Analyze this: Why do so many ultra-Orthodox Israelis seek psychotherapy now?
In recent years, more and more Haredi Israelis get over their fear of psychological treatments, and the rising demand has led to long waiting lists, as well as new concerns
“COVID caused major damage to the Haredi family and the community,” said psychologist Noam Shnoor-Green. Photo by Emil Salman
This article originally appeared on Haaretz, and was reprinted here with permission. Sign up here to get Haaretz’s free Daily Brief newsletter delivered to your inbox.
One after the other, they went down to the basement level at the Ramada Hotel in Jerusalem, entered the side room where they had been told to gather, and sat down. No one would know they were there and their identities would be kept secret, they were promised.
Some 30 men and women were in the room: the men with beards and black kippahs, the women with hair coverings and long skirts. Some people wore their name on a shirt sticker. Men and women sat separately, although there was no barrier. “Something new is beginning,” the host announced.
The anonymous ultra-Orthodox audience sitting before her were not seeking something for themselves. The meeting was part of a two-day seminar on mental health held in June, with the participation of ultra-Orthodox psychologists, social workers and activists. Such meetings, in which the future of mental health in the Haredi community is discussed, are considered rare.
But they presage something new. It’s now possible to discuss psychological issues and seek professional treatment. Even if the process is only just beginning, the fact that it exists at all is a major change. And although mental health professionals welcome this, it’s a challenge for them as well.
They need to know how to treat people who never even thought about professional help; how to legitimize such help; and most of all, how to break down the wall of shame surrounding the subject. Conversations with Haredi psychologists and therapists reveal that the wall hasn’t fallen, but in recent years it has cracked significantly.
One ultra-Orthodox therapist recalls a woman in her 30s who was concerned because she was still unmarried at an age higher than is generally expected in the community. “She knew that something might not be all right, and she needed to talk about things, but she waited a long time until she realized it was OK to go to therapy,” she said. “She told me, ‘It’s a shame I didn’t come sooner.’”
The therapist said a good friend of the woman who was dealing with the same issue and sought treatment was the impetus for her to stop being afraid. There are other reasons that women seek treatment today, she says, like victims of domestic violence. “In the past, women were very afraid to seek treatment and they would come only after [the marriage] broke up,” she says, adding that “now they come here as soon as it starts.”
This change in attitude has been developing in the past decade, mainly the past three years, during which there were two significant triggers. “COVID caused major damage to the Haredi family and the community,” says Noam Shnoor-Green, a psychologist now doing her residency. “And we had the Meron disaster, in which thousands of people experienced trauma and needed help.”
In this case, there was supply for the demand: hundreds of Haredi psychologists and social workers trained specifically to help Haredi clients. They understand the language of Haredim and the social nuances involved, and they provide safe space without compromising on professionalism. They have managed to assuage concerns in large parts of the Haredi community, and among the rabbis, too.
“In the past, when the need arose, the first call made was to a high-ranking member of the community,” says Shnoor-Green. “Now, the first call will be to professionals. The people involved have changed. Now we have psychologists and therapists who know how to maintain being both a Haredi and a professional.”
This is a dramatic change, in more ways than one. Beyond the fact that a senior member of the community isn’t trained to deal with psychological issues, he also has other considerations besides the good of the client, such as concern for the good name of those involved, or the image of the community.
These considerations can tip the scale in various cases, the most extreme of which are sexual offenses. Then someone who does not follow ethical rules or the obligation to report could sweep the case under the rug. That’s not the case when real professionals are involved, for whom the good of the client is paramount.
“We see how damage could have stopped years before, how violence could have stopped,” says Shnoor-Green, who produces a podcast and is co-director of the Psychologists Speaking in Haredi organization. “Now we don’t ignore these things.”
But it’s not only the fear of damaging the community that stands between ultra-Orthodox Israelis. and psychological treatment. So does fear that their faith in God is being shaken. Another challenge is the belief that people have certain characteristics that cannot be changed. It’s no accident that Sigmund Freud became persona non grata in the Haredi therapeutic world.
“The way we work is more positive psychology, the kind that believes in the power of the patients,” says Yishai Shalif, one of the first Haredi psychologists in Israel. “We see the problems as external to the person, not internal. They influence the person, but the person has the choice of giving in to them or dealing with them, or even growing from them.”
Shalif, 64, an educational psychologist and counselor, is the director of the public educational psychological service in the Haredi city of Modi’in Ilit, the largest Israeli settlement in the West Bank. With nearly 30 years of experience, he has seen first-hand the changes in the community’s attitude toward professional treatment – and vice versa.
When he was asked to run the educational psychological service in the municipality in 1994, the very establishment of the position raised suspicion. “They checked me out as if it were a shidduch,” referring to the custom of introducing the two parties in an arranged marriage.
At first, he says, demand was low and he would come in only once every two weeks. Now, the service has 40 psychologists and therapists, almost half of whom are ultra-Orthodox. For the past 15 years, a treatment center has also operated in the city for schoolchildren who have been sexually abused.
