Wednesday, November 28, 2012

Torah & psychology: Conflicts in values and goals I

The recent events with the Weberman case in Brooklyn and apparently a similar situation in London, calls for a serious discussion of the integration of secular psychology with Judaism. The  problems for treatment of the opposite gender, conflict in values and goals. And what happens when the therapist takes on the role of the rabbis in teaching values and roles in marriage versus the rabbi taking on the role of therapist. Tomorrow I will be posting an important article sent to me by Dr. Klafter on this topic. Today I want to pose a question which someone asked me that clearly indicates the problems. 

There is an organization which provides therapy to frum clients using trained psychologists and social workers. The organization has a posek who has answered their questions for years. Recently a question arose dealing with a wife who was severely abused in all possible ways. She has been destroyed psychologically without any self-esteem or ability to function as an independent entity. Therapy and the law requires that she be treated as a separate entity and be given the skills and confidence to decide whether she wants to get divorced. The Rav insists that the Torah requires that the husband be involved in her therapy and especially the issues of divorce. 

What would you advise?

First update - the other side of the story.

After some investigation, I found out the rav's point of view. He had been informed by a number of people who had worked with the couple previously for shalom bayis that the woman's account of abuse are questionable and might possibly indicate delusions and psychosis. The rav said that the reality of the woman's story needs to be verified with others before giving her treatment as an abused person who probably should get divorced. The wife refuses for the therapist to speak to her husband and the therapist believes she is telling the truth. Legally and ethically a therapist can not go behind a clients back to solicit information when the client objects. Thus the rav is not asserting that the husband has to be involved because he is a husband but because of the need to clarify the truth of her claims. Thus there is a clear conflict between the values of secular therapy and secular law and the Torah position 

 Second update: Thursday Nov 29
Another case. A troubled marriage of a couple who are at the highest levels of Torah society. If they get divorced it will destroy their children's chance of happiness in shidduchim. Therapist insists that the marriage is unhealthy and supports wife call for a divorce. Their rebbe tells the therapist to provide wife with sedatives so she can survive the marriage until the kids are married off. This is a question of values - not reality or professional judgment. Does the therapist have to listen to the rav or does his Ph.D. exempt him from Torah obligations as seen by the rav


Third update - another  case
I remember, as a bachor in yeshiva, speaking to the psychologist of one of my fellow students who became psychotic. The therapist told me, "the basic problem is you people don't touch girls until you are married. My client would be way better off psychologically if he got a girl friend." When I objected that this was against our religious laws, he snickered and said, "It is my professional view that this is necessary for my client's well being." Would you require that a prostitute be hired until he got a girl friend because a licensed expert in the field of pscyhology said it was necessary? 

Fourth update - December 1 2012 What does it mean when a rav issues a psak in medical issues -  

See Rav Sternbuch paskens that alternative medicine can't be used instead of conventional medicine in pikuach nefesh cases 

78 comments :

  1. I think there are two ethical problems in the realm of psychotherapy and religion.

    On the one hand, there might be some principles of psychotherapy that run contrary to religion. But there are also, on the other hand, principles of religion that run contrary to the ethics of psycho-therapy (e.g. the wish to "straighten out gays").

    I do not think that the participation of this husband in the process of psychotherapy is a problem in and of itself. However, I would deem it problematic if the husband was to keep the wife from having confidential sessions where the psychotherapist can speak to her alone. (If there is a problem of yichud, it could be solved via transparent doors...).

    Furthermore, many discussions on this blog have shown that the position of some Rabbis on divorce is problematic in and of itself.

    Rav Gestettener claims that the woman can never be supported against her husband if she initiates a divorce, but the husband wants "shalom bayis".

    If this Rabbi's position is that the psychotherapy should only serve to reestablish "Shalom Bayis" (on the husband's terms), i would deem this problematic not only from a deontologic point of view, for the psychotherapist, but from a moral point of view in general...

    If this were really the torah position, I would deem halacha contrary to morals in this case.

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    1. In any of the cases you cited, the religious-orthodox therapist should not go against his deontology and not against the torah (however, I suppose that the torah is not always what those rabbis make it seem). If there is a conflict, either way, he should abstain from treating the patient.

      In the case of the sedatives, he should rather stop treating the patient than prescribe sedatives against his professional opinion.

      the same would go for a patient who suffers from a dichotomy between his sexual urges and halacha. If the therapist cannot say that he should give in to the sexual urges, because the torah forbids it, and he cannot say that he should not give in to the sexual urges, because his professional opinion is he should, then he should refer the patient to a different therapist. However, he should check out first whether the "medical prescription option" exists, as the therapist in your example suggested...

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  2. I think this goes to the all encompassing question of how halacha operates. Does it operate after given the facts (the facts being presented by "secular" experts such as scientists, doctors, psychologists, psychiatrists) or can halacha work independently and actually be used to ascertain the facts as well as decide the judgement. In other words, is halacha the judge, the jury and the advocate or is it only the judge?

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  3. Find a new poseik.

    Therapy norms and the law are based on a much more solid understanding of the risk than the rabbi has access to. Refusing to follow the law is simply an example of refusing to learn from others' mistakes.

    Just as someone would listen to a doctor over a rabbi when the risk is physical, one should simply ignore a rav who says that she should be encouraged to stay in a relationship that may be killing her.

    Seems obvious, no?

