Psychotherapy and Teshuvah

A traditional perspective.

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Reprinted with permission from "Psychotherapy and Teshuvah: Parallel and Overlapping Systems for Change,"  Torah U-Madda Journal, Vol. 11 (Yeshiva University).

People come to mental health treatment because they are in pain. The presentations of their pain vary--they come because they suffer from symptoms that restrict or threaten their lives, because they struggle with inner conflicts that undermine and torment their integrity, or because if they don't come, they will lose their job, their spouse, or their children. 

Seeking Change

People seeking mental health treatments desire change in either outlook or behavior that will result in the removal of their pain. Most people who seek mental health treatment understand--or quickly come to understand--that the alleviation of emotional pain requires active participation in a process that involves understanding the reasons for their suffering and making concrete changes accordingly.

brain puzzleTeshuvah, repentance, can be considered a Judaic analogue of the process through which one's emotional pain is linked with the requirement and inevitability of change. In teshuvah, the change takes the form of eradicating delinquent behavior according to the precepts and ideals of Jewish law.

Indeed, observant Jews who believe in a religiously ordered cosmos accept the responsibility to fulfill 613 commandments, mitzvot. Transgression of any of these commandments constitutes wrongdoing that the offender is obligated to correct. The observant Jew who commits a transgression presumably feels pain and perhaps guilt, reflecting a disturbance in his/her proper orientation in God's creation.

Powerful Processes

The religious prescription for teshuvah constitutes, according to many authorities, a mitzvah in its own right. Teshuvah includes several components--confession to God, remorse, restitution, and the capacity to act differently when placed in the same circumstances, including, inter alia, the same temptation.

Teshuvah is a profoundly powerful moral goal in and of itself, in part, no doubt, in recognition of how difficult change can be, even if it is motivated by pain or guilt. The process of teshuvah is largely outlined in various halakhic [Jewish legal] texts where different sages address the nature of the transgression that has been committed.

Sins against one's fellow man, for example, require that specific behavioral restitution be made. Teshuvah following theft, therefore, can only be accomplished after the stolen property has been returned.

Like psychiatric treatment, the process of teshuvah is optimally performed when a person expresses a desire and commitment for change. The individual engaging in teshuvah has a well defined idea of the deficiencies that must be corrected and a relatively clear picture of the optimal end result.

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Dr. Michelle Friedman

Michelle Friedman, M.D. is Assistant Professor of Clinical Psychiatry at the Mount Sinai School of Medicine and Director of Pastoral Counseling at Yeshivat Chovevei Torah.