Mystics and medics: A comparison of mystical and psychotherapeutic encounters

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Book Revie\ts

While describmg the medical pluralism in Zambia he draws from the work of Frankenberg and Leeson 11974. 1977). complaining that no previous work really ever covered the interaction of traditional healing and cosmopolitan medicine in Zambia. Before givmg tables on the topic “which patient with which disease chooses which healer when” it would have been desirable to offer some data on the epidemiological situation in Zambia. which Leeson and Frankenberg also failed to give. But Van Binsbergen more than makes up for these small statistical shortcomings when he takes the reader with him to hospital doctors-dispensaries. healing cults. name-giving ceremonies, family twists and catastrophies-and all this centered around an ailing Zambian infant, whose ailings are partially due to the medical situation and the structural complications of a Nkoya marriage contract. In this way the author is able to show how “health activities are part of a sustained social system” (p. 26). The way he “gained in depth at the expense of representation” (p. 62) is very fruitful for the reader. when he demonstrates the infant’s mother’s helplessness, as her lactation stops prematurely due to neglect in an urban hospital, and how the mother then looses her affective bond to the child, while preparing dutifully the milk bottles for the child.. An ailing child, however, is classified by its relatives as somebody who has attracted either evil magic or is afflicted by the spirit of an unsatisfied deceased ancestor or is attacked by a coming sibling. In this case certain rituals are applied and if these fail to help the child WIII die anyway. Van Binsbergen shows in this excellent presentation the power of the traditional cognitive classification of health states and how the parents of Edward, even if they wanted, had a hard time to convince themselves and their relatives to make use of the cosmopolitan medicine offered in the hospitals. The second contribution of this volume. also on Africa. deals with the judgement on herbalists and doctors by Ghanaian school pupils. The data were obtained Pu tests. The author, W. Bleek. is aware that the word “medIcme” in this context covers both magical and scientific aspects. This puts the results of the tests m a rather limited position. The third essay by I. Tijssen, also on Ghana. investigates reputation. methods and results of traditional bone-setters.‘Van Enk’s report on a follow-up study on gastrectomy patients in Ghana is a rather unique presentation. since It is extremely difficult under the local infra-structural conditions to get into contact with former patients. The results suggested that the applied type of surgery is problematic in tropical Africa. since nutritional and dietary habits of the patients fail to rehabilitate them after surgery. In both of the contributions on India is shown how the nature of the social network and the caste structure in present day India influences health behaviour of the people. While Loes Schenk describes the distressed situation of the Untouchables (Bhangis) and Tribals (Kukna) in a city in Gujarat who cannot get access to medical care because of their low social ranking, K. W. van der Veen describes how the social network in a clinic is governed by extra-clinical obligations and relationships. He shows how the nature of the obligation and the communication of doctors and patients are mutually dependent. Both authors reveal the contradiction of the fact that modern India offers (“officially”) free medicare to all classes and castes but that the (“unofficial”) caste-society still nowadays prevents people who are poor from receiving adequate medical (and post-medical) care. This collection of essays gives in a very vivid (sometimes almost dramatic) way insights into the health care problems of Zambia, Ghana and India. Instirure of Tropictrl Hyyipne South Ask Institute Unicersity of Heidrlbery, War Gl2rmunJ

Slystics and Tvledics: .1 Comparison of Mystical and Psychotherapeutic Encounters. b) RECLEU P BLLK~. Human Sciences Press. New York. 1979. 120 pp. S4.95