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    1. No. Let's change the scenario a bit. The rabbi has heard rumors that a particular client has talked about violence to family members. The therapist says in his assessement the statements do not constitute a danger to others. The Rabbi insists that the family be informed. What is the halacha?

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  4. The problem is manifold, and lies in the practice of halacha.
    Just as a caveat, whenever I make radical comments, RDE will oppose my views on a davka basis. however, on several occasions I caught him out using my exact arguments in other posts, which means he may agree with me, but has to moderate my views,because, i am admittedly very radical and out of the box / and derech.

    There are problems in the question above. In previous discussions, Stan was using the quote from the Steipler gaon, that anyone who always favours the woman must be suspected of znut. Thus, if we take a position defending the woman, without halachic precedent, we face being attacked by Stan et al.

    In the various issues of abuse, we have an enabling system, known as halacha. We are taught to give the benefit of the doubt, to encourage Jewish unity (this was R Kook's worldview, which I have come to realise is a false one). We are told to honour our elders, and control anger, which is often a natural response to danger.
    We have leniencies regarding abuse, and homosexuality. We are told by rabbis that male on male sex before marriage is preferable to male/female contact.

    There is the granting of power, and the abuse that comes with it, since absolute power corrupts absolutely.

    We have an entire literature obsessed with loshon hara, which is expanded beyond the specific issur of talebearing.

    In every system, abusers find loopholes to take advantage, and this kind of halachic system is one that is abused. Thus, several persons have said that the Orthodox world is a kind of Mecca for child abuse. This is the biggest tragedy of all IMHO.

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  5. The therapy center doesn't need just a rav. It needs someone with giant shoulders and the time to deal with the issues al pi daas torah. Failing to obtain this, they should practice shev v'al ta'aseh in matters such as these, where an error on either side leads to tragedy yet the way to procede is not clear. Therapy and law don't trump Torah. They are elements that may or may not be relevant to psak. As it stands now, they should listen to their rav and if they don't want to do that, they should involve a true gadol with giant shoulders. Failing that - don't do anything.

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  6. http://torahmusings.com/2012/11/sexual-misconduct-and-the-question-of-rehabilitation/

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  7. I second the motion to get a new posek as his "psak" is clearly antithetical to Torah. If she is being abused, her life is in danger and her husband is a rodef. Saving her life and removing her from the danger and the danger from her is the first and foremost priority. Full stop. Her husband the rodef has no rights here. One doesn't need to know halacha or the law to know what to do in this situation. Unless one's brain has completely turned to mush, which is unfortunately a common affliction in our times.

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    1. But if she is making up stories of abuse she might be psychotic and a danger to herself and others. If the husband is truly abuse then it needs to be established because among other things he might be a danger to other members of the family or community. why do we need to assume that the therapists judgment is identical to reality? In sum, the issue of danger cuts both ways. She might be a victim of abuse or she might be more seriously ill than the therapist acknowledges and thus a danger to herself.

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    2. This is what you wrote: "Recently a question arose dealing with a wife who was severely abused in all possible ways."

      You presented the abuse as established fact. This is what I replied to.

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    3. "She might be a victim of abuse or she might be more seriously ill than the therapist acknowledges and thus a danger to herself."

      If she is lying: let her out of the marriage - problem solved. If she needs further treatment after the marriage-problem is solved, give her treatment.

      If she tells the truth: you stand by the blood of your fellow if you don't get her out of the marriage.

      therefore ending the marriage to save her would be a good idea anyway.

      and since the torah forbids to stand by the blood of your fellow human, the torah should also opt for an end to the marriage. Therefore, again, there is no contradiction between halacha and therapy, but between halacha and social conventions. No, those social conventions are neither above halacha, nor above medical deontology and therapeutic know-how.

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  8. xyz: You're not just seconding my motion... the majority of the comments are that this just isn't healthy rabbination. It's the professional's decision to assess risk, it's the rabbi's job to accept that assessment and pasken. Clearly this blog has attracted a group of commentors who are of one mind on the topic.

    As per the update, though, this is an entirely different situation. The rabbi is still acting in a way I find troublesome, though, in dictating a particular resolution over another -- again he is strategizing as a psychologist and criminal investigator, rather than as acting as a rabbi.

    But rabbi is a communal leader in addition to his technical role as rabbi -- decider of halachah and provider of spiritual direction. I'm not sure that's true for a rabbi being relied upon by an umbrella group, but for the moment let's say it is. He should be getting an investigation launched, not specifying how it should be done. He is undervaluing the help this woman may be getting if the "she says" version of events is true, and interefering with a process based on the idea that her possible help is worth less than verifying his (a possible abusor's or a possible long-suffering husband's) claims.

    Meanwhile, if the woman is currently deluded and the psychologist gives her "the skills and confidence to decide whether she wants to get divorced" then she would want to stay, no?

    The opening paragraph seems to bring up many issues. Personally, I find the most interesting one "what happens when the therapist takes on the role of the rabbis in teaching values and roles in marriage"? The reverse, "rabbi taking on the role of therapist", is raised by the example here. (Really "examples", in the plural. A "wife who was severely abused in all possible ways. She has been destroyed psychologically without any self-esteem or ability to function as an independent entity." as a definite given is very different than "the woman's account of abuse are questionable and might possibly indicate delusions and psychosis.")

    Rael: The topic you raise is also in the opening, but is more for the next post. I'll comment there.

