Pathways

Source: Pathways

Source: Pathways

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Pathways

Source: Pathways

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What an twelve year old Palestinian girl might be thinking?

There’s a monster over there.   There is.   Everybody knows about it and they told us also.   But it wasn’t like they said.   Oh, it is a powerful beast that attacks with sudden deadly force.   It attacks cowards and fools first but eventually gets to the rest of us.   Yet they suddenly turn toward the children and other simple souls and bring us to safety.   But this was not a topic of discussion among our tribesmen.    Things were so confusing anyway.    The paramilitary training with live ammunition was fun but I’m a little afraid of all the guns anyway.   And there’s lots of guns and other things even in our aunt’s bedroom.   I guess I liked the uniforms and masks we used to make parades.     It was wonderful really.     Together with my friends.    I don’t want to hear bombs anymore.    Every time one of our heroes shoots a missile toward the monster I feel sick for a few moments or hours hoping the monster’s missiles find the right target and let us live.   I never told anyone but sometimes I think the monster is not bad.    Our heroes all die and we must get ready to join the endless war against the monster.    I’m not sad. 

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Confusion About Syria

The latest news is spreading shockwaves through Israel.   People have lined up in record numbers to acquire gas masks.    The government is forecasting shortages while the army is happy the public is finally taking it seriously.   My own children are encouraging us to get ours and stock up our bomb shelter with basic necessities.  This is all in response to threats the U.S., British and French are preparing to attack the Syrian stronghold of Bashar Assad’s government center.   

From the public’s view it’s all about a few alleged attacks on rebels and collaterals with the use of toxic chemical warfare.   Some reports say 20 people were killed, and another 300 by chemical attacks.    Do I have this right?

SO after two years of extraordinary violence where upwards of 100,00 people, children, women and combatants have died in sectarian fighting the “enlightened” western trio is indignant over the less than 1% killed by chemicals.   Even the UN is putting it up to a vote.   Up until now the horrible plight of the ‘Palestinians’ has dominated that farcical body’s proclamations over the Israel’s insufficient peace process and tyrannical tactics for more than forty years.  So what has caused this brief shift in world attention?

Presumably its the “chemical” in chemical weapons that has everyone up in arms.   For two plus years rebel combatants and collaterals have been dying from gunfire, bombs, shrapnel, falling debris, mortars, rockets, lacerations, smoke and fire as well as famine and disease..   They’ve died in the street, in their homes, in the cities and in the country in every way civil war kills people.   But nothing has produced the serious proposals and threats we hear coming out of the moralistic trio and those rallying behind them.   

So why has chemically induced killing, a grim and scary reaper for sure become the red line we hear so much about?   Humanitarianism?    A concern for massive annihilation of innocents?   Moral indignation?   Even to bring them up is obviously laughable hypocrisy.    Lets agree it’s not about the value of human life.   If that were the case sabers should have been rattling back at the beginning of the slaughter.    

Weaponized chemical or biologic warfare is the latest red line of intolerance because of what it ostensibly represents.   Killing and risk to human life is the common denominator that can be achieved in so many ways as we know.   One difference with ‘conventional weapons’ (guns, bullets, missiles and bombs, etc.) and chemicals is the human capacity to believe there is some sort of defense against hard, fast moving objects.   Surprise chemical weapon attacks are silent and invisible.    Weaponized germs seem almost supernatural and yet are no more deadly to the individual than any other well aimed lethal force.    Individual death or injury are not about statistics, death rates, or relative risk.   Ultimately the method of lethal force matters little to the one “in the wrong place at the wrong time.”

The horror and mystique of chemical warfare is an arbitrary result of a society steeped in statistics and scientific objectivity.   Unless the risk factor is extraordinarily high, the victims are represented as statistical points on a graph rather than flesh and blood individuals. In the mathematical abstraction of statistical man
we can tolerate the loss of 80,000 entities. Something about chemical, poison gas that shifts the attitude and almost becomes intolerable and a “legitimate” reason for war.

