Medicine, Psychology and Spirituality

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Are They Compatible?

Among the more heated debates, and even battles, that currently rage between science and religion and between modernity and faith, are those in the realm of medicine and healing: How much of a role do religious practices, faith and trust in G-d play in the healing process?

Does religion and especially mysticism offer a viable psychological model for healthy living? Does religion have positive or, as some argue, negative effects on health, especially mental and emotional health? Should physicians address or not address religious issues in clinical practice?

Is there a connection between “sin” and “illness”? Or is that unhealthy thinking, bringing on feelings of guilt, neurosis and shame? Does modern medicine’s way of explaining diseases do away with the belief that illness is a result of defying G-d’s will? In our age of advanced technologies, how do we explain verses like “If you hearken to the voice of your God, and you do what is proper in His eyes, and you listen closely to His commandments and observe all His statutes, all the sicknesses that I have visited upon Egypt I will not visit upon you, for I, the Lord, heal you?”[1]

Does prayer have curative powers? Is there such a thing as faith healing? And what about miracles?

And how about when doctors state with certainty that death is inevitable, should there be any room for a patient (or his family) defying their professional opinion and expending valuable resources to do whatever is possible to keep him alive using every means at their disposal?

These and many more questions, a number of which deal with serious issues of life and death as well as key theological ideas, are being argued, with no resolution in sight.

In 2001, Dr. Fred Rosner wrote a piece titled Religion and Medicine, published in the Journal of the American Medical Association, where he captures the history of the relationship between medicine and religion. “In the beginning religion and healing were inseparable. In some societies, the priest and physician were one and the same person, administering spiritual and physical healing with divine sanction. The advent of scientific medicine in the middle of the 19th century separated medicine from religion nearly completely. A century later, the direct interrelationship between the body and mind became firmly established, although psychosomatic medicine had already been described in the 12th century by Moses Maimonides. Over the past several decades, there has been a broad revival of interest in spiritual healing and religious practice and health.”

But the link between medicine and religion – as in the broader war between science and faith – remains roiled in controversy, serving as a matter of passionate and seemingly perpetual disagreement.

***

In my work I face these types of questions on a daily basis, with opinions ranging from one extreme to the other. On various occasions, usually due to some swirling storm, I have addressed the issue of duality and unity – whether we can bridge the secular and the spiritual – especially in context of Torah/Judaism and the modern world. Here are a few articles on the subject dealing with the balance between faith and modernity (Orthodoxy vs. the World, The Kabbalah of Duality, and here is a series dealing with finance and soul (Money and Spirituality).

In this column I would like to address this conflict in relation to psychology and spirituality. The primary reason for this is due to a recent controversy regarding the role of modern psychology in context of faith based communities, particularly Torah ones. Actually, this article is part of a more comprehensive position paper I am working on addressing the role of Chassidic thought, which presents a comprehensive system of soul psychology, vis-à-vis modern therapy.

As one can imagine, the debate around medicine and religion becomes even more complex when dealing with the less tangible areas of psychology. Where does the mind end and the soul begin? Do they meet? What is the relationship between psychology and spirituality? Do they overlap? When you have a religious-based map of the soul and the psyche, how does man-based psychology fit in? What about when there are conflicts between a theological ideology and the consensuses of psychologists and their many studies?

Obviously, the issues are less thorny (or are they considering the tension between religion and medicine in general?) when addressing clinical mental illness, which requires the expertise of a physician no less than any other physical ailment. But they certainly become far more complicated when discussing the contrasting role of a trained therapist and say, a spiritual mentor (a mashpia or a Rav), and when offering various psychological approaches to a community or an individual who follows a spiritual discipline.

Physicians, psychologists and therapists of every sort are taught to walk ever gently when it comes to the thin line between people’s belief systems and medical matters. Some go as far as insisting on a morally neutral “separation between church and state” attitude, never allowing medicine or therapy to take or advocate a religious or moral position.

This may all be cordial and respectful, but it doesn’t resolve the question how, or whether, we can bridge faith-based spirituality with modern psychology.