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  9. I just think that psak is incorrect. It's not that halacha and psychology are in conflict. It's that this rav is trying to control the therapist. What should happen instead is simply that the rov should voice his concerns to the therapist, who will then have the benefit of that information. Most therapists would listen to the rov and share with the patient the fact that they have received such information, identify the source of the information, and here what the patient has to say about it. The therapist might choose to meet with the husband provided that the patient grants permission. But all of this is a matter of the therapist’s professional judgment and not a matter of halacha to be poskinned by the rov. How do we know that the rov’s version of events is accurate? Also the rov says the therapist must hear the husband’s side of the story before the therapist advises the patient to get divorced, but why does the rov assume that the therapist would give such advice? Therapists are well aware that their patients may not be telling them an accurate version of events. Marital therapists, in particular, are 100% sure than none of their patients are giving a full, objective account of the marriage. They are giving only their own narrative. It's also highly unlikely for an individual therapist to give advice that a patient should divorce. Rather, an individual therapist would recommend marital therapy for the couple. Furthermore, if the therapist did not ask a shayla, then the rov has no authority to tell the therapist what to do. If the husband wants to take the therapist to a din torah for an ikkul then the husband can try to do that, but I find it highly unlikely a beis din will poskin that a husband can block his wife’s treatment. Sach ha-kol, this is a matter of professional judgment to be negotiated by a competent, professional therapist, and not a matter of issur ve-heter in halakha.

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    1. You are assuming that the therapist has a greater understanding of reality than the Rav. However this seems to be a commonsense situation which doesn't involve specialized training to be concerned that the woman is delusional.

      The question is really when the Rav raises an objection or concern - is that simply to be viewed as advice that the frum therapist can ignore or is it considered a psak halacha that the therapist must follow - in spite of his professional judgment.

      Another case. A troubled marriage of a couple who are at the highest levels of Torah society. If they get divorced it will destroy their children's chance of happiness in shidduchim. Therapist insists that the marriage is unhealthy and supports wife call for a divorce. Their rebbe tells the therapist to provide wife with sedatives so she can survive the marriage until the kids are married off. This is a question of values - not reality or professional judgment. Does the therapist have to listen to the rav or does his Ph.D. exempt him from Torah obligations as seen by the rav?

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    2. I am saying that the neither the rabbi nor the therapist have expertise in finding the truth. You're drifting further from Torah vs Pyschology with each revision. Now the case is about two people who want to help the same couple who have different understandings of the situation. The rabbi knows about shidduch issues and the cost to the family. He also knows that others involved have their doubts. The therapists knows more about where the wife is coming from and the coherence and rationality of her perception of the situation. Different sets of info yielding different decisions. If the therapist knew about how irrational the woman sounded in the past, the therapist's values too would advise a different course of action.

      Turning this into a religious issue, that the man is rabbinating, or that his serving as the program's halachic consultant means his opinion is law, is what got most of the early responses. Because it simply isn't. What's at doubt is the situation, not the law or values of the decision-making.

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    3. I presented two different cases. the first case I originally preseented the view of the therapist. then I updated when I found out the view of the Rav. The second update is an entirely different case

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    4. " Their rebbe tells the therapist to provide wife with sedatives so she can survive the marriage until the kids are married off."

      Yes of course the rebbe tells the WIFE to take sedatives.

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    5. thank you, nachum klafter, for the excellent article you wrote about the problem of therapists and rabbis who commit sexual abuse. It is really clear, well structured and full of insights!

      Thank yo also for you answer on this thread, which is also very clear and shows that many problems asked by the blog owner are really false problems.

      the first case presented might be an example of an abusive husband using a rabbi to hold on to his abusive authority over his wife. And a rabbi lending a willing hand to this tactics, perhaps without being aware of it. I suppose that this kind of scenario is a quite common "professional error" made by rabbis, especially in the more closed, strict communities.

      Ultimatly, the supporters of Weberman oder Y.M. weingarten or the son of the shomrei emunim rebbe are exactly in this wrong way of thinking. They are really being manipulated by a cunning manipulator, but they think they defend "torah values".

      and according to his questions and answers, the blog owner also seems prone to fall into this trap.

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  10. I have a hard time understanding what the daas Torah of this rav is. What is his evidence that she is delusional? Certainly if there needs to be testing as to her state and whether she is lying/not in touch with reality, it makes more sense to forensically interview than to have the husband in the room which, good, bad, or indifferent, is a negative figure. What is the husband going to do in the session, call her a liar? What is the point if that?

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    1. The rav has spoken to a number of shalom bayis counselors that the couple had used prior to going to the present therapist. They voiced concerns that they felt she was making up stories or at least saying things which sometimes were not true. The husband is there solely to help establish what the facts are in the case - including whether the wife is reality oriented. "The therapist is rlying solely on the wife's testimony. Rav says that is not sufficient.

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    2. I do not think that the husband is the right person to testify as to the veracity of the abuse charges. An accused cannot be a witness. They should take evidence from third parties (with no negiot) to establich the truth...

      The therapist might want to interview husband and wife in separate sessions, but the husband asking to be present in HER sessions is clearly a violation of privacy, or even an attempt at intimidation.

      In general, I find it destructive when the next of kin interfere in any psychotherapy. Because the patient and therapist try to establish a therapeutic relationship, a room of liberty where the patient can express what oppresses him, and even if the parents, spouse, etc just ask after the session "how did it go?" and want to hear what was said, without any negative intent, this can destroy this fragile "space of liberty"

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    3. a simple alternative is to have a consultation with an recognized expert in psychosis. The current therapist is a marriage therapist without any significant expertise in psychosis.