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The Art Metaphor of School Shootings

 The Art Metaphor of School Shootings

I spend my days evaluating and treating people with mental health problems.   As disturbing as the horrible slaughter of innocents is I like the metaphor of (murder) art because it takes the issue to a whole new level of accuracy without the simplification.
Just as one somehow finds himself in the role of an artist, often by exclusion of many other roles that don’t fit,  it is completely fruitless to seek the common denominator of artists.   It is the differences that give them notoriety, fame or popularity.    Then there are the issues of execution,  elegance and the power of expression.    This follows the earlier stages of development and formation of the artist, his media and style.
Of course there is a risk of sounding callous or unsympathetic to the victims when the brutality is elevated to something as sublime as art that is usually considered “harmless.”  In reality art can appear so but actually has great power to influence and form values.   This is another aspect, the influence on the “state of the art,”  our appreciation of their craft and the horizons it may open for us (in this case the opening of evil).
Contrary to the struggling artists trying to make their mark, our murder artists get instant recognition, and “fame.”   Yet our sqeamish sensitivity to evil and its reality makes it nearly impossible to speak of these things on their own terms.    We do hear in passing the evil Austrian flunked out of art school leaving him to seek recognition in other ways.
There are many other models of violent crime being tossed around, like viral loads, and the epidemiology seems to show some promise in deepening our understanding but loathe as I am to say it,   the gun seems more powerful and immediate than the brush.     There is also much less certainty of success and more competition in the creative arts.
Murder is, thanks to the widening influence of the media,  such a big seller even if the final act rapidly dwarfs once the smoke clears leaving  the survivors to grapple with their misery.    Yet the secret society of alienated and impressionable souls are waiting for the inspiration, and preparation to make their way to upstage the ones who thought they finally got it right.

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The Psychiatric Crisis

FreePsychArticles #4:   Pinchas: The Ultimate in Crisis Intervention

In the story of Pinchas, in the Biblical book of Numbers (Bamidbar), that traverses two parshiot, we see a snapshot of crisis intervention and resolution.   To review, we are witness to the malevolent scheming of Balak, the Moabite king to bring about a ‘pre-emptive metaphysical strike’ on B’nai Yisrael as they camp in the desert.    He attempts to enlist the master sorcerer Balaam to utilize his world class ‘magical powers’ and divination to invoke curses on the Jewish nation.   With this, he attempts to

drive it away from the land,” and ‘diminish their number…’ per Rashi.

Meanwhile B’nai Yisrael goes on with it’s activities and approach to the promised land, assumedly unaware or unconcerned about their neighbor’s  (enemies in this case) business.  Here we find the brewing of a significant crisis in the spiritual wellbeing of the burgeoning nation.    In truth, it is the failure of Balak’s scheme that presents another unexpected attack on Israel.    Balaam, riding the prophetic heights finds himself unable to utter narry a curse.

This leaves the intrepid Balak to devise a new approach to undo the feared and powerful “priests of the nations.”

In come the daughters of Moab, to use their “powers” of persuasion to coax the young Jewish men to forget The True G-d, diminish their enumah by submission to the charms of female beauty through the act of bowing to the avodah zorah of small gods.   This proves to be more effective than Balaam, if not more labor intensive.

The wrath of G-d is invoked and as the crisis rages, plague begins to wipe out the Holy nation.   Moshe called out for a solution.   Weeping spread through the camp yet all were frozen in shock and disbelief.   Out of the chaos emerges one clear and decisive act though the deft and righteous figure of Pinchas, son of Elazar son of Aharon who “saw” through the crisis, and ‘remembered the law.’  In this one act of true devotion and courage, Pinchas brings about the cessation of the plague thus ending the first parsha of the two part story.

Part two: Our hero is rewarded as we are taught the gravity and ultimate honor he deserves.

Moshe receives order to make take a census, as the first order of business in reorganization following the passing crisis.   Much of the rest of the parsha delineates the korbanos of all the Yom Tovim (Festival Days) as a further rebuilding of the national spiritual life.

The Psycho-Spiritual Crisis model:

In my work as an interim psychiatrist I encounter people who bring their experience to expression during our meetings.    Frequently they are distraught, upset, emotionally labile and even desperate.    Often, suddenly, as they find themselves in company of someone with a trained and empathic ear they frame the moment in extreme and tragic terms.   All the calamity of their day-to-day life can take on an epic quality as their difficulties bubble to the surface of their consciousness.    The present problems merge with emotionally charged fragments of memory bringing the overwhelming impression they are trapped in an insurmountable and tragic sea with no hope, peace or survival.

Just as frequently an objective eye can see there is more crisis than tragedy and therefore more action and intervention than bereavement and grief required.   As often happens, we find ourselves feeling overwhelmed and our emunah starts to wane.   The crisis compounds as we forget our purpose and experience the pain our own or others actions have brought.