The therapists at the educational psychological service work with schools in the city and give them professional guidance, advise educational staff, make diagnoses and provide treatment. Similar educational psychological services exist in other Haredi cities, such as Jerusalem and Betar Ilit.
The center in Modi’in Ilit, which operates in conjunction with the local welfare department, has a waiting list of over a year. “We are desperate for funding to operate more programs,” says Shalif. “It’s impossible to provide for residents’ needs.”
Help for those who provide help
Perhaps this is just how things are now. While in the past there were fewer patients than therapists, today the picture has reversed. In spite of the increase in supply, demand has risen much more, and people are forced to wait for months for a therapist, and it can’t just be any therapist. The therapist must understand their world very well, even if they don’t come from it, says Adina Bar Shalom, founder of the Jerusalem Haredi College.
“Even a Haredi psychologist who comes from Borough Park in New York, is not suitable for treating Haredim in Israel,” she says. In 2009, the college opened a track for studying psychology, a move that ran into quite a few obstacles, from both inside and outside the community. Bar Shalom was forced to fight voices from within the Haredi community who opposed the opening, as well as resistance from the academic world.
“They didn’t make life easy for us,” she says. If not for her father’s intervention – she is the daughter of the late Sephardic Chief Rabbi Ovadia Yosef – the initiative would never have gotten off the ground. Since then, the college has trained hundreds of psychologists and therapists – men and women – who then continued on to do a master’s degree and residency. But the college she headed is now history: it closed four years ago due to financial problems. And the problem of training has reappeared.
For Haredi students, the challenge of studying in secular institutions lies not just in the lack of separation between men and women. They also have difficulty in getting answers to various questions concerning Haredi society. “We conducted diagnoses for Haredi women and things came up that we didn’t know how to explain,” says Bracha Segev, a clinical psychologist doing her residency who studied at the Interdisciplinary Center in Herzliya (now Reichman University). “The lecturer didn’t know the answer and asked us to ask each other,” she said.
In an attempt to deal with these difficulties, Segev founded the group Psychologists Speaking in Haredi. It works mostly in WhatsApp groups dedicated to this purpose, where discussions on ethical and professional questions are held, in addition to patient referrals and mutual assistance.
The group, which was launched four years ago with just six members, now numbers about 170 psychologists, all of them Haredi. “I realized that Haredi is a language in itself and we needed to bring the subject to us,” Segev says. Over time, a virtual community was created.
The need to belong to a community exists for therapists, too, Shalif says. “This group is a space for belonging – for a positive atmosphere, connecting to professionals. It’s really a support group, and you need the support because you run into a lot of difficult things, such as violence and suicidal ideation.”
Other subjects come up, too. Sexual orientation is one of the most complicated subjects Haredi therapists – men and women alike – deal with. “Without a doubt, it’s complicated,” says one Haredi therapist who adds that even among Haredi professionals, there are still therapists who send young Haredim for so-called conversion therapy. “They won’t do it themselves,” she says. “but they’ll send them to someone else.” Things are changing on this, too, and only a few therapists do this, she adds.
In general, sensitivity to the subject has risen, but so has the challenge in providing help, the therapist says. “What a Haredi therapist can do with a gay patient is mostly to give support,” she says.” You need to understand that a young man who goes to a Haredi psychologist, and not through the Open House [LGBTQ rights NGO], for example, is making a statement – he wants to remain in the community. It is his choice and that’s OK. We, as therapists, leave the choice in the patient’s hands.”
Generally, to remain in the community is to remain in the closet, she says. “The psychologist will listen to the options, comprehend the difficulty, and understand him better than a nonreligious psychologist, but there’s no concrete solution. In general, we, as therapists, do not offer concrete solutions. Whatever a patient decides, we’ll be with him.”
Faith in the path
One of the most explosive issues in the field is the relationship between the rabbinical and therapeutic establishments. “These days, there is across-the-board approval on the part of the rabbis to go to a psychologist,” says Bar Shalom. “Nonetheless, the rabbis will check and investigate quite well before they send someone to a specific therapist.”
There is also another especially relevant point for the patient: “When you go to a therapist, you have to make sure he is on a high professional level and that he does not harm my beliefs, that’s all.” Segev adds: “You must not approach this in a different way from how you approach physical health when you are looking for a good doctor.”
In the Haredi community, the Lamerchav Institute is the almost automatic answer for adults seeking treatment. This is a network of mental health clinics specifically intended for the Haredi community, which operate under the auspices of the Yad Eliezer nonprofit organization – and which is subsidized by the country’s HMOs. The network’s pace of growth is possibly the best evidence of the significant change that has taken place in recent years, in part thanks to an overhaul of the mental health system. Lamerchav, which was founded seven years ago, has two branches in Jerusalem, one in Bet Shemesh, and one in Betar Ilit, and is now opening another branch in Rehovot.
“We began with two or three therapists and with something like 13 patents,” says Rachel Arbiv, a clinical psychologist who is a professional director at the institute and one of its founders. “After a few months, we reached 30, and that seemed like a lot to us.” Today, the numbers are a different order of magnitude.
