In the powerful tefilla of Refaeinu, our request for health, we pray for both refuat hanefesh and refuat haguf. While refuat haguf translates as the healing of the body, refuat hanefesh refers to the health of the mind. Nowadays, medical journals and psychological papers have begun to focus on psychosomatic illness: where the state of mind impacts the body. That anxiety of the brain can cause aches in the body or even heart attacks. In truth, this was discussed in Torah sources as early as the Rambam who spoke of the ideal regimen for an eved Hashem as one which protected both mind and body. It was the Rambam who pioneered the view that worry or sadness can cause bodily ailments. Mental health was indeed something understood and discussed in the Torah and this article will explore some of these ideas.ย
The reality of emotions is acknowledged at the very beginning of the Torah. When Chava is cursed1, Hashem says โI will greatly increase your pain.โ The word used in the pasuk is itzvoneich, meaning sad or heavy. The Alshich explains on this pasuk that at the time that a woman is nidda, her emotions will cause her to feel down. That is the itzavon, the sadness and the heaviness of the pasuk. In other words, the Torah is explicitly telling us that a woman will experience hormonal changes which can make her more moody or emotional.ย
The Torah is also considerate towards these emotions. While an individual cannot rule halachically for themselves, below we will outline two cases where the Torah permits an individual to override a halacha out of concern for their mental state.ย
The Gemara in Shabbat 128b permits a light to be switched on during Shabbat for a woman during her labor, even if she is blind. The halachot of Shabbat are incredibly intricate and strict, yet Hashem wove into the halachot consideration for the emotional state of a birthing woman. Putting the woman’s mind at ease is the priority of the Torah at the time of labour, and this takes precedence over Shabbat observance. Even, as this case demonstrates, if the act brings no tangible benefit. The calm state of a woman during birth is paramount.
Instances of mental illness are depicted into Sefer Neviim with the complex transformation of King Shaul. King Shaul, an incredible talmid chacham, outstanding in the nation, selected by Hashem Himself as King is the same King Shaul who is stricken with what the pasuk calls โruach raโahโ and attempts, many times, to kill the future King David.ย
While we cannot fully understand the nature of the illness, nor can we judge, we can certainly see that the Torah does not hide from or vilify mental illness.ย
This understanding is based on the Abarbanel2 who writes that following Hashem’s rejection of Shaul as King, David is selected as the new King. As soon as David is chosen, Hashem’s special presence left Shaul and entered David. The loss of Hashem’s presence was catastrophic for King Shaul and consequently, he fell into what the Abarbanel calls melancholy. King Shaul entered a state of mental illness. The Abarbanel writes that King Shaul no longer behaved in a typical manner and was constantly tormented by thoughts of being punished by Hashem. Logical thinking left Shaul, and his imagination tortured him constantly with thoughts of Hashem’s punishment and rejection. He obsessed over the loss of his kingship which only reinforced his feelings of distance from Hashem.ย
While we cannot fully understand the nature of the illness, nor can we judge, we can certainly see that the Torah does not hide from or vilify mental illness.ย
Finally, we will explore some of the ideas of the Rambam, who was a strong advocate of the mind-body connection. The Rambam believed that excessive negative thinking could lead to a decline in bodily function, an idea which is now widely held in the scientific world. In fact, Rebbetzin Zimmerman discusses how the Rambam himself fell into a depression after the death of his brother, something he describes in his writings. The Rambam remained in bed for a year and wrote that he still had not fully recovered from the loss and trauma of his brother, who drowned together with all of his possessions.
In the 12th century, the Rambam served as the physician to the powerful Sultan of Egypt, Saladin. The Rambam was entrusted to treat Saladinโs son who was stricken with depression. While the Rambam entreated him to โstrengthen his psyche,โ he believed that any positive or hopeful thoughts would be insufficient without medication. At the same time, he wrote that medical knowledge alone without psychological contemplation would not fully bring emotional stability.
The Rambam certainly instructs us to try to allay anxiety-provoking thoughts with emuna and believed that hopeful thoughts can enhance bodily functions. However, he was realistic about mental illness and did not hesitate to diagnose anxiety, depression and the like, nor did he hesitate to prescribe herbal remedies and medicines to heal them. Emuna alone is not enough to combat the effects of mental illness and many of the Rambam’s cures are used until today3.
Mental health is a topic which we are still struggling to understand. Yet, if mental illness is as real as humans are, then of course, the Torah, which is written not for the angels, but for us humans, deals with it too. I write this with the hope that it will validate the reality of mental health struggles and also shed light on the compassion and the consideration which the Torah ascribes to mental illness. The Torah is in many ways a mosaic of all human life and if we have questions, we can be certain that the answers are contained within its timeless words.
- Bereishit 3:16 โฉ๏ธ
- Shmuel I 16:14 โฉ๏ธ
- https://www.ou.org/life/health/how-maimonides-dealt-with-stress-anxiety/
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