From Yom Kippur
to Ecclesiastes: Models of Change in the Bible
By Gerald Wiviott MD
A few years ago I was asked to lead a psychotherapy
seminar for psychiatry residents in the diploma course at McGill. The seminar
had previously been led by a psychoanalyst and the focus had been on aspects of
analytic theory and technique. I felt that psychiatry was changing; no longer
was the analytic model the major influence on our profession…we were entering
the world of science where psychopharmacology was changing our treatment
strategies, and brain chemistry was the paradigm that offered the most promise
in explaining the causes of mental illness and the emergence of symptoms. The
talking therapies were also evolving to make them more efficient, more
effective, and more appropriate for a wider range of patients than costly and
time consuming psychoanalysis. So the focus of my seminar became “What is the
mutability factor in various forms of psychotherapy?” Experts in various
therapies were invited to present to the residents and to try to spell out what
they thought were the ingredients in their brand of therapy that led to change.
The analysts said “insight”. The existentialists listed “authenticity”, Self-psychologists
talked about empathy, and systems therapists spoke about “strategies.” Of
course in one way or another, they all added that the relationship with the
therapist is important. No one mentioned “inspiration” and I found that
surprising. I think that we were all afraid of giving ourselves too much
importance, as if enthusiasm or modeling were dirty words.
I was thinking about these ideas when I was asked to
give this Yom Kippur afternoon talk on the subject of “change.” First of all, let’s limit the discussion to
changes that people make in their lives. I don’t want to talk about
contingencies (changes like an earthquake or politic upheaval or cycling
accidents) that require adaptation and resilience. That is another kind of
change. I want to address intentional changes, the kind that lead to attitude
modification, behaviour shifts, life altering decisions, and relationship
transformations. This is the message of Yom Kippur: we have a final day to
influence God’s decision about our destiny during the coming year. Since Rosh
Ha Shanna, we have been aware that our fates are being inscribed and the books
will be sealed on this day. And the service has been designed as if it were a
kind of therapy to motivate us to make the necessary changes so that the coming
year will not see us punished by a judgemental God.
For the next 30 minutes or so, I want to talk about
the elements that contribute to change, or rather, how people come to realize
that they want or need to change, and what allows them to successfully make and
maintain the necessary steps. We’re talking about “therapy” but in the broadest
terms. Like Jerome Frank in his seminal work, “Persuasion and Healing” first
published in 1967, I also want to look for common elements that lead to change.
Frank wrote specifically about conventions that are found in every culture and
in every historical period designed to help the “demoralized” regain their zest
for life. Whether it is the shamans of Africa or the Priests in the Temples of
Asclepius in ancient Greece, or analysts’ offices in Manhattan, there are
similar elements in each setting: 1) there is a designated healer, 2) there is
a specific venue where healing occurs, 3) there is a prescribed ritual or
method of accomplishing the healing, and 4) both the healer and the sufferer
accept the validity of the method.
I would like to be little more specific in this
talk. I’m going to suggest a number of
ways in which we could categorize the catalysts, or the mutability factors, for
change: 1) Inspiration: (Having an example, or wanting to be a participant) 2)
Motivation: (fear of consequences, health, happiness, 3) Provocation: (being
challenged or dared) 4) Support: (the necessary accompaniment to lasting
change.
So what is the mutative ingredient of Yom Kippur? In a
word, it’s Freudian. It’s no coincidence that Freud died on Yom Kippur, 1939.
His work is a testament to guilt, shame, and conflict. According to him all our
problems, the stuff that motivates us to seek help, can be attributed to our dark
side. It’s as if he took “original sin” to a new level, took it out of the
hands of priests and put it front and center into the hands of
psychotherapists. During the golden period of Freudian theory, almost every
leader in the field of psychiatry was an analyst and most residents in
psychiatry were obligated or encouraged to undergo their own personal analysis.
