Mental Illness in the Jewish Community

This article came out recently in the New Jersey Jewish Standard, and I think it is absolutely right on the money.  It's called, unabashedly, "I Have Bipolar Disorder." Take a look.
http://jstandard.com/content/item/i_have_bipolar_disorder

One More Day

Another easier-said-than-done tip to help avoid those conflicts that never really needed to happen. To make it easier to do, too - start practicing now.

Online Therapy

In an effort to spread the hype, I am posting links to the various sites where I am listed as a therapist. Pass it on!

• http://therapists.psychologytoday.com/rms/129024
• http://thriveworks.com/find-counselor/listings/raffi-bilek-lsw/
• https://www.proventherapy.com/Raffi-210.html
• http://www.wellness.com/dir/6017040/counselor/nj/paramus/raffi-bilek-block-federbush--associates-lsw

The Gratitude Platitude

This one goes under the "Things We All Know but Don't Do Enough of" category.

Moving On

I thought this song, written by a young man based on his own experience, was a meaningful contribution to the discussion on child sexual abuse.

A Beautiful Mind

And now, for the lighter side of psychotherapy... here's a thought I recently had: there seems to be an awful lot of mental illness in "Beauty and the Beast" (over and above, of course, the whole Maison des Lunes number):

• Belle: Stockholm syndrome
• Beast: Intermittent explosive disorder, possibly Asperger's disorder
• Belle's father: dementia
• Cogsworth: obsessive compulsive personality disorder
• Lumiere: possible sexual addiction
• Gaston: narcissistic personality disorder
• LeFou: dependent personality disorder

Did I miss any?

Whose Turn Is It?

"I took the garbage out yesterday - you do it today."
"I already changed three diapers today, it's your turn!"
"I walked the dog this morning in the freezing cold, you'd better do it tonight."

Do these sound familiar? It's not uncommon in relationships for people to try to equalize the workload by taking turns with the chores - and by keeping tabs on whose turn it is.  Here's my take on this approach:

My New Books!

This post is part parenting discussion and part personal plug.

You may recall an older post of mine which linked to an article I wrote for the OU discussing how to influence one's children towards better behaviors.  In it, I cite the obvious principle that lecturing children (especially young children) is a brilliantly ineffective way to do so.  Children do not respond to lectures. They respond to visual cues, rhymes and rhythms, modeling, and stories.  Thus, when we were facing an issue with my older daughter of her being rather bossy with her friends and her younger sister, rather than try to explain to her why this was problematic, I wrote a little book about it (with the help of Bat-Sheva Kivelevitz, my intrepid illustrator).  I can't tell you that the book was a magical success, but I can tell you that we don't really have this problem anymore. So it seems to have at least been part of the solution.

Likewise, early on my younger daughter was having trouble sharing. So I wrote a book for her at her level to help her understand how and why to share. Again, I don't know how much it contributed, but I can tell you that now she is very proactive about sharing.

It was actually a rather long process to finally make these available to the public once I decided to do so, but now here they are!  Bossy Baila and I Share are available on Amazon.com and CreateSpace.com.  And they make great gifts for all your pre-school friends!  Bossy Baila is great for around the ages of 4-6, and I Share is more for younger children, perhaps 2-4.

Note that although I expect these books will be helpful for children of any background, they are written primarily for the Orthodox community (e.g. the names, illustrations, etc.). Actually, they are written primarily for my daughters. I didn't really intend to formally publish them when I wrote them. But here they are! So now pass it on.

Shabbos with the Bileks

We are going to be scholars in residence of sorts at House of Israel in Ste. Agathe Des Monts, Quebec (about an hour outside of Montreal) this Shabbos.  (I say scholars, plural, because really it's my wife they want to hear. She will be speaking about her life's journey from being born in South Korea to becoming a rebbetzin.) If you're in the area, it's a great place to spend Shabbos!

Feel the Burn: Relationship Counseling Exercise

As you may have noticed by now, many of the tips I've posted here require a bit of effort on your part.  Rarely can you grow as a person without putting some emotional elbow grease into it. In this video, I'll explain how to channel the feelings of emotional strain and striving into something productive.

Pornography Addiction Revisited

A friend of mine and I were discussing my post on pornography addiction in the Orthodox community and weighing in on the prevalence of the problem in different communities - religious, non-religious, Jewish, Christian, etc.  He said something that I thought was most thought-provoking, and I am sharing it here for the good of the masses.  Would love to hear others' responses to this:

The non-religious are addicted to porn because it is easier to satisfy your desires without a connection to people. The religious are addicted to porn because it is impossible to satisfy your desires by connecting to people.

Indeed.

The Royal "We"

Using "we" when you mean "you" is one great way to leave your partner feeling vaguely resentful and keep negative feelings brewing under the service. In this video I'll explain this a little more:



The Benefit of the Benefit of the Doubt

Here's a useful example of how Giving the Benefit of the Doubt benefits everybody:

The Hidden Lessons of the Hebrew Letters

If you're in the environs of Passaic this Sunday, stop by the Ahavas Israel shul (181 Van Houten Ave.) at 10 AM to catch the opening shiur in a series I'll be giving on the meaning of the Hebrew letters.  It promises to be most interesting!

