Refuat HaNefesh

Rosh Hashana 5775,
a sermon by Rabbi Gary M. Bretton-Granatoor.

“…I have set before you life or death, blessing or curse; choose life, therefore, that you and your descendants may live.”

On Yom Kippur morning, we will read those words in an alternative Torah reading, which, while not found in our Machzo, will be read in hundreds of communities around the world. It comes from the Book of Deuteronomy. You will hear it in its fullness 10 days hence, but I want to focus on one line to begin this morning’s drasha: “…I have set before you life or death, blessing or curse; choose life, therefore, that you and your descendants may live.”

“Choose life…” It seems simple enough, logical enough. But for some, it seems impossible. The Latin sui caedere “to kill oneself” is the source of our word suicide. And given events in the news recently with beloved celebrities, it has been bandied about with some abandon.

Ernest Hemingway, Robin Williams, Spaulding Gray, Philip Seymour Hoffman, died of a disease, one often dismissed, rarely recognized publicly as a true ailment and rarely disclosed by the sufferer. they died of depression that led to the taking of their own lives.

Each one was enormously talented but could not overcome the crushing feeling of depression – they died as a result of their illness.

Depression can come as a result of outside forces – I experienced severe debilitating depression as a result of my physical injury – the physical pain, the deepening sense of losing control over my body, my need to rely on others for basic tasks (this from a person whose first word was “self” – as in, I’m going to do this myself!), led to a sense of worthlessness. These forces combined with the physical impact of surgery and pain-killers to attack my self-esteem, and I found myself consumed with a veil that spread over me – one of sadness, and ultimately hopelessness. It took a major intervention on the part of my beloved wife and mostly my Social Worker daughter to try to seek out help. And while there are many possible treatments for depression, what I needed was a pharmaceutical supplement, to help me swim up to the surface, rather than drowning in my sadness.

My maternal grandmother’s youngest sister, Aunt Sukie, was spoken of in hushed tones as I was growing up. One or another cousin or other relative would whisper about her problems and eventual suicide. The subject was taboo-especially in Jewish families because of religious biases. Her daughter, my mom’s first cousin, Annie, also suffered deeply and her life was ended way too soon as a result of her despair (luckily, her sister Ellen became a well-known and established psychotherapist). Other members of my extended family and close circle of friends have had to deal with depression and I always wondered why it was discussed as if we were trying to keep a secret – why we had to pretend that it didn’t exist. We have learned to discuss cancer, marathons are run for breast cancer – survivors and their friends proudly wear pink ribbons. Purple ribbons are worn for those with ovarian cancer. AIDS, once the scourge of modernity, is discussed openly. But not depression.

As our youngest son, Zach, approached is high school graduation, I asked what he wanted to mark the occasion. He responded that he wanted permission to get a tattoo. Now this sermon is not about Jews and tattoos (though the truth is that Jewish law is not absolutely opposed , as Rosanne and others might lead one to believe – feel free to ask me about it some other time). What intrigued me was not that he wanted a tattoo – we live in Brooklyn, so it is a rather common sight – but WHAT he wanted as a tattoo. In fact, the tattoo artist was as astounded as I was initially, for it was a chemical symbol that Zach wanted on his left fore-arm The tattoo artist stared at it as he prepared to leave his mark on Zach and finally gathered the courage to ask, “what the hell is that?” Zach responded in his usual “know-it-all” tone, “It is the chemical symbol for Serotonin.” You see, throughout the early years of Zach’s high school experience he experience bouts of depression. Filled with self-doubt and anxiety he lived in a fog, until he finally asked for help. He met with a therapist, and talked, and was eventually prescribed an SSRI, a selective serotonin re-uptake inhibitor – which made all the difference. The funny, happy, brilliant kid was given back to us and left behind was the kid who didn’t want to get out of bed. He wanted that tattoo so that every time he would feel blue in the future, he could look at his arm and be reminded that this was a chemical problem in his body – it wasn’t him.

And yet there remains a societal disinclination towards thinking of depression as an illness. I come from a line of pharmacists: my grandfather and my father believed that there was a medicine for every illness, and yet there was prejudice against dealing with depression in this way, and until recently many of the drugs used were not very effective. 1966, in the wake of the increased use of Diazepam trade name Valium, the Rolling Stones had a sonk that peaked at #8 in Billboard Single Chart of that year – “Mother’s Little Helper”.

What a drag it is getting old
“kids are differnet today”
I hear ev-ry mother say
Mother needs something today to calm her down
And though she’s not really ill
there’s a little yellow pill
She goes running for the shelter of a mother’s little helper
And it helps her on her way, gets her through her busy day.

Clearly, not all depression is rooted in blood chemistry – many who suffer depression arrive at that state after crushing blows to their lives: economic devastation, loss of a loved one, severing of a critical relationship, betrayal of trust, failures upon failures. And not all who appear depressed suffer form depression, they can be experiencing grief, which may not be treated in the same way – but ultimately, the emotional upheaval of depression or grief takes its toll on one’s body and the pall manifests itself physically as well.

Jonathan Franzen, the great novelist and essayist wrote:

“Depression, when it’s clinical, is not a metaphor. It runs in families, and it’s known to respond to medication and to counseling. However truly you believe there’s a sickness to existence that can never be cured, if you’re depressed you will sooner or later surrender and say: I just don’t want to feel so bad anymore. the shift from depressive realism to tragic realism… strangely seems to require believing in the possibility of a cure. But this ‘cure’ is anything but straightforward.”