Each of us can “fall” into this downward spiral during our lives, sometimes when least expected.    We can be riding the crest of the wave, while oblivious to an undercurrent of trouble in the making.    Suddenly the wave crashes on the shore, the surfboard shatters and we’re left wondering how it came about?    What did I do wrong?   Why didn’t I see it coming?   Is it because of prior lapses in judgment?    Is it my fault or someone elses?

With the human mind’s inclination to contain and encase experience, we have a natural tendency to view our current dilemma as the conclusion of the story.   This is the tragedy of our imagination.   True enough, there are tragedies, losses, and damages without the chance of reversal.   These events demand another topic and approach.   The issue here rests in the fallen enumah and the discomfort it engenders.   This is the psycho-spiritual crisis.

One of the results of this type of crisis is viewing it as a tragedy and viewing ourselves as powerless victims in it’s stead.    Hence we freeze up, stand by, fill with remorse and cry.

Often this fuels our imagination to further complicate (read fragment) our emunah in ourselves and Hashem, Ha Kodesh Barchu.

In our story, even Moshe Rabenu stood by.  As Rashi states, the law…was concealed from Moshe.   Pinchas, who’s been observing the unfolding events, gathering the information while maintaining his emunah, remembering his ancestral lineage and natural dedication to B’nai Yisrael unites with Divine Inspiration to fulfill the Holy dictates of G-d’s Law at the perfect moment, thus quelling the harsh decree.

Thus Pinchas personifies the man of faith who navigates the course of events through the psycho-spiritual crisis to arrive at this ultimate “crisis resolution.”    As each of us sees or experiences times of trouble in our own lives we should remember “from whom we come” and be able to see our way though thought, speech and action as needed to reach higher levels of emunah.    We can do this by realizing our current difficulties, rather than tragedies, are indeed crises and relish the emes (dynamic truth) they contain as pathways to greater levels of achievement.

Finally,  we see the division in the Torah story between two parshiot as the two stages of crisis and resolution.   In Pashas Pinchas, we see the rewards of maintaining enumah and action in spite of the calamitous events, to elevate us to greater and greater spiritual heights.

Gershon Freedman, M.D

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Dealing WIth Trauma

FreePsychArticles#24    NEW PERSPECTIVES OF TRAUMA

I use the word “New” because these observations are new to me, and may have been discussed by others already. My handle on PTSD and other trauma-related disorders has recently come in contact with a broader view. Treatment of these disorders has always been limited by my own conventional clinical view. I think I always knew current psychiatric biological approaches were limited.

Treating symptoms of PTSD or character disorders with medications certainly has merit to reduce many of them. The treatment is generally chronic and requires other disciplines often not available in public psychiatry clinics.

Some very frank conversations with a 50 year old woman patient with a diagnosis of Bipolar Disorder II and PTSD were eye opening to me. The treatment with Lithium helped to reduce her mood swings and both hypomania and depression,  but flashbacks of severe childhood molestation by her father increased. She wasn’t histrionic and complied well with treatment but was left with the question I had no answer real answer: “What do I do about the memories?”

At that stage of treatment I finished my temporary assignment at the clinic.   The patient’s psychiatric disorder had responded well to the medications but, unfortunately failed to ameliorate some very distressing subjective symptoms.

I have been talking with Rabbi Immanuel Legomsky of Tzfat,  Israel about Emotional Freedom Techniques (EFT) and other “alternative therapies” for PTSD. He showed a film called “Operation Freedom” that showed a group of clinicians trained in EFT working with several Viet Nam veterans suffering from an array of classic symptoms for 20-25 years over a five day workshop. The results were remarkable and it presented a compelling view of a very different approach to treatment.

Within the treatment is a kind of training in which each patient can “treat themselves” and maintain a level of wellbeing for decades.  Effects of chronic traumatic stress, endemic to populations exposed to chronic terrorist attacks or threats of the same are often undiagnosed due to many factors. The reasons why some people are clinically effected and show blatant traumatic stress disorders while others appear unscathed are obviously complex. Armed with more adequate psychological defense mechanisms, many “normal” subjects show subclinical effects.

Due to economic, political and personal dynamics it is assumed all but the most effected victims fall outside the range of clinical relevance. The diagnostic limitations tend to miss many suffering from levels of stress reaction that directly effect their relationships, daily behavior and social interactions. An example is an 87 year old Army veteran who suffered hyper vigilance, vivid nightmares, moodiness and irritability for over 50 years until his family insisted he come for an evaluation for PTSD stemming from his experiences at Pearl Harbor in 1941!

