By Rabbi Bernard Barsky, Beth Abraham Synagogue

Most days it was Barry the Messiah who greeted me first when I entered the Brooklyn daycare center for those suffering from mental illness. I worked there for a year, 2002-03, as a rabbinic pastoral intern, and Barry had a lot he wanted to explain to me. Tragically, he was a messiah who knew he must suffer for the sake of all the sufferers of the world. I had to be careful what I said, because he was easily agitated.

Barry’s destiny was to save the world, no matter the cost to himself; but young Zalman, gentle and bright, knew that his fate was to cause destruction. He believed that with the thoughts of his mind he could bring down airplanes or blow up buildings, and was convinced that he alone was responsible for the fall of the Twin Towers on 9/11. He regretted it, but couldn’t stop himself, and feared that worse was coming.

Most of the center’s clients were more ordinary sufferers, neither savior of the world nor destroyer. For many of them, ever present voices in their heads were dulled by medication but not silenced. For others, their general disorientation from the world as the rest of us understand it made it difficult for them to negotiate ordinary conflicts, carry on normal conversations, or do any but the simplest kinds of work. Many had histories of addiction, of broken or abusive families, or an inability to form relationships that were not obsessive and dependent. For those with bipolar disorder, periods of manic activity might bring on delusions or hallucinations that returned them to the hospital and heavy medication, while periods of depression would shutter them from the reach of normal human contact.

More than any other setting where I have worked, there was an ardent need for prayer. I learned there myself how deep and powerful prayer could be. After listening closely to what a client wanted to tell me, I would repeat those concerns in the form of a prayer and we would offer it together to God. One woman said, “I felt your words pass through me like a powerful light on their way to God.”

At some periods in history the mentally ill were deemed closer to God than the rest of us, and their confused words sometimes seemed like prophecy. In Shakespeare’s King Lear, the character of the king’s fool, as well as Lear himself, speak more truthfully about the state of things the deeper they descend into madness. Lunacy strips away all filters of propriety or decorum, and they say what everyone knows to be true but no one else will say.

That certainly romanticizes the truth about mental illness, and ignores the reality that most sufferers are neither prophets nor poets, but simply unhappy people in great emotional anguish.

Ancient Israel also believed in some connection between prophecy and mental illness. King Saul, who clearly suffered from a manic depressive syndrome, was overtaken by the spirit of God and “spoke in ecstasy” when he encountered a band of itinerant prophets, but “raved in the house” when “an evil spirit of God” gripped him so that he tried to murder David. The words translated as “spoke in ecstasy” in one context and as “raved” in another context, are from the same Hebrew root that designates prophecy.

Further, some of the psalms attributed to David describe moments of deep despair and loneliness. And the strange behaviors of the prophet Ezekiel as well as the profound depressions of Jeremiah certainly also suggest what now we would classify as forms of mental illness. But it was their exceptional gifts, not their mental illness, which transformed their suffering into prophecy and poetry.

Rabbinic Judaism was altogether a tamer thing than ancient Israelite prophecy. The Talmud and law codes consider mental illness only in terms of legal competency and of the danger posed to self and others. A shoteh, literally an insane person, could not be held responsible for his actions or give testimony in court. The Talmud does not give a definition of a shoteh, but only lists symptoms: he who goes out alone at night, sleeps overnight in a cemetery, or tears his clothes. Maimonides also mentions walking around naked, breaking vessels and throwing stones.

But Maimonides understood that these examples were just a sampling of behaviors to be considered. “Those who cannot note contradictions and cannot understand any matter in the way normal people do, and so too, those who are confused and hasty in their minds and behave in an excessively crazy fashion, these are embraced by the term shoteh. The matter must depend on the assessment of the judge since it is impossible to record in writing an adequate definition of insanity.”

Today we seek the assessment of medical professionals rather than judges to determine mental illness and competency. Medical science has taken great strides in determining the chemical processes of the brain and the fundamental physiological causes of mental illness. And this has gone far — though not nearly far enough — in removing the traditional stigmas associated with mental illness.

In that Brooklyn daycare center there was a client named Steve, a traditional Orthodox Jew, who came to us each day without the knowledge of anyone in his family except his wife. His own children and his wife’s family presumed he went to work every day in New York’s diamond district.

Within the most traditional and insulated Orthodox communities, where marriages are arranged and yichus (family distinction) is important, there has been a long-standing stigma associated with mental illness and suicide. A young man or woman in a family with any history of mental illness may have a difficult time contracting a marriage. And so a person like Steve will spend his difficult life in hiding, with little family support.

But outside such closed communities, there is a broad acknowledgement of the medical basis for mental illness. A common brain dysfunction such as Alzheimer’s is now widely regarded as a geriatric disease rather than a mental illness, and many forms of depression are so well managed with drug therapies that patients can lead normal, productive lives in highly successful careers.

Yet from my personal and pastoral experience, I know that understanding and sympathy often fail within the sufferer’s own family. The closer one lives with the sufferer, the harder it may be to find inner resources of acceptance and patience. Nothing is so common as the belief that, if only he or she would try harder, the sufferer could “get on with life.” The sense of shanda (disgrace) may still persist, but there might also be feelings of guilt, since mental illness is sometimes exacerbated by dysfunctional family life. And often there is resentment at the financial strain that a child’s mental illness places on the rest of the family, who may feel he or she is simply “acting out.” Of course, all of these responses within the family simply make the situation worse. So a major responsibility for the health care provider, the rabbi or the family friend is to pastor the family as well as the patient.

Although there can hardly be said to be an official “Jewish position” on mental illness today, there is a clear Jewish position on how we regard anyone different from ourselves. In the second century, the great Rabbi Akiva and his colleague Ben Azzai were searching for the highest principle of the Torah. Rabbi Akiva said it was “Love your neighbor as yourself.” Ben Azzai countered with an even higher principle. He said it was the verse, “This is the book of the generations of Man (Adam). In the day that God created man, in the likeness of God made he him (Gen 5:1).”

Every human being is created in the image of God, and therefore every human being must be loved as one loves God. With that as the highest principle of Torah, there is no need for a special “Jewish position” on mental illness, only the reminder that it applies here, too.

And as for Zalman and Barry, I ask myself whether any one of us is wholly free of responsibility for the violence of this world; and whether in fact each one of us is not the destined messiah, but hiding from that dreadful role for fear of madness.

I occasionally used to have caffeine-induced nightmares in which my eyes would open while I was still asleep, and I would see the actual room I was sleeping in, everything just as it really was, yet full of terror and I could not move in it. All I could do to escape was to force a groan from my throat that would wake me up. Those dreams showed me that the world of mental illness is exactly the world we all live in, but with no place in it for me.