They Asked WHAT?! Mental Health and it’s Real Life Implications on Psak Halacha

foreign [Music] so it's a pleasure for all of us to be a part of the third annual unite to heal Campaign which is in support of the incredible work and the important work of amudib my name is Shai shefter I'm one of the Rob Dunham at the Young Israel of Woodmere and I was asked to come join a panel of other rabbanim to talk about not only the amazing work of ahmudin which I venture to say all of us and so many of our colleagues all over the country have made use of when we have situations in our communities that arise which clearly are out of our depth and beyond our league but things that we need to pass on to professionals and to organizations that really strive at uh at helping the community members who need their help and as we know ahmuda is something that helps not only with many mental health crises and many issues but obviously those who are struggling with all kinds of addictions and most prominently those who unfortunately go through a traumatic experience of abuse in so many different ways and we have all turned to our mudim at many different times in our lives and in our careers to uh to try to get some assistance to get perspective and to try to help people as much as we can so it's really a pleasure for all of us to be here I want to just introduce the panelists who are going to be sharing with us what I believe is a very powerful conversation and as we know whenever we have shyla's whenever we have questions that arise in our communities as individuals and certainly as so we have to do our best to try to look at all the Angles and evaluate all the different sides and try to understand what's really beneath the question and is there something that's beyond what's being presented that we maybe need to consider or need to think about and this is something that is part of the incredible challenge that we Face especially in light of the mental health issues that sometimes need to be considered and it's something that our uh that that all of our colleagues try our best to be sensitive toward and to be understanding about and um what we're going to talk about today is different kinds of questions that have come up in our communities where we have opportunities to think not only about the strict letter of the law not only about the halafah itself but to think beyond that to try to consider a number of other factors that may be presenting themselves in the questioner who is presenting so uh with us today on the panel and we thank um all of the rabbanim for making time in their busy schedules to be a part of this and to be a part of helping to support our mudim and their very very Noble and special work so the first panelists that we have is Rabbi Larry rothwax who is a rather than Congregation Beth Aaron in New Jersey and Teaneck and he's also the director of professional rabbinics at REITs which is so much an integral part of teaching young about these very issues and trying to make sure that they understand that not only is learning important not only is Mastery of information important but professional rabbinics is also important and to have to have a perspective of how to deal with somebody who comes to talk to a young Muslim with a question our second panelist is Rabbi Danielle Feldman who is a rather also in Teaneck in congregation or Sadia and also serves as a rosh hashiva REITs but is very very well known for his sparim that have become very popular over the many years that they've been published on a range and array of topics both in English as well as in Hebrew focusing very often on issues of and he has written so extensively on so many of the things we're going to talk about today and I encourage all of you to try and find some of his articles and some of his writings online to educate yourselves a little bit more about the very incredible perspective that he shares on so many issues that we're going to talk about and finally how they are elibowitz who's the rava based Festus in North Woodmere also a mahabres farm a popular series called hakone olama which also deals with very much is and dealing with human complexities and the shilohs that come up in communities but is also the director of Smith Outreach and uh has such a perspective from the many many talmudim that he has helped to guide in uh their paths and their Journeys in the robotics so we're going to jump right into this and maybe just the format that we're going to have is uh each of the rabbana will share some stories some anecdotes some questions that have come up and and we should all feel comfortable to comment on each other and to fill in whenever there's an appropriate need to do so so maybe we'll begin with Rabbi rothwax who can uh share a scenario with us and give us somewhat of a perspective okay thank you very much for receptor and it's a it's a great personal honor to have the opportunity to participate in this important conversation uh my personal goal is to try to stay as much as I can just out of the way so we can learn from our Felder believe which if I've been successful with the help of Hashem and in any way whatsoever it's uh some people have entrusted me uh with you know some very delicate questions and dilemmas that they have they have faced and I've had the opportunity over the years to you know to try to assist people from wherever they were and trying to offer them personal guidance and whenever appropriate halacha guidance as well I think that all of us today have a little bit of a dilemma because we want to be able to really share with the community uh some of what's going on out there because I think there's great benefit and there's something very validating for each and every one of us to know that some of the real struggles that we maybe experience personally within our family within our inner circles are shared by many many people that the community at the same time I think we want to all make sure that we are being respectful and mindful of people's privacy and most importantly make sure that individuals feel that they can ask ashyla to a REV and and not and not be concerned that it is going to be uh you know shared with the public so I think that all of us are committed to uh to giving uh to trying to share you know shy was by preserving their integrity uh but at the same time you know doing so in a way that no way whatsoever would would uh disclose the the identity of any particular of the the questions so I'm going to start off with a fascinating Shiloh that was um shared with me years ago um I imagine that some of the questions we're going to deal with today uh may be rather intense and we're going to deal with I'm sure some very very serious shyles this is a very intriguing question uh not one that involves but one that I think for myself personally uh was was sort of like a gay Gateway in terms of my own thinking and appreciation of how how complex some mental health issues are particularly as they intersect with with halacha a number of years ago I was involved in a situation with as a young man who had become Bar Mitzvah within the past year and it was so long ago and I was not actually at the time sophisticated enough to be able to really comment much in terms of what