Mussar in Psychiatric Practice
By Harvey Rosenstock

Editor’s Note: Yashar welcomes contributions that inspire or teach fellow Mussar students. Our goal is to make space each month for guest articles. Please send your suggestions to info@mussarinstitute.org.

Q&A: A Psychiatrist’s Use of Mussar As a Tool

Yashar: Tell me briefly about your practice?
Rosenstock: I’m a board-certified psychiatrist. My practice includes adult, family, child and adolescent psychiatry. I do individual psychotherapy. I also do marriage therapy and group psychotherapy.

Yashar: How long have you been practicing Mussar?
Rosenstock: I’ve been involved and really thinking about Mussar for the past five to eight years. I’ve read “Duties of the Heart,”  “Climbing Jacob’s Ladder,” “Everyday Holiness.” and “Zohar.” I’ve been a Talmudic student for over 13 years.

Yashar: How did you begin to think you could use Mussar in your practice?
Rosenstock: Some years ago I had an interesting patient who couldn’t find meaning in her life. Everything was black. Getting out of bed was the biggest task of the day. But the patient was a college educated intellectual.  So I tried to teach her something she probably didn’t know in an attempt to engage her strengths. I took out a Mussar book out and started talking about how to find substance and joy in everyday life. This peeked her interest. I began with the trait of Trust. This was selected because of the imperative to establish therapeutic rapport with any given patient. Especially for those with paranoid issues, the establishment of trust is critical to all of psychotherapy.

Yashar: Do you use Mussar with just your Jewish patients?
Rosenstock: I use Mussar with all my patients, even with young people. If a person is extremely oppositional and suffering from with interpersonal skill problems, I might start with a different trait. For example, I might first teach savlanut, the trait of Patience. I might use some quotes from a Mussar book and tell stories. Sometimes I’ll pull out one of the gates from “Duties of the Heart.” That really generates meaningful discussion, which, in turn, allows us to address pertinent symptoms. But the trait of Trust continues to be a major focus. Sometimes we’ll deal with Gratitude. Or for someone with a substance abuse disorder – I will combine the traits of Order and Equanimity to show them the logic of what we’re doing and how to proceed.

Yashar: What’s the response been like?
Rosnestock: The response has been very positive. I’ve had people go out and buy the books. They get inspired and want to talk in further depth.

When doing marital therapy, depending on what the couple’s presenting complaints are, we may use Trust in combination with Truth and Gratitude. Often in marital discord there’s a sense that one person is taking advantage of the other by not telling the truth or not expressing gratitude. One may accuse the other of lying or having extramarital affairs or not telling the complete truth about what they’re doing with their with their time. Mussar catalyzes the work of therapy by helping the couple re-focus on the critical issues.

Ethical concerns in daily living readily lend themselves to Mussar. I also work with priests and other clergymen as patients. They, of course, have a rich knowledge of Bible and ethics. Mussar discussions from a psychiatric perspective are a natural for them. Amazingly, I find that some of our Mussar discussions find their way into their sermons!

Yashar: Give me some other examples of how you are using Mussar in your practice?
Rosnestock: I use Mussar for depressed adults. That’s a very big category.

And I’ve added a new category lately. Some young college students get involved in smoking pot to such an extent that it precipitates a mental breakdown such as the first experience with a manic-depressive psychosis.  I’ll show them “Everyday Holiness,” and ask them to skim through the middle 18 traits (A Shmoneh Esreh of a special sort.) and pick one that’s meaningful for them at this point in their lives, and we’ll work with that.

Another example that comes to mind is with adolescents, say 14 or 15 years old, who are acting out in abject defiance of most authoritarian figures. What I’ll do is to try to engage their temporary omniscience. I might invite the adolescent to help me understand why Jews are called Jews. Eventually, I will get into origin of word ‘Jew,’ yehuda, which means to give thanks, and then we’ll gravitate into Gratitude. Truth and Moderation are also major issues for adolescents because they’re way away from telling their parents the whole truth about anything.

In summary, the selective use of Mussar as a therapeutic tool has proved to be quite valuable in helping patients of nearly any age find meaning in life. For those with significant depressive symptomatology, for those trying to re-embrace reality, for those who are still searching for their true identity, and for those who are trying to survive an important and painful loss, Mussar have proven to the right catalyst for establishing that absolutely vital therapeutic alliance.

Harvey Rosenstock is a Houston psychiatrist and a student of Mussar since about 2005. He has found Mussar to be a powerful component in his work with patients. Yashar Editor Len Felson spoke with him recently about the work he’s doing.

Home | About Us | Mussar Wisdom | Courses & Learning | Books | Audio
Schedule | Resources | Contact Us | Mailing List | Donate

site designed by nrichmedia | site map | disclaimer and copyright