-92-93, Franzen, Jonathan. “How o be Alone. New Yrok: Farrar, Straus & Giroux, 2002.

And yet it is not just a pill – not just dealing with how one’s body processes Serotonin. That is part of the puzzle, as depression changes the way one views the world and oneself. Once the biological aspects have been stabilized, if they, indeed, need stabilization, one still needs to work through the residual world-view with which one is left. Talking things out, reaching out to another human being, climbing outside of oneself is critical as well.

The great Jewish sage, Rabbi William Shakespeare wrote in his 29th sonnet:

When in disgrace with fortune and men’s eyes
I ll alone beweep my outcast state,
And trouble deaf haven with my bootless cries,
And look upon myself, and curse my fate,
Wishing me like to one more rich in hope,
Featured like him, like him with friends possessed,
Desiring this man’s art, and that man’s scope,
With what I most enjoy contented least;
Yet in these thoughts my self almost des;ising,
Haply I think on thee, and then my state,
Like to the lark at break of day arising
From sullen earth, sings hymns at heaven’s gate:
For thy sweet love remembered such wealth brings
That then I scorn to change my state with kings.

Shakespeare nailed it when he summed up depression with just one line, “With what I most enjoy contented least…” I have so often reflected on this sonnet since being forced to memorize it in 7th grade – a rather brilliant stoke of pedagogy for helping emerging adolescents – a time in life, when hormones rage, and life conspires to alternately make one feel as if the world was created for oneself, and the world would be better off with one less person. For more than 45 years, those words have played in my subconscious. the darkness is well described, and a possible solution lies in the peroration: the author thinks of someone – something – outside of himself. He forces himself to surface and grabs onto one thing that can give pleasure, and he finds a way out. The source of that comfort is ambiguous – one could guess that it is a lover, or a close friend, but it could be an object or an idea – it is  something that the author believes gives him “sweet love.”

The word in Hebrew “to pray” is lehitpalel – it is in the reflexive case based upon the root of the word “to plead” or “to judge” – it means “to judge oneself.” The only way to judge something is to have a sense of the ideal and comparing the ideal to the “real” of the moment. Prayer is the dual act of looking outside and inside oneself and finding a way to reconcile both.

Rabbi Hirshel Jaffe (a colleague who almost lost his battle with leukemia, and then had to battle depression and triumphed over both):

“In Jewish tradition, prayer doesn’t mean somehow finding God’s unlisted phone number or rubbing a magic lamp to bring forth a genie. It means looking into yourself, determining the meaning of your life. finding out what really is of value, and discovering what you believe. Prayer is the ‘self-judgement’ that empowers us to reach higher, search deeper and be true to ourselves.

(Getting Through Tough Times – Ravblog)

That is the meaning of these days. the Yamim Noraim – these awesome days are a time meant for each one of us to look inside ourselves – inspect ourselves and try to find value and meaning in life, while trying to jettison the things that weight us down. That is the act of Teshuvah – that turning from what ails us to what enlivens us.

So if one discovers that the weight of the world is pressing down – for whatever reason it might be happening – it is critical to find a way to reach out. We have to train ourselves and those around us to speak out about depression. How often have we called in sick to work? We are not afraid to reveal that we have succumbed to a virus, or the flue, or a cold. But in all the years of being a “boss,” while I might have heard someone say that they needed a “mental health day” and understood it as a claim to being “burnt out” or exhausted, I have never once heard someone call in depressed.

How does one break free of the abyss? It is, almost always, through another person. And that person needs to withstand the grief, and the darkness, and the sadness, the pain – and help. And is is so very hard to watch another suffer, and some cannot do so. But those that can, really help.

Rabbi Shlomo of Karlin once said:

“If you want to raise a person from the mire and darkness, it is not enough to reach your hand down and pull that person up. You must go down into that darkness and with great strength pull yourself and your friend up.”

To be a help, one must employ empathy – not express sympathy. “Gee, it is too bad you feel that way” is sympathy. “while I cannot fathom what you are going through, I stand with you and will share this burden with you” – that is empathy.

On Sept. 5, the New York Times ran an op-ed article by a young medical doctor, trying to answer the question of why so many physicians commit suicide. the writer, over extended by the pressures of his new title of Doctor, realizes that with the awarding of a degree, nothing changes. Spinning out of control because of severe fatigue, numerous clinical errors, a constant and haunting fear of hurting his patients and an inescapable sense of inadequacy, he finally confided in a trusted colleague, who listened carefully and finally said, “Dude, me too!” those three words the writer called the most beautiful words he had ever heard.

So when we read the words from one of the final chapters of Deuteronomy next week, “Choose life so that you and your descendants may live,” know that choosing life is not just a de3fault position – but an active choice that must be made each day – and one we make not just for ourselves, but for those around us. And when we see someone whom we love struggling with this question, it is incumbent upon us to step forward and reach out and help make the choice to choose life, not just for the one who is suffering but for the future as well.

Tomorrow for the second day of Rosh HaShana we will read the opening lines of the book of Genesis, which tells the story of the creation of the world and humanity. But the creation of humanity begins with the creation of a single human being. The Talmud (TB Sanhedrin 37a) raises the question as to why the human race began with just one person. The answer found in the text is to teach us that “…whoever preserves a single soul, scripture ascribes merit to that person as though the entire world was saved.”

Choose life.

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