* * *

In general, debates around the collision of any two systems divide into three camps, with many variations of each – from one end to the other end of the spectrum:

Camp number one argues that the two systems, in this case, medicine and religion, are mutually exclusive, and should not be mixed together. For medical advice go to a physician; for religious matters go to your trusted clergy person. One should not be getting involved in the other’s business. Science and faith are two separate worlds, governed by different axioms and rules.

Some even go as far as being derisive to religion, dismissing it as primitive and outdated, with no place in a world that is witness to the miracles of modern medicine and technology; but obviously due to freedom of religion, it needs to be (according to this belief, no pun intended) at best tolerated.

And what should be done when there is a conflict between the physician’s opinion and the faith of the patient (the doctor, for example, has given up hope but the patient insists on being resuscitated)? According to this camp, doctors need to respect, as in all instances, the wishes of the patient, unless of course we are dealing with a life threatening situation. But that does not mean that religion has any scientific value or objective healing powers.

Some even suggest that religion may be detrimental to health. Take a 2000 paper written by Dr. HG Koenig, a psychiatrist and currently the director of Duke’s Center for the Study of Religion/Spirituality and Health. In his study, titled Religion and Medicine: Historical Background and Reasons for Separation, he presents the case for maintaining the continued separation between medicine and faith. “Religion and medicine,” he writes, “have a long, intertwined, tumultuous history, going back thousands of years. Only within the past 200-300 years (less than 5 percent of recorded history) have these twin healing traditions been clearly separate… the split between religion and medicine became final and complete. Among the many reasons for the continued separation is that religion may either be simply irrelevant to health or, worse, that it may have a number of negative health effects. I review here both opinion and research supporting this claim.”

On the other extreme (far more rare, but nevertheless important to mention for clearer contrast), camp number two insists on the universe being governed only by G-d and rejects some form of medical attention, opting instead for prayer. Some even go as far as rejecting most medicine. They argue that no man, neither a physician nor a witchdoctor (without insulting either of them), can intervene in our health. (See here for a list of such belief systems).

And then there is the middle of the ground camp, which tries to find a compartmentalized balance and complementation of the two. As Dr. Rosner attempts to do in his said article: “The return to spirituality and religion by patients as an adjunct to their physical healing is no longer ignored by physicians and other caregivers. In a sense, religion can be considered a form of complementary or supplementary therapy… The priest and the physician are no longer one and the same person as they were in biblical times. However, the services each provides should complement and supplement each other for the benefit of the patient and the patient’s total physical and mental well-being during health and illness and at the end of life.”

This middle of the ground, compartmentalized approach advocates mutuality. For example: in addition to doing everything medically possible to fight a disease, one also prays and has faith and trust that G-d will bless the healing process, or even preform a miracle in case doctors have no solution. In other words: One can completely embrace medicine without compromising ones beliefs. But is that true? How about all the instances when they contradict? Do you follow what a doctor says or what your rabbi says? What about the religious concept of illness caused by sin? Does compartmentalization really resolve the dichotomy and bridge the schism between science and faith?

A Fourth Radical Approach

What does Judaism hold? The Torah surprisingly offers us a fourth, unexpected, option.

First and foremost, the Torah makes this interesting statement about doctors:  From the verse (Exodus 21:19) “He shall provide for healing” (or literally “heal, he shall heal”) we derive that “permission was hereby given to a physician to heal” (Baba Kama 85a).

The fact that healers need to be granted permission suggests that had they not been granted such permission one could argue that since G-d caused someone to be stricken, we mortals cannot presume to heal him (Rashi). So, by granting them permission physicians have the right and indeed, the obligation to do whatever they can to treat and heal illness; not just injuries caused by other humans, but also illnesses that come from G-d (Tosafos).

But this does not offer us a definitive answer as to which of the above camps the Torah subscribes to. Permission to heal obviously precludes camp two’s rejection of medicine, but can mean either that once permission has been granted medicine is strictly in the domain of the physician (as camp one argues), or it can suggest a form of compartmentalization (as in camp three).

