Stigma & Shame: Breaking the Silence on Mental Illness
Rabbi Lauren Grabelle Herrmann, Rosh HaShanah 2022/5783, delivered at SAJ-Judaism that Stands for All
In the Unetaneh Tokef Prayer, the liturgist writes: “On Rosh HaShanah, all people pass before (you) God like sheep to a shepherd.” This image has always resonated with me. Though some people take this metaphor as a sign of judgment, I understand it to mean that Rosh HaShanah is a time for being fully seen by a Force greater than myself, and it is a reminder that I am held in compassion. I see it as an invitation toward vulnerability, an invitation to come into this sacred space, which is the locus of divinity, and be seen in all our beauty and imperfection.
In this spirit, I want to start my remarks today by sharing some of my personal journey in dealing with a mental health crisis in my family.
I share from my experience not only to be seen — but to allow others in our community to be and feel seen because even though my story is particular and unique, most of us have our own versions of this story.
And most importantly, I share this story as an invitation to individual and collective teshuvah, repentance and repair so that we can consider how to change our own perceptions and behaviors, individually and as a community. We do so for the sake of saving lives, which as our tradition teaches, is like saving worlds.
So here goes:
In January 2020, my life and Jon’s life and Nadiv’s life changed forever, when our older child, Mint, told us that he was having active thoughts of suicide. Our child, whom we loved from the moment he was born — and even before — and would do anything for, did not believe his life was worth living. Despite us trying to instill hope and optimism and self-worth and pride into our children and family life, Mint experienced profound depression and anxiety and dealing with ADHD and gender dysphoria. As a result, his self-esteem plummeted and he did not see — at that moment in time— that he had anything to contribute to the world.
Thank God, he reached out to us and told us.
These are extremely hard words to say out loud, but Mint, Jon and I think it is important to say them because we are not alone. So many other people have gone through and are going through what Mint experienced, and what our family experienced, and yet so many do not feel safe to share their experiences. Suicide is the second leading cause of death for people between 10–34. All the more so, mental illness is so common — 1 in 5 people experience mental illness in their lifetime; 1 in 20 have a serious mental health condition*. Whether directly or through family and friends, we have all likely been touched in some way by mental health struggles, however they manifest.
It is important for me to be honest: One reason I feel comfortable sharing this story now, this year, is because Mint is now officially in recovery after a year in intensive residential treatment settings in CA and Utah. With a combination of access to the right care and his incredible hard work, he has found confidence in himself and has hope for the future. Mint is coming back to New York City full time at the end of October.
I want to take a moment and ask us to consider: Why is it so hard for me to share this story?
Why does it take so much courage and vulnerability to be honest about mental health struggles?
Why did I have to wait until Mint was recovered to share them?
If my child was diagnosed with cancer, I assume I would immediately tell all my friends and family, to gather in the troops, to welcome all the physical and emotional help I could get.
If my child had diabetes or any chronic condition with occasional flare ups, I imagine I would not hesitate to share anecdotes and updates regularly with friends and family.
If I had a child who was in the hospital for asthma and would be there for a few days or weeks, and it was very stressful to care for my other child and ourselves and manage hospital visits, I would think — especially as a rabbi who promotes the ethos of hesed (acts of lovingkindness) in community — that I would have called upon our amazing Caring Committee and ask for a mealtrain or other tangible forms of support.
But I didn’t do any of those things.
And it all comes down to stigma and shame.
Imagine you have severe migraines and when you told your doctor you needed medication to treat the pain, and doctor’s response is: “Are you sure you are ready to take that medicine?”
Imagine you discovered you had heart disease. When you told your friend, his response was: “But you don’t LOOK like you have heart disease.” Or: “You get dressed every day and go to work, it can’t be that bad.”
Imagine your child broke their foot, and other parents whispered behind your back, considering all the ways you might have caused your child to break their foot. They also told their children to keep a distance from that kid with the broken foot, just in case it was contagious.
