Does Jewish Observance Promote OCD? A

Remarkable Recent Ruling

Rabbi Ariel Rackovsky

Does Jewish Observance Promote OCD? A Remarkable Recent Ruling Ariel Rackovsky

Allan Nadler •The Riddle of the Satmar ​ ​ Thursday, February 17, 2011 http://www.jewishideasdaily.com/824/features/the-riddle-of-the-satmar/ ​

A massive new biography of the rebbe—privately published in Montreal, and the first of its kind ​ ​ in English—has now appeared. Composed by Rabbi Dovid Meisels, the son of one of Teitelbaum's closest Hasidim…

To experts as well as to curious outsiders, the great value of Meisels's volume will surely be its surprising disclosure of many aspects of the rebbe's personality and psyche that shed a different kind of light on his evident inability to adapt to discomfiting realities and accept the magnitude and multitude of blessings bequeathed to world Jewry by the state of . Some of the details are quite intimate. Early on in The Rebbe, Meisels relates tales of ​ ​ Teitelbaum's early childhood—standard procedure in the literature about hasidic tsadikim, or ​ ​ saintly persons destined to become rebbes. Here, however, one finds bizarre accounts of three-year-old Joel Teitelbaum repeatedly engaged for long periods of time in rinsing his mouth, washing his hands, and sitting on the toilet, often interrupting his own prayers to return to the outhouse. The explanation offered for this behavior, which was a source of great concern to his mother, is that the saintly child could not appear before his Creator in prayer without having completely purified his holy body of all forms of uncleanness. Needless to say, a very different, clinical explanation jumps out from these narratives of childhood fixation: namely, that they testify to an extreme, textbook case of obsessive-compulsive disorder (OCD). The refusal even to touch Israeli currency can be adduced as another example of the same psychological disorder, as, still more weirdly, can Teitelbaum's unusual interest in the density of the fabric (the technical term is denier count) of the stockings ​ ​ worn by women in the Satmar community.

Totally Engrossed: Extreme Piousness or Obsessive Compulsive Disorder? Rabbi Simcha Feuerman, https://www.ohelfamily.org/?q=content/totally-engrossed-extreme-piousness-or-obsessive-c ompulsive-disorder

Yaakov was admired from a distance. Many boys in the yeshiva were amazed at his ability to daven such a long Shemoneh Esrei. He would spend close to an hour every Shacharis,

1 seemingly intensely engaged in tefilla. However, his closest friends and his Rebbe knew the truth: Instead of davening with kavanna, most of Yaakov’s time in Shemoneh Esrei was spent agonizing over the possibility that he missed or mispronounced a word, compelling him to carefully repeat words and phrases over and over. Yaakov was not engaged in a deep mystical exercise. Rather, he was engaged in a torturous battle with himself. He sought the advice of his Rebbe, who would constantly assure him that he was worrying about nothing, but it did not make a dent in calming Yaakov’s fears. One time, after an extremely frustrating give and take over Yaakov’s endless worries about tefilla, his Rebbe became exasperated and told him, "Yaakov, I promise that you will not be held accountable for missing a word of prayer. I personally guarantee that I will take you out of Gehinnom with my own two hands. Now, stop worrying!" After that, Yaakov still worried, but he was afraid to bring it up anymore with his Rebbe, so he suffered in silence.

Rivka is a happily married young mother. She was always careful about halacha; her friends used to call her "the ." Lately, though, she has become overly concerned with kashrus. She keeps coming up with interesting but strange she’eilos that don’t seem to bother most people. For example, she wonders why it is OK to use the same water pitcher for milchig and fleishig. She watches how everyone in the family touches the handles with greasy hands and then goes on with eating and touching the food. When she brought it up to her husband, he shrugged off her concerns saying, "They don’t have separate pitchers at my ’s house, so why should we!" But Rivka remained uneasy. Because of this, Rivka feels obligated to clean and scrub every kitchen counter and every shelf in the refrigerator. After watching all this, her husband says, "Rivka, it’s not Pesach. You can take it easy on the cleaning." Instead of bringing her comfort, her husband’s mention of Pesach only causes Rivka more distress giving her something new to worry about. Locked in Ritual Obsessive Compulsive Disorder (OCD), a mental illness that affects 2-3% of the population, imprisons people inside rituals and routines they feel compelled to follow, as a way to ward off intrusive fears or thoughts. When a person who has OCD attempts to resist these compulsions, he or she experiences extreme anxiety and panic, with a feeling of impending doom unless the rituals are followed. Some of the typical rituals manifested by persons suffering from OCD are: - Excessive hand washing out of a fear of becoming contaminated. - Checking behavior. Such as before going to sleep repeatedly checking to see if the door is locked. - Needing to get dressed in a certain order, to avoid certain words, or say certain words to fend off doom, or to ward off what the person considers to be dangerous or harmful thoughts and impulses.

