Monday, June 16, 2008

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.


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.

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