was going on for men mental health perspective but in retrospect I think that this was an individual who probably had uh you know somewhat of an obsessive personality combined with what at the time was maybe some sort of confused or maybe you know complicated ideological perspectives on on animals and our relationship with animals and and the the the Divergence of those two led to the following situation and that is that uh he did not feel comfortable having to do anything I can do with leather he wouldn't wear leather shoes he wouldn't wear leather belts he wouldn't wear like the yamagas if I remember correctly he wouldn't even want to sit on a leather seat it was really extreme we're not talking about somebody who just uh you know was a vegetarian or was choosing you know not to eat uh you know byproducts of animals this is really extreme the people became a bar mitzvah obviously became an issue with him when he was putting on filling he was encouraged at the time uh to try his best and even though he didn't particularly enjoy it and he found it to be uncomfortable for him to push his way through but over the course of several months this became a real struggle for him to the point where what he described and certainly what he displayed was a tremendous amount of personal anguish wearing filming it was painful for me it literally brought tears to his eyes and you didn't get the impression that this was an individual who was looking to be difficult he was not rebellious per se he wasn't uh as far as as far as you can tell in every area he was he was committed to living a life of ter mitzvos but this particular Mitzvah obviously a very important one uh presented him with uh with the extraordinary challenge so I will now open the floor and allow Rabbi Lee was whenever Feldman who you know we're not there at the time uh um to share any thoughts that they may have in terms of uh and again and again I I think that we want to try to keep this conversation focused on two things at the same time you know what are some of the halachic issues and what's an approach that maybe we would take but at the same time to realize and to appreciate you know the the real the human struggle here and to understand you know how complicated and and not necessarily intuitive you know some of the real struggles mental health struggles that people encounter well I'll speak first just to frame the question further so then I can shift over by liberowitz but before even addressing the specifics although it's very relevant to trying to understand exactly from what direction to come just to clarify this is an issue that can come from a mental health perspective but can also come from ashita it can also come from someone's attitude towards say veganism and animal rights and I've heard the question in that context also so if the question is being asked by someone who feels philosophically that he has no right to use leather in any form and therefore that extends to not even wearing fill in that would require one kind of level of understanding and approach while it sounds like from what you're describing that it's not necessarily coming from an intellectual or philosophical place but rather it's more of an emotional reaction that's not the kind that can be addressed from that type of perspective is that an accurate frame yeah that is correct that was very much my impression at the time and I think in that regard I think it is what makes it somewhat unusual I think we would more naturally expect that it would be more Vegeta but in this case I think it was actually was an underlying pathology and even though I'm not going to try to you know offer a clinical diagnosis at the moment I think it's it's clear to say that Wade was presenting was that this this was a real real struggle for this individual and not something that he just needed to you know try to adjust his thinking in terms of you know his world views of philosophies yeah when it comes from that perspective that if one feels uh an enormous discomfort that they are not able to overcome so then it probably enters into some of the literature that we know in this group that uh ravasha Weiss has discussed extensively for example to parallel the question of dalekosos where it comes up that sometimes there are impediments to someone being able to perform a Mitzvah that are not necessarily life-threatening but it creates some kind of a debilitating condition whether it's physical or mental and being that we know that they can be of equal difficulty whether they are physical or mental so without coming to a conclusion on this point but there is a literature about that that we don't necessarily assume that even when dealing with a positive mitzvos that we have only a dispensation when it's in the category of life or death but sometimes when something is really incapacitating so then that opens up another Avenue where that Avenue will go again it's not something we can conclude so easily but in some contexts it's brought from a cavachometer from monetary expenditure that we know that's filling as important as it is yet it's still subject to a limitation when it comes to expenditure of one-fifth of your money it's in the category of hamesh so a incapacitation that is so absolute even it's going to be subject to how exactly you assess it theoretically would bring up some of that literature I would I would suggest uh along the lines of what rafeldman was saying that we know when it comes to avoiding violating a low sassay a lot of process give up all of their money but when it comes to fulfilling a Mitzvahs to say so it's only up until 20 of your money if I'm not mistaken in the juva relating to a uh an almana covering her hair um uh after uh she's no longer married but she's in shudukum now and uh technically strictly speaking she's supposed to still cover her hair I think in that context of Moshe writes that if it's so traumatic for her or it's something that's so difficult for her that she would sooner give up 20 of her money rather than do this Mitzvah that uh that then that that would be beyond what the daughter expects of her in in that Mitzvah now that's not just that that's in that specific circumstance we're covering the hair remotion suggests is only perhaps a mitzvah's assay rather than for a married woman where it's a low SASE so no one should extrapolate about hair covering in general but when it comes to mitzvah's assay we typically assume that if it's the type of trauma that you would sooner give up 20 of your money uh then to uh to have to fulfill the Mitzvah that it could be that uh one is exempt from fulfilling the mid side there are a couple of other factors though that have to be taken into account first of all um it's not so clear that if it's not just a one-time Mitzvah but it's a constant where every moment you're getting a new Mitzvah that we would have that same measuring stick of 20 percent I mean for example when it comes to the midst of mezuzah where every second there's a nuclear Mitzvah it could be you have to spend way more than 20 percent of your money on mezuzah when it comes to wearing till and also each moment that a person is wearing fill in is a new a Mitzvah it's not just it's not the same to put on fill in for 30 seconds