By H. Steven Moffic, MD
Chapter 1. A Psychiatrist in Biblical Times
In Genesis, it is described that man, and then presumably woman in a first example of matchmaking, is created in the image of God. Imagine a modern day psychiatrist time traveling back to observe this creation. If you don’t believe in such a God, but are a parent, think of a child created, at least half genetically speaking, in your image.
As holy as it may seem to be created in the image of a God, would a psychiatrist think that this was mentally healthy? What happens to the children of parents who want their children to fulfill their own dreams? Could it be too much of a narcissistic wish and expectation to be created in anyone’s image? Wouldn’t this make normal separation and individuation more difficult, the psychiatrist wondered?
Indeed, the psychological challenges and problems for Adam and Eve emerge quickly in the Garden of Eden. The psychiatrist observing this scenario wondered about offering a walk, as Freud did about a century ago with Mahler, to discuss the temptation and symbolic meaning of the Serpent and the Tree of Knowledge. But the psychiatrist wondered if this was an impossible paradox to resolve. Without knowledge, how does one understand the risks of obtaining knowledge?
So Eve goes ahead, and she and Adam are banished from the Garden in shame. If our psychiatrist could have met them in this wider world, perhaps they could have processed their shame and the current status of their relationship before they had children. Instead, the result is 2 sons, Cain and Abel, who portray the first sibling conflict and competition, so severe that Cain murders Abel.
After this tragedy, history seems to progress adversely until Noah. Noah is said to be the best of his time. In the Ark that he builds, his family, animals, and himself survive drastic environmental and climate changes. If a psychiatrist were also on the Ark, there would have been ample time to discuss how Noah felt about the responsibility of saving the world, and how he might prepare himself for a different future. As it turns out, he becomes drunk afterward. Noah might have needed detox and Alcoholic Anonymous; his family might have sought support from Al-Anon. However, just like the lives of so many modern day celebrities, their lives and the story goes on without completing treatment.
The next major figure is Abraham. No one claims to know, not even himself, why he is chosen to start a new religion. Later on in his life, sibling rivalry emerges again, but now between stepbrothers. After Abraham has his son Ishmael by the handmaiden, Hagar, Abraham and his wife Sarah have their own son, Isaac. Can’t you just predict the need for some challenging family therapy? Instead, Sarah, with the apparent approval and support of God, orders Ishmael to be banished. Abraham acquiesces, and God, to seemingly even things out a bit, says that Ishmael will start his own Kingdom, which many have taken to become the Arab people.
Abraham is later asked to sacrifice Isaac. Any psychiatrist might say that at times of exasperation, a parent might think of sacrificing their child. But this time it includes the actual preparation, without the apparent knowledge, of Sarah. Isaac is spared at the last minute, but to a psychiatrist, it might seem that he suffered PTSD. Sarah may have died soon afterward from the shock of grief.
Without treatment, as family problems are wont to do, the sibling conflicts continue in Isaac’s sons, Esau and Jacob, and then again in Jacob’s sons. Esau also goes off in exile, perhaps to start what will become the Roman people.
This story should be enough to call forth a psychiatrist, shouldn’t it? Finally, do we see the prototype of God’s psychiatrist in Jacob’s son, Joseph? Though Jacob’s favoritism, culminating in his giving Joseph the coat of many colors, seems to produce excessive narcissism, Joseph overcomes the trauma of being sold by his brothers and given jail time in Egypt, to use his prophetic interpretation of dreams. He attributes this skill to God, succeeding beyond anyone’s wildest dreams in a new culture, in which he prepares successfully for climate change, forgives his brothers, and is united with his father. After this family forgiveness, the cycle is broken and there is just “normal” sibling rivalry depicted in the Old Testament.
With the psychological path cleared in one way, but challenging in another, Moses arrives. A psychiatrist in the court might wonder if his stuttering was a consequence of an unusual child rearing, both in the Egyptian court, where he is adopted, and with the surreptitious involvement of his own family. Maybe he was dealing with buried anger, too. Moses, despite being so humble, has several outbursts of anger, which cost his entry into the Promised Land. Would anger management and/or a prn calming medication have helped him? If he were calmer, perhaps he would have recommended group psychotherapy for those disgruntled among his people, and maybe then sought psychoanalysis for himself. Following the death of Moses, the Old Testament ends.