Imagine you found out you had a life-threatening disease, but you didn’t tell anyone around you. Maybe not even your closest friends or partner but if so, only them; certainly not your colleagues or your acquaintances — because you felt ashamed and embarrassed that you had the disease in the first place.
It’s hard to imagine those scenarios!
But if you substitute “depression” “bi polar disorder” “anxiety” “obsessive compulsive disorder” and so on or any of the manifestations of those issues like “eating disorders” or “self harm” or “addiction” then you, too, might have experienced the kind of rejection and dismissal I described.
Stigma, negative feelings or associations associated with mental illness and people dealing with mental illness, is very much alive today. We can start by thinking for a moment about your own reactions or associations with the phrase “mental illness” which should just be a medical term like any other.
As research shows, stigma can lead to external barriers, like in obtaining and maintaining employment; stigma enables a climate of harassment and bullying in schools (this has been researched)*.
Mental health stigma translates to a health care system that treats mental health as secondary, and as such does not typically cover (financially) anywhere near the full costs of treatment, creating barriers and systemic inequality.
Stigma leaves people suffering or caring for someone with mental illness feeling alone and isolated. I have spoken to many other parents along my journey, and nearly word for word, they describe the same phenomena: their friends, family, and co-workers do not understand what they are going through, and diminish their child’s suffering or ignore it altogether. One woman described the loneliness of having a large family Christmas gathering when her child was at a Wilderness therapy program, during which not one of 30 family members gathered asked how her child was doing.
As a result of experiences like these, people pull away from their communities and families and social circles when they most need them.
Stigma internalized becomes shame.
And let’s be really clear: The presence or absence of stigma and shame can be the difference between life and death, between recovery or decline.
People who feel ashamed of themselves and what they are facing are reluctant to share their struggles with anyone, whether it is a healthcare professional or a friend. As has been studied, stigma correlates to reluctance to seek treatment. According to the National Institute of Mental Health, it takes the average person suffering with mental illness more than ten years to ask for help*. Ten years! Imagine the jobs lost, the relationships that have fallen apart, the childhood days of innocence gone in that decade before seeking help!
And, for those who receive treatment, the shame associated with mental illness results in reduced hope, lower self-esteem, increased symptoms and a lower likelihood of maintaining one’s treatment plan, according to the American Psychiatric Association*.
It doesn’t have to be this way.
The stigma of mental illness doesn’t have to be a blanket of darkness and shame that we cannot throw off. It doesn’t have to just be accepted as reality, as what is and will be forever. Another way is possible.
Today is Rosh HaShanah, a time of teshuvah, a time turning and repairing, where we aim to improve ourselves and to commit to tikkun olam (repair of the world). As the philosopher Rav Joseph Soleveichik taught, this time is also when we look at the weaknesses of our nation and find what we can do to mend them.
Rosh HaShanah is also HaYom HaRat Olam, the time in which the world is being born. This is a day where we give ourselves space to imagine a better world — one in which everyone is valued and are free to prosper and then we take steps, even small steps, to move the world in that direction.
And though mental illness is one of the most challenging and complex problems in our society, I believe there is ONE simple and important and impactful thing we can do as individuals and as a community as a first step.
And that is: Treat mental illness and mental health like normal parts of life — because they are.
Treat mental health and mental illness like normal parts of life-because they are.
Treat mental illness like other illnesses. Do not question someone’s character, strength or past decisions when you find out someone is struggling. Do not question someone’s parenting because you find out their child is suffering.
Recognize that diseases of the mind/spirit need healing and compassion as much as physical ailments. This is an idea that is deeply rooted in Jewish tradition. We say at every service Mi Sheberach prayer for healing. In that prayer, we say: V’yislach lahem refuah shlema, grant them a complete healing; refuat haNEFESH — healing of our souls/spirits; and refuat haguf — healing of body. Our ancestors may not have had the same vocabulary as us, they may not have known from diagnoses — but they intuited and understood that mental and spiritual illnesses are not shameful. They understood that it was just as important as illnesses involving our physical health — worthy of being acknowledged publicly in communal prayer.
