Pikuach Nefesh: Mental Health and Our Responsibility as Jews

On day three (or was it four? Trazadone made evenings blurry), I realized that this wasn’t working: I was barely out of my mid-20s and found myself inpatient in a psychiatric hospital three times. That’s not to say the facility wasn’t topnotch and the staff wasn’t kind and professional – it was simply the striking epiphany simply that the way I was spending my 20s wasn’t working.

Feeling a panic that might have been quelled by Xanax, I prayed to God from the tiled bathroom I’d barricaded myself in that the rest of my life wouldn’t be like this – that I wouldn’t spend my summers with supervised visits, checking out plastic knives and forks during meal times. I’m glad I didn’t have Xanax in that moment (though I needed it many times after) because sometimes a panic can orient you – but that doesn’t mean the stability is instantaneous.

Some years later, I find myself as a less-than-regular synagogue-goer. Once, attending a few weeks ago, I pieced something together. During the Torah service at Temple Beth Sholom in Hamden, CT, my rabbi offered a Mi Shebeirach  (prayer for healing) for sick congregants, as is custom. My Hebrew isn’t great, but luckily, he translated: Refuat hanefesh, v’refuat haguf, “healing of spirit and healing of body.”

Even after hearing the prayer countless times in my youth when my parents towed me along for Saturday morning services, I never thought about the healing of the soul and the body. I was more focused on what was being served for Kiddush. Now, this blessing makes more sense. The intertwining of the body and the soul is so pivotal in Judaism, and nowhere is this more prominent than in how mental health disorders can manifest.

In my early 20s, I was gripped with panic attacks that arrived with little warning (luckily, I’ve since learned my triggers) and left me drained, exhausted, sad, and just hopeless. I experienced those feelings in my body and my soul, and thus, defined my life. It was a trap. My mind ached, and I didn’t get out of bed. I stopped running and seeing friends. Everything hurt: my body and my soul. That was my life, on and of from 2006 to 2014.

With serendipity, in 2017 I stumbled upon my youth Hebrew school lessons of pikuach nefesh, the concept of saving a life. It is our obligation as Jewish people to save lives whenever possible, even above observing the mitzvot or commandments.

Today, with respect to mental illness and treatment options, societal perceptions are not where they should be. They’re better than they used to be, but rampant stigma still exists. Misinformation abounds, and extremely troubling is the phenomena that individuals with disabilities make up a third to half of all people killed by law enforcement officers, as reported by The Ruderman Family Foundation.

In the same white paper, the Ruderman Family Foundation explains that individuals with disabilities make up the majority of those killed in use-of-force cases that attract widespread attention. How often are we relieved when we learn that the perpetrator shot by police was “crazy”? We feel safer because a dangerous person is off the streets – but someone else who commits the same crime but doesn’t have a mental health disorder makes it to trial. Why is it that a life with a mental illness is a life less worth saving?

Judaism establishes the obligation to save the life. Heal the life. Save the life and soul. How often do we see mental illness swept under the rug because it’s “all in our heads” and doesn’t materialize, the way, say, cancer does? Without proper treatment, both are equally serious and potentially life-threatening illnesses. Fortunately, Judaism, in its infinite wisdom, does not see it this way.

Our sages teach us to save a life, be it our own life or the life of another. I believe that “life” doesn’t necessarily refer to corporeal being, and when I asked my rabbi for clarification, he explained nefesh as the “life force,” reasoning that it is a combination of spirit and soul. There’s no distinction, as a life is a complicated recipe of tangible and ephemeral components.

Without even applying a bandage, so many people have saved my nefesh through the years. If we see a person hurting, perhaps from the grips of anxiety or a panic attack, it is our obligation to save them. This can be accomplished through lending an ear, driving someone to a therapy appointment, or calling 911, if necessary – but mostly, just by being kind.

The Union for Reform Judaism is proud to partner with the Ruderman Family Foundation to ensure full inclusion and participation of people with disabilities and their families in every aspect of Reform Jewish life. Visit the Disabilities Inclusion Learning Center to learn more.