as it is to put on tone for 45 minutes um it's not like uh love or something like that although discussions three missions and given that as an example but it's not a uh necessarily a one-time Mitzvah and uh the longer you know some of the posts can recommend I heard Morena of chapter Salita um suggests for someone who missed putting on still in one day where you're telling twice as long tomorrow meaning uh even though each and every day there is a fee of the balance fill in but each every moment there's a Kia Mitzvah of its villain on the flip side one always has to be mindful of long-term goals and short-term uh gains meaning if uh pressuring a person to do a Mitzvah is going to create such a traumatic experience that forever there will be a negative association with this Mitzvah and then once the person gets to a healthier place there's still no it's going to be a trigger that mitz was going to become a trigger for them so then it could be that we're really shooting ourselves in the foot by uh by putting too much pressure to do to do the midst not obviously as both Ruby rothback said everybody Feldman pointed out this is really a case-by-case basis where a person has to really really assess the situation what the long-term impact is going to be what the short-term impact is going to be what the attitude of the person actually is and obviously in consultation with a mental health professional who's familiar with the case not just the mental health professional in general which by the way I don't know if it was mentioned probably rothwax is a mental health professional in addition to his uh rabbinic duties but a mental health professional who is I was familiar with the case I think it's worth mentioning also once we're talking about us that sometimes community members who hear about such a question don't really fully appreciate the struggle that the individual is having and don't really understand what the question is I remember for example there was a woman who had posed the question as I believe with mentioned before um so he spoke about the variation that ramosa has about an Albano who's now in shidil him and covering her hair but there were a number of situations where women came to discuss a question about covering their hair they are married and they just said that they have terrible migraines terrible headaches every time that they have anything on top of their heads now that's a question which obviously again needs to be a very Case by case and not to extrapolate from but I remember mentioning it to someone else in the community and he said come on just just do it what could it actually do you put something on your head like is it really bothering her how much going to bother her ready she should just do it and I think there needs to be an effort to try to educate people that they need to be mindful of the fact that yes there are some people who have conditions or who have situations that maybe you don't experience and maybe you don't fully understand but it doesn't just mean that you know it doesn't just mean that they have to suffer and that they need to uh and that they need to ignore or suppress that struggle it's something that needs to be spoken about and dealt with and obviously these questions are dealt with and sometimes the answer is yes you need to suffer and you need to struggle and that's what it is but very often that is not the case and there is a discussion and how that could be had I I was just wondering from the other up on him I've had several shaylas that relate to what's called exposure therapy and what the limits are and and maybe they had similar shyles and how to navigate um you know the this kind of uh situation I'll just give two examples two quick examples exposure therapy from what I understand in our growth of access can certainly correct me if I'm wrong is the idea that if a person um has whether it be an OCD or an anxiety that relates to a particular area a particular topic where they have extreme attitudes or um extreme thoughts that you sort of expose them like if a person is terrified of cats and can't walk on a block that has cats on the on on the block or that they once saw a cat on the Block that they're uh that they then slowly slowly uh you expose them a little bit more to uh to the uh the source of their trauma and they they grow accustomed to them they get used to it so I had two cases one where a guy was struggling with OCD and anxiety and uh he had these very extreme thoughts that he thought that any time he thought negatively of somebody it constituted a tefila that the person should suffer and he believed that his thoughts were actually making people suffer because he was davening that they should suffer and this was a result of something that happened in childhood that he had wished ill on somebody and the person really suffered uh pretty terribly shortly thereafter and the therapy uh the way this therapist had recommended was to say out loud that he wants something negative to happen to somebody and I don't know that you're allowed to do that uh meaning uh generally speaking it's not nice to say you know to curse a person to say that you want something bad to happen to uh to somebody else another situation was a person who had you know uh who had OCD relating to um to religious behavior of people around it that he just couldn't uh he couldn't handle when anyone spoke any avocado or any nival pair anything of that nature and and what the therapist recommended was that he either say or hear uh nibble bad words and uh through by being exposed to them and not reacting to them that it would be that would be helpful to him to function like a more normal person in his day-to-day life and you know each case is different but I just wonder if you've ever had either questions about that or um you know have any insight onto the effectiveness of such such treatment and what the limits of exposure therapy might be as far as that first point about somebody who feels that what he says is harmful to people so we know there is a concept of a koala and we know that there's an Issa in the Torah of cursing people although it was somewhat of a debate as to whether it's because we connect that to any real world effect the rambam didn't think there was any real world effect but he did certainly believe there was still a Prohibition nonetheless and in his view footner has an essay about this that it probably connects to the broader goal of the have and not subtracting from how people are felt and experienced and the love that's supposed to be directed towards them but also especially what you're referring to that somebody feels that they want somebody to suffer so by definition that certainly seems to fly in the face of the absolute if you love anyone else as yourself you're not going to want them to suffer but what's particularly striking about this is that the one who's struggling with this is struggling so much because he doesn't want it to happen because deep down the the yid inside it very much doesn't want there to be any real world effect and doesn't want the person to suffer so I think that might be an opening point to consider as far as the paths that he needs to take in order to get to that result now but it's very difficult