In the development of EFT based treatment for Traumatic Stress Disorders there is much to be said for conceptualization as an educational tool. With the de-medicalization of PTSD, addictions, and Attention Disorders among others new delivery models must be developed due to the increasing demand and diagnosis of such conditions. Another facetrelevant to delivery systems and denial is the stigma of these conditions as”mental illnesses.” When, in the case of EFT, the “treatment is training” in that it benefits both the teacher and the student. There is a considerable reduction in the obstacles of embarrassment and associations with disease.

The medical management model aspect is not replaced. Since many of the above disorders or “variations from the bell’s curve” frequently have significant findings of depression, psychosis, mania or hypomania and other conditions that can require psychotropic medications. Chronic distressing or debilitating mental states especially respond well to medications. Issues of metabolism, internal organs integrity and function, electrocardiograms, laboratory studies and appropriate medical examinations continue to serve as prudent routine aspects of holistic health maintenance. In fact it is prudent to have patients under consideration to receive EFT be seen first by a psychiatrist to screen for underlying disorders if possible. Improved diagnostic ability of trainers can reduce the need of initial psychiatric evaluations.

At this point the road map to relief from chronic stress and addictions is to convert psychophysiologic syndromes into conscious learning and training exercises. This is the shift from the medical model to sphere of education. It’s important to keep in mind it is not an all or nothing framework, rather it is a paradigm shift. Conditions amenable to EFT are, without a doubt the largest and most under-diagnosed sub-group in society. PTSD, Chronic Traumatic Stress Disorder, and addictions are all under-reported due to the medical diagnostic criteria. The broad view reveals certain populations, geographical, ethnic or politically compromised groups are effected in ways considered normal or acceptable and yet undermine relationships, interaction in and out of the home, temperance and fulfilling social and professional life.

EFT training is a parallel model to learning and living a Torah life. The serious study of Jewish Scriptures that includes actual changes in temperament and behavior has a social consciousness as well. Although Torah covers all aspects of living well in specific detail on all levels of the individual,  family and nation the particular “unblocking effects” within the traumatized person with EFT helps to establish a holistic comfort enabling one to take full advantage of his life and potential. Education ,in both, is the principle learning (therapeutic) tool. Torah learning is done in groups, with a 1:1 learning partner or alone which is paralleled in EFT by group exercises, mentor-student work and self-practice as the need arises.

In summary, there is a vast and growing field of practices that address a nitch in personal growth. This field falls between debilitating medical and psychiatric disorders and optimal health. The biomedical model’s risk/benefit ratio begins to tip to render it’s use risky or possibly harmful in this theoretical “field” of subclinical mental states. Those who occupy this field suffer quietly seeking treatment after treatment that fails to help. Due to the dominant western cultural hold on the general population the biomedical model tends to be placed at the pinnacle of disease treatment casting a shadow of doubt about the efficacy of so-called alternative therapies. EFT and other non-invasive modalities either belong to this shadowy field or can be viewed in another light, that of life education.

Gershon Freedman, M.D.

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Advise for Bipolar Child

FreePsychArticles#23        UNSOLICITED LETTER TO THE PARENT OF A BIPOLAR CHILD

To Whom It May Concern:

You didn’t ask or inquire or request my advise.    I’m almost sure you don’t really want to know what I’m going to say.   But since you’re reading it someone who cares about you must have advised you to read it.    You might not recognize it but in one way or another this letter is about you or someone who wants to be closer to you and wants to see you happier.

This letter is is directed to those people who are struggling with the problems of bipolar disorder and the use of psychiatric medications.    You have decided your child can be treated for this disorder without the use of conventional drugs.   “Drugs.”  Sounds terrible and I don’t blame you.   You have heard so many horror stories about psych meds you really believe you’re protecting your child from something dreadful.   Maybe he or she has been given these drugs and got worse or sick from them…and when they were stopped improved?   It could have been someone close who took the meds and deteriorated or had terrible side effects?   There’s plenty of literature written or media coverage by groups with extremely convincing arguments against psych drugs and you have no reason not to believe them.   Why trust psychiatrists, the pill pushers?   They “probably cause brain damage.”   They change the person so much you can hardly recognize them.   There must be a better way like naturopathic or vitamins or special diets.   Maybe biofeedback or hypnosis?  They’re at least not so “invasive.”  There’s got to be a better way and you’re going to try to find it.

