To The Esteemed Members of Our Holy Community,
As psychiatrists and public health advocates, we have been asked by neighbors, community leaders, and Rabbis alike to make a statement regarding the tragic events that have just transpired. Unfortunately, these events happen frequently enough that they don’t always make the newspapers. Even when they make the front pages, they are quickly forgotten, replaced by the next tragedy with the opportunity to inspire drastic change being lost.
We should be clear that what is being written is not a clinical assessment regarding any specific individual or case, nor a statement of Jewish law. Rather, we would like to share some brief thoughts as formally-trained and licensed professionals who have dedicated our lives to improving mental health in our communities both here in Israel and abroad.
Sexual Abuse is a horrifying plague of immeasurable magnitude. It happens in every nation, in every culture, and affects multiple generations. In many cases, the abuser is not a stranger. The aggressor can even be a well-known and respected ‘pillar’ of the community. Many questions come to mind. Shouldn’t a person who the community looks up to know better? How much more confusing is it when sexual abuse is perpetrated by a ‘therapist’ or helper? Shouldn’t they know how much this can hurt a person and their family?
Suicide is an equally tragic disaster. There is a link between suicide and sexual abuse in that victims of sexual abuse are more likely to develop mental illness and to subsequently end their lives intentionally. There is also another link between suicide and sexual abuse: both may be mitigated through education. The more we talk and create a public forum for these problems, the better our solutions will be.
Licensed mental health professionals have a code of ethics as well as a scientific understanding of personal and interpersonal safety. To become a psychologist or a social worker, one must learn massive amounts of material in a structured, graduate-level program. Trainees must be supervised by senior therapists for multiple years. This supervision is similar to the shimush that a Rav does before getting their smicha. Throughout this process, individuals who are morally-inappropriate to serve as therapists are identified and removed from the training program if they cannot serve as professionals. Licensing boards provide a further degree of supervision regarding standards of care and behavior. They also provide a course of action for those abused by professionals.
Amongst other things, licensed therapists will often work in offices with other clinicians or have support staff present to avoid unsafe situations for their patients and for themselves. Licensed therapists are restricted from having any benefit, other than paid fees, from the treatment relationship. They are prohibited from entering into any other type of relationship with clients and their family members to prevent them from taking advantage of the relationship and/or personal knowledge.
While there are certainly cases of professionals behaving unprofessionally, the general trend is that formal training and licensure are associated with adherence to accepted codes of conduct. Individuals without formal training and supervision can more easily get in trouble, crossing lines without even realizing what is happening to them. Of course, some do it intentionally, with little respect for their victims who are already experiencing significant shame.
Our community also has a behavioral code. There are laws of yichud that prevent an unrelated man and woman from being secluded together for an extended period of time. This is meant to avoid inappropriate relationships: ein apotropos laarayos. The Torah gives us a keen insight into the nature of a human being and it doesn’t hide it from us: all individuals need to protect themselves at all times. The length of one’s beard or skirt doesn’t necessarily provide protection and no one is above this, not even the Gadol Hador. The laws of yichud have proven successful for thousands of years. For this reason, and others, it is general practice in many circles for men to be treated by male therapists and for women to be treated by female therapists.
The more that we are aware of the challenges facing our communities, the more likely we are to stop the damage. This applies to sexual abuse, suicide and many other mental health problems.
With this in mind, we applaud our communities for working hard to address these and other problems. There is always more work to do, but we believe that we are on the right track. As psychiatrists, we are proud to be part of a great nation that fights against those who seek to harm others, regardless of their rationale or excuses.
Yaakov Freedman MD Board-Certified Psychiatrist Jerusalem, Israel
Shmuel Harris MD Board-Certified Adult Psychiatrist Founder and Director of Machon Dvir, Jerusalem, Israel
Ronen Hizami MD Board-Certified Child, Adolescent, and Adult Psychiatrist New York, USA