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TOPIC TITLE: The Yeshiva Bachur Who Couldn’t Stop Davening
Created On 7/24/13 5:19 PM
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JewishPress
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7/24/13 5:19 PM
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(Originally appeared in May 2013 issue of Mind, Body & Soul)

By Dr. Jonathan M. Lasson


Obsessive compulsive disorder (OCD) is an anxiety disorder that affects many people throughout the world. OCD is the subject of media coverage usually in the form of humor. Many people observe individuals with OCD and laugh at them for their overly scrupulous behavior. However OCD is no laughing matter. Those who suffer from this disorder are in severe psychological and emotional pain. Pain that can torment them for many years if gone untreated.

For Yeshiva Bachurim, OCD can manifest itself in many ways. Some OCD sufferers will wash their hands more than they need to, others will repeat words of davening while others will obsess about whether their Tefillin are placed precisely in the center of their heads. These Bachurim will, at times acknowledge that they are suffering and that their OCD impacts their ability to daven, learn and function at the level of their peers. The awareness that they have OCD, is one step closer towards getting the help that they need to move on.

When counseling Yeshiva Bachurim, I have noticed a pattern amongst the OCD sufferers. They tend to have psychosomatic complaints such has frequent headaches, stomachaches and general lethargy. They also complain of racing thoughts that interfere with their ability to remain focused. These racing thoughts will often inhibit their ability to fall asleep which explains why they are feeling tired. There is usually a family history of either OCD or some other form of an anxiety disorder. When assessing these Bachurim, it is often discovered that another form of anxiety preceded the full blown OCD. At some point during early adolescence, these Bachurim will admit with a deep sense of guilt and shame that they have been thinking inappropriate thoughts. Adolescence is an awkward time for any boy. How much more so for religiously observant Yeshiva Bachurim. The messages that they often misperceive due to their concrete thought processes catapult them into a downward spiral from obsession to compulsion to dysfunction.

There have been some articles written about over-scrupulosity amongst the religiously observant. Prevalence and incidence are usually underreported. In the course of my practice, psychotherapy that involves the Rebbe of the Bachur as a co-therapist has been helpful in reducing the OCD symptoms to the point that the Bachur can regain functionality in the Yeshiva world.

Oftentimes when I see Bachurim, they will initially relate an incident where they had “impure” thoughts. They hesitate to label and/or expound on the nature of those impure thoughts but it is usually self-evident. However, sometimes the thoughts are relatively benign to the average person but monstrous for the OCD sufferer. For example: A Bachur who felt he might have accidentally looked on to another student’s test paper and feels guilty about possibly cheating. He begins to engage in compensatory and compulsive behaviors such as obsessive davening and learning to the extent that he neglects his basic needs of eating and physical activity. Another example would be a Bachur who touched his head or feet during davening and will wash his hands obsessively to try to rid himself of the “impurity” that is on his hands.

Halacha dictates much of what we do and how we strive to lead a Torah based life. But to the OCD sufferer, Halacha is black and white. (Black and white or concrete thinking is common among OCD sufferers). They will often misinterpret Halacha or read too much into the minutia causing them to miss the big picture. They also misunderstand what their Rebeeim are trying to teach them with regards to Halacha and use their Rebeeim’s words that were meant in general as if they were talking to their situation specifically.

Fortunately, the treatment options for OCD sufferers have improved especially for those suffering from a religious form of OCD. Individuals with religious forms of OCD are easy to recognize and therefore they are more prone to getting the help they need while the OCD is in the early phase. In fact, Rebeeim are usually the first ones to recognize OCD in their students. Going for help usually means you are over 50% of the hurdle on the journey towards functionality. Of course, finding the right therapist is crucial to any successful interventions and some OCD sufferers become frustrated when their symptoms do not improve immediately. Remember, the OCD sufferer thinks in concrete ways and they want to know precisely when their pain and misery will end.

Cognitive behavioral therapy which helps the individual with OCD understand their faulty thought processes and correct the thoughts in order to reduce the compulsions, has been found to be very successful. As mentioned earlier, consulting with a Rav is especially helpful as many religious OCD sufferers are dubious about the therapists’ ability to understand where their situation from a Halachic perspective.

Medications are usually reserved as a last resort for the treatment of OCD. However research has found that medication along with therapy speeds up the healing process. Finding a psychiatrist who is familiar with religious Jewish practices is very important in order to avoid the frustration of having to explain Halacha to the physician who is not familiar with Jewish law.

What I have found as a useful tool in treating Bachurim with religious OCD is the technique of welcoming the intrusive though and giving the thought a time limit as to how long it can remain in your mind. The theory behind this technique is simple. If I were to tell a child, “you can go in any room but you absolutely cannot go into THAT room,” the child would be obsessing about what could possibly be in that room that is off limits? The same is true with intrusive thoughts. When a person tells himself that I cannot go there (meaning it is forbidden to have these thoughts) the obsessive mind will wander towards that thought until it renders him dysfunctional. Trying to force thoughts out of your mind usually backfires.

Welcoming the thought eliminates the psychological pressure on the OCD sufferer. They can have the thought without fear of retribution, but they also have the power to control how long the thought is allowed to remain. This technique might not work for everyone but for many, it is a powerful tool.

OCD is anxiety based and anxiety is usually related to the fear of losing control. Empowering Bachurim to feel that they are in control of their thoughts but giving them the ability to allow the thoughts to enter their minds is often helpful in controlling religious OCD. OCD can sometimes be a lifelong disorder but with proper help, Bachurim can lead successful and functional lives.

Jonathan M. Lasson Psy.D. is a psychotherapist with a private practice in Baltimore, Md. He has written and spoken extensively about psychological issues that affect the frum community. He may be reached at Jonnypsy@hotmail.com


Edited: 7/24/13 at 5:29 PM by JewishPress
 
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