2 - A fear that a blessing was not recited correctly or a word was mispronounced or not said properly, necessitating several repetitions of the same prayer.

Devotion or Disorder? Since it is at times appropriate to be scrupulous about religious matters, one of the questions that come up for persons suffering from OCD and their family members is how to differentiate between behavior that stems from piety and religious devotion, and behavior that stems from OCD. Someone who is ignorant about Yiddishkeit and observes a balabuste before Pesach could easily conclude she was obsessing over crumbs, or someone watching a baal kriah prepare the weekly leining would think, "This guy is crazy, making sure he has each syllable properly pronounced." And consider recent current events: The observant community was turned upside-down over hairs and microscopic bugs! Any of these behaviors would appear compulsive and irrational to a person from a different culture than ours. Yet, to us, scrupulousness in these areas is considered a Torah ideal. The problem that often arises when a religious person becomes obsessed about an observance is that it is hard for others to convince him that the behavior is irrational. When such persons ask a Rav for advice, the Rav might say, "It’s OK, don’t worry," but the person suffering from OCD may keep asking, "But I forgot to mention this detail, or maybe you misunderstood this point, etc." This can lead to the Rav, and the petitioner, becoming very frustrated. How then can we separate compulsion from choice and religious devotion from emotional disturbance? According to the DSM IV (Diagnostic and Statistic Manual for Mental Disorders), Obsessive Compulsive Disorder is built upon the presence of two factors: Obsessions and Compulsions. Meaning, the person must experience recurrent anxiety-provoking thoughts (obsessions), which then induce the person to behave in a manner to address these fears (compulsions). For example, because a person is persistently and irrationally afraid that robbers will enter his house (obsession), the person keeps checking the door to see if it is locked (compulsion). Or, because the person is afraid of germs (obsession), she keeps washing her hands over and over again (compulsion). In addition, these behaviors must be significantly debilitating, such as causing extreme distress or disabling social or occupational function. The DSM also requires that the person suffering from the disorder acknowledges or recognizes at some point that the obsessions or compulsions are excessive or unreasonable. In other words, if the person is irrationally obsessing over some matter, but he or she never feels any distress about it and considers it normal, it is not a diagnosable case of OCD. Technically, the final criterion above would seem to rule out a pious person who engages in what appears to be excessive and irrational rituals. But in practice, such persons may still be suffering from OCD. This is because if a person was worried about a drop of chametz falling into the reservoir on Pesach, the person might acknowledge that he is unusually obsessed with

3 the matter, and that he wishes he could be freed from his "chumros" (stringencies) so he could live life like others. In addition, the DSM does acknowledge that children may be diagnosed with OCD even if they do not recognize that the obsessions or compulsions are excessive or unreasonable. This is due to a child’s lack of life experience and inability to realize the unreasonableness of certain behaviors. If so, perhaps a person who is under the sway of mistaken interpretations of religious law could also be considered as a child.

Rabbi Elli Fischer, “Rav Asher Weiss on OCD” http://adderabbi.blogspot.com/2014/09/rav-asher-weiss-on-ocd.html

I recommend reading it inside. The humanity and understanding that shine through in this responsum are simply breathtaking. R. Asher never tells his correspondent that he is "wrong" for thinking that his speech acts are insufficient. And yet, even as he gives the patient the validation he craves, he shapes and works within those constraints just as a therapist would, even encouraging him to move ever so slightly out of his comfort zone (don't be ashamed of your illness; have your wife make Kiddush for you). It answers the halakhic question, but more importantly it answers the person asking it (think the iconic scene in "Patch Adams)."

Just amazing.