Chapter 2. Psychiatry in the Common Era
Let’s go on to the Rabbis who replaced Jewish priests in the diaspora outside of Israel after the beginning of the Common Era. They seemed to grasp some therapeutic principles that would help sustain the Jewish people and keep them together over the next 2 millennia, despite pogroms, exiles, and most recently, the Holocaust. They came to interpret the Old Testament in different ways and on many levels, including the Talmud, Midrash, Kabalah, weekly Torah study around the world, and pastoral counseling. In the early Middle Ages, one particular Rabbi—Maimonides—who was a general physician and philosopher all in one, conveyed basic concepts of mental well-being, supportive psychotherapy, and even the basis of our most popular and evidence-based therapy, cognitive-behavioral psychotherapy.1
Nevertheless, there was still no formal field of psychiatry, that is, until a Jewish physician emerged about a century ago to complement the work of Kraepelin. Sigmund Freud, after a childhood as an honor student in Jewish religious schools, went on to take the new field of psychiatry to a different level with his psychoanalytic theories.
Like Joseph, Freud arrived at his conclusions after analyzing his own dreams. The difference is that Freud analyzed the conflictual issues in his dreams, and Joseph analyzed their prophetic meanings. In the ensuing therapeutic process, different levels of interpretation paralleled the Rabbis’ interpretation of the teachings in the Torah.
Was Freud God’s psychiatrist at long last? Not likely. Actually, Freud’s views may reflect why a psychiatrist was not around from the beginning of humanity in Biblical times. Freud, though publicly valuing his Jewish cultural background and involved with B’nai B’rith meetings in Vienna, was famous (or infamous) for claiming that religion was an illusion, an opium for the masses, and that belief in God was a matter of the transference of feelings toward one’s parents.
Freud also seems to underestimate anti-Semitism, which labeled psychoanalysis as that “Jewish science,” only leaving his home at the last minute when his daughter’s life was threatened. Since Jewish theology values action over thoughts and beliefs, Freud’s actions—to find new ways to heal people—couldn’t be more Jewish. What did it mean, then, that Freud died on Yom Kippur, the Day of Atonement, in 1939? And if he was thinking of his death in the physician-assisted morphine mental state, did he reassess his feelings about God?
What about that other famous psychiatrist from Vienna, who studied some with Freud? That was Viktor Frankl. In one of life’s ironies, he lived for a time in close proximity to Hitler. What if he, or another psychiatrist, had at one point been able to treat Hitler during his troubled childhood? As it turned out, however, Dr Frankl2 was about to go to America, only to have an existential crisis:
Should I foster my brainchild, logotherapy . . . or should I concentrate on my duties as a real child of my parents and stay by them?2
He returned home to find the letters of the Ten Commandments stating to honor thy father and mother. He let his Visa lapse. Sent not long after to Auschwitz, he became a sort of concentration camp psychiatrist, struggling to give meaning to the struggle to survive. That meaning was to see his wife again and to lecture about the psychological lessens learned. Only the latter came to pass. After the war, he resettled in Vienna and remarried a Christian woman. He soon published the perennial best seller, Man’s Search for Meaning, and established Logotherapy, a “therapy of meaning.”
Although I was trained in Freudian psychotherapy in the early 1970s, by the end of my clinical career, I came to follow the path of Freud to Frankl by focusing on the meaning of life for the decreasing amount of time I had with each patient.3
Did Dr Frankl end up believing in a God? He never would say.
In our time, it seems that the number of psychiatrists who believe in a God are increasing, parallel with the decreasing influence of Freud’s ideas. Jewish psychiatrists, although still prominent in the newer areas of group psychotherapy, cognitive therapy, understanding brainwashing, and even Freud’s predicted psychopharmacology, are nevertheless decreasing in their relative numbers.
Perhaps the notable example of a Jewish psychiatrist who clearly and overtly believes in God is Dr Abraham Joshua Twerski, who is also a Rabbi and scion of a Hasidic dynasty, and specializes in substance abuse. For a comparable Christian psychiatrist, we can cite the late Dr E. Mansell Pattison, who was also a minister.
Chapter 3. The Moral of the Story
What, then, is the moral of this tale, as Hannah, my grandchild of 2 Rabbis, would ask? Just in time, a valued teacher and colleague asked, “Isn’t God a Psychiatrist”? If God is a psychiatrist and we psychiatrists were also created in God’s image, and if we psychiatrists have come currently to view religion and psychiatry as more overlapping than conflictual, then together we can work to help and maybe even improve human nature. Amen.
References 1. Pies RW. The Judaic Foundations of Cognitive-Behavioral Therapy. Bloomington, Ind; iUniverse; 2010. 2. Scully M. Viktor Frankl at Ninety: An Interview. First Things. April 1995. http://www.firstthings.com/article/2008/08/004-viktor-frankl-at-ninety-an-interview-18. Accessed April 1, 2013. 3. Moffic HS. The meaning of life in a 15-minute med check. Psychiatr Times. May 19, 2011. http://www.psychiatrictimes.com/bipolar-disorder/content/article/10168/1864201. Accessed April 1, 2013.
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