A fascinating Zohar – the classic work of Jewish mysticism – can help illuminate this issue:

The verse states (Jeremiah 17:14) heal me, O Lord, then shall I be healed; help me, then I shall be helped. Why the redundancy? Since he says “heal me” why does he add “then I shall be healed,” since he says “help me” why the need for “then I shall be helped”?

Answers the Zohar: “All healing elixirs in the world are in the hands of G-d. However, there are those that are [performed] through a messenger, and those that were not delegated to a messenger.[2] And those administered through a messenger are indeed healing agents, yet at times the illnesses return.[3] But the illnesses that G-d Himself heals never[4] return.”[5]

This introduces an entirely new holistic perspective on medicine and healing, both of physical ailments and psychological ones.

We can appreciate it by understanding the core foundational principle of Jewish thought captured in the most famous liturgy of all: Shema. In this prayer we declare G-d’s unity – Hashem Echad.

Divine unity – Echad – does not just mean one G-d. It means one reality. This unity negates any form of duality, plurality and compartmentalization. Everything from earth to heaven and beyond, from matter to spirit, from mind to faith, from medicine to soul, is part of one indivisible reality.

This lies at the heart of all Judaism, and indeed of all science today – as evidenced by the never-ending search for the Unified Field Theory: One principle which governs all natural phenomena. Physics has increasingly come to the realization – which has now become common knowledge – that all of existence is one large field of energy. This unified field may be invisible to our naked eye and raw instruments, so we perceive the universe as a multitude of localized particles. But in truth they are all pieces of one large mosaic. Think of it like many different parts all lying on one invisible quilt.

As such, there is in truth no real duality between science and G-d or between medicine and faith.[6] Yet, by Divine will the unity took on two manifestations, which in our perception is healing from above and healing from below. G-d endowed nature with laws and logic, He endowed man with intelligence to seek out this logic, and uncover the healing powers within the body, within nature and existence. No physician and no physicist creates anything; they simply endeavor to understand G-d’s mind and logic and tap into the forces that lie embedded within the universe to effect healing or any other technology in existence.[7]

We thus have a system which joins two vital ingredients in every healing process: The body dimension, and the soul dimension. When addressing any illness – whether physical or psychological – these two factors come into play, and both need to be addressed.

Based on this approach the concept of “sin” is actually not such as the stereotype would have us believe; sin in Hebrew is “aveirah,” which means displacement or dissonance. Mitzvah means connection. Every mitzvah and aveirah is in effect a way of either aligning or misaligning your life with its divine mission and purpose.

Counter to the stereotype, the concept of reward and punishment in Torah as well, is not some form of divine retribution (why would an omniscient and eternal G-d have the need to get even with His creatures?), but is rather cause and effect: When someone puts his hand in fire, the inevitable burn is not a “punishment,” but simply an effect caused by that act. All divine “reward and punishment” is essentially a type of cosmic immune system of causes and effects – with each of our actions causing a reaction.

Health, in effect, is simply defined as a life completely aligned with its purpose and realizing its raison d’être. Like a machine that hums smoothly when it is fulfilling the purpose of its creation. When you behave in way that is aligned with the needs of your “machine” called life, by feeding and exercising your body with the proper nutrition and activity, and you also feed and exercise your soul, by spiritually living up to your calling through a life of virtue and kindness, then your “machine” works smoothly and healthily.

Disease and illness, in all its forms, are a result of a misaligned soul and body.

Think of it this way: A newborn healthy child has all its systems aligned, both the physical body and the spiritual soul.  Like a new machine – freshly fallen snow. Once it begins to experience the toxins of the world, both physical toxins (unclean air, bacteria laden objects, processed foods) and psychological ones (lack of love and nurturing, abuse, duplicity), it begins to pollute the mind, heart and soul of the growing child. As the child’s body and psyche reacts and compensates for all these pollutants, the child’s personality gets shaped (or better said: misshaped) and hardens into an adult whose identity has been defined by its experiences, not necessarily by its natural, healthy, original self. Once a child loses his/her innocence, and as a result repeatedly develops new routines and habits effected by the pathology – attitudes, insecurities, expectations – of its parents and adults – the consequential adult that grows out of this process has now developed an entire personality with its own set of armor and defense mechanisms, which may be very distant from this inner child’s true soul.