Rav Asher Weiss-Minchat Asher II:134 (trans. Rabbi Ariel Rackovsky)

Question: An exalted and God fearing Torah Scholar suffers from a serious case of Obsessive Compulsive Disorder, and is mostly unable to pronounce blessings or say the Shema prayer in accordance with halachically correct practice. Sometimes, he struggles a great deal to say the name of God correctly, and this causes him a great deal of emotional distress.

According to the physicians who are experts in this area, the correct way to treat this is that he should never repeat any words of prayer, and if, on the first try, he does not succeed in pronouncing the word correctly, he should make no further attempts. In this way, the physicians hope to release him from dire straits and ease his pain.

4 This Torah Scholar is asking an emotionally painful question. When it is known to him as clear as day that he did not pronounce the name of God correctly and that he has not fulfilled his obligation, is he permitted to eat? And if he is, is it better to avoid eating bread so he will not be obligated to recite the Birkat Hamazon, or at least not eat until he is satiated, so as to avoid being biblically obligated to recite it?

Answer:

I. It appears that, as a matter of Jewish law, this person has an obligation to do whatever is necessary to find succor and healing for his illness, for which one is permitted to transgress in the Torah, for one or two reasons:

1. I have already explained in several places that it is permitted to violate a positive commandment so as to avoid becoming ill and bedridden. For if a person is exempt from spending a significant amount on the performance of mitzvot, that person is also not obligated to become ill, since a person’s money should not be more beloved than his health. In the matter at hand, we are dealing with refraining from performing positive commandments, and not transgressing negative ones, so it appears that it is permitted to passively refrain from performing a positive commandment in order to recover from his illness when there are no other options, because in the same way it is permitted to refrain from performing a positive commandment so as to avoid illness, the same rule applies to being cured of an illness.

Even though our sages have said (Berachot 35a) “It is forbidden to benefit from this world without a preliminary blessing,” implying that this is an active transgression, I have explained elsewhere (Minchat Asher Devarim 15) that the correct opinion follows the view of Rashi, that this is a passive violation of a positive commandment.

2. Even if we say that it is prohibited to violate a prohibition in order to be cured of an illness, our matter is different, because if he does not become cured, he will never ​ perform these commandments, and this is exactly the kind of case where we say it is “better to violate one Sabbath so as not to violate many.”

I have learnt this principle from the words of the Chatam Sofer (Responsa, Orach Chaim 83, s.v. Nachzor Leinyaneinu), who dealt with the question of whether a child who has ​ ​ the status of an insane person may be committed to an institution where he will be cared for and may recover, such that he would no longer be insane and can then perform mitzvot, but will be fed non kosher food during his sojourn there. ​ 5

The Chatam Sofer wrote that if, by admitting this child to such an institution, there is a chance that he will recover, it is obvious (that this is permitted), for even if we say that such an action is akin to force feeding the child forbidden foods, which is biblically prohibited, it would be permitted because we are not obligated to leave a person in a state of insanity such that he would be exempt from mitzvot.

The Chatam Sofer proved this point from a scenario with similar characteristics, regarding a person who was traveling in the desert and didn’t know what day was . In such a scenario, our sages only permitted a person to perform labor that is necessary to survive, but they never limited the amount he could travel, because it is incumbent upon such a person to do whatever he can to leave the desert and arrive at a settled locale so he can fulfill the mitzvot of Shabbat in a halachically optimal fashion.

One can make an obvious distinction between a scenario in which the outcome is certain, as opposed to one where the outcome is in doubt. In the matter of a person traversing the desert, there is a possibility that he is not transgressing any sin at all, as opposed to a scenario where the consumption of prohibited foods is an inevitability. Nevertheless, it is clear that the intent of the Chatam Sofer was solely to bring a source for and support of what was obvious to him as a matter of logic, namely, that a person is permitted to transgress a prohibition in order to remove oneself from a situation in which he will be compelled to transgress the same prohibition sevenfold. For this reason, a person is allowed to exceed the permitted boundaries of Shabbat travel in order to exit the desert and observe Shabbat properly, and it is permitted to feed prohibited foods to a child so that he can recuperate and return to his obligation in the observance of Mitzvot.

So it appears in our situation, in which it is permitted for this special person to refrain from making blessings and reciting the Shema in order to be cured, and fulfill the mitzvot according to the correct halachic procedure in accordance with all the details of their performance.

