Spiritual Exercises To Beat Back Anxiety

The caller this summer, a 20ish man from Brooklyn, was anxious. Still single, Modern Orthodox, he got nervous in “social situations,” he told David Rosmarin. The crowds at kiddush in shul on Shabbos unnerved him; he felt uneasy leading congregational prayers from the amud, the podium at the front of the sanctuary. “Public speaking,” the man told him, “forget it.”

Rosmarin, after meeting the man in his Midtown office, offered some rabbinic advice: force yourself to walk into a kiddush five minutes after it has begun; volunteer to daven from the amud; join a public speaking group.

But, Rosmarin points out, “I’m not a rabbi.”

He’s a psychologist, an expert in spiritual-based mental health treatment who has taught and conducted research at Harvard University for a decade; Rosmarin opened a part-time practice here this summer that concentrates on the Jewish community.

Rosmarin’s specialty is the type of obsessive-compulsive behavior that often manifests itself, among Jews, in such acts as an excessive focus on the intricacies of kashrut, repetition of certain prayers to ensure they are said correctly, or repetitive repositioning of the tefillin on the middle of the forehead.

Anxiety (which often results from OCD behavior), he says, “is the single largest public health problem facing America today with nearly 20 percent of the population meeting criteria for a full-blown diagnosis in every calendar year.”

Standard psychological and psychiatric practice for dealing with such problems, says the Toronto native, is to delve into the genesis of one’s problems, into the patient’s childhood, into the patient’s relationship with his or her parents.

As an advocate of “evidence-based treatment,” Rosmarin seeks to change OCD behavior through prescribing spiritual exercises. “It’s not just schmoozing” about a patient’s feelings.” He may advise someone to think about gratitude for a few minutes each day, recite one of the siddur’s morning blessings that reflect a specific trait of God’s relationship to His creations, or to read and ponder an inspirational book.

All this, as a psychologist.

“I’m not a mekubel,” a practitioner of Jewish mysticism or of semi-superstitious traditional Jewish practices, he says. “I’m a mental health care professional. I’m very clinical about this. My interest is symptom reduction … to help people with mental health problems.”

While studies for years have shown the medical and mental health benefits of a patient’s religious faith and regular attendance at worship services, Rosmarin says he is one of the few mental health practitioners who actively brings such spiritual exercises into his therapy, especially in a Jewish milieu. “It’s not being used in the Jewish world. To my knowledge, I know very few people [in his field] who combine evidence-based treatment with Torah.”

“I know that a lot of people believe in God, but does it really matter to mental health?” some of his colleagues remark, he wrote in an article on the aish.com website.

His work, he tells them, proves that it does.

Rosmarin is “a very well-thought-of person,” says Benjamin Babad, director of Relief Resources, a mental health referral service with four local sites that serves the Jewish community. Since Rosmarin’s Center for Anxiety opened here only a few months ago, Babad’s organization has referred only a few patients so far, but they have reported that they are “very happy.” Patients who are “very, very distressed” when they first go to Rosmarin report “a reduction in symptoms” after a few weeks, Babad says.

“He seems to be very qualified. We’re excited to have this [innovative] service available in New York,” he says.

An Orthodox Jew, Rosmarin frequently consults with experts in Jewish law about guidelines and limits of what a non-rabbi can suggest, and involves a patient’s rabbi in the course of treatment.

His spiritual exercises work, he says. They “create a shift in emotions.” He limits treatment — with individuals and groups — to a maximum of six months, but most patients report a change in their action and improvement in their emotions in less time. “People can change,” he says.

Rosmarin says his interest in psychology, and in his unique approach, grew out of an experience during his sophomore year at college. He was feeling anxious about “academic stresses,” and had trouble falling asleep at night. He asked a rabbi, with whom he studied Torah each week, if he should see a psychologist.

Instead, the rabbi handed him “Duties of the Heart,” a classic 11th-century book of morale exhortation written by a rabbi in Spain. Read this for 10 to 15 minutes each night, the rabbi said.

Rosmarin took the rabbi’s advice. “Six weeks later,” he tells The Jewish Week in a telephone interview from Boston, “I was really feeling a lot better.

“It showed me,” he says, “that people can change how they feel … and that Torah can be a part of this.”

He scrapped his plans to become a lawyer.

As a member of the Harvard faculty, he gives public speeches and publishes academic papers on the quantitatively proven value of introducing spirituality into mental health treatment, has served as clinical supervisor of the school’s McLean Hospital Obsessive Compulsive Disorders Institute, and chairs the Spiritual/Religious Issues in Behavior Change Special Interest Group of the Association for Behavioral and Cognitive Therapies.

“You don’t have to be Jewish … or Christian, Muslim, Hindu, Sikh, etc. … to reap the benefits of believing God is benign and generous rather then judgmental and punitive,” he wrote on spirituality.com.

“Although considerable evidence has linked religious beliefs to mental health among Protestant Christians, previous theory and research has emphasized that practices play a more important role than beliefs for Jews,” he wrote in an abstract for a 2009 paper titled “Are religious beliefs relevant to mental health among Jews?” “Beliefs about God’s benevolence may be salient for Orthodox Jews, however, as such beliefs are central to traditional Jewish doctrine.”

Most of his patients in Boston are not Jewish, but he and his staff at his Center for Anxiety (centerforanxiety.org) in Manhattan target Jewish patients, most — but not necessarily exclusively — from the Greater New York area’s Orthodox community. They, he says, are familiar with the range of spiritual exercises he introduces. “I only do this kind of work with people who” — after an initial consultation — “want it.”

The anxious man from Brooklyn followed Rosmarin’s advice, he says. Within a few weeks, the man started socializing at shul kiddushes and leading shul prayers, and he joined the Toastmasters public speaking group.

The man feels less nervous in social settings, Rosmarin says, and is about to get engaged. “I’m expecting an invitation.”

The man comes to Rosmarin’s office infrequently these days. Unlike standard therapy, which can last for years, sometimes a patient’s lifetime, Rosmarin’s use of spiritual exercises is designed to make professional intervention unnecessary, he says.

Rosmarin says he considers an encounter with a patient — like the man from Brooklyn — a success when “they don’t need me.”

E-mail: steve@jewishweek.org