If they were unable or unwilling to acknowledge the illicit behaviors, the
unacceptable thoughts, the selfishness, the jealousies, and the lingering
feelings of shame from previous events, the analyst was only too quick to point
out the defensive maneuvers that kept such ideas unconscious. Yes, everyone had
something that lurked in the psyche, something that bubbled up to the surface
to cause anxiety or depression or fear of success, and it was the job of the
analyst to uncover those hidden sources of anguish. It wasn’t so much
confession; confession is easy because it relies on conscious awareness. No,
Freud went one better. He would get people to become conscious of dark secrets
that they weren’t even aware of; it was a kind of suggested confession and it
was called “insight”. But the mutative agent was not much different from what
we are experiencing today in our service. Together we have read, and will read,
whole lists of behaviours and thoughts about which we should feel guilty. I
imagine the Viddui and Ashamnu are still reverberating in your minds as you
listen to me. Unless we take
responsibility for having engaged in those deeds or harboring such thoughts, and
vow to repent, we will feel the punishing hand of God writing our names in the
ledger that could condemn us during the next year. If the less-than-noble parts
of ourselves didn’t cause symptoms before today, recognizing the consequences of
harboring such parts without confessing and repenting is enough to evoke
terror. The stakes are high…”Who shall live and who shall die.”
Freud never pretended to have control over life and
death, but one of his analysands, Joseph Wortis, a New York psychiatrist who
was analyzed by Freud, wrote about his experience on that famous Oriental rug
covered couch: “There was the unpleasant prospect of developing what Freud
called resistance, against him, my present lord and master; who sat in quiet
judgement while I talked, like a stern Old Testament Jehovah, and who seemed to
take no special pains to act with hospitality or reassurance…” Freud strongly
believed that his theories of the mind were absolutely valid and that therefore
his treatment offered the only cure for psychological maladies because only by
uncovering the underlying (often unconscious) forces of unacceptable wishes,
ideas, and feelings, could people be cured of their misery. And many were. The
threat contingent upon not doing something, either repenting on Yom Kippur or
developing insight in analysis is a powerful motivator for change and if the
motive is strong enough, change is possible. Today, to be “in the good book” we
need to stop coveting, refrain from gossiping, renounce lying, and attempt to
fulfill God’s expectations for us. In a remarkably parallel way, under Freud’s
guidance, we will finally be rid of our anxieties and personality quirks that
contribute to life’s miseries if we become aware of previously unknown
forbidden sexual desires, hidden hostile thoughts, and unacknowledged guilt
connected to unsavory deeds.
Jay Haley, a well-known psychotherapist once remarked
that if people want to change, they are not in therapy. Sounds strange until
you think about it…the assumption is that anyone can change if they want to;
ergo if someone seeks therapy (implying they can’t change on their own) it’s
because obstacles to change are getting in the way, or, they are actually
fooling themselves when they think they want to change. In fact, the rewards of
not changing may be too great (the successful conman) or the fear of what
change might bring inhibits the motivation to make the desired changes. Here’s
where analysis and Yom Kippur differ: analysis tries to remove the stumbling
blocks by interpreting the so-called resistances that impede change, while the
stakes are so high during the High Holiday season that resistances sufficiently
shaken can be overcome.
Times, they are a changin’. No longer is psychoanalysis the holy grail of
therapies…most of this congregation knows that (half of the congregation are
either therapists or in therapy or have been in therapy or think they should
be), and also most of this congregation is not likely to take literally the
threat that if we don’t repent on Yom Kippur our fate is sealed. All the
repetition of sins, all the chest beating as we utter or shortcomings, and all
the tales of Jewish martyrs will not be enough to motivate us to make
fundamental changes in the way we live our lives. Even most analysts no longer
take literally the existence of unconscious dark forces that manipulate and
coerce us into misery and dysfunction. The days of reifying Freud’s template
are over.
But other therapies have made use of the fear factor
to promote change. Irving Yalom, the well-known writer and therapist speaks of
“existential shock therapy” to shake up his patients in order to catalyze
change. He tells his/her patient to draw a line on a piece of paper with one
end representing the moment of his/her birth and the other the moment of death.