The rest, as they say is history,

From here on the adult seeks to compensate for the  misalignment. He or she looks everywhere for a love lost, or never fully found, for unconditional acceptance, for self-confidence – for whatever it is that the healthy newborn child has been lacking.

This is the root of all disease and illness: Misaligned matter and energy, body and soul. Some of these diseases take on a physical form and others a psychological form, and usually – a combination of both.

But all is not lost. The same G-d that gave us life and placed us in a toxic universe, where matter is ostensibly disconnected from its spirit-energy, also provided us with the cure. Indeed, the cure precedes the illness (Megillah 13b). G-d gave mankind the wisdom to study and understand medicine, to diagnose and heal disease and the “permission to a physician to heal.”

However, we must always remember that the healer is but a divine messenger, and in addition to the physical interventions and medications (which are also infused with spiritual power), complete healing includes the spiritual dimension as well. This can range simply, from a sensitive bedside manner to a more comprehensive offering of emotional and spiritual support.

In Dr. Rosner words: “Clinical studies continue to clarify how spirituality and religion can contribute to the coping strategies of many patients with severe, chronic, and terminal conditions. Physician attention must be devoted to the spiritual and religious dimensions of patients’ experiences of illness. Physicians must respect their patients’ requests for pastoral care and religious services.”

Mention must be made here of Maimonides’s elaborate discussion (both in his Mishne Torah[8] and in his “Eight Chapters”[9]) – something well worth studying due to its relevance to our topic – that just as there are physical illnesses so too are there moral/spiritual illnesses. And just as we need a physician and medicine to treat physical ailments, so too do we need to go to a sage who is a soul doctor to treat moral/spiritual illnesses. And Maimonides enumerates a series of suggestions how to achieve both physical and spiritual health.[10]

How About Psychological Issues?

If the spiritual is important for physical healing, how much more so is this necessary in the realm of psychology?

Psychology means “the study of the soul.” If all healing comes from  G-d (distinguished only whether the process reaches us through a messenger or not), then it is self-understood that the divine hand is more pronounced in the healing of the soul than in the healing of the body.

This does not mean that “permission to heal” was not granted to physicians in matters of the psyche and the soul. Nor does it mean that humans, through their own initiatives and efforts, cannot arrive at brilliant insights into human conscious and even unconscious. However, it would be more than prudent – actually, outright necessary – to complement the best of man-made psychology (the healing the messengers have discovered) with looking into the genome of the soul and its faculties mapped out in Jewish mysticism and Chassidus to gain insights into our core makeup, and ways to improve and refine our personalities, as well as what to avoid, and what to do when we are emotionally wounded.

Indeed, we are now honoring the conclusion of 200 years from the passing of a giant of a man (1812-2013) — we shall call him the true father of modern psychology – who developed a comprehensive system how to grow and develop emotionally, and become truly emotionally intelligent creatures. This visionary, Rabbi Schneur Zalman of Liadi, presented a fascinating methodology of plumbing the depths of our psyches and fusing mind, heart and soul into a seamless whole in realizing our life mission on earth. What is sad is the fact that despite its revolutionary and literally transformative power, this system is mostly unknown. The time has come to reveal these teachings to the world — teachings that address every important aspect of our lives and our relationships.

Seeing the great need and the importance of these teachings, I have committed to presenting these teachings to the mainstream. Please join me in this effort, and together let us find ways to uncover the secrets to resolving our emotional dissonance, finding inner peace and gaining true emotional intelligence.

Learning and internalizing the key principles of Rabbi Schneur Zalman’s sweeping and breathtaking philosophy and psychology of life can turn each one of us into the healthy, fully actualized, emotional and intellectual adults we deserve to be.

