TY - JOUR
T1 - Working with Jewish ultra-orthodox patients
T2 - Guidelines for a culturally sensitive therapy
AU - Bilu, Yoram
AU - Witztum, Eliezer
PY - 1993/6
Y1 - 1993/6
N2 - The epistemological gap between the medical reality of mental health practitioners and the sacred reality of their Jewish ultra-orthodox patients poses a major challenge for therapy. Based on our work with psychiatric patients from the ultraorthodox community of northern Jerusalem, we propose a set of guidelines to cope with this challenge. Basically, we seek to incorporate religiously congruent elements, composed of metaphoric images, narratives and actions, into the wide range of our "secular" treatment modalities in order to respond to the patient's suffering, often expressed through distinctively religious idioms of distress. This endeavor calls for "a temporary suspension of disbelief" on both sides. The guidelines presented include three sets of factors which appear pertinent to working with ultra-orthodox patients. The first set is contextual in nature, dealing with the image of the clinic and its physical setting; the second discusses the necessary role requisites of the therapists; and the third one, accorded a central importance, deals on various levels with the therapeutic interventions administered in terms of form and content. Several case vignettes are presented to illustrate three classes of religiously informed interventions: healing rituals, dream interpretation, and the use of culturally congruent metaphors and stories. In the concluding part we discuss ethical and instrumental issues that the proposed therapeutic guidelines may raise.
AB - The epistemological gap between the medical reality of mental health practitioners and the sacred reality of their Jewish ultra-orthodox patients poses a major challenge for therapy. Based on our work with psychiatric patients from the ultraorthodox community of northern Jerusalem, we propose a set of guidelines to cope with this challenge. Basically, we seek to incorporate religiously congruent elements, composed of metaphoric images, narratives and actions, into the wide range of our "secular" treatment modalities in order to respond to the patient's suffering, often expressed through distinctively religious idioms of distress. This endeavor calls for "a temporary suspension of disbelief" on both sides. The guidelines presented include three sets of factors which appear pertinent to working with ultra-orthodox patients. The first set is contextual in nature, dealing with the image of the clinic and its physical setting; the second discusses the necessary role requisites of the therapists; and the third one, accorded a central importance, deals on various levels with the therapeutic interventions administered in terms of form and content. Several case vignettes are presented to illustrate three classes of religiously informed interventions: healing rituals, dream interpretation, and the use of culturally congruent metaphors and stories. In the concluding part we discuss ethical and instrumental issues that the proposed therapeutic guidelines may raise.
UR - http://www.scopus.com/inward/record.url?scp=0027619165&partnerID=8YFLogxK
U2 - 10.1007/BF01379326
DO - 10.1007/BF01379326
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C2 - 8222706
AN - SCOPUS:0027619165
SN - 0165-005X
VL - 17
SP - 197
EP - 233
JO - Culture, Medicine and Psychiatry
JF - Culture, Medicine and Psychiatry
IS - 2
ER -