in this case is to understand exactly why speaking it out loud is going to be helpful to him I just can only speculate as a Layman that perhaps being confronted more absolutely with the reality of it is a step towards then actually dismantling it as opposed to a thought which remains somewhat unaddressed I don't know if that's the the nature of it but overall certainly we have a great discomfort with saying that anyone else should suffer whether it actually constitutes a color whether it's a more broader kind of objection but the fact that this individual is so troubled specifically because of that because in real life that's the last thing he wants to actually happen and to whatever extent this may help to mitigate that and to bring him to a place where he's not even having these thoughts in the first place so the worthiness of that goal is something to hold on to how much you can accomplish for that it's probably more in the hands of the Professionals in this area it struck me as a little risky also meaning he's going to say something out loud that he wants something negative to happen to somebody and what if it happens you know then it's going to send him back I would imagine it seems right so the nature of that I think this would also be a case where for the rabbi to speak directly to the therapist if possible and to understand that how this is supposed to help and how it's supposed to operate and I think we've all had the experience that there are therapists who are more connected to our value system and less connected to our value system but also some who speak more generally and more specifically so it's one thing to say I'm scared of something so to confront it more directly is going to help me eventually become less scared it's probably another thing to say that one should be encouraged to say horrible things because they have an aversion to these horrible things they should have an aversion for those horrible things and what exactly is the nature of that aversion and where do we draw the line between the appropriate aversion and an incapacitating aversion yeah I agree 100 especially because the um in these types of situations talking about exposure therapy for anxieties for phobias there is a fair degree of flexibility that the therapist has this is not is it's not regulated by you know you know when it comes to medication for example well there may be different types of medications to address certain illnesses generally speaking you know the the pharmacology is what it is I mean there's there's not all that much flexibility when it comes to designing a protocol to help somebody experience less anxiety and to face some of their fears and challenges there can be a lot of flexibility and I think more often than as every felon said has a lot more is accomplished when the Rev can interact directly with the therapist and and sometimes there's not even a conflict of values as much as the therapist didn't necessarily understand and appreciate that you know that there was some there was some tension there I remember years ago there was a young woman in the community who was going through a very difficult time in her life and she spent a lot of time horseback riding and she was spending almost every day of the week and she could reached a point where she wanted to go horseback riding on Shabbos as well and she she asked me if this was something that she could do she had been in a very compromised state for a long period of time and this was you know she had reached the point in her recovery where you know this was giving her a tremendous amount of in many ways so there's a particular rub a post that he would have been very involved in helping and guiding this family through many of the challenges that they face so I went to him and I asked him if it would be permissible for her to go on Shabbos and he didn't need a lot of background because he was already familiar with the case and he said 100 percent 100 and it's just a matter of the details how is she going to get there and we have to work that out but in no way whatsoever should we stand in our way if this is what she needs and it'll continue to give her the um the therapist heard about this and the therapist to my knowledge of America was not was not Jewish and certainly not not an observant you said absolutely not she may not go on jobs there's nothing to discuss here because from the third therapist for a second this wasn't this wasn't necessary this girl needed to experience a little discomfort of sitting around one day of the week and not being able to do what it was that brought her you know tremendous relief for me personally that was a that was a fascinating moment where I saw a clash of Two Worlds but it was completely flipped in the way we would naturally expect and bringing rabbis and therapists together can teach us a lot not only about halacha but but about mental health and don't assume that the rabbi is always going to be the Malcolm and the therapist is always going to be pushing this way sometimes you know everybody just needs to speak to each other and there can be a lot of a lot of benefit uh on all sides just for the record that case of the obsessive thoughts it was the therapist that asked the question it was a from therapist it was a rabbi also but asking the question whether he can recommend that as a uh as a course of treatment I don't know if this was the truth that was referenced earlier but in the I think the second volume of ravashi Weiss there is a revolutionary truth on OCD and I think there is is well he I don't know if he's speaking about exposure therapy per se but he does uh outline certain Clum basically sort of what was said before lose the battle win the war sometimes you need to really think big picture over here and um I think you know speaks about you know Sam sulfur who says that if a person is wandering in the desert on Shabbos we do not impose upon him the the requirement to well he's lost in desert doesn't know what day it is so when it comes to the seventh day he's not going he's not bound by the Allah Shabbos because otherwise it's never going to get out of there and I think you get takes to go that we as well to to to think in these terms and to apply these column in these types of situations but it's very very important to remind ourselves that we we have to be willing to to explore all possibilities that doesn't mean that everything's going to be okay but uh because the alternative sometimes as a person can really be trapped rehearsal Weiss is China who uh who had uh OCD about Dominic and he would constantly repeat words in davening and ravashar told him to never repeat words in any of your braces or filos no matter how certain you are that you didn't uh get it right and then like you said like Rabbi rothwax said that was his his logic that uh that you have to keep the big picture in mind about a shelter that has a chance at rufua in a mental institution that doesn't serve kosher food um and then he could stay there because where you wanted to remain his entire life and be part of mitzos you have to keep the the long-term goal in mind so I I will say that although that chuva is printed and it's specifically talking about OCD um we once had a Shyla here about