The basis for this reasoning is that this is similar to what our sages said (Yoma 85b), “Violate one Shabbat so that he will observe many others in the future.” If we do not let him refrain from performing these commandments for a short duration, he will never be cured and will constantly perform them incorrectly through a broken heart and exhausted soul, and in this case, it is clear that this is the path that will bring light.

I have looked a great deal at that which our sages said (Nazir 23b) “A sin with pure intent is great.” They learned this by the praise the verses lavish upon Yael, the wife of Hever the Kinninte. Even though they did not make this statement as a definitive matter of Jewish law, we

6 find in the works halachic authorities (Bayit Chadash Choshen Mishpat 256) that it is quoted as a matter of Jewish law, and boundaries on this matter were never clarified, for it is obvious that it is entirely prohibited to transgress a prohibition deliberately even when one is well-intentioned, for good intentions cannot permit that which is prohibited or purify that which is impure.

It appears that this principle was articulated to describe situations where there was no other recourse, as Yael the wife of Hever gave herself over to sin to save the Jewish people. Clearly, there was no other option for her, for could she let the Jewish people all die? From her, they learned that in a situation where one is clearheaded and simple logic dictates that there is no other recourse and that passive violation is not an option and that action is necessary, and there is no clear permission that can be derived, nevertheless a well-intentioned deliberate sin is the best option, as is the case in our situation.

I was happy when I saw that which our teacher, the author of the work “Kehillot Yaakov” (ed. ​ ​ ​ Note- Rav Yaakov Yisrael Kanievsky- 1899-1985) in the book Karyana De’Igreta (273) about ​ ​ ​ this very scenario:

“I instructed him that he should pray from a prayer book, and whatever he had already passed should not be repeated under any circumstances, even if it is clear to him that he said it incorrectly or that he skipped words. It is clear that, as a matter of Jewish law, he is not obligated to recite these words any longer, but you cannot explain this to someone whose nerves are stretched on this matter. Therefore, you must say this to the person with great certainty and without offering any explanation, save for the explanation that ‘there is no concern of transgressing a biblical prohibition, and I cannot elaborate on it at this time.’ One should rule for him that anything that has been said should not be said again.”

At the end of his words, he wrote, “Thank God, this young man was cured in a short amount of ​ time and now occupies a prestigious position.”

For us, he is describing exactly what we had just said: As a matter of halachic ruling and analysis, this appears to be correct. Would that in our situation, we will receive similar news that soon, with God’s help, he will have attained a full recovery.”

II. With regard to that which he asked about whether it is appropriate for him to avoid consuming the requisite amount of food that would obligate him to recite the Birkat Hamazon on a biblical level:

7 It appears unnecessary to insist upon this at all, for the reason we already explained. This is the nature and the essence of the illness this person is experiencing, in which a person afflicts himself constantly with fears that he did not do what was expected of him and did not fulfill any of his religious responsibilities; only when he is able to overcome these fears and be released from them can be find relief for his wound. If we rule for him that he should refrain from eating bread until he is satisfied, he will find a thousand more questions. For example, is it better to eat less than the prescribed amount in the amount of time it takes to eat a slice of bread so that he is not obligated in a final blessing at all, or should he eat his entire meal in an uncommon way so as not to have to make preliminary blessings, or should he not sleep normally and thereby become exempt from the preliminary blessings on the Torah, and many other questions in every possible area, for which there is no end.

For this reason, it seems clear that he should behave like any other person would and try fulfilling the mitzvah once, as has been explained.

III.

There is reason to investigate how such a person can discharge the obligations of his family in regards to Kiddush if he does not pronounce the name of God correctly, for even if we permit him (to skip words) on his own, what will the members of his household do if they don’t hear God’s name pronounced properly?

The truth is that it is most fitting for his wife to make kiddush at home and discharge his obligation, and if there are children who have reached the age of majority in the house, they can also discharge the obligations for the members of the household.

When there are guests in the house, he should overcome his embarrassment and ask them to make kiddush and discharge his obligation due to the great difficulty he experiences, for in the same way a person is not embarrassed by a physical limitation, there is no reason to be embarrassed from this one, for there is no difference between this illness and any others.

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