Then he tells the patient to place a mark on the line to indicate where he/she
feels they are at that moment. It is a sudden confrontation with mortality, a
realization often avoided by people. Of course, as we think about the Yom Kippur
service we see that death images abound and we are constantly reminded of our
mortality. Like Freud, Yalom too was influenced by the High Holiday rituals
though he is in avowed atheist, but that is the subject of another talk.
I’m going to suggest other parallels to examine the
religion/therapy models of change. The first is the role of inspiration,
specifically the power of an inspiring person. Mordecai Kaplan has inspired
many of us to return to our Jewish roots and to feel comfortable with our
traditions and religious practices even as he was labeled “heretic” by the
orthodox community. And Rabbis, not resorting to charisma, can by their example
of compassion, dedication, creative leadership, and “menchlikeit” inspire
congregants to transform their lives.
For better or worse, there is also the attraction of
charisma. The Chabad movement, as an example, has its spiritual leader, The
Rebbi, Menachem Schneerson, who even after his death continues to inspire his
supporters and disciples who are making Chabad the fastest growing denomination
in Western Judaism. Here in Montreal, Chabad now has houses in every part of
the city. In addition to free membership, the Lubavitch movement attracts
people by its mystical and idealistic message, but Schneerson’s charismatic
leadership is responsible for recruiting followers who have changed their
beliefs, attitudes, and behaviors in accordance with the Rebbi’s message.
.
A novel experience can also be inspirational. Last
year, my son, Matt, went to Burning Man, a weeklong event where 50,000 people
come together and create a temporary village on a plot of Nevada desert. People
create huge art projects, and wooden effigies are burned at the end of the
week, a celebration of temporality or the ephemeral nature of life. An article
that Matt sent to me touches on the power of an event to lead to fundamental
personal changes: “Properly executed, a Burning Man experience can shift the
paradigm of what is important, even what makes a meaningful life. It will bring
into sharp focus just how myopic we can be with our judgement of others, and it
can profoundly alter one’s perspective of humanity’s potential.” If we want to
change, the challenge then becomes to indulge our curiosity and generate the
courage to engage in new experiences.
Likewise in therapy, we have seen the explosion of
self-help books, where the appeal rests mostly on the inspiring story of the
author rather than the instruction or suggestions contained in the book.
Another growth industry is the Life Coach. Again it’s the power to inspire
change rather than specific techniques or a novel approach that makes a
successful coach. I admire inspiring coaches. I wish I were one. I can look
back and appreciate my good fortune in having had excellent coaches at various
times in my life. Yes, they were knowledgeable; yes, they had experience; and
yes, they taught technique. But what set them apart was their capacity to
inspire confidence that change was possible. They did that by conveying a sense
of caring, a sense of understanding who I was, and an enthusiastic optimism
that I could make the necessary changes to achieve my goals…not their goals.
That was the kind of inspiration that motivates change. I’m going to come back
to that point later.
So far, I’ve looked at two examples of change
producing events. The first was the scare/confession model and the second is
the “inspiration” paradigm. The first is exemplified both by Yom Kippur’s
explicit message of sin and punishment, and by psychoanalysis’s more subtle
suggestion that it’s our underground reservoirs of guilt and shame that keep us
miserably trapped in repetitious patterns of frustration and failure. And the
second example is inspiration possibly by the energy,
optimism, and image of a successful coach. For sure there are dangers. We must
guard against the possibility of being seduced and manipulated by the appeal of
charisma. Furthermore, when the
conditions for change are entirely dependent on the continued cheer-leading of
the coach, then no genuine and enduring change is possible. But coaching does
work and charismatic leaders have created flocks of devoted followers who are
grateful to be part of the group.
A few weeks ago, I had a lovely conversation with Ron
while enjoying a cappuccino as we sat on a Monkland Ave. terrace. Of course the
topic turned to books and Ron mentioned “Subversive Sequals” by Judy Kinstler.
The book suggests that two stories from the bible may deal with similar themes,
but that one will contradict or subvert the apparent meaning of the first.