exposure therapy in particular and it was a much more Hummer Shiloh than the ones that were presented it had to do with Indiana rice potentially and it was a very very serious Shyla and I did present it and I'm not going to get into the exact particulars of the answer or the case because uh you know again it's just very personal but but a lot of the logic that was used there was also that same custom server that if we don't figure out how to use the exposure therapy to think about the long-term goal and the long-term healthy uh Vision that this person can have on their Journey moving forward then they're just going to be debilitated for years to come and they won't be able to do many other things I do remember a number of years ago when I introduced her Russia wise to Dr pelkowitz and they were having a conversation about a particular issue it was a more General conversation but then at some point they spoke about a particular issue that um was on both of their minds in a certain condition and Dr palkowitz asked a very compelling question when I have a patient like this or when a therapist is faced with a situation where on the one hand you have to worry about the psychological issue that's going on and the mental health component of it which is obviously very serious at the same time as a result of this condition this individual is now giving up on religion and very often we find that that happens so which one should I be focusing on first which one takes the primary role should I first be working only on the mental health should I be paying attention at the same time should I do parallel therapies and have two different therapists seeing this individual and robuster wise was very clear in his answer and he said if you're not alive you can't be fruit so he he basically was telling him that the first thing that needs to be taken care of is you need to make sure the person is healthy and stable and and strong enough to be living life and living the journey and experiencing life and going through it in a healthy way everything after that is secondary and and only once a person is healthy do they have the ability to to then be fruit and to consider that I just add on the flip side of that though I I we also heard from Russia Weiss once that what makes mental health treatments particularly challenging more so than physical health treatments is that typically there's more certainty in the treatment when it comes to physical health that this is the treatment that will work no other treatment will work and this treatments as a track record of working uh there are certain therapies that you could perhaps say that about but there are a lot of things that may be suggested as a course of therapy by one mental health professional that maybe uh you know he the the mental health professional may be just trying something you know May and and has very little certainty of whether it's going to be effective um and uh and and and it's not certain at all that it's the only uh course of treatment so I know in a certain very Hammer arios case which I'm not going to share the details not because I'm trying to protect anyone's privacy but just because I don't remember the details I remember uh reverse device also said I mean I would try to present someone's privacy also but uh but I I happen to not remember the details uh ravasha Weiss uh said that uh we couldn't they couldn't pursue a particular uh path of treatment because it's not so clear that that path of treatment was the only way to help and what was even going to help but this is why everything's on the case the flip side of exposure therapy just another type of question that we're going to will get is in the the management of addiction sometimes there's an approach that's called harm reduction uh in which a person is addicted to a particular Behavior which is harmful in some cases Usher as well and I think it would almost always be both um and whether it's after failed efforts to to eliminate um The Addictive behaviors to to break these patterns or maybe it's just under the circumstances the only way to help sort of reduce the intensity of that addiction the recommend the recommended approach is to pursue what's called harm reduction which is exactly what it sounds like and that is to reduce the either the frequency or the or the nature of the device so that would mean perhaps when dealing with let's say a drug addiction perhaps instead of uh instead of using a certain type of drug which is potentially much more toxic it would be to use one that is you know that provides a high but a little less toxic to reduce the intensity when it comes to exposure to pornographic material there's another approach where again the the treatment is not well do it less the treatment is do it less you know it is because if the goal is going to be to just go from one extreme to another given this person's track record and the the particulars and again we're talking very general terms right now that is not something that that's going to work it's a little different I think from the from the from the perspective of how long it may be different in terms of how we would view that over there we're not necessarily looking to introduce something that is not already a part of this person's struggle but rather give them license uh to continue but to do so in a way that will hopefully again enable them to find their way out of the desert I would uh just add it just a few as far as that you can apply or Not Apply decide how much they account for but it's noteworthy that first of all the point about the desert as we mentioned just to put that in context of the nature of the proof from there is that traveling if one assumes that we don't know when Shabbos is so any day is the suffix Shabbos so if we're going to be machner on other things that's one thing to imagine we're in traveling means that right now it's not because of Netflix okay you can sit in one place for a day but the result is going to be that there's no severity to ever be more Maple than any other day unless you look at it as the whole picture you're never going to be able to get out of there and therefore the accumulative effect of everything of being a master on every single case is going to end up being unlivable and that's a part of what plays a role in some of these questions but there are also other gemaris that also contribute to being able to have some leeway and the question of the sugiya of hate which is somewhat of an unresolved issue and it draws on a lot of complicated factors but we sometimes times do find that we're able to draw on some kind of a relative assessment and it's also interesting to consider especially as rabbanim and I think there's a big difference between what we're specifically allowing or instructing or what we get in the way of and when there's room just not to get in the way that's something we should really pursue sometimes especially because even when we already asked the question directly so a lot of the consideration is that it was we don't want to give advice that is harmful we don't want to be a part of somebody else's Avera but it's also very possible that never and how exactly to relate to it but certainly it comes out from achuva widely quoted true that it goes