Well, maybe you’re right!   Certainly your intentions are right and your desire to save your child of needless suffering.   It’s not irrational to see things like that and if you’ve got others on your side it’s easy to be convinced you’re right.   If your child agrees or asks for your help to stay off the doctor’s drugs there’s even more reason to keep up the fight.  And a fight it is.   You’ve had to argue with all sorts of people and conclude that “perhaps they’re not on your side?”   You’ve become stronger in your position rather than to give in because you really believe you are right.    You have plenty of excellent arguments and “proofs” to show your decision to refuse the drugs is right.   Anyone who opposes you has some hidden agenda or just doesn’t”t know what you know.

If most of the above is true for you I must tell you  few things.   If you really want to help you child please read on.  You have nothing to lose except conflict and frustration while gaining clarity.

The first thing I want to tell you is this, “if your child has a diagnosis of Bipolar I that has led to arrests and/or hospitalization and if this diagnosis is correct” you are exactly who needs to know the following information.    The second thing you must know is you can’t help your child by preventing the use of meds.    In fact you can’t hep him by going against conventional psychiatry if the major consensus is that meds are needed.    The third thing is you can do irreparable harm to your child by striking out on your own against the advise of two or more psychiatrists or clinical experts.   It’s true, occasionally you find a doctor who is simply wrong.   Wrong in the diagnosis and the treatment.   Perhaps that’s why you’ve taken the position you now hold?   But if several clinicians in different locations and at different times have told you medications are necessary, believe them.

There’s more you must take into consideration.    Your child’s condition can be helped through numerous approaches in addition to the medications.    Perhaps some of these can reduce the need for medications.    In fact let’s be very clear,  medications are only the beginning of the road to recovery.    Bipolar Disorder clouds judgment especially when untreated and requires a lot of education and training for the afflicted person to improve his judgment.   Medications and “psycho-education” are the main tools for recovery.

It may take some time to find the doctor who can hep your child.   But, before you can do that you have to be ready to move over to the doctors side and relinquish control of your child’s treatment.    While you are in control of the care you will suffer greatly and unnecessarily.   You may see brief improvements but a slowly deteriorating course will occur over years as long as you are at odds with the doctors.   If you want to help, both yourself and your child, relieve yourself of a false responsibility.    You aren’t prepared to provide the kind of help you really want to.   Even if you yourself are a psychiatrist.

The successful treatment at this stage of history is with the careful and judicious use of medications and appropriate guidance.    In my experience over the last 25 years with thousands of patients with Bipolar Disorder I have seen a large number of families like yours who are trying to protect their child by running interference to the doctor’s advise.  That’s why I am writing this letter now, since a case of this kind has presented itself to me very recently.   I wish what I am saying was not so.   I have great pleasure removing or lowering medication doses or telling someone they don’t need them.  I wish there were better ways but at this time, in 2011, there are none.   I pray to the Kodesh Barchu improved, non-medical treatments will soon become available, but meanwhile we are left with the difficult problem of finding the right combination of medications.

I believe there are two requisites for successful treatment with medications: they must be comfortable and effective.  Often they both come gradually according to the length of time the person has shown symptoms of the disorder without taking the proper medications.   The longer the treatment is delayed, the longer it takes to find the right treatment.

The first requisite is comfort.   This is often the determining factor in holding off the meds.   This is what you need to know about medications.   ALL medications have side effects, both psychiatric and non-psychiatric.   The idea is to reduce those side affects as much as possible.   Very often, once one starts seeing benefit and good results with them finds the side effects are minor and comparatively unimportant.   Most side effects are uncomfortable and scary but not harmful.   There are ways to reduce them by starting at low doses and going slow.   Medications in psychiatry are the most interchangeable chemicals of all medicine.    The art of psychiatry to a large degree is with what is called medication adjustment or management.   Once the correct diagnosis is reached the phase of treatment the dominates the work of the psychiatrist is “Medication Management.” The comfort of the patient is the good doctors first major concern.

Effective medication treatment means symptoms of unstable moods, irritability, agitation, grandiosity or euphoria or depression or a mixture of these are reduced.   Any auditory hallucinations or paranoid ideas should be at a minimum or completely absent. The person should be able to function at a higher level then before the medications were started for longer periods of time.   This can be a long and difficult process but at least recovery will be possible.   I treated a bright 19 year old bipolar girl who came to me after a single encounter with a psychiatric hospitalization.   She was resistant to treatment but gradually began following my advise throughout one year before she had reached a degree of recovery enabling her to begin college and move forward with her life.   Others had such chronic conditions improvements were extremely limited.   As I mentioned the longer they go without medications the more difficult they are to achieve success.