* * *

This integral-unity approach to the universe offers us an entirely new perspective on the integration of medicine, mind and soul. It allows us to explore new horizons on the impact of our spiritual wellbeing and our mindsets on our health. Instead of seeing ourselves as compartmentalized fragments, which are often fractured into disparate pieces, we are indeed one whole; one entirety. One field of energy.

The historical and far-reaching implications of this thinking are  astounding. Imagine what potential can be released in the healing process by accessing new levels of psychic and emotional energy? Is it possible that certain diseases could be conquered by releasing this – we shall call it – G-d particle?

Could this holistic approach actually lead us to a world eradicated of disease?

 


[1] Exodus 15:26. See also: Deuteronomy 7:12-16. 28:15; 20-24; 58-60.

[2] See Bereishit Rabba 10:6: G-d made elixirs grow from the earth. With them the healer heals the illness, and the pharmacist concocts medicine.

[3] See Shemot Rabba 50: 3: “For I will restore health to you, and I will heal you of your wounds, says the L-rd” (Jeremiah 30:17): G-d does not work as mortals work. Man wounds with a knife and heals with a bandage, but G-d wounds and heals with the same thing. See Ohr HaTorah Nach p. 361-362 where he connects it with the verse in Jeremiah 17:14.

[4] See Maharsha Sanhedrin 101a. Ohr HaTorah Nach p. 360.

[5] Zohar III 304b-305a. Zohar Chodosh Balak 44c.

[6] Perhaps this is why there is even a consideration in the Talmud (Berachot 60a) that “it is not the place of people to seek medical treatment (people should need seek medical solutions to their health problems but should rather pray – Rashi), but so have they accustomed themselves,” because in an ideal world that would be the way to heal (see Ramban Leviticus 26:11. Toras HaAdam, Inyan HaSakanah).

[7] One interesting reason why G-d endowed man with the ability to heal can be explained according to Rashi (Pesachim 56a):  Why did King Chizkiah hide the Book of Remedies – a book that contained direction for speedily curing all illnesses? Chizkiah felt that because people were cured so quickly and effortlessly that illness failed to promote in them  a spirit of contrition and humility, which illness should engender (see also Rashi and Rambam Berachos 10b). Why then is the Talmud  filled with medicinal and herbal remedies? 1) To avoid them being entirely forgotten, and 2) to make it clear to future generations that there is “no branch of wisdom lacking from the Talmud”… so that “no scoffer will be able to say that the Sages of the Talmud lacked healing wisdom” (Maharsha Gittin 60a).

[8] Laws of Knowledge 2:1.

[9] Chapter 3.

[10] Important to note the classic work of Maimonides, Hanhagat HaBri’ut (Guide to Good Health), which was written in 1198 in response to a direct request by the Egyptian sultan for medical advice. This is a comprehensive work on matters of health and healing, in which Maimonides elaborates on the psychosomatic relation between a person’s mental state and his physical sensations known today as mind–body medicine. This text is still utilized today, by physicians around the world, as a guide to integrate physical and spiritual healing into complete well-being.
Here is a taste of a few points he makes: “The physician should make every effort to see that everyone, sick and healthy alike, should always be cheerful, and he should seek to relieve them of the spiritual and psychological forces that cause anxiety.  This is the first principle in curing any patient” (3:13-14). If the patient can be treated through diet alone he should not be treated with medicines (2:21-22). One should never forget to strengthen the patient’s physical vitality with nourishing food and to strengthen his spiritual powers with fragrant odors, with music, by telling him happy stories that expand the heart, and by distracting his mind with things that make him and his friends laugh.  The people chosen to take care of him should be those who know how to cheer him up (2:20).

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Jack Bloom
4 years ago

But how does this explain how a totally aligned person gets ill through a virus or a germ? According to the law of cause and effect in this world if there is a virus going round you are likely to get it. And if you are injured by someone else or in an accident you need healing too. Lots of very good people have died in epidemics.