      Agree with the rest of you comments here

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    4. The fact that she has psychosis are no proof as to the veracity of her abuse claims. She might be psychotic AND he might have abused her and is hiding behind her psychosis.

      And an important factor in psychosis are delusions - if you cannot verify the veracity of the claims, you might take true statements for psychotic delusions. (this happened just now to a person in Germany who blew the wistle on German banks and how they help their clients to do tax fraud... he was declared psychotic and put in residential treatment, and now it turns out all he said was true).

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  11. But even if she IS delusional, the Rov or husband can simply call the therapist and tell him or her that. This is not a rare event for a therapist.

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    1. But the client insists that the therapist not speak with the husband or anyone else. Is the therapist required to comply with her demands?

      More to the point - if the therapist believes what she says but the rav has a number of diverse sources that strongly indicate that she is delusional - what is the rav's obligation? What if the rav is convinced she is a danger to herself or children and the therapist disagrees - what is the rav supposed to do?

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    2. I really have a hard time understanding this whole discussion. A therapist is trained and is supposed to be neutral as to the facts. It sounds to me that if anything the Rav is biased on the part of the husband. Who are these "shalom bayis" counselors that feel it appropriate to share information about this couple with any other individual. At best they are professionals who have violated confidentiality and are poor clinicians and at worst self proclaimed experts who have no real training in understanding how to determine fact from fiction when being told a woman is delusional. The very idea of the husband being in the room is ludicrous, let alone the idea of anyone, a rav, or any expert determining why should happen in therapy.

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    3. It is not the question of him being in the room - it is whether he can be consulted as to help determine what is actually is happening - wife says no the rav says yes

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    4. "But the client insists that the therapist not speak with the husband or anyone else. Is the therapist required to comply with her demands?"
      in any case, the therapist is bound to confidentiality. If he feels he cannot keep confidentiality, he should change profession. If his patients do not trust him that he keeps confidentiality, he should change profession too. If the patient asks him not to speak to the husband, this wish should be respected. How can the rabbi impose on the therapist to see the husband??? The husband can always write letters to the therapist, if he feels it is useful...

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    5. The client doesn't want the therapist to communicate with the husband

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  12. I think you are trying to make a huge hashkafa clash out of a relatively simple case where a rav is concerned that a woman he believes is delusional is going to convince the therapist that her delusions are true. Just tell the therapist. Poskinnig that the therapist isn't allowed to listen to the wife makes no sense to me.

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    1. Unfortunately the story is real and the two sides involved clearly view it as a clash of values - I agree that there are ways of mediating the disputes - but that is not where the two sides are right now

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    2. As I wrote above:

      You're drifting further from Torah vs Psychology with each revision. Now the case is about two people who want to help the same couple who have different understandings of the situation. ... Turning this into a religious issue, that the man is rabbinating, or that his serving as the program's halachic consultant means his opinion is law, is what got most of the early responses. Because it simply isn't. What's at doubt is the situation, not the law or values of the decision-making.

      I would add now that it is within the bounds of psychotherapy to suspend judgment as to whether one is hearing an objective reality that is unmanageable, or an unmanageably broken perception of an okay life.

      "[T]he two sides involved clearly view it as a clash of values." Well, that's a broken perception, or a pair of them.

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    3. that both sides believe that there is a clash of values doesn't mean that in reality there is such a clash. people use all sorts of things as weapons, including Torah.

      perhaps a simple "sit down" between the therapist and the rav would settle the whole thing.

      btw my wife is also an orthodox therapist and she is of the opinion that (as presented here) the rav is way out of line.

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  13. The unfortunate thing is that the rav does not feel it appropriate to subjugate his view to professional expertise. Just like a Baal habos would be expected to subjugate his daas to a talmid chacham in matters of Halacha and hashkafa, and a patient is expected to subjugate himself to a physician, a rav should be seeking advice from mental health professionals, not controlling them, or worse acting as MH professionals themselves.

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    1. Psychology is not a science. It is not clear whether the marriage therapist is competent to diagnose psychosis. In fact a potential resolution is simply to go to a recognized expert in diagnosis.
      Furthermore it is clear that there is an inherent conflict between Torah and secular psychology in the fact that there is no inherent halacha of confidentiality in Torah law - rather it is a question of to'eles. Psychology has a principle of confidentiality which is backed by secular law and professional ethics.

      I remember as a bachor in yeshiva speaking to the psychologist of one of my fellow students who became psychotic. The therapist told me, "the basic problem is you people don't touch girls until you are married. My client would be way better off psychologically if he got a girl friend." When I objected that this was against our religious laws, he snickered and said, "It is my professional view that this is necessary for my client's well being."

      Would you require that a prostitute be hired until he got a girl friend because a licensed expert in the field of pscyhology said it was necessary?

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    2. It is hard for me to believe that a competent psychologist would say something so stupid. Any mental health provider who is appropriately liscenced should be able to asses whether she is psychotic through proven evidence based models. Your example of a prostitute is ridiculously specious. There are bad therapists and good therapists. Anecdotes about one stupid one does not prove that we don't need to go to them as experts.
      I know someone that has exertion based chest pain for an extended time. His cardiologist told him it was hyperacidity. He did tests an they were inconclusive. This cardio insisted it was. He finally had a cath which showed a 75% occlusion is 5 major arteries. Does this mean that cardiology is not a science? Come on.

