would come water the plants and sit as in a quiet church, feeling the serenity in temenos even in my absence. When I returned, she said how helpful it had been to come. Had I heard that a fellow analyst was giving keys of his office to patients during his absence, I would have thought that the analyst was “crazy” in dire need of supervision and analysis and I would be wrong. Sometimes but only sometimes, to heal, we must do the crazy thing because it is in service of the temenos and healing tikkun.

Jung once reported a dream of an elegant society lady who dreamed that she was lying up to her neck in a bathtub full of shit. She saw Jung approaching and called out to Jung to help her. He came to her and said “Not out but through!” and pushed her into the shot. Elsewhere, he wrote we are healed through suffering only when we experience it to the full. Rabbi Nachman, whose parable of the turkey prince we studied is famous for his sayings. Let me end with two of them:

The entire world is a very narrow bridge "A person has to cross a very narrow bridge in this world. The most important thing is not to be afraid.”

There is nothing more whole as a broken heart