to the goal of the what's actually happening so if somebody is going to fall were you making them fall harder or making them fall less so there is much more license to take a result based approach especially when you're the one guiding your are advising or choosing not to interfere especially to say that I can look at what's going to be the end result of this process and will there be more of a nephila if I get involved or more in the field if I don't get involved then to allow that to be a part of it so so we've all um dealt with various varying degrees of addictions and different kinds of variations of that I'm just curious about rothwax I know the question comes up you know many many times in communities what do you do when you have an alcoholic who's really been working hard on themselves and really been to therapy and really doing very well and then they're confronted with pacef and they're sitting around the table with people who are all drinking not doing anything that's that's uncomfortable but for that person it could be extremely damaging well what would you say what's the suggestion for that individual yeah so so first of all before we get to the pesos data there's you know there's you know every other day of the year and I'll take this opportunity to to just remind anybody who's listening how sensitive we need to be uh it goes without saying we need to be sensitive to individuals who we know are in uh various stages of recovery but we also have to be extra sensitive and considering the fact that there are people who are either in the throes of an addiction or in earlier late stages of recovery you can never truly be truly recovered that's another important point to mention and and we wouldn't necessarily know that um I distinctly recall uh once uh being present at the Shalom I'm sure this happens often but I just recall there was an individual who was walking around offering everybody drinks he meant well he wasn't about a bus it doesn't matter can I give you a client here and if anybody said no so he's he said he said again come on a little a little little and um he he went over to one individual who said no he says come on a little guy said no and the third time that the person he was he turned red in the face and he said I can't have alcohol can you please stop asking me you know and it you know I don't want to over dramatize the event I don't think the entire room heard but I saw it um and I've seen since these sort of encounters very very innocent so I think we should be very careful um we're not going to get into conversations around now policies alcohol policies and schools and schools um well sure alcohol policies in schools but it is important to to recognize that we should not be offering and serving people drinks if if and when it is appropriate for people and they feel that they're able and that they would like to go ahead and to have a drink let's leave it up to them otherwise I think we should assume that and is this is assumption based on statistics and amudum could provide the numbers I don't know what they are but there's a significant number of people in our community who are who are struggling and we would never want to in any way whatsoever contribute to that and then as you've asked there are times of the year that we completely cannot avoid the the train wreck at all I think most people can easily manage a Shabbos table and certainly a poem which is a conversation for another time um but the pesos later you almost can't avoid the the question uh now it's true this is my closest opposing about using grape juice for the purpose of dalekosis which may be you know one solution but what if that's not enough for this individual and I think of rubber Chef if I understood your question correctly the question was not whether this recovering alcoholic should be drinking wine for dalucosos it goes without saying that that's something that is not an option but what if he finds it to be very challenging to be sitting there at the table so there's two possibilities one possibility is well we'll just we'll just have a state by himself or go elsewhere or can we consider the possibility that everyone at that table well they'll have like we'll call a dry Seder I mean I'm I'm gonna I'm gonna pause now and open that as a question but again I think that the power to this conversation is in the questions more than the answers I think that if if anybody's listening right now and that question just makes you feel very uncomfortable I think it's a moment to just just reflect for a moment to understand and appreciate that it could be a very lonely place to begin with to be in that stage of your life whatever and and recovering from an addiction that tells such a person you know listen this is why we do it and if it's not comfortable for you we understand but you know this is the way we do it it's you know either way the question should should weigh on us my wife was once uh we had guests in Shabbos and she was serving chicken and one of our guests complimented on it she goes hey it's a new recipe so the guy says what's what's the secret ingredient and she said beer and he he spit out the chicken right away and we we didn't know how to react and he said I'm sorry I apologize he said I've been in in recovery for I don't know he said like 25 years and I I can't touch alcohol so we were obviously stunned and afraid that maybe we we just set him back 25 years thankfully he did not fully evaporated in the oven isn't that a thing well that's the thing he listen I guess he was he was he was you know he was in recovery mahajana he was not going to take any any risks but again it was just a moment of just it just just you just you just don't know you just don't know this was the person that we thought we knew well and we obviously know much better now we did before and he was actually very comfortable with the disclosure it hadn't come up before but it took and this was not a pesos this was just you know a Shabbos meal and one of the ingredients was beer and again the takeaway message is not that we should eliminate beer and wine from all of our recipes as much as just understand and appreciate that we don't really know from time to time who we're who we're interacting with I'll if it's okay I'll just I'll just pivot for a moment because what this question uh really what what it puts on on the on the table for this conversation is the possibility that there are times in supporting and helping individuals in various stages of mental health treatment and Recovery other individuals must at least consider the possibility of adjusting their own routine which for the purpose of our conversation means you know considering their own their own possibilities for their own halachic observance it's a very unusual type of Shiloh to ask but is it permissible for uh an individual to to do an answer which would directly benefit another individual but I'll share a question that I had years ago and actually sort of resurfaced a very recently right after yamtif that there was there was a woman uh it was was it was a girl a young girl teenage girl who was in a in in in a residential program for an eating disorder uh treatment of eating disorders I mean particularly on a residential level