Without going into detail I’ll point out as examples: comparing the Jonah story
which we will read this afternoon with the Noah story. While Noah meekly,
passively did as a punitive God instructed him, Jonah (also underwater) displayed
some degree of autonomy, but, more importantly, in the Jonah story, God
displayed the capacity for compassion toward humanity. And the citizens of
Nineveh, after being given sufficient warning were able to change their ways.
I’m not doing the subtlety of her thesis justice, and I’m certainly not
properly recognizing her scholarship, but I want to convey that I found her
ideas sufficiently interesting that I was motivated to see if in the Bible I
could find something subversive about Yom Kippur. After all, not everyone in
our Congregation takes Scripture literally; we may not respond to the threat of
a sealed fate with the same rush to repent that might have been the norm
generations ago. Does that mean we’re not spiritual or religious or capable of teshuvah?
Of course not. As much as we might revere Abraham as the father of monotheism,
I don’t think most of us would follow his unquestioning obedience to a God who
instructs him to sacrifice his son. Perhaps it’s more accurate to say that we
are too rational than to say that we are cynical. Maybe we are a bit too
stubborn to suspend disbelief, but the awesome “quaking in our boots” that
might have previously accompanied today’s recital of guilt and punishment
doesn’t seem to arouse such terror or to provoke a passionate desire to repent.
For better or worse modernity has broken free of the
linear, the rational, and the logical. While we still appreciate Mozart and
Beethoven, it was Stravinsky who shook up the musical and esthetic world with
Le Sacre Du Printemp. It was Picasso who taught us a new way of seeing things
with his distorted figures, and Einstein and Heisenberg showed us that reality
is not what our everyday experience leads us to believe. All this to say that
change also may come about in novel, unexpected, and counterintuitive ways. And
one of those ways is paradox.
An example: I saw a young man who was hospitalized
following a motorcycle accident. He suffered a broken femur and a broken wrist.
I was asked to see him because he was refusing to engage in physiotherapy
claiming that he was too weak and the pain was too great. The staff felt that
there were psychological reasons for his refusal to “follow the recommendations
of the professionals.” He told me that the worst part of his injuries was the
right wrist fracture because it meant that he would not be able to draw a gun
out of his holster and since he had always dreamed of becoming a policeman, he
now must give up the dream. After listening intently, I told him that I was
going to ask the nurse to bring him a wheelchair so that he could start
practicing using it. I added that I understood that the pain must be too great
plus the disappointment about giving up his dream and that I could understand
perfectly why he would never put in the effort to walk again. And as I started
to leave, he shouted after me not to bring in the wheelchair. I told him that I
knew he was proud, but that it was clear to me that he shouldn’t try too hard.
And I asked for a chair to be brought in.
Two days later, when I went on the ward, his nurse and
the physiotherapist both said that right after my previous visit, he was eager
to go down to the rehab room and get on the parallel bars. Of course I was
pleased and went back to see the patient who again was lying in his bed. When
he saw me, a sly smile crossed his face and he said, “Doc, I know what you were
trying to do. You wanted to make me angry so I would do the treatment, but I
saw through it.” And I replied, “I guess
it didn’t work.” We both laughed, shook hands and I wished him well.
Those of you familiar with the work of Victor Fraenkel
will see the similarity between the paradoxical approach I used in the above
case and his brand which he called “logotherapy”. Basically he pointed out that
sometimes the more we try to do something, the more we focus on getting it
right, the more often we screw it up. He used the example of a man who came to
him because his job demanded that he give public speeches, but every time he
had to give a speech, he sweated so profusely that he became terrified of
getting up in front of a crowd. “How many handkerchiefs do you typically use to
dry yourself?” asked Fraenkel. “I just
take one” said the gentleman. “Next time,” said Fraenkel, “take three and
saturate all three.” Of course at the next therapy meeting which took place
after a couple of speeches, the man announced that it didn’t work…he could not
saturate even one handkerchief!