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    3. Your comment can be rephrased - just because a therapist makes a declaration it does not have to taken as representing reality. However if one of the leading experts in diagnosis said this it should be presumed to be accurate.

      The fact that the Rav has serious questions regarding the facts suggests that the therapist has done an inadequate job. If it is clear that the therapist is a major expert and that alterative explanation have been explored and rejected - then I would agree that the Rav needs to acknowledge the primacy of the therapists.

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    4. So if someone with professional credentials is doubted by someone who does not have those professional credentials, not using the tools of the profession, that puts it in doubt? What about a rav who is not acknowledged as an "expert"? I his opinion is challenged by a stam Baal habos, do we pay heed? Do we question the rav? Or do we say he represents "Torah"?

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    5. An excellent question which goes to the heart of the matter. Are we talking about authority because of status and chazaka or because of knowing the correct answer?

      For example in the case of child abuse - the rabbis who poskened coverup the matter were wrong according to the halacha. However they are rabbis. They were challenged by bloggers who in general know nothing about halacha. Should we be concerned with the bloggers? "Do we question the rav? Or do we say he represents "Torah"?

      If a psychologists insists that a person was abused because of evidence discovered during a therapy session from "repressed memories" do we send the accused parent to jail on the therapists say so - when in fact the memories could have easily been created by the therapist?

      In sum - what role do credentials - secular or Torah - play in how we view pronouncements and should the challenges to credentialed individuals be taken seriously?

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  14. Thus there is a clear conflict between the values of secular therapy and secular law and the Torah position.

    The Torah position always must prevail when it is in conflict with the values of secular law.

    I'm surprised this point is even open for discussion.

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  15. The Rav insists that the Torah requires that the husband be involved in her therapy and especially the issues of divorce.

    The Rav is the authority of what the Torah requires and one must differ to his opinion and accept his judgement based on Torah values.

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    1. Except that while the Rav insists he's saying what the Torah requires, his disagreement with the therapist isn't due to a difference in understanding the Torah. The Rabbi is saying he has reason to doubt the woman's ability to perceive the situation accurately, and implicitly the therapist's ability to determine that ability before irrevocable decisions are made. Those are issues of fact, not halachah or Torah values.

      In the other story, the rabbi is deciding that since the children's happiness is dependent on their shiduchim, and that there is a likelihood that a divorce will lead them to getting much worse shiduchim, the mother should live in a situation that requires her to take sedatives to survive for their sake. This might be a conflict of values or a conflict of perceptions about who is in more danger of misery. We don't know enough to comment, really.

      But Dovid, even if someone must listen to the Rav, PhD or not, that only applies to a competent rav. In a case where lives are at stake, I would seek a second opinion, and would question the competency of a rav who would make such a decision without seeking one himself. (Especially with lives at stake and the rabbi can't explain his position to my satisfaction, but even if he could.)

      After all, even major halachic figures of our times, like Rabbi Shlomo Zalman Auerbach or Rav Ovadia Yosef would not risk making a ruling that might lead to mamzeirim without finding "another rabbi who can 'take some sticks off the bundle'" (to quote the aphorism). In this case, no less so.

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  16. Does the therapist have to listen to the rav or does his Ph.D. exempt him from Torah obligations as seen by the rav.

    Of course the therapist must listen to the Rav. Of course a Ph.D. in no way, shape of form exempt one from his Torah obligations.

    I'm surprised this obvious even needs to be stated.

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    1. No. The therapist needs to listen to the Torah. Not the rav. If the rav represents that outlook then he is obligated by dint of the Halacha, not because he is a rav. This entire discussion is misrepresented as a conflict between Torah and secular opinion. It is not. It is an argument as to whether a professional has to listen to te opinion of another professional in another discipline who is opining not based on his discipline but based on his personal opinion. This is not yiddishkeit it is cultural Judaism.

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    2. the complicating factor is that this group of therapist selected this rav as their posek. If they feel that he is not accurately representing the Torah then they should get a new posek. They feel however that he is accurately representing Torah but that it is conflicting with the rules of psychotherapy as well as the secular law. they do not want a different rav.

      Their claim seems to be that if the rav better understood the pscyhological significance of violating the demands of the patient and the demands of therapy then the Rav would modify his position. The rav rejects their view as condescending misrepresenation of his views. His counter argument is that this issue has nothing that requires a deep understanding of psychotherapy but is simply commonsense. Where there seems to be serious disagreement as to whether the woman was abused - this needs to be clarified before any serious steps are taken.

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    3. so the entire (or much of) working relationship between the rab and the therapists is breaking down, maybe there are power struggles going on here. the whole structure needs rework. the question isn't only what is going on with this couple but what are the boundaries in the group.

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  17. Dovid, aren't you tired of always feigning surprise that there is a discussion about any matter of which you have formed a definitive opinion?

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    1. Actually, I am of the belief that "Dovid" is trolling.

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  18. Your third case is almost an explicit gemara in Sanhedrin.

    Your second case is horrific. If I understand what you are posing, the rebbe is asking the therapist to prescribe psychotropic drugs to a woman with no signs of mental illness so she can tolerate an intolerable marriage until her kids find shidduchim. That is dangerous. If the shidduchim system requires this in his community, it is his obligation as a leader to change it; if the search for spouses from "perfect families" is driving people to this, or worse yet as in some parts of Israel to not seek treatment for cancer lest it impair kids shidduch prospects, the system is so far removed from Torah valuse that it must be changed immediately.