Another thing well known to the field of psychiatry is each time the person stops the medication, the more difficult achieving the same level of function or better.   Most of the time they require increased doses of the medications and/or addition of other medications.   This is well documented across all psychiatric literature in Bipolar Disorder.

I speak directly from my heart and soul imploring you to give it a try.   Every day you resist worsens your child’s chances of recovery.

Gershon Freedman, M.D.

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A Need for Vigilance

FreePsychArticles#22      OUT OF THE CLEAR BLUE SKY?

Recent events over the last month have shocked the world…again.   Innocents were brutally murdered in Borough Park, Norway and Beersheva by different men for different reasons.   We are horrified and bewildered.   First an eight year old Hasidic boy was killed and mutilated by a single Jewish male living in a building owned by his father and uncle in Brooklyn.   Next Norway is shocked by a carefully planned pair of acts of murder and mayheim via home manufactured bombs and firearms.    Then, last Friday Rabbi Elazar Abuchatzeira was stabbed while receiving visitors and subsequently died of his knife wounds on the way to the hospital. Suffice it to say, on the surface all three of these murderers were worlds apart in “purpose, geography, and methodology.”   A hardware store clerk in Brooklyn, New York, a young misguided defender of Christian Europe from Oslo, Norway and an Chassidic Jewish misfit living near Beersheba, Israel.    And yet, from a common perspective all these acts can be reduced to a common denominator: driven and accomplished Evil.    I believe there is no clearer definition of “evil” than the murder of innocents. We’ve all heard, read or somehow witnessed hundreds, if not thousands of atrocious acts like the three above.   The stories intrigue us and to varying degrees we suffer from all of them.   There is a constant bombardment of fictional accounts of real or imagined escapades of violence and murder in the media.   Viewing them is considered “pure entertainment” and has brought about a diminished collective sensitivity.  The initial moments of discovery of such real life events produces a stinging effect to all but the most hardened spectators.   But the sting is short-lived until it fades away into the realm of the impersonal.    Meanwhile those most directly involved in the trauma  suffer with descriptions of “shock, disbelief and horror.” In the religious sphere of life there are no meaningless acts.   The Chassidic concept of ‘effervescence’ is how G-d’s life force drives and pulsates through everything.  Creation and Existence saturated with His Holy Consciousness.    When it comes to the unspeakable cruelties of life religious and secular alike must cope in their own ways.   For the devout G-d is All Goodness beyond any earthly understanding.  In spite of our experience through our senses emunah connects us to G-d’s Creation.   This Goodness is fundamental to Everything. How can we speak of Goodness and Evil in the same breath?   How can we be repulsed and bewildered while knowing it’s all for the best?   The answer is  of course, we can’t.   Or are we not complex enough beings to contain these extremes?   If it was truly beyond our capacity we would have to conclude This G-d wants to torment us.   There are many who either dismiss His existence or conclude the latter.   Looking at the separate pieces of existence as they parade through our lives can appear a cruel reality. This is where Father Abraham enters the stage of history having seen the Unity of all things.   Did he only experience the Bliss of Heaven?   There was no shortage of horror in his life.    His knowledge endures through his spiritual descendents to this day.  But while he survived the tests alone,  we have each other and with that we are girded  for the challenge. In fact, in spite all the rhetoric, descension and hysteria we already know what we must do.   None of these three acts came “out of the clear blue sky.”   Freud and his cronies made this all too clear and called it Psychic determinism.  Must we be psychiatric giants to see the the precipitants and prodromal behavior?    Must we pensively analyze for years to unravel the mystery of our childhood?   Our own natural abilities to “see whats in front of us” have become stagnant and submerged.   Perhaps because we feel alone and afraid of how evil man can be?   But this is a luxury we can no longer afford. I am unable to verify the myriad details these “men” presented prior to the ghastly acts.   The specific veracity assumably required in a courtroom is not mandatory in the shared judgement of the real witnesses.   Mishnaic Law demands three adequate witnesses and they certainly don’t all need PhDs. Eight-year-old Leiby Kletzky was killed by Levi Aron, 35. However, now it has emerged that one of Aron’s neighbors has accused him of previously trying to  kidnap her young son.  Neighbor Zisa Berkowitz told the New York Post that she already spoke to the police to report an incident, which took place sometime in the past two years.  In another alleged incident, Aron also stalked an 11-year-old boy in Borough Park in Brooklyn. He is said to have been following the young boy in his car, “creeped-out” children and had been seen glaring at school yards.   Yet his ex-wife, Debbie Kivel, 34, who lived with him in Tennessee, does point out that Aron had no previous criminal record, save a citation for public urination.   Kivel meanwhile told the Post she was “shocked” at his arrest. “He loved children. He loved kids. My kids are now 13 and 10, but when we were married they were younger — and he loved them.” In Norway our brilliant, self-righteous, self-proclaimed reactionary to the Islamization of Europe Anders Breivik published a 1,518 Page Manifesto and explained how he built his bomb.   He carefully prepared his heinous acts of bombing and gunning down innocents years in advance certainly not in a vacuum .    Regardless of some Norwegian press reports he was an anonymous “lone-wolf,”  red flags were flying all over the place.   Indications are he had numerous moral and financial supporters who have now headed for cover. Murderer Asher Dahan’s neighbours of the Haredi town El’ad claim that he has been an important community member delivering great Shiurim (sermons).    He went to see Rabbi Elazar several times in order to get advice in relationship matters. Neighbours claim that, lately, Dahan started threatening important community members. Also he is said to be mentally disturbed, on medication.  (likely he has a compliance problem as well).   It has also been pointed out that Asher Dahan is a Ba’al Teshuva (returned to Torah later in life).   It said that he tried killing the Rav in the past.   By the way,  the Charedi media said he believed the Rav was Moshiach ben Yosef and the day before the murder, he davened the Yom Kippur service. When asked why was he praying the YK service while we were in Tammuz, he answered “I need to pray the YK service so that Moshiach ben Yosef won’t die!” In psychiatry psychic determinism is axiomatic.   Unfortunately all too often those witnesses closest to the future perpetrator see without seeing.   Excuses, explanations and fear fueled by denial cloud judgement.   Hence, the first line of defense is compromised.    Even Baba Elazar was said to ignore the deadly behaviors of his future assassin with the belief he had repented.  We are indeed capable of denial of evil.  The problem therefore becomes “our” problem.    Our only excuse is our ignorance since seeing the signs just isn’t that difficult. First we must consider anyone is capable of extreme acts until proven otherwise.   Then we must clarify a very important question:  “Who’s business is it anyway?”  There is a saying, “One must believe Hashem Created the world for you.”   This baffled me for years until I heard the following interpretation:  When one is given something, a gift, he becomes responsible for it’s care.   Certainly each of us has been given his own world of experience whether we want it or not.   You can’t have it both ways and grown-ups know the more you love, the more you are loved.    Greatness comes with owning greatness and accepting evil is a prompt for responsibility.    Otherwise we become victims of our own making while we wait for someone else to respond to the evil in our midst.   We must try to respond to the signs, talk with each other about the things we fear or fail to understand.    Ultimately the outcomes are in G-d’s Hands while our efforts are never in vain. Gershon Freedman, M.D.

