A man went to see his physician because he wasn't feeling well. "Doctor," he said, "I am suffering from a dark and unshakable depression. Nothing I do gives me any relief. I am overwhelmed with pain and most days, I can't even make it out of bed. Doctor, what should I do?" The doctor thought for a moment then offered the following treatment plan. "This is what you need to do. Tonight, go to the theatre where the Great Carlini is performing. He is the funniest man in the world. He is guaranteed to make you laugh and drive away your depression." Upon hearing these words, the man burst into tears and sobbed uncontrollably. "But doctor," he said, "I am Carlini."
This story sounds eerily familiar, reminding us of entertainers, like the late Robin Williams, who harbored such deep depression that they took their own lives. I share it to illustrate the way that mental illness can be invisible to outsiders. It also demonstrates that the ways that we choose to help others, even with the best of intentions, may have nothing to do with what a person truly needs.
I won’t ask people to raise hands, but I suspect that many, if not most of us, have encountered mental illness in our families. You understand better than most the stigma surrounding mental illness as well as the destructive impact of discrimination and of silence. Still, rarely do we feel safe enough to talk about the distress of people we know and love, or especially, our own struggles.
Rabbi Nachman of Bratslav suffered bouts of depression in the midst of his inspired leadership. He taught his followers, “Sometimes, people are terribly distressed but have no one to whom they can unburden themselves. If you come along with a listening heart, you uplift them and help them find new life.”
At our congregational retreat in June, a dozen adults gathered with a listening heart. We shared stories of our own experience with mental illness in our families. Parents who attempted suicide. Children who could not find a bed in a mental health facility. Siblings who required life-long attention and support. The open-hearted discussion reminded me of the heart-stopping Personal Offering that a mother gave several years ago about her son’s ongoing bouts of depression. She revealed that he had spoken of wanting to end his own life from the time he was four years old. Listening to these stories, our community can began to recognize how many of us know the frustration, pain, and helplessness of mental illness. Through these openings we begin to speak honestly and listen patiently. In these conversations we can bring light and comfort to the darkest corners of people’s lives.
This year Ed Levy invited Dr. Tanisha Pinckney to speak about the impact of the criminal justice system on people who have mental illness. She described how police can respond more effectively to someone who is acting strangely if they are made aware that the suspect has a history of mental illness. The difference can be a matter of life and death. Dr. Pinckney opened our eyes to look at mental illness in new ways.
In these perilous times, I sense a higher level of anxiety, depression, anger, and isolation among us all. Many of us are blessed to have support systems, spiritual practices, and the inner resilience to live our lives in tension with the never-ending cycle of breaking news and broken hearts.
For those of us without a diagnosis of a chronic mental illness, such emotional swings are often temporary. Grief, illness, and trauma can touch anyone, and yet we find ways to overcome them, or at least live with them.
Imagine how much harder it is for someone who is already living with social anxiety or chronic depression to “bounce back” after a day’s bad news? Imagine how much worse it is for those who live with the existential fear of being deported, or experience harassment and abuse for being gay or trans, and people of color who encounter racial profiling every day and live in fear of being shot, whether on the street or in their own home.
More than any time in my life, I believe we all need to be aware of the prevalence of mental illness in our midst. More than any other place, our synagogue, this holy community, should be vigilant in creating a safe space for people living with mental illness.
Because they are among us, whether we know it or not. One in five Americans experiences a form of mental illness in a given year. Severe mental disorders among youth between the ages of 13 and 18, is shockingly also one in five. Mental illness is the leading cause of disability in America today.
The Centers for Disease Control reported this summer that suicide rates are on the rise. More people die by suicide than in automobile accidents. Someone is twice as likely to die from suicide as homicide. Twice as likely. Children, veterans, and the elderly are particularly vulnerable. Worldwide, suicide is the 2nd leading cause of death for those aged 15-24 years. Among LGBT youth, three times as many contemplate suicide as their straight friends.
Experts tell us that 90% of those who take their own lives have suffered from mental illness, though many have not been diagnosed. We also know that proper treatment can prevent most suicides. Fully 80-90% find relief from their symptoms and pain through treatment, continuing to live full lives.
Unlike broken limbs, the flu, or a debilitating physical condition, mental disorders are often hidden from view. And we treat them differently. As a congregant of another local synagogue wisely noted, “When someone is in the hospital, we send them a brisket. We visit them. We check in on them after they get home. But when someone is at McLean (which specializes in psychiatric care) we do nothing.”
Mental illness is not a new phenomenon, but it has not always been hidden in the shadows. In our own tradition, we read of King Saul’s ruach ra’ah, the “bad spirit” that manifested in uncontrollable anger that led to violent eruptions against young David and against Saul’s own son, Jonathan. In the Torah, Moses himself declares to God,
"I can no longer bear the burden of this people alone...it is too heavy for me...Please kill me, let me no longer see my wretchedness."