At this point I want to take a bit of a break and get
personal in order to highlight an example of change. I have had the good
fortune to participate in fund raising bicycle ride called the 401 bike
challenge. Monies raised go to support the Sara Cook Ward of the Montreal
Children’s Hospital, a unit that treats kids who are battling cancer. The 401
bike challenge is a two and a half day ride from Toronto to Montreal. It is
challenging. Last fall, one of the fellows with whom I occasionally rode on
weekends, Mark, told me that he was going to do the 401 ride this year. When he
told me that, he weighed about 280 pounds, and he would get tired after a slow
50 kilometers ride. The second day of the 401 covers 260k from Belleville to
Cornwall. I heard from another friend that Mark told him that if I could do the
ride, he could do it. For better or worse, I guess he felt inspired.
A video company decided to make a video about Mark’s
training and determination, a kind of inspirational video. I was interviewed
for the video and they asked what I thought about Mark’s chances of completing
the ride. I have to admit that I had
serious doubts about his fitness and even his judgement, and I expressed them
on camera. But over the course of the winter I would get reports about Mark’s
progress…he was seeing a nutritionist, he lost over 50 lbs, and he was training
three and four times a week. By the time the ride started, he had lost over75
lbs and had completed several difficult bike trips in preparation for the
Challenge. He successfully completed the Challenge which was especially
remarkable this year because the rain and headwinds which confronted us on that
second day made it even more arduous. When we reached the end of the ride at
the Children’s Hospital, a very tired Mark managed to say to me with a sneer,
“I wanted you to eat your words”
There is something common in all three examples, the
boy who had the accident, the man who sweated too much, and the story about
Mark. In each case there was a dare, a challenge to go beyond what someone else
thought possible for them. Motivation was aroused as a response, not to
encouragement, but to scepticism. It gave rise to an “I’ll show you” attitude.
It doesn’t always work, but when used appropriately, it can be a very effective
change agent. Part of its power rests on respecting the individual’s pride and,
yes, stubbornness. Many of us, despite our overt request, do not want to be
told what to do. Heavy handed messages of “you should do this” either appear
like common sense or the person has been given the same advice countless times
already and it hasn’t worked.
And that takes us to the subversive sequel to the Yom
Kippur service. I’m talking about Ecclesiastes. Probably written somewhere
between the 4th and 2nd Century BCE, it was hailed by
Thomas Wolfe as the “greatest single piece of writing that I have ever known,
and the wisdom expressed in it the most lasting and profound.” Known for
phrases like “Vanity of vanities, all is vanity” and “The sun also rises, and
the sun goes down…there is nothing new under the sun” and finally the Pete
Seeger song “Turn, Turn, Turn” “For everything there is a season, and a time
for every purpose under heaven.” Its existential weariness has a contemporary
ring to it. It makes me think of Samual Beckett’s novel “Malone” or his play
“Krapp’s Last Tape” or Camus’s “Myth of Sisyphus” which proclaims that the only
important philosophical question worth asking is whether to kill oneself. If
everything is as meaningless, empty, futile, fleeting, or absurd (depending on
the translation of the word “hebel”) then what difference does it make to
struggle through a life without meaning? Over and over again Koholeth, the
preacher, acknowledges that we all die, rich and poor, the wise and the fool,
honest and unscrupulous, human and animal, and, on top of that, knowledge is
not going to make us happy; “He who increaseth knowledge, increaseth sorrow.”
The second theme, almost like an antidote to
meaninglessness, is the injunction to enjoy life. “There is nothing better for
a man than that he should eat and drink, and make his soul enjoy the good in
his labor.” “Then I commanded mirth, because a man has no better thing under
the sun, than to eat, and to drink, and to be joyful…” “Go your way – eat your
bread with joy, and drink your wine with a merry heart..Live joyfully with your
wife whom you love all the days of your life of vanity…”
Imagine a therapist working with a client who seeks
help because of depression, the all-to-common depression that accompanies a
sense of meaninglessness, ennui, or emptiness. One approach, quite literal,
would be to refute the idea that life is meaningless and to suggest that
depression predisposes one to see it that way, but, really, life has a purpose,
and in therapy we will find the purpose. A second therapist might suggest ways
that the patient could find meaning, perhaps volunteering or learning a new
skill. A third therapist, paradoxically disposed, will agree wholeheartedly
that life is meaningless; so one might as well enjoy it. Why might that be more
effective? Because it avoids the inevitable fight about world views, it
prevents the therapy from becoming a fight about life itself, and it fosters a
relationship with the therapist.