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Life’s Obstacles

FreePsychArticles#21    OBSTACLES

In Parshas Shlach in the book of Bamidbar (Numbers) is the story of the “spies.”   The princes of the tribes are given permission by G-d to scout and appraise Palestine as B’nai Yisroel prepares to enter the Land Promised by G-d.   Prior to this there is a discussion between Moshe Rabbenu (“our teacher”) and G-d.   According to the commentator Rashi Moshe told G-d he had attempted to dissuade them by reminding them G-d promised He would “…bring you up out of the affliction of Egypt” to the land He promised to the Jewish people.    G-d answered by saying, “I shall give them an opportunity to err through the words of the spies.”   They were determined to go and spy the land.    When they returned ten of the twelve gave grave reports to Moshe, Aharon and the children of Israel of fierce people and fortified cities “in order to make them afraid.”  All but two expressed a unanimous opinion the land was unconquerable and “eats up the inhabitants…”

The congregation of B’nai Yisroel responded in fear and protest to Moshe and Aharon.   G-d said to Moshe, “How long will this people despise Me and how long will they not believe in Me, for all the signs which I have wrought among them!”   Initially G-d wanted to destroy them but following negotiations with Moshe He proclaimed all that generation would die in the desert over forty years and none would be allowed into the land (except Caleb and Joshua) and the generations who did not witness or participate in their loss of faith.

I want to focus on one of numerous issues brought up in this section,  the response to the obstacles seen by the spies and accepted by the congregation.    B’nai Yisroel exhibits this sudden loss of faith throughout the Torah which invariably brings about plagues and death.   They seem not to learn, nor to sustain their faith in G-d despite direct and personal experience of His Omnipotence and Omnipresence.  In this case it is none other than the princes of the tribes,  the greatest of their generation that are totally convinced their conclusions override their faith in G-d’s Promises.