This book is a collection of right articles m hlch orlymall! appeared In the Journal of Psychology and Judaism. The edltor maintains that “there IS a lingering susplclon that the truths about human nature which habe been uncovered m the last century are not new discoveries: rather they are insights into the human condition spelled out m the unlqus jargon of the psychology ~-language.. It ISclear that kabbalistic [Jewish mystical teachings and prnctlces] and hasldie traditions have much to offer the modern clinician and philosopher”. Hasidism was a mass movement of religious revival among the Jews of Eastern Europe that began in the 18th century and which adapted and popularized certain aspects of the kabbalah. It is true that modern psychology..to Its own detriment. has tended to ignore many of the psychological insights. practical and theoretical. of ancient and medieval religious systems. However. the suggestion that the past 100 years of psychological and psychiatric theory. research and expertmentation have merely restated old truths in new termmologies IS not true. and bespeaks a narrow view of contemporary psychology. which is a well established and sophlsticated social and bioloelcal science. Some of the articles rn this collectlon do provide valuable insights into certain ps?chologlcal dimensions and implications of kabbalistlc’ and hasldic teachmgs and practices. I doubt. though. that they will be of much practical or theoretlcal use to a modern clInicIan working within a non-religious conceptual framework. The first and longest of the papers. by Zalman Schachter. Tllr D!,nunlic,\ 01 rllr Ye/Ii&t Trcrrz.~acrforl. is a rich. detailed and fascinatmg analysis of the cognmve. affectlve and behavioral (primarily verbal) dynamics of the private encounter between the hasidic Rebbe or Tzaddik. the charismatic leader of a hasidic sect, of which there are many. and his hasid or devotee. In Hasldlsm. the Rebbe is assumed to be endowed with holy spirit and to use his uruque splrltual power to improve the spiritual and material states of his faithful followers. The hasid goes to the Rebbe for advice. assistance and guidance when faced with a problem. whether of a spiritual. psychological, financial. social or medical nature. Schachter malntams that one central component of the Rebbe’s relatlonship to his “client”. the hasld. is love. and another. is a helghtened capacity for and sensitive use of empathy. which is also a mark of the successful psychotherapist. Schachter’s analysis is based almost exclusive!y, upon the writings of various Hasidic Rebbes and theoreticians or of their disciples and followers. He may have also rehed upon informal reports of the personal experience of contemporary members of the hasidic movement. As IS well known. self-reports are not always reliable sources of information about psychological processes. especially when the reporters believe themselves or theu leaders to be endowed with quasi-divine powers and to be making use of these powers in the course of the process about which they are reporting. Therefore. in order to obtain a non-idealized, balanced description and critical evaluation of the psychological dynamics of the Rebbe-hasid interactIon. an objective study of the relationship and its outcomes is necessary. This. however. is very diHicult to do (though not impossible) given the hostility of most contemporary hastdic leaders and their followers to objectl\e psychological research. Furthermore. some serious scholars of the Hasidic movement. such as S. Dubnov. have pointed to examples of charlatanism among certain Hasidic Rebbes. took advantage of their naive followers’ BEATRIX PFLEIDERER who allegedly belief in them In order to Improperly enrich and aggrandize themselves. None of this critlcal literature IS cited by Schachter. Schachter also falls to give sutficlent attention

Book Reviews to the negative psychological consequences of a relationship that depends upon and frequently fosters an extremely high degree of long-term dependence of one individual, the hasid, on another, the Rebbe. Jonathan Woocher, in his article, The Kabbalnh, Hasidism and fhe LiJe O/ Unijicarion, provides a concise and lucid summary of some basic concepts of Jewish mysticism and hasldic teachings and then goes on to explore their psychological dimensions and implications. Unfortunately, but not surprisingly. definitions of key kabbalistic terms, such as “unification” are general and vague so as to hardly qualify as useful terms for psychological discourse in a scientific sense. A major contribution of Woocher’s fine paper is his translation of “the essential psychosocial teachings of Jewish mysticism into a set of [twenty-one] propositions expressed in a contemporary idiom”. For example, the person’s fundamental problem is separation, estrangement and alienation; human fulfillment depends on the overcoming of separations and the rectification of disharmonious relationships on every level of experience; between people. unification involves the attempt to resolve confltcts and build community on the basis of the ideal of unreserved love with respect for each individual’s uniqueness and awareness of the unity of all people; and, despair is the greatest evil. It should be noted that Woocher’s propositions reflect a humanistic-existential orientation in contemporary psychological thought. an orientation whose therapeutic efficacy and optimistic assertions about human nature have been demed on empirical and theoretical grounds by leading psychologists of psychoanalytic, behaviorist and other persuasions. Woocher perceptively raises two related questions, which. however. in my opinion, he fails to answer adequately. Since many of the psychological propositions culled from Kabbalah and Hasidism would be endorsed by contemporary psychological theorists (of Woocher’s orientation). why should they bother to attend to them at all in their traditional. mythically and theologically laden formulations’? On the other hand. what does the contemporary hasidic devotee gain from a modernized, de-mythologized formulation. which is unacceptable to him and probably even unrecognizable as an expression of his belief and practice? Can any practical benefits accrue to any clinician, enterprise? from Woocher’s religious or secular, Woocher maintatns that since Jewish mysticism has a core of humanistic concern and has a common agenda with modern psychotherapies. he would like to see a genuine encounter between kabbalah and Hasidism and modern psychology. In such an encounter, says Woocher. psychology must confront directly the religious vocabulary and character of kabbalistic teaching. It seems to me, howe\er. that modern psychology and philosophy have confronted rehgious and mystical traditions (Jewish and Christlan) and have found them unacceptable because of their dogmatic and supernaturalist character. Does the fact. for example. that psychology and philosophy reject, on any number of grounds. (along with most of modern Bibhcal scholarship). the fundamental premise of kabbalah and Hasldism. that the Pentateuch was revealed directly by God to Moses and that it is the source of ultimate and absolute religious and moral truth. mean that their encounter with Hasidism is not “genuine”? Moreover, can Hastdism reciprocate genuine encounter by relating sympatheticall! or at least openly to modern psycholog>‘s secular vocabulary and character, given the IntenseI) antagonistic attitude of Hasidism to Western thought and culture? I for one suspect that it cannot do so while remaining faithful to its own worldview. In his paper Hasidism and Logotherapy. Bulka. the editor of Mrsrics and Medics and of the Journal of Psychoiop! and Judaism. demonstrates remarkable affinities