Mental Illness - Rules of the Game

I just read a brief review of The Book of Woe, a critique of the DSM-V (the latest edition of the Big Book of Mental Illnesses that mental health professionals use to categorize disorders and people). It contains the following apt description:

The basic message is this: everyone in the mental health profession knows full well that the DSM is a work of fiction—that the hundreds of “disorders” described therein are just labels for fuzzy, overlapping clusters of symptoms and that we have never found a definitive biological marker for even one of those disorders. Mental health professionals pretend that the disorders are real, but they're not, period.

I have long maintained openly that the categories laid out in the DSM are made up and not very useful for actually helping the people who suffer from the disorders therein.  The only part I disagree with above is that "mental health professionals pretend that the disorders are real" - because I am a mental health professional, and clearly, I don't. Nonetheless I am forced to play along with the labeling system because unless you have an "approved" disorder, your insurance probably won't pay for your therapy.  Stressed out because of your boss, your significant other, your children? Major depressive disorder (probably unspecified type).  Worried about your financial situation?  Marital trouble? Generalized anxiety disorder.  Does everyone who gets these diagnoses meet all the criteria? Unlikely - but if you want coverage, you have to play by the insurance companies' rules, which thus far still include the DSM's fiats. (I must confess to being ignorant of the rationale for the insurance companies' approach, but I imagine it has to do with practicality over precision - see below.)

I think it is important to note, however, that the DSM and its labels are not entirely useless.  Firstly, diagnoses help somewhat with being able to identify clusters of symptoms as representative of a certain disorder which thus requires a certain treatment.  You don't do cognitive-behavioral work with psychotic disorders; if someone appears to have borderline personality disorder, dialectical behavior therapy is the only treatment that has demonstrated any effectiveness. 

Likewise, categories are helpful for research purposes.  If we want to know what has been effective for people who are struggling with exaggerated worry, we need some definitions in order to study what sort of treatment yields the best results.  The problem is that the categories often become gospel. Many or even possibly most people with anxiety problems might respond to treatment X, but certainly not all of them will.  People, after all, are people - no two alike.

As an on-the-ground practitioner, I use the labels to satisfy the insurance companies; but I am in agreement with the author of this book that by and large, the whole approach is something of a farce.

How to Be Married to a Man - Revealed

Some months ago, you may recall that I posted about the publication of an article of mine in Binah Magazine.  Now that the time limit they put on redistributing the article has elapsed, I am posting it below for everyone's edification and enjoyment.  (Actually, I am posting the original version of the article, which differs from the one they printed in that it is better.  They did a lot of editing.)

How to Be Married to a Man

You may be thinking, that I, as a man, am not the right person to be writing this article.  After all, I clearly have very little experience being married to a man.  However, it so happens that I have very close connections with someone who does have lots of experience in this area, and together we have collected some relevant sociological data. 

The points I will share with you are grounded in the assumption that in general, men and women have dissimilar ways of doing many, many things.  (I know that not all men do it “the man way” and not all women do it “the woman way” – we’re talking in general here.)  Here, then, are a few tips for wives who are trying to survive and thrive through the experience of being married to a man:

1.       If you don’t want him to solve the problem you are about to describe, tell him so beforehand.

Before I got married, I had been clearly taught that women often like to talk about their problems without having anyone jump in to solve them.  Thus it was quite surprising to me when, after stepping into my role as husband, I would do precisely that - jump in to solve my wife’s problems right in the middle of her telling them to me.  This is actually a reaction that is hardwired into many men, myself included.  So my wife and I, after some time and much frustration, came to the following agreement: if she wants to share a problem with me and does not want me to solve it, she says before beginning, “I’m just saying…”  That is our code for me to shut off the problem-solving mechanisms and engage the empathy apparatus in my brain (which really is quite effective, once the problem-solving machinery is on break).  Not only does my wife proceed to get what she needs from me – a listening ear, empathy, affection – but I am relieved from the internal pressure that my brain puts on me to immediately start thinking of possible solutions.  Truth be told, it’s very freeing.

This prefatory code is actually needed even though I already know that she probably just wants me clam up and listen.  Apparently possessing the general knowledge is not enough for me to overcome my deep-seated male tendencies; an active intervention is needed. 

You may be thinking, “Why do I have to do that?  Can’t he just get it?”  It’s a fair question.  But the answer is no.  He cannot.  As a man, your husband is programmed to take care of you.  In a man’s world, that means fixing your problems.  “Just listening” is not a way that a man, untrained, identifies as taking care of someone else.  As soon as you hint towards some kind of difficulty, his gears begin turning furiously to make the difficulty go away.  Because he loves you. 