Rabbi Elliot Kukla of the Bay Area Jewish Healing Center explains that, "What the biblical stories teach us is that mental distress is a natural part of human life and a part of every society. Surviving our own moments of emotional suffering and finding the strength to walk with others through incredible pain are ancient and sacred obligations."
Many of us who do not live with chronic depression or experience serious mental disorders are troubled, anxious, or depressed these days. Still, our own emotional turmoil can open our hearts in compassion to walk with those whose suffering and pain often take control of their lives.
It is not our community’s privilege to diagnose others. Just as we can’t set a broken limb or diagnose cancer, we are not equipped to provide therapeutic services. What then is our synagogue’s responsibility? What can we do?
One of my favorite verses in the evening service of Yom Kippur reads: Haneshama lach vehaguf p’olach, chusa al amalach
Our soul comes from you. Our body is your work. God of mercy, have compassion on us, the fruit of your labor.
Within our tradition we find confirmation that our physical and emotional selves are intertwined, equally in need of compassion.
Each time we offer the prayer for healing, the mi shebeirach, we acknowledge equally those who need healing of body and spirit—refu’at hanefesh v’refu’at haguf. We easily share that a certain individual is recovering from an accident, someone else had surgery, or another person has a terminal illness. And yet, when someone has been hospitalized for psychiatric reasons, how do we share that?
First of all, it is not up to us to decide. If we ask, those with a mental disorder will tell us how they see themselves and want to be seen.
For some, mental illness is a fact of life, something one wishes that others would simply accept. We want others to treat us with respect, without trying to change us or even expecting us to change. Others would rather not live with the illness and would love to be different.
In either case, we can’t presume to know what they need. Each individual may be doing everything he or she possibly can to attend to their mental health. Sadly, our health care system does not provide enough doctors, beds or affordable care for people with mental disorders. For example, only half of Americans who experience a serious episode of depression receive proper treatment.
Despite the wisdom I’ve received from congregants, teachers, and colleagues, I’m left with many questions.
How do we, as individuals, respond to people whose minds work differently from our own? Are they shunned? Ignored? Tolerated? Pitied? Embraced?
How do we respond when someone’s behavior frightens us?
Do we seek safety? Do we consider whether that person is in danger?
Do we ask appropriate questions? Inappropriate questions?
How do we respond when we hear of a diagnosis? Is it a relief, a comfort, knowing the source of someone’s words or behavior? Does it spur us to want to help, to fix, to direct? How can we be respectful of the different ways that individuals experience their diagnosis?
Can we learn to notice and hold back our own need to diagnose others, without having real expertise or direct understanding of the individual?
How can we be supportive without projecting our own needs on others?
When is it appropriate to help someone who is not asking for help?
And what are respectful ways to find out what people want?
Today I have more questions than answers. Fortunately, in the coming year our congregation has two opportunities to delve into these questions further and perhaps arrive at some answers. Thank you to Ed Levy for arranging for Dr. Tanisha Pinckney to return this year. Those who missed her last year will not want to miss her again.
I am also pleased to announce that Hillel B’nai Torah has been invited to participate in the Ruderman Synagogue Inclusion Project, in partnership with Combined Jewish Philanthropies. With the help of the Ruderman Foundation, we will consider what we need to expand our congregational resources to be more welcoming to people with all kinds of disabilities, mental illness included. We will begin by forming an Inclusion Task Force, a group of congregants and staff to do a thorough inventory of our synagogue’s strengths and weaknesses. Following the slogan from the disability community, “Nothing about us without us,” we invite anyone with an interest, especially those who are living with a disability of any kind, to volunteer for this task force. You will be hearing more about this soon.
Over the years, our congregation has laid the groundwork for considering how we welcome marginalized individuals. Members of Hillel B’nai Torah have engaged in multiple conversations about race, sexual orientation, and gender. Our school spent a year in a reflective process to better serve students with different abilities. These conversations have led to concrete and visible changes in how our synagogue looks, how our teachers teach, and how we talk about ourselves with honesty and ongoing self-assessment. These past experiences can help us enter into this new discussion with compassion, openness, and our accumulated wisdom to guide us.
Tonight I invite you to enter into this conversation. Quietly, in prayer, we can each begin a private internal dialogue with the Source who endows each one of us with a pure soul.
May the prayers this Kol Nidre night, cause our hearts to break open with compassion for the fragility of every human being. May we find the patience to listen, the attention to truly hear, and the genuine capacity to care. May we never lose hope of repair, reconciliation, and redemption.
Together on this holy night, pouring our hearts out to God each in our own unique voice, may we plant the seeds to cultivate a holy place where every one of us is embraced, body and soul.
Ken yehi ratzon.
Rabbi Barbara Penzner/Kol Nidre 5779