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between some elements of hasidic thought and logotherapy by juxtaposing quotes from hasidic literature alongside paraphrases of the writings of Victor Frank]. Although Bulka does not suggest this, I would not at all be surprised if these similarities are more than coincrdental but rather reflect a familiarity on the part of Frank1 wtth hasidjc literature. Notwithstandmg the similarities of value and technique in hasidic psychology and logotherapy, such as the primary importance of a sense of purpose and meaning in life for psychological health and the deliberate adoption of certain attitudes towards suffering and misfortune in or& to transform them into sources of spiritual and psychological growth, I question Bulka’s conclusion that “hasidic sages could easily practice logotherapy and logotherapists could easily be hasidim” since logotherapy does not depend upon a religious world view whereas such a view is of the essence of Hasidism. In the remaining briefer papers, Spero maintains that although the Rebbe-hasid relationship could be characterized as psychotherapeutic (which I would question, since most of the problems brought by the hasid to the Rebbe were probably not primarily psychological in nature) it differs significantly from a psychoanalytic relationship. Safier describes and compares the use of therapeutic paradox, where the therapist offers a new way of conceptualizing a situation by transcending its paradoxical elements, in hasidic thought and in existential-humanistic psychotherapy. Kirsch attempts a Jungian analysis of a lengthy dream of Rabbi Nahman of Bratzlav, a prominent, early Hasidic Rebbe and Kuperstock discusses the techniques used by Jewish mysticism to extend consciousness beyond a strictly rational mode of perceiving reality. Although these papers provide some useful reflections on psychological aspects of kabbalah and Hasidism they are insufficiently critical in their approach to an understanding of these movements within Judaism and display a lack of conceptual and methodological rigor in their psychology. Hebrerv College DiGsion qf Education Brookline, MA. U.S.A.

SOLOMON SCHIMMEL

Social Causes of Illness, by RICHARDTOTMAN.Pantheon Books, New York, 1979. 263 pp. $10.00 Social Causes ofIllness is a valuable and welcome addition to the literature on life events and illness. The book presents an organized, cohesive and original approach to psychosomatic disease, an area much in need of theoretical development. The book begins with a well researched and highly readable account of the historical approaches to illness and cures. Totman provides a fresh perspective on this history by relating it to modern research in areas such as cognitive dissonance. placebos and hypnosis. He then discusses the physiological bases of psychosomatic disease. explaining the physiology of the stress response. Anatomy and biochemical interactions are described without diverttng the reader from the fact that there is as yet no incontrovertible proof linking psychologically significant events to the onset of symptoms. The second half begins with a review of rhe literature on life events and illness. The majority of tbls research has focused either on specific types of illness (e.g. cancer. heart disease) and has searched retrospectively for antecedents. or on specific types of life events (e.g. bereavement. loss of job) and their ability to predict illness in general. Totman appropriately critiques the methodology of these studies but draws from thts vast literature two themes from which