November 14, 2018

A Mishkan for all: A communal approach to mental illness

I grew up with my younger brother, Zack Thomas, who has struggled with bipolar disorder since he was a very young child. 

What it has taught me is that as individuals, and as a community, encountering mental illness is a blessing and a challenge — and one that we need to do a much better job of talking about.

I say blessing because I am who I am today because of the empathy, humility and strength that my experiences have cultivated within me. I say challenge because struggling with mortality, whether of the mind, body or soul, is perhaps the greatest challenge we know in this life. Mental illness exists in my nuclear and extended family, as well as among many of my close friends, two of whom tragically committed suicide during my high school and college years. I hold their memory in my heart today.

There is a brokenness that reaches into our hearts and our minds. A brokenness that causes alienation and disrupts our plans and our dreams. It is a brokenness that breeds loneliness, guilt, despair and anger. I am speaking of the brokenness that comes from the suffering and stigma of mental illness, a brokenness I have known in my personal and professional life.

As Zack’s sibling, I learned how to differentiate between my brother and his disorder. I learned that empathy and forgiveness, instead of anger, fear and blame, are crucial in speaking with someone who struggles with manic highs and lows. For much of my life, I have lived in terror, trying to prepare myself for the worst, while still trying to live as though everything is “fine” and “normal.” I have tiptoed, compensated and shed many tears. I am familiar with what Rebbe Nachman poignantly names “יונפה‭ ‬ללח,” (hallal hapanui) an emptiness that arises in the face of suffering. I have learned and continued to learn that mental illness for many is a wave, ebbing and flowing, with good days, better days, bad days and worse days, and that healing is a matter of perspective.

But I have also learned kindness from my brother, Zack. I have learned sensitivity from his Betzalel-like artistic talents and his literary brilliance. I have learned love from his willingness to greet and accept anyone he meets. My brother, who as a child always gave away his toys to his friends, quite clearly embodies what the Torah describes as the בל‭ ‬בידנ‭ ‬(nadiv lev)‭ ‬and‭ ‬בל‭ ‬תמכח‭ ‬(hachmat lev), the generous heart and wise heart. My brother is my role model in living both in his brokenness and in his wholeness.

Today the Los Angeles County Department of Mental Health estimates that one in four Americans has a diagnosable mental illness. One in four people in our families. That is an astounding figure, especially given how much stigma exists around mental illness and how little psychiatric care and psychological care we seek out as a country. Mental illness does not affect “other people,” “them” or “the disenfranchised.” Mental illness affects everyone, and has no boundaries or awareness of financial, religious or cultural differences.

Diagnosable disorders include but are not limited to anxiety disorders, mood disorders, schizophrenia and psychotic disorders, dementias, intellectual disabilities and eating disorders. Many of these diagnoses also have a high comorbidity with addiction and substance abuse. And some tragically include suicidal ideation. Although suicide is a much larger topic, I want to mention that statistically, those who attempt suicide do not want to die, but instead want to stop their pain. These are disorders with which many of us live and, perhaps despite of or even because of, have deeply meaningful lives. 

My prayer is that we will begin a conversation that will continue to evolve. We must educate ourselves about mental illness to reduce stigma and create a safe space, and to empower us in providing support to each other. In seeking to better understand and empathize with those living with mental illness, we have the ability as a community to decrease the suffering and shame that come from stigma and to even encourage comfort and dignity. For example, when we say the misheberach, the prayer for the sick, we can pray for a friend fighting cancer or heart disease as well as for a friend struggling with depression or anorexia. Or we may be able to sit with a mother or father who is worrying and praying for normalcy in the face of a child’s recent mental-illness diagnosis.

On the other hand, given how stigmatized mental illness is, it is crucial to respect and honor others’ privacy and boundaries, as we are not always ready or in need of sharing our suffering publicly. Even the language of “mental illness” and “disorder” can feel like labels that alienate and isolate. I encourage us to be creative and rethink our language with informed empathy.

In the Gemara, Masechet Bava Batra 14b, we learn that the ark in the Temple contained both the first set of broken tablets, תוחול‭ ‬(luhot), and the second set of whole tablets. Why do we keep the broken tablets? We have all experienced brokenness, we have all known fragility, and it is not something about which to feel ashamed. It is an inevitable part of being human. We do not seek it out. Yet through our breaks, cracks and fissures, we have the opportunity to allow more light in. At times, our brokenness is part of our wholeness. 

As a chaplain specializing in psychiatric care and suicidal ideation, I have learned this Gemara of the broken and whole tablets with patients of varying cultures, backgrounds and faiths, and it resonates. Each time, the same themes arise: guilt at having broken the tablets in our own lives, anger at ourselves and others for that brokenness, pain and longing in learning how to forgive ourselves, and comfort in knowing that brokenness and wholeness can coexist.

God does not ask us to be “fixed,” but instead to recognize all of the raw, broken parts of ourselves. The ark, the center of God’s holy home, holds our broken selves and whole selves. We need the presence of the broken tablets to remind us to be patient when we are fragile and to help us value and not shy away from the shared human experience of brokenness. 

Alissa Thomas-Newborn is the Kehilla intern at B’nai David-Judea Congregation. She is also a chaplain specializing in palliative care, end-of-life care and psychiatric care. She is a writer for Metropolitan Jewish Health System’s Center for Jewish End of Life Care. Thomas-Newborn is completing her final year of studies at Yeshivat Maharat.