Just the main branch in Jerusalem holds some 400 sessions a week, with a waiting list of 1,500 a year ahead. “The shortage in the field is not unique to the Haredi community,” says Arbiv. “It is in all sectors.” But there is progress, she adds. “In the past, my grandmother was embarrassed to go out wearing glasses, so mental health treatment has also become something different. It is hard to identify this sector today. Public discussion in Haredi media, and in general, has expanded and awareness has risen.”
Raising awareness and breaking the barrier of shame, in the area of mental health and in general, is also being done on social media and websites dedicated to the issue. One of the ones that stands out the most is the Akshiva, a site where Haredim post questions would have previously been discussed only behind closed doors.
Subjects such as depression, modesty, the status of women and protection against sexual assault are raised anonymously. Answers are given by dozens of educators, therapists and rabbis. It is a “sort of emergency room,” says Michael Nachtiler, manager and founder of Akshiva. “People who are at a dead end turn to us. From the ‘emergency room,’ you have to decide where to transfer them. The answer may satisfy them, or maybe we will refer them to therapy.”
As part of this online forum, some 90 volunteers – men and women from within the yeshivas and religious women’s seminaries, and mostly professionals and psychologists – answer with comprehensive answers. Nachtiler, the deputy CEO of the Netzach Haredi educational system (which also teaches nonreligious subjects), says the path to the Akshiva initiative was natural. “I worked with dropouts and saw kids who ended up in the streets after they accumulated a lot of questions and distress in the yeshiva, and in the end it exploded,” he says. “I said we need to find a solution. They don’t feel comfortable with their parents and rabbis at the yeshiva, so we provided them with an anonymous and safe space.”
He set up the site and got started. He wasn’t prepared for the flood of questions that hit him. “Very quickly, I realized that I had entered a ridiculous vacuum – questions of all types, from all groups and all ages – women, married people, singles.” he says.
Treatment without legitimacy
The Haredi community has no shortage of treatment centers of various types, but sometimes there is a loose – or nonexistent – connection between the diagnoses provided and the staff’s training. An organization with different branches makes autism diagnoses without being certified to do so. That’s not the only case.
For a range of reasons – not just because of a lack of information and knowledge, or the lack of legal regulation of the field – this phenomenon is spreading in the Haredi community, even though it is not exclusive to this population. “The quackery comes first of all from true distress, because there are still not enough professional therapists,” says Segev. “In addition, there is still fear and stigmatization of psychology in parts of the Haredi community.”
Some of the people involved in these organizations earn quite a bit of money from providing accelerated courses for “therapists,” Segev adds. Add to this the need for help that has grown in recent years, and there is fertile ground for unacceptable practices. But the Mount Meron stampede disaster, and then the deadly beacher collapse at the Karlin Stolin Synagogue, underscored for the heads of yeshivas and rabbis from the Hasidic community the importance of professional treatment. Nonetheless, at this stage the matter is passed on in the most Haredi manner: word of mouth.
This is how, inside the community, there are still many who are not aware of the difference between a certified therapist and one who awards himself the title, and certainly they don’t give preference to the former over the latter.
Sometimes these are the most senior members of the community – elected officials. At the moment, Haredi members of Knesset are trying to advance an initiative that would allow Haredi women’s seminaries to certify art therapy studies as therapy in every way. For people involved in the matter from the professional side, this is no less than sacrilege and could lead to irreversible damage to the community.
An example of such as treatment by someone who unqualified so can be seen in the story of a girl who suffered from sexual abuse and whose details were obtained by Haaretz. At first, she was referred for treatment by a woman who was not certified to do so.
“She did everything that is forbidden to do in therapy,” a certified therapist says. “She cast the blame on the patient and claimed she should have gotten over it.” Only at a later stage did the young woman see a professional for treatment. “We estimate that it will take about a year to gather the pieces and overcome the improper treatment,” she says, and there are an “endless” series of similar stories about Haredi men.
One of the people who is at the forefront of the battle against treatment by unqualified people is Nati Becker, a social worker and head of the social services department in the town of Kiryat Ye’arim near Jerusalem. Eight years ago, he established an association of Haredi therapists exactly for this purpose. With the help of various conferences and training seminars, he has introduced expertise into the community. Today, the association has almost 400 psychologists, social workers and other professionals.
To a certain extent, this is Becker’s weapon – increasing professionalism from the inside. This is already producing dividends, he says: there is now much more awareness and understanding among the public, and among the rabbis and public figures, who are seeking out the professionals.
But one element is still very lacking: there is no public discussion of the topic. Professionals may be working to raise awareness among rabbis and community leaders – and even collaborate with them in various ways – but these leaders, even when they support the shift to professional treatment, don’t speak out publicly. “There is silent support and many rabbis make use of professionals. “There is a very dignified discussion and the professionals believe in [the authority of the rabbis],” says a well-known source in the field, “but these are things that are done quietly and are not discussed.”
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