‘Pathologized Problems’

There are many times when I have disagreed with Rabbi Shafran’s views (and other times when I agreed with them) but I have never before felt compelled to write a letter to the editor with regard to his column, as I did not feel that his opinions were dangerous in those cases, just not in agreement with mine.

However, Rabbi Shafran has crossed a line here. Telling people that everyone is just somewhere on a continuum of normal and that children that he knew growing up seemed to have various mental health issues that never needed to be treated is very irresponsible. First of all, unless Rabbi Shafran is a licensed professional who is qualified to diagnose these issues, we have no idea just how obsessive or compulsive or hyperactive or what-have-you these boys were. Is he speaking of normal boys who we might feel were just annoying, or is he speaking of boys who really needed help then and never got it and maybe had treatment later in life, or who were miserable as children due to their issues? We don’t have any way of knowing this.

And what of the child who really suffers from OCD or depression or major anxiety issues whose parent is convinced not to get needed treatment for this child? Will Rabbi Shafran take responsibility for the suicide of a child whose parents read his column and were convinced that a little more learning or Tehillim would cure his major depressive episode? Even though anxiety and sadness occur to some degree in everyone’s life, there is such as thing as a pathological level of anxiety, as well as OCD, major depressive illness, and other mental illnesses that certainly do need treatment. Not treating depression can be fatal. Pooh-poohing this condition as just needing some “contemplation, consultation … and willpower” is criminal.

I am very disappointed in this article and disappointed in the editors who allowed it into print.

Rena Freedenberg

Rabbi Shafran responds:

Dear Ms. Freedenberg,

I’m sorry that you were disappointed by my observations about what I suspect is widespread over-medicalization of emotionally challenged people or those with certain psychological impairments.

No, I am not a medical professional, but I served as an educator for some 20 years, have read widely on medical topics and have spoken with mental health professionals. I do feel capable of recognizing, both in retrospect and in the present, things like compulsive behavior and hyperactivity.

Far, though, from “telling people that everyone is just somewhere on a continuum of normal,” I openly stated that “there are mental disorders that require intervention.” What I shared was my feeling that there is often an improper rush to diagnose illness and medicate children for behavior that is not pathological. That is a feeling shared, as you likely know, by many mental health professionals themselves.

“Normal,” I simply suggested, should be able to encompass a wider swath of behavioral differences than some assume. And yes, imbalances in middos, as the Rambam tells us, are subject to being addressed without medical intervention, with contemplation, consultation and willpower.