OCD and Orthodox ritual

Jerusalem Post

Ritual complements ethics in Jewish law, but Orthodoxy and ultra-Orthodoxy seem in recent years to have put greater stress on ritual and on praising those who observe it pedantically. Thus it may be difficult to distinguish a simply devout person who is meticulous in his observances from one who suffers from obsessive-compulsive disorder (OCD).

While experts say OCD is not more common among observant Jews than in any other group, when the observant do suffer from OCD, the symptoms usually relate to ritual observance, causing them to carry out practices compulsively in prayer, ritual hand washing, milk/meat separation, family purity or personal hygiene.

In 2001, psychiatrists Prof. David Greenberg and Prof. Eliezer Witztum of Jerusalem's Herzog Hospital wrote their pathfinding volume Sanity & Sanctity: Mental Health Work Among the Ultra-Orthodox in Jerusalem, published by Yale University Press, that devoted a few chapters to OCD in this community. But it was an academic volume and not a guide to the treatment of OCD.

Now Dr. Avigdor (Victor) Bonchek (drbonchek@013.net), a long-time Jerusalem psychologist and ordained Orthodox rabbi, has written a $30 book called Religious Compulsions and Fears: A Guide to Treatment. Released by Feldheim Publishers (www.feldheim.com) in Jerusalem, it is prefaced with a note of approval by Rabbi Abraham Twersky, a hassidic scholar and well-known psychiatrist living in New Jersey who specializes in treating substance abuse. His name on the cover alone is enough to encourage many observant Jews to read it. Twersky writes that in his 45 yeas as a psychiatrist, he has noted a "marked increase" in the prevalence of OCD. "It is unclear whether this is due to a greater awareness of the condition or an actual increase in its incidence."

Twersky notes that OCD is known among professionals as "the doubting disease" because its sufferers "cannot be sure of anything. [Someone] may have washed his hands many times or spent hours in the shower, but still doesn't feel clean. He may have repeated a word in davening [praying] many times, but may feel it has not been pronounced correctly... An OCD sufferer may take on absurd and totally unnecessary precautions to avoid mixing milk and meat... In short, he is tortured by persistent doubt."[...]