Treat mental illness as a normal part of life by freeing it from secrecy and silence, the places where shame lives and multiplies. Tell your stories, share your concerns, ask questions. Talk about the risk of suicide. Tell your children and grandchildren about “outside boo-boos” and “inside boo boos”; tell them that there is nothing shameful about feeling sad or anxious even and especially if they don’t understand why they feel that way.
Breaking the silence is what cuts off stigma at the root, creating the conditions in which people can share their truth, pursue treatment, and reach out for support without fear of judgment.
So, let’s imagine for a moment what this might look like if we could create those conditions here, in our kehilah kedosha (sacred community).
It might look like an individual or family experiencing a mental health crisis who can feel safe reaching out to the community and receive physical and spiritual sustenance.
It might look like a Shabbat “celebrations aliyah” (honor to the Torah marking a joyous occasion or milestone) and someone comes up to honor an anniversary of their recovery or sobriety and everyone naturally, without question, exclaims “Mazel Tov!” It might look like an individual reciting the Birkat HaGomel, the blessing for having been saved from danger, after mental health treatment. It would be a sanctuary where even more people experience healing and wholeness inside these four walls.
We will begin to build this culture of openness in the coming months (and beyond). The week after our community gala, I will host a program where people can share personal stories of the impact of mental illness in our lives, or can simply listen and support. Over the course of the year, we will explore Jewish sacred sources on mental illness, health and healing. We will provide education and resources to parents, especially for parents of tweens and teens. Because — I am not sure if everyone is aware- that there is a mental health crisis going on right now for teens. The Surgeon General recently put out a rare advisory on the mental health crisis for adolescents.
And, I know that what I am sharing today is likely going to stir up many thoughts and feelings, memories perhaps— I want you know to know that you can reach out to me and I am here to listen.
The power of this vision of a world without stigma and shame, a world where compassion and support are freely given, is articulated in a Talmudic story, one of a series of short episodes on the same theme- visiting the sick (rabbis visiting other rabbis who are ill).
In this instance, Rabbi Yochanan fell ill and Rabbi Hanina went to visit him. Rabbi Hanina asked: “Are your sufferings welcome to you?”
Rabbi Yochanan said: “No, my sufferings are not welcome to me.”
To this, Rabbi Hanina said nothing. He simply offered his hand. And he lifted Rabbi Yochanan up.
The Talmud then comments on itself, asking: “Why didn’t Rabbi Yochanan just get up himself?” (Which could point to the fact that Rabbi Yochanan is in need of healing of the soul, not just physical healing)
The Talmud then answer the question: “Because the prisoner cannot free himself from prison.”
The prisoner cannot free themselves from prison.
Suffering in isolation, suffering in silence serves no one. It is harmful, it has us sink more into our own personal prison. But as the story so beautifully teaches, when we make space for vulnerability and when that vulnerability is met with empathy and compassion, those who are struggling might be able to be lifted up toward healing.
And for those for whom there is no recovery, for whom full healing of mental illness is not possible (thankfully this is the minority of people but sometimes treatments do not work), at least they can be met without judgment or agenda, fixing or setting straight; they can know they are not alone.
We cannot get out of prison alone. Let us lift each other up. Let us build a better, safer, and more compassionate world, starting right here.
I will end with the words from our daily prayers (from the Ahava Rabbah prayer): “Lo nevosh v’lo nikaleym v’lo nikashel l’olam va’ed” “May we never feel shame, may we never feel embarrassed so that we might not stumble, now and forever.” And let us say: Amen.
Please see this fact & resources sheet for more information and for vitally important resources for those in our communities (and beyond) who are dealing with mental health challenges.
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Talmud Berachot 5a-b