Let me offer an example of therapy based on this
principle: I saw a family in which the 25 year old son was talking about being
suicidal. Mother and father were beside
themselves with worry, mother even crying while her son, in my office, casually
said that life held no interest for him and suicide was an option. When I heard
that, I went to my bookshelf, pulled out “The Myth of Sisyphus” and read the
first page where Camus speaks of the importance of facing the possibility of
suicide. I complimented the young man on his courage to face such a difficult
decision. Of course, Mom and Dad were appalled that I didn’t take another tack
and dissuade their son from even thinking such thoughts, but their son
brightened up, and, for the first time in a long time, told his parents not to
worry. The next time I saw him, he was sitting in the audience as I gave a
lecture to medical students.
But Ecclesiastes goes further than merely postulating
that everything dies in the end so you might as well seek pleasure. In keeping
with my attempt to posit a message subversive to the Yom Kippur Service, and to
show the paradoxical therapeutic intent of the writing, I have to bring God
into focus. At the beginning of this talk, I spoke of the heavy handed message
of the Yom Kippur God, the God who reminds us repetitively of our guilt, His
power to determine our fate, and the urgency of repentance. Ecclesiastes brings
the same message, but oh so different. After hitting us over the head with the
ultimate futility of striving, of competing, of gaining wisdom, of confronting
evil, of attempting to control our destiny, we come to the last paragraph:
“This is the end of the matter. All has been heard. Fear God, and keep his
commandments; for this is the whole duty of man. For God will bring every work
into judgement, with every hidden thing, whether it is good, or whether it is
evil.”
Like a hypnotic suggestion after being lulled into a
state of comfort with pleasure seeking as an antidote to ultimate vanity or
futility, we are gently told to “Fear God and keep his commandments.” There is
no reflexive opposition, no need to dredge up sources of guilt, no life or
death consequences to overwhelm us. Just a statement of what’s important in a
world of unimportance. The message from Koholeth lets God’s words resonate, for
some people, more profoundly than the words spoken by God Himself. God’s
message updated, ironically, by the “carpe diem” of Nietzsche.
I want to go back to my riding companion Mark for the
final word on the question of change. At the end of the 401 bike challenge,
while we were at the finishing line in the park next to the Children’s
Hospital, the video crew that filmed Mark’s training and participation on the
ride asked him for a few words now that he had reached his goal. He said, “If
you believe in yourself, you can do it.”
Whether the catalyst for the changes you want to make
comes from inspiration, or from motivation to achieve a goal, or the result of
feeling challenged to go beyond yourself, I hope, today, Dorshei Emet has
provided a place for you to start the process.
And here I’m going to quote from an email I received
from a friend, Beth Stutman (another 401 rider): “What I need to say about
change is that”, referring to Mark’s end-of-ride comments, “if you don’t
believe enough in yourself (faith) then find someone who does to help you!...A
coach, a therapist, a friend, a teacher, a support group…whatever it takes
–find someone, some place, to help support that desire to change.”
Whether the catalyst for the changes you want to make
comes from inspiration, or from motivation to achieve a goal, or the result of
feeling challenged to go beyond yourself, I hope, today, Dorshei Emet has
provided a place for you to start the process.
I believe that is why we are here today, to find in
this community, sufficiently likeminded folk gathered together, people who
share our view (a la Jerome Frank) of which rituals facilitate change, and who
by their participation give us the support we need to make the changes that
will enrich our lives. For sure, if those aims are realized, we have heard the
call of the shofar and we have entered the holy space of Yom Kippur.