there are different stages and once uh the individual who is sort of graduating from one level to the next they try to get her or him whatever the case may be to a point where they could have supervised meals together with members of their family so in a residential Center they're usually not living with their family obviously but the parents will come in if it's from out of town they'll come in for a few days and they'll have supervised meals so the situation was like this the the girl was in a program and they told her going in that the food is kosher the truth of the matter is most of the food probably was kosher but it wasn't up to their standards they told her that it's not going to be necessary to serve which never it is they weren't going to have make her have you know bacon but you know where all the cheeses and all the yogurts necessarily you know with with an OU probably not and this particular facility was not interested in accommodating that and I do want to point out that in my experience which is it is what it is some of the eating disorder facilities that are less accommodating in this regard tend to provide a much a much better type of treatment because they just run a very very tight ship and they're just very much on top of things it's not come they're not looking to be probably you know difficult and it's not they're not they're not against Allah religious observance they're just trying to they have a they have a much bigger consideration so this girl had been there for months and under the impression that everything she was eating was kosher and um her parents came in for a supervised meal and the parents were told don't worry we're gonna have special food for you and um the parents came into the room and um they were sitting at a table and um discovered lo and behold that those accommodations were not offered to them so this was a question thankfully that that came my way after the fact that they couldn't do anything in the moment and they were right then and there and I guess the Charlotte that they had in the moment is what do we do we sort of keep this lie going it's hard to it's re it's I'm I find it hard to to speak the shadow through without feeling the the intensity and the emotion at the time you know what do we do we've made it this far she's doing well do we just sort of keep the lie going or do we hesitate and say the lady you know I can't have this uh I can't have this cheese I you know you know do you have do you have anything else I'm just curious what other abundant feel about uh mental health how does that fit into the picture of of Shabbos you know we have very clear guidelines regarding Shabbos when it's somebody's life we have guidelines with regards to shmat on Shabbos as the chiffon Arab rights but what about when you have somebody um what about when you have somebody who has a mental health issue and that collides with Shabbos how do you approach that I think again I'm going to jump in here because uh for the most point I'm standing on the side when Ruby Feldman or religious but correct me if I'm wrong Would we not Would we not look at every mental health issue as we would any health issue and try to figure out you know how to classify the the level of of illness it is being of course that yeah mental health issues can in fact create a situation where a person is a genuine call I think that you know we would not necessarily have have had that same understanding appreciation sensitivity a couple Generations ago but now that we are where we are not all mental health issues are created equal and and and and depending on the diagnosis the prognosis the situation the treatment you know we would you know we would have to apply you know whatever whatever rules when when it comes to a physical illness but tell me if I'm wrong I would certainly think so and I would certainly think there's all kinds of different levels there are conditions which certainly pose an immediate risk to life which should have that realization and that consequence uh there are those which pose a cumulative risk to life and that I think we've addressed a little bit and seen that there's recognition of that impact as well and then there are things that are incapacitating or create tremendous tsar and that may not have have the same level of impact on halafic permissibility but it certainly is significant when dealing with a number of things that come up in Alpha Shabbos and the question is how to assess within each one but I think there's no question that if we had a credible reason to believe that somebody's physical health and physical well-being is at stake so then the logic should should fit even if we're not comfortable making qualium and we're worried about how that might be misapplied but the soira is certainly there and it's there in very early sources and to appreciate what that might mean just from your experience I'm curious what are the robot and feel would be um some direction maybe for family members or community members to make themselves a little bit more sensitive to try to sensitize ourselves as as a entire Community from the experiences that you've had is there something you can share that maybe people who are watching can can walk away with and allow themselves to feel a little bit more of a sensitivity or are there places in religious life in in things that we do and hug them that we're part of that maybe we can add an extra dose of sensitivity toward those who might be struggling and we're not even being mindful or aware of it to go back to a previous point because I think it's also relevant the question about the drinking at the Seder so the question was raised should we ask everyone to have a dry seder if one individual there needs to be avoiding alcohol completely so that's one question that's fair to ask but separate from whether that actually has to be as far as that step has to actually be taken but the attitude that we convey about the drinking and this would certainly benefit us if all year round we were aware of just how harmful it is for people to be exposed to an attitude that sees drinking as the be-all and end-all of human experience and to recognize just what impact that has whether somebody is a recovering or like a earthquake said and not yet recovering alcoholic or somebody who's just potentially at risk for alcoholism or for any of the tremendous harm that can come and the whole culture that has developed that is portrayed as the most enjoyable activity and the most uplifting activity possible so there's a lot we can do to change that culture so whether it means that everyone at the Seder is not drinking alcohol and if grapes as an option it may be realistic to ask everybody at the table to drink grape juice and I think that would probably be a tremendous statement that would be enormously appreciated by somebody who's there and wouldn't involve that much philosophy compromise but even if we didn't go that far just if we related to those who were drinking at the theater related to it more as a Mitzvah rather than as something that they are enjoying tremendously for reasons that go beyond the Mitzvah so I would throw out the question let's say you had somebody at the table at the Seder table who had Celiac and couldn't