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    1.  Actually I don't see a connection because obviously the therapist was wrong. It seems from the following gemora diagnosis was clear that the man was dying from his love for the woman.

      Sanhedrin(75a) Rab Judah said in Rab's name: A man once conceived a passion for a certain woman,3 and his heart was consumed by his burning desire [his life being endangered thereby]. When the doctors were consulted, they said, ‘His only cure is that she shall submit.’ Thereupon the Sages said: ‘Let him die rather than that she should yield.’ Then [said the doctors]; ‘let her stand nude before him;’ [they answered] ‘sooner let him die’. ‘Then’, said the doctors, ‘let her converse with him from behind a fence’. ‘Let him die,’ the Sages replied ‘rather than she should converse with him from behind a fence.’ Now R. Jacob b. Idi and R. Samuel b. Nahmani dispute therein. One said that she was a married woman; the other that she was unmarried. Now, this is intelligible on the view, that she was a married woman, but on the latter, that she was unmarried, why such severity? — R. Papa said: Because of the disgrace to her family. R. Aha the son of R. Ika said: That the daughters of Israel may not be immorally dissolute. Then why not marry her? — Marriage would not assuage his passion, even as R. Isaac said: Since the destruction of the Temple, sexual pleasure has been taken [from those who practise it lawfully] and given to sinners, as it is written. Stolen waters are sweet, and bread eaten in secret is pleasant.4

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    2. She cannot be forced to submit, just because he has a problem.

      but in the case at hand, marriage might have been a solution for the bocher, that would satisfy the therapist and torah values...

      I don't understand who brought up the idea of prostitutes...???

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  19. Aderaba, from the fact that the "doctors" in the gemara kept finding successive lesser cures it is clear they didn't know what they were doing.

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  20. How do you get from "girlfriend" to "prostitute"? In case you don't know: that's not the same! i am shocked that you jump to a prostitute to solve the problem instead of just advising a girl friend, the way the therapist recommanded!!!!!

    As for the sedatives: it is clearly against the deontology of a therapist to prescribe medicine when he thinks the problem should be solved on a different way.

    Furthermore, I do not think that the position of the Rav in this case represented the "torah" position. It looks more like the "social conventions in this community". I suppose that the torah would advise to divorce if one spouse is loosing health over the marriage. or else, the torah would be immoral, like in the case I pointed out above!

    I am quite astohished that you cannot see that a rav saying "there will be no divorce until the children a grown" is not equivalent to the halacha being "there will be no divorce until the children are grown".

    I sincerely hope that it is just those particular rabbis who are immoral or give immoral advice, not the torah.

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    1. 1) the psychologist told me it was the lack of sex that was the problem and therefore the bachur needed a girl friend for the purpose of sex. For such a cure a prostitute is an acceptable equivalent.

      But that is the question whether the view of a rabbi - especially one considered a gadol - is identical to that of the Torah. In other words is a gadol a living Torah? If one acccepts Torah as authority based then if the Rabbi is expressing community norms - that becomes Torah!

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    2. possibly the diagnosis was wrong but how is this rabbi, even a gadol, to know that? unless of course he is an expert in the field, someone with a great deal of training in psychosis.

      this isn't a stam remark. just like no one would accept a psak regarding electricity on shabbat if the rav doesn't understand electricity, engineering, the particular device, et or no one would accept a psak regarding the bracha on some type of processed food if the rav didn't know something about the food industry, so too this gadol has to be an expert in this field before getting involved.

      is he?

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    3. if the question was given to the kids i wonder what they would say.

      "listen, your mother is thoroughly miserable in this marriage. you must see it day in, day out. tatti is also suffering, without a doubt, and will continue to suffer until he moves out). be aware that this bad marriage is affecting you as well (bad marriages affect the kids in ways just as seriously as divorces do).

      so here is the question: if your mother takes pills for the next 10, 15 years, until the youngest is married off, she'll somehow be able get through the marriage, maybe in a stupor, but she'll get through it (btw did the rav consider how having a mother who walks around like a zombie will affect the kids?). however, you'll be able to get good shidduchim (unless of course rumors start flying around about mom being a drug addict).

      on the other hand, your parents can get divorced, go their separate ways, hopefully find new, more suitable partners and maybe live much more fulfilling lives. the price will be that your chances for getting a good shidduch will be greatly lessened.

      now, you the kids have to choose."

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    4. I am shocked that you would deem a prostitute an acceptable replacement for a girlfriend, and also shocked that you should think that a prostitute should be more torah-compatible than a girlfriend...

      I would view the order of preference according to halacha like this:
      1) marriage
      2) marriage even if it won't last
      3) girlfriend (possibly marriage before intercourse)
      4) girlfriend - goes to mikve, but no marriage ("pilegesh")
      5) girlfriend - no mikve
      6) non-jewish girlfriend
      7) prostitute

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    5. @ben Waxman:
      "no kids, you choose"

      I completely agree with you, perhaps not for small children, but for teenagers.

      I have a friend who is doing more or less what is described in this case (minus the sedatives, I hope): she is holding up a destructive marriage, her husband says he wants out, and often displays abusive behavior, but she won't divorce "until the children are married", without asking them.

      The unmarried children are now 17-23, and I told her exactly what you said here: but did you even ask them whether they want your sacrifice? How do you know you will make better shidduchim with a dysfunctional family (fact that does not really go unnoticed in the community) rather than a divorce?
      but she will hear no reason!

