A Jewish therapist or a therapist who is Jewish
What
follows is a letter that I wrote together with my chavrusa of many
years Dr. Baruch Shulem. I am posting it because it is relevant to the
issue of mental health professionals and the role of religon and
religious values in so call value-free therapies.
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We
read with interest your special edition of IJP on religion and
psychotherapy. We have been involved with these issues for some time and
would like to share our observations with you. Dr. Buchbinder's article
is an excellent summary of many issues and we would like to explicate
an issue that was touched upon in his and other articles but was not
clearly addressed. We are concerned with the relationship between the
values of the therapist and the values of the model of therapy he uses.
As you are aware, the issue of judgmental precepts of models has been a
major concern of the professional literature in recent years. There is a
growing acknowledgement that all models of therapy are highly
judgmental and are inextricably entwined with personal, political and
well as philosophical principles. Therefore the choice of any model is
first and foremost a value-laden decision on the personal level. This
was denied for years under the rubric of "non-judgmental attitudes". We
are proposing that once a therapist selects a model, his subsequent
therapeutic activities are determined primarily if not exclusively by
this model irrespective of the therapists personal or religious values.
As Dr. Buchbinder clearly showed that the model is at times influenced
by particular concepts at certain points in therapy -- but it is in fact
the model which sets the boundaries of therapeutic behavior. Otherwise
why choose a therapeutic model at all? It follows then that a religious
therapist might actually be using a therapy which is incompatible in
part or in totality with his professed religious values. This issue was
alluded to by the observations mentioned in your review articles, that
Dr. Buchbinder would follow his religious values when there is a
conflict with his therapy while Dr. Spero would allow the psychodynamic
values to predominate.
This
awareness that we can no longer claim that our professional activities
are scientifically determined and therefore are value-free is relatively
recent. It is obvious that many of us, however, are still influenced by
this fallacy. In short, therapies must be first examined by all of us
to whether they are compatible with our values and the values of our
clients. In is unfortunately necessary to note, however that we are
often not aware of our values. This problem is compounded for the
therapist whose values are ostensibly determined by the religion he
belongs to.
This
lack of fit between personal and religious values and those of therapy
has been a great concern to us. In our years as religious therapists we
have found a significant difference between a religious therapist and a
therapist who is (also) religious [1]. The therapist who is religious
will be trained professionally but has learned to keep his religion out
of his work. He will of course not openly violate Jewish law in this
practice (e.g. encourage a client to marry out of the faith) but his
therapy is not guided by religious values and goals. His basic view of
man is based on his professional model and not those he learned in his
religious studies. He may often find Jewish quotes which can be made to
be compatible with his professional model. These he will readily use
when needed as dictated by his professional model. The relation between
religious beliefs and therapeutic behavior is basically pragmatic. The
professional criteria determine when and if to utilize religious
material. His understanding of his client, the language he uses
(particularly with colleagues) and most important of all the goals of
therapy are predetermined by secular theory.
In
strong contrast, a religious therapist subjugates all aspects of his
life and actions to Torah laws and values. Just as he would investigate
the kashrus of the food he eats, and the potential conflicts involved in
reading modern literature he will critically inspect the model of
therapy to determine if it is consistent with Torah principals. In my
own case (B.S.) I had to re-examine my professional model of working
after I became an observant Jew. I had been originally trained in
classic long-term individual psycho-dynamic therapy. After a serious
evaluation, I found that it presents serious conflicts with traditional
religious values.
The
model I now use, developed by Michael White, is as far as I can see
(and from the opinions of Rabbis I have consulted) seems to be much more
fully compatible with Torah Values. A short but telling example is in
order. Torah law prohibits talking negatively about others. The
therapist who is religious will seek a blanket exemption from this
injunction in order to delve into history, explore negative feelings,
etc. because the model requires this type of behavior. The religious
therapist would question the validity of the therapeutic need for such a
(forbidden) activity on both empirical and religious grounds. This
would lead the religious therapist to choose a model that attempts to
avoid this type of forbidden activity. Both the therapist who is
religious and the non religious therapist at this point are probably
asking themselves whether this approach of religion first means that
therapeutic effectiveness must be sacrificed in the name of religiously?
This can be answered by the extensive research that indicates that most
professional models (including White's) are equivalent in
effectiveness. That being the case, a therapist should therefore focus
on the match between his values and those of the therapeutic model he
uses - as well as the values of the client.
In
summary, it is important to look beyond the overt religiosity of the
therapist when studying the interaction between therapist and client. We
propose that it is no less vital to focus on the relationship between
the therapist and his model of therapy in understanding value conflicts
in therapy. We believe that the therapeutic model will predominate in
shaping the ongoing therapeutic interaction for both the non-religious
and the therapist who is religious. This is in contrast to the religious
therapist who will choose a model of therapy which will support his
values and the religious behaviors that emanate from them. Our
religious/professional experience has shown us that by choosing a model
carefully there need not be conflict between model / therapist /
religion. Then all we have to do is worry about our clients...
Baruch Shulem Ph.D. Daniel Eidensohn Ph.D.
The Chofetz Chaim in Hilchos Lashon Harah clal 10 sif 14 writes in a hagaha ואפשר דהוא הדין אם כונתו בספורו להפיג את דאגתו מלבו הוי כמכון לתועלת על להבא ע”ש
ReplyDeletevery important to publicize more
ReplyDeleteRav Dr Avraham Twresky would say that he doesn't use any particular type of therapy, but will use any therapy if it works.
ReplyDeleteIt reminds me a bit of the Hareidi approach to drinking water. The e xtremists will fill a tanker with water. Before pesach, in case the kinneret has crumbs of bread in it. So where did it come from before pesach? A special badatz lake we don't know about?