Torah commentaries on this episode abound through the ages.   What were their intentions?    Why couldn’t they maintain their faith in G-d’s prophesies and continue forward as they were about ready to enter the Promised Land?  All of  these strong and righteous men saw the same things yet only two arrived at different conclusions and remained faithful to G-d’s plan.    They all saw it was an “exceedingly good land…which floweth milk and honey.”  Yet the ten spies fear of the inhabitants of the land spread the contamination throughout the camp and aroused the rath of G-d.

This brief yet ultimately influential episode gives us a powerful key to understand the nature of obstacles in our own lives to this day.   This section of the Holy Torah reveals a recurring pattern for B’nei Yiroel with the extra effect of extending the journey from slavery in Egypt to the freedom of the Promised Land from a duration of a few weeks to forty years.   In some ways the result of their behavior was worse than the plagues they had suffered in prior occasions.   Why did G-d chose to prevent the generation that witnessed the greatest miracles of all time enter the land?   To live throughout the years knowing they would never see the fruition of the Exodus?   Was it simply the loss of faith of the people and their leaders of G-d’s Promises?

Commentaries of the sages allude to some of the answers.    The princes were wise and intelligent men not without great spiritual depth.   Their leadership was deserved.    They were superior leaders and exercised sincere responsibility for thier tribes.    They also understood the nature of the change that would take place once the people entered Eretz Yisroel from a totally spiritual existance to a more independent and worldly actualization of G-d’s law into the daily life of work and toil.    On one level they believed it was too much of a challenge for a generation becoming accustomed to G-dly shelter, protection and nourishment.   On the other hand they saw the obstacles awaiting them in the land as beyond their ability to conquer.    Since this generation was to be the rishonim (first)  to leave the desert, enter the Promised Land and everything would follow from their examples,  they were essentially disqualified.   Missing was a very specific quality Hashem wanted to set the tone in the creation of the new Jewish state.

Certainly He wanted a highly developed spiritual and religious group of leaders.   The desire to spy out the land became a test brought about by their own inclinations.   There are precedents thoughout Jewish history that produced different outcomes.   One such episode is Akeidas Yitzchak (the binding of Isaac).

Avraham was informed by G-d he and his offspring would by the progenitors of a great nation.   Shortly afterwards he G-d told him to sacrifice this only son of his wife, Sarah.   This presented a great challenge since the one act would cancell out the prophecy.   Beyond the pain of sacrificing his beloved son was the sheer impossibility of the obstacles placed before him.   Never the less, without protest he moved forward ‘as if there was no obstacle at all.’    Avraham’s total faith in Hashem superceded the logical intrinsic problem.   As we know, Yitzchak was replaced by a ram for the sacrifice and Avraham “passed” this tremendous obstacle on the way.

Another hint into managing obstacles is found in Rebbe Nachman of Breslav’s story of “The Lost Princess.”  As the prime minister volunteers to search for the missing princess for the king, he travels all over until he comes upon a huge fortress staffed with armed guards stationed all around, with horses and weaponry.   He has reason to believe the princess may be held within and decides to “go and try” to enter the grounds.   But nothing happens.   He walks through the gates, passes the guards and no one even notices him when he explores throughout the rooms of the edifice.   What is going on here?   The fortress appears particuilarly menacing and dangerous as an obstacle to his mission and he thinks he may be killed.    Despite all appearances we discover the fortress is really illusory and the obstacle in truth does not exist.

This is the lesson we can take from the the episode.   Holding to the task or mission and moving forward regardless of the appearance of of obstacles is what G-d wanted of the people.   The  inclination to fear and respond to imposing obstacles is natural.   Hashem’s mission for the Jews is not merely fulfillment of nature and natural law, but rather “supernatural.”   As we can see in the course of history,   the Jewish people have defied the natural order of events and instead of being wiped out,   continue to thrive and advance.

In psychiatry the problems of encountering “insurmountable obstacles” is endemic in all people.    This can “stop one in his tracks” as he settles into a defeatist attitude or assume he’s reached the limitations of nature.   Yet, the lessons of the Bible are for all mankind, not just the Jewish people.   We will all encounter obstacles.   In such a case, the advise is to “go and try” anyway since wondrous things await us if we do.

Gershon Freedman

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