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  21. regarding the psychotic student: why exactly did the therapist tell you his diagnosis?

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    1. this incident happened 40 years ago. There was not so much focus on ethical and legal niceties in those days. The bachur was hospitalized. I was asked by Rabbi Friefeld to deal with the hospital and therapist

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  22. Rabbi Eidensohn, I now see more clearly with these new cases what our disagreement is.

    I respectfully disagree with your basic premise in this thread. This is not about Torah values vs. Psychology. It is about extreme-Haredi sociological practices vs. liberal humanism. You are calling extreme-Haredi sociological practices "Torah Values." You are calling liberal humanism "psychology."

    When I read these cases, it reminds me why I could never be part of an extreme Haredi community. I believe that Torah values are more truly represented in more moderate communities. I believe that these extreme sociological practices are actually a distortion of Torah values.

    I just don't take seriously a rav who POSKINS that a couple MAY NOT DIVORCE until after the children are married off. To give the eitza that the woman's unhappiness can be temporarily solved by sedatives is foolish and unenlightened. This is one of the most flawed rulings I have ever heard in my life, and another example of when bad advice is turned into a psak.

    This rav is fabricating prohibitions, מחדש איסורים יש מאין ממש and I would challenge you to find a basis to say that divorce is forbidden until children are married off. This is not a psak. It's advice. Very bad advice, by the way (עיצה שאינה הוגנת).

    I also take exception with another aspect in which this question was framed: "...a couple who are at the highest levels of Torah society..."

    Has it really come to this? The "highest levels of Torah society" is so dominated by shidduchim and so intolerant of divorce? The rav in the "highest levels of Torah society" recommends we drug the wife with sedatives for years for the sake of shidduchim? Sedatives will NOT help anyone cope with marital unhappiness. They will cause addiction and depression, and will very hard to stop.

    Again, I will respond in the same manner: You have found an absurd psak (really bad advice and not a psak), you claim that it represents "Torah values" (as though there is any such thing), and then use this to illustrate your premise that there is an inherent conflict between Torah values and psychology. This is a conflict between bad advice and common sense, between extreme Haredi sociological practice and liberal humanism. It is not a conflict between Torah and Psychology. At moswt it's a conflict between a miguided rabbi and a psychologist.

    Many of us would call this a "distortion of Torah values" or might call it the "most unfortunate illustration of what can go wrong in Torah society," but we simply do not agree that this represents the "highest" of anything.

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    1. Yes you have identified a significant issue dividing the Chareidi world from the rest of the Orthodox world. There is obviously more to this since even within Chareidi circles what you call sociological practices are in fact sometimes viewed as sociological practices - but sometimes as halacha. Correspondingly there is sometimes confusion for therapists when they view their decision as being "PSYCHOLOGY" OR "THERAPY" When in fact is simply a fad - with no experimental data validating it. Someone once described psychology as an enterprise where the most significant decisions are made with the greatest confidence with the least justification.

      Yes it cuts both ways - to be continued

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    2. I don't understand this reply at all. Nachum Klafter writes "I believe that Torah values are more truly represented in more moderate communities." He then writes "You have found an absurd psak (really bad advice and not a psak), you claim that it represents "Torah values" (as though there is any such thing),".

      Is there such a thing as Torah values or not? I understand you disagreeing and saying - 'hey, those aren't Torah values, these are'. But it disturbs me greatly your sudden slide into moral relitivism ('as though there is any such thing [as Torah values]') while you disagree. What do you mean by this?

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    3. An increasing problem, and we saw this at the Internet Asifa in New York as well, is that the Daas Torah train is still advancing. In 1950 the idea didn't exist. By 1990, the average chareidi believes it's identical to Emunas Chachamim, and therefore it's included in the eighth Ani Maamin.

      But now there is a blurring of the line between Daas Torah and deciding halachah, between advice (whether or not rabbis are more capable of giving it than equally bright professionals) and binding interpretation of law. And so one can sat it is "assur" to use a smart-phone, and someone who owns a smart-phone cannot be an eid -- unless you're Amnon Yitzchak to whom such advice is unnecessary. So what is it, a new law (made by which Sanhedrin?) or advice?

      Similarly here we have a confusion of sociology and halachah. Yes, it could be that a professional community is subject to a fad. But now we are discussing detecting a fad, not a conflict of values or interpretation of Jewish Law. It is no more binding whether the rabbi complains it's a fad or someone in a related professional field would.

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    4. In a related issue - what does it mean when a rav gives a psak in a medical issue such as Rav Sternbuch's recent psak that alternative medical treatments can not replace conventional treatments such a chemotherapy in cancer cases. Is psychological diagnosis equivalent to medical diagnosis?

      http://daattorah.blogspot.co.il/2012/12/rav-sternbuch-pikuach-nefesh.html

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    5. There is not a hint of moral relativism in my response. It is moral outrage. Moral outrage that we are resorting to falsehood and sedatives because we so want to have children marry into a society that is so intolerant of divorce, and because we are so status-conscious about shidduchim. And this is ostensibly the "highest level of Torah society," which in itself is such an arrogant claim. It is the highest level of ga'avah, not of Torah.