Rabbi Gabriel Cousens MD
4 years ago

please supply best and most condensed source to study Rabbi Schneur Zalman’s psycho/spiritual healing system. As a holistic physician , psychiatrist and student of Maimonides for over 43 years this sounds very interesting. My email is:
gc@treeoflife.nu
Thank you

Ionah Estevez - Breton
6 years ago

Shalom. I am an Orthodox Jew and a Family Physicyan. Judaism has deep convictions (a long time ago) of the unity of soul and body (plus its medical implications). A healer can only truly adress health problems if he/she applies a unified existence approach to his / her patients (& their complains) … and treats them with honest friendship and kindness. Thank you.

Rabbi Meilech Leib DuBrow
6 years ago

You wrote: I have committed to presenting these teachings to the mainstream.

Then welcome from those of us who have working on this over the past several decades. The College of Torahpractic Medicine and its most recent project, http://www.TorahRX.com, are the result of over 40 years research into traditional Jewish soul-body medicine.

As you proceed, you might want to update some of your information. For example, you quote an article by Dr. Harold Koenig, in which he purportedly states, …that religion may either be simply irrelevant to health or, worse, that it may have a number of negative health effects. In fact, Dr. Koenig is currently one of the leading advocates for the inclusion of spirituality in medical care. Indeed, he has compiled a two-volume work covering 20 years of research that convincingly demonstrates he positive health benefits of religious practice.

You might also clarify what you mean specifically when you write that Health, in effect, is simply defined as a life completely aligned with its purpose and realizing its raison dêtre. and Disease and illness, in all its forms, are a result of a misaligned soul and body. At the College of Torahpractic Medicine, we define health–both physical and spiritual–as a manifestation of our connection with the Divine Flow of Light and Life-force, and disease as a disruption in that connection creating disorder in the Flow.

I would also take issue with your conjecture that A newborn healthy child has all its systems aligned, both the physical body and the spiritual soul. In fact, a child does not reach fully manifested health–again physically and spiritually–until at the very least her or his 12th or 13th birthday, respectively, and some would argue even later. It is not the toxicity of the world that impugns our health, albeit a contributing factor. It is our behavioral response to the world, including our thoughts, speech, and actions.

I look forward to your contributions to the field of spirituality and health.

Rabbi Meilech Leib DuBrow
Founder and President
College of Torahpractic Medicine

Editors reply:
We thank you for welcoming us to this work. But we dont appreciate your condescending tone; as if you have some seniority. Frankly, the Meaningful Life Center with Rabbi Simon Jacobson as its dean, dedicated to presenting Torah as a psycho-spiritual blueprint for life, precedes most if not all others making attempts in this direction.
Not that we want to pull rank, but its important to set the record straight.
Thank you for your comments, and much success in your work.

Marc Oromaner
6 years ago

Ive been following your writings for decades. Theyve inspired much of my thinking about the world and my own writings about it. Back in April, 2013, I wrote an article titled, The Invisible Thread that speaks to the idea that we are all one using metaphors from our technological world such as WiFi and Cloud digital storage. You and your readers may find its parallels intriguing, as it expands on your invisible quilt metaphor. (http://thelaymansanswerstoeverything.com/2013/04/28/the-invisible-thread/) Thank you for continuing to share your wisdom.

Shirley Mankowitz
6 years ago

Thank you so much for putting so clearly a subject so involved…I will print out your whole text and take it to my Rabbi – Rabbi Nossel who has a depth and an openess as broad and wonderful as you have Rabbi Simon – thank you once again.

Ruchama Burrell
6 years ago

I enjoyed your commentary on psychology and religion. I do have a question about reliance on concepts from the Tanya and Maimonides, since both sources assert that the Jewish people have different and superior souls and that in some respects it is not possible for the other nations to be truly good or to be united with the Divine. I simply attribute this to the times in which these works were produced and the reliance of Tanya on Maimonides, but it has made it difficult for me, personally, to study Tanya, since I do not and cannot agree with that central premise. Given that premise, how can the ideas promulgated by Rabbi Zchneur Zalman benefit anyone who is not Jewish.