To change that deep programming is nearly impossible.  You can override it with a direct command, but probably not by subtle hints or wishful thinking.  Yes, it costs you an extra couple words.  I think it’s probably a worthwhile trade-off.  
 

2.       Recognize that he does not care if it’s pretty.

I cannot tell you how many times my wife has asked me to bring some Shabbos dish from the kitchen to the table and has reacted with horror when I brought it in the tin pan in which it was sitting on the blech.  I understand somewhere deep in the recesses of my male brain that this is somehow not “pretty” or “aesthetic,” but it just doesn’t progress into any kind of real-world action (unless there are specific instructions, which is an entirely different topic in male-female relations).

The fact of the matter is, most men wouldn’t recognize an inanimate object as pretty if it bit them on the nose.  And the truth is they really don’t care.  I am much happier bringing the brisket out in a tin pan than trying to lay it out attractively on the correct serving plate because that is 90 fewer seconds until that beef is in my gut (see tip #3).  Men do not generally seek aesthetics.  Men seek functionality.  I once tried storing a snowbrush for my car on a ledge above the coat closet.  It came down minutes later on the orders of my wife, barred from that location as an “eyesore.”  I really had no counterclaim; it was an eyesore.  But boy, what a practical place to store it!  Immediate access, perfect fit, and what else was I going to put there anyway?  That’s how men think.

So what’s the upshot?  First of all, if you are buying something new, say, a lazy susan, don’t try to justify the purchase to him by explaining how it looks just right on the table, or how it goes perfectly with your dish set, or how it’s really fashionable these days.  Explain to him how functional it is: it increases space on the table; it distributes food more efficiently; perhaps most importantly, it will aid in getting food into his gut more quickly.  You are much more likely to succeed with such an approach.

Secondly, in the case where functionality can definitely not be called upon – such as in the case of a pair of brown boots that are exactly like your black ones except they’re brown – it still doesn’t pay to try to convince him that your wardrobe had been missing something and that this was exactly what was needed.  Rather, you are probably best off with the following approach: just tell him it makes you happy and you appreciate him buying it for you (even if he didn’t).  Do not try to explain to him why it makes sense, because to him it never will.  However, it is hopefully the case that the value of making you happy does make sense to him.  Most men want to make their wives happy. If you frame it as such, without trying to convince him of the logic of matching boots, you have a much better chance of success.  (Note: this approach is not going to work if the boots cost $400 and you are already under financial strain and little Shmueli needs braces.  You need to be sure that the purchase/request is reasonable, that this is not happening every week, etc.)  This is true for buying matching boots, replacing old carpeting, arranging furniture, hanging pictures, setting the table, and many other applications.
 

3.       Feed him.

 
A hungry man is a cranky man.  If you want him to be able to override his problem-solving circuitry or subdue his misgivings about those boots, he is going to need the mental fuel to do it.  However – this is a bit tricky – he may not realize it himself. It will be easier for him to give you what you need if his system is well-oiled, but many men don’t have a good gauge (or they forget to look at it). You should be that gauge and make sure that he has nutritious, satisfying food to power his system. Often if he is in a vaguely grumpy mood, you can resolve it entirely by feeding the poor beast.

There is a deeper function of this strategy as well: because the average man likes food so much, and because it is so vital to his proper functioning as a sensitive and caring person, it is profoundly meaningful to him when you provide it for him, and, even more than that, when you take responsibility for providing it to him.  He probably doesn’t take nearly as good care of himself as you would.  He might grab an instant coffee and a cereal bar for breakfast; you can oatmeal, eggs, or whatever it is you know he likes.  You can be the First Officer of his stomach.  (My wife was designated Head Lunch Lady on our 8^th date and has filled that role ever since.)  There is nothing that conveys to a man the sense that he is loved more than a hot dinner waiting for him when he comes home.  For women who work and can’t pull this off, a plate in the refrigerator that is prepared and ready to pop in the microwave does the trick just as well.  (Note that it has to be right in the very front of the fridge. You know he’s not going to find it otherwise.)

This is obviously not a comprehensive manual for spouses of men.  It’s just a starter guide with a few tips to help you bridge the gender gap and maybe get you thinking about other ways in which you can be effective in managing the man in your life.  I wish you luck in this challenging endeavor, and I hope that even as you attempt to overcome the hurdles that present themselves, you can do it with a bit of a smile.

A Marriage Counseling Take on Mistakes - Take II

The next logical step in dealing with each others' mistakes:

Shiur on Shmini Atzeres - Thursday at 5

If you're going to be in my neck of the woods (that would be Passaic) over Shmini Atzeres and Simchas Torah, I'm going to be giving a class on Shmini Atzeres and what it's actually about (since nobody really seems to know!). 5 PM on Shmini Atzeres (Thursday 9/26) at Ahavas Israel. See you there!

Real Teshuva

I saw this just before Yom Kippur. It blew me away. I hope it becomes a trend.

A Marriage Counseling Take on Mistakes

Okay, but what if your significant other is actually really truly wrong? What if they just messed up? THEN what?