      Yes there are Torah values. Here are a few:
      1. Ingegrity (tocho ke-boro)
      2. Honesty (i.e., you don't portray yourselves falsely to your in-laws and then drop the bomb on everyone suddenly as soon as your children are divorced)
      3. Humility (which means you don't consider yourself in the highest level of Torah society)
      4. Not judging others
      5. Dan le-kaf zechut (including that when serious, conscientous, observant people get divorced there is a valid reason)
      6. Encouraging your children to marry people for their actual middos, and not for your own pride in the social status of their shudduchim

      None of these Torah values are reflected in the vignette's portrayal of the "highest level of Torah society." This represents a horrible distortion of Torah values, and if you don't want to accept that what I am saying is true, then please accept the disgusting eitza that we should drug a woman with sedatives for years so that their divorce won't interfere with her kids' "shidduchim."

      The more I think about this vignette, the more disgusted I am by this rav's preposterous "psak" which should be seen as a religious scandal. Why are people accepting this insanity as a valid reflection of our holy Torah.

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    6. I agree with your points above - but that doesn't change the fact that there is a concern for yichus and non-divorced parents as well as absence of physical and mental illness, money etc etc



      I saw yesterday in Rav Zilberstein sefer the following story, There was a rosh yeshiva who had a son who was a fantastic illui and everyone said he would be the next gadol hador. He went to the Chofetz Chaim to ask if he could suggest an appropriate shidduch for his special son. The Chofetz Chaim said I have just the girl with the best midos - she is the orphan girl who cleans my house. The rosh yeshiva went into shock and refused to consider such an inappropriate match.

      Rav Zilberstein ends off by noting that this ilui died in the Holocaust. "Perhaps if he had accepted the Chofetz Chaim's suggestion he would have merited to have been saved."

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  23. here is your solution to the first case you posted:

    In order to build up a therapeutic relationship, it is important that the client trusts the therapist, especially with regards to confidentiality and neutrality. If the wife says she cannot trust the therapist in case he sees the husband, therapyp is not possible.

    this is even true when the wife's "suspicions" regarding neutratlity and confidentiality are unfoundet, since it is her subjective trust that is a prerequisite for the therapy to help.

    Therefore, the therapist could either refrain from seeing the wife and refer her to someone else or refrain from seeing the husband as the wife wishes.

    this is not a halachic problem, but a "technical" problem in therapy. Therefore, the therapist has to decide what is the right treatment. It's like a case of eating on yom kipur for a sick person: the opinion of the doctor takes precedence over the opinion of the rav, or rather: the rav has to leave the decision up to the therapist.

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    1. as a corollary to Remark's last remark, one of the community rabbanim here once said that ikkar hadin there is no need or place to ask a rav if one can/should eat on yom kippur. eating (yes/no, or in shiurim) is a medical question, netto. and indeed, if one looks at the Shulhan Aruch, Yosef Caro never mentions a rav having a place in the decision process. The Aruch HahShulchan also doesn't talk about rabbanim. The Mishne Brura does, but only in the context of today's doctors being kofrim.

      how in the world rav can demand that a woman take pills for years (and not merely OK the decision of a doctor) is beyond me.

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    2. There was a case of a woman who had severe post partum depression after every time she gave birth. She asked Rav Moshe Feinstein for a heter for birth control and was told no. This is a teshuva in the Igros Moshe. What isn't stated is that I was told that she had another child and ended up in a mental hospital. If a psychiatrist said she should be given birth control and the rav said no - who do you listen to?

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    3. psychiatrist. and I suppose that if R. Moshe Feinstein had learned about the result of this psak he gave, he would pasken differently the next time... Or let a psychiatrist judge.

      I cannot imaginge that R. Feinstein would knowingly contribute to destroy a person psychologically.

      So this is a good example that our rabbonim are not the pope: they are not infallible!

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    4. can you state the tshuva? tia

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    5. "She asked Rav Moshe Feinstein for a heter for birth control and was told no. This is a teshuva in the Igros Moshe."

      In IM אבן העזר חלק ג he has a psak about a woman who might suffer a possible mental breakdown (נערוון בראך) if she gives birth again, he permits birth control very clearly. such a problem is one of pikuach nefesh (she is a danger to herself and her children (very true)).

      http://www.hebrewbooks.org/pdfpager.aspx?req=919&st=&pgnum=440

      Your case is wrong.

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    6. There is a danger on relying on memory. There are many teshuvos where Rav Moshe permits birth control in a case of danger, nervous breakdown or severe depression which he says is also danger - E. H. I,#13, #62 #63,#64, #65, E.H. III #13, #22, E.H. IV #36, #69, #74.3.

      However he does note that having defective children - even those who will live a short time - even if it is upsetting and a burden is not a reason for birth control - if there is no mental illness i.e., psychosis or severe depression.

      I think the teshuva I remembered is E.H IV #35 where he refuses to give a heter for birth control when a woman has a defective child and the doctor tells her that she more likely than other women to have another defective child - even though she had two healthy children afterwards. Rav Moshe said the doctor is making a false statement as seen by the fact that she had two healthy children afterwards.

      He also refuses to give a heter in EH 73.1 in a case where she has a 3 year old with Leukemia and doesn't want other children so she can take care of her daughter.

      In contrast in E.H. IV #36 where a woman had a defective child because of German measles he gives a heter for birth control for three years because she is very upset and is afraid to have another child.

      He also gives a heter in E.H. III #12 where there is no sakana but severe upset after giving birth to two handicapped children

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  24. this spiritual woman on priestessmunak@ gmail. com brought my husband back even after dirvoce. I'm surprised tho.

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