eat matzo so let's say that individual wasn't eating matzo would he feel the same kind of pressure from everyone else eating matzah as the recovering alcoholic feels where he's not able to drink wine is it simply that he's not doing what everyone else is doing or is there more about the culture that makes this more tempting and that elevates this beyond the midst of status and that if it was viewed more as a Mitzvah rather than that which else everything else that comes with it it might be easier for someone to say I okay so I have a personal condition that doesn't allow me to do that mixed foot there's things like that that happen to people all over and I'll sit this one out and it won't necessarily have the same effect also the more we talk about these things publicly this kind of event is very helpful that people should hear that these things actually happen for a long time there was and it still remains to some degree a culture in our community of just hiding uh mental health issues addiction issues I think our muddin has done a great deal of work in terms of bringing this to light uh even if if it just involves saying statistics of how many people were lost to Suicide or drug overdoses how many young people where it used to be wow we have a high rate of aneurysms in our community where now we realize that and we're able to say that no this person had a disease they had they had a severe depression they had an addiction and uh and you know you the more it happens sadly there are two ways we can learn about it one is where a person has it in their family and they're exposed to it directly and they they gain a high level of sensitivity uh toward these things and and the other is just by talking about it more publicly I I would I would add as well that uh it would go a long way for us to appreciate that there are features of our community I think more cultural than Alaska but you know the the line between the two can sometimes be blurred that may present some individuals who are struggling at a sort of a heightened risk if you like think about food as an example we have a community that is very I would say on a communal level very obsessed with food uh some of that is because you know there are a lot of times that we need to eat there's a key of suda you know every Shabbos three times but beyond that I think we have you know culturally our community has adopted in a way um has adapted rather in a way that that you know has really has has we we we speak a lot about food and we talk about a lot the about the presentation of food and all that and we have to understand appreciate that while that may be very uh satisfying and enjoyable and fulfilling for some it may be very triggering uh to others uh it's always already been mentioned that there are certain times throughout the year where alcohol is an important part of our experience as Jews we have to understand and appreciate that that very feature which makes our community unique and special uh also again can be challenging for some I think that the the levels of of stress that already teenagers and particularly you know people who are trying to support their families are subjected to in order to have uh you know to support uh the lifestyles that that are demanded of us in our communities uh this the stress is real and it takes a toll and for somebody who's already predisposed and already struggles with anxiety depression could literally push them over the edge and in some cases does when we are sort of when we when we deny that and we want to be overly defensive and say no it can't be it can't be it's a Mitzvah so therefore it has to be always good or this is what we do and this is the way it was raised and it works for me and so therefore there can't be anything wrong with that I think that's a it's a very it's first of all it's a very uh narrow-minded perspective but it's an attitude when we hear that could be actually very hurtful to some and does exactly the opposite of what conversations like this are designed to do and that is make people feel comfortable and sort of talking about some of the issues and the struggles and trying to seek help and we'll also point out that I think our community has some very unique protective factors I mean the fact that we are such a strong community and we have the infrastructure and the ability to produce conversations like this as an example um and really reach so many people I think is is showing that you know this very community that it's you know it's difficult and challenging sometimes to to maintain an equilibrium within you know provides me with the resources and the support um and the and the hope and the desire and the motivation to be able to to push forward so uh speaking about it honestly openly without being defensive and uh all questions are good questions uh I've seen over the course of the last 10 years alone and I think people who have been paying attention for longer could probably say the last 20 or 30 years a significant reduction in terms of the stigma around mental health issues I don't know that we could ever you know we should we're not there yet I'm not sure what it means to be there but I I think I think we're doing very well in particular um the the stigma around therapy has really really thank god um in many circles when almost reversed uh you know there are certain places where like if you're not in therapy like what is wrong with you why aren't you uh you know why aren't you talking to somebody um you know I had a an experience couple of summers ago um where I run a program for guys who are learning 18 19 year old guys who are learning all day over the summer and there's always a counselor or two someone who's 21 22 23. um that's uh that the boys look up to and that they admire and one particular occasion um it was a Friday night and we were schmoozing and we were just going around the room and I was asking the boys you know what's the nicest thing anyone's ever done for you um you know what can you share something that like really uplifted you that someone else did for you and you know most of the boys were saying my parents did this my rebby did this and the counselor the one who they all looked up to as the coolest guy in the room as the one that he said well I my therapist I I never would have been able to date or get married if not for my therapist in front of all of these kids that were looking up to him and I was thinking 10 years ago would that have ever happened with that you know it was it was even surprising to me now but uh but I think we're making making great progress so thank you to all the rabbana for joining and we just want to once again uh give a tremendous for the unbelievable and incredible work that they do for so many individuals and for so many of our communities and you are a indispensable resource for the work that the community needs and for the help that so many individuals um require and we're so grateful to you and we hope that all who are watching will help in this effort in this uh unite to heal effort to support the work of amudim to allow them to continue to help our community to be strong to be healthy and uh to continue on in the journey serving in the best way we possibly can thank you thank you foreign [Music]