To watch Rabbi Limmer give his sermon click here.
Kol Nidre is a night of quiet. It commences our signature ceremony of introspection: this evening we examine our souls, search out our faults, and begin to change our ways. For that, we create quiet. We silence our voices as the music of Kol Nidre rushes over us. We pause for silent reflection, silent prayer, silent remembrance, silent confession. We turn down the noise of our physical needs, refraining from food and drink, from activity and exercise. It will only be with the blast of the shofar tomorrow at nightfall that we break our spell of quietude just moments before we break the fast.
Ages ago, Yom Kippur was quite a noisy affair.[i] Crowds filled the Temple so far before dawn the rooster didn’t even need to crow. In a public pageant of pomp, sacrifices were staged, blood was sprinkled, communal confessions were made before God. Perhaps the most anticipated ritual came at Yom Kippur’s close: two goats were brought forward to effect final atonement. The High Priest reached into a jar containing two placards, two small identifying labels: one goat would be designated for Adonai, to be sacrificed on the altar in atonement. The other goat would be designated for Azazel, a demon who lived in the wilderness. As Torah tells it:
21Aaron shall lay both his hands upon the head of the live goat and confess over it all the iniquities and transgressions of the Israelites, whatever their sins, transferring them to the head of the goat; and the goat shall be sent off to the wilderness. 22Thus the goat shall be burdened by their sins, and carry them to an isolated place: the goat shall be sent alone into the wilderness.[ii]
That poor goat. The Priest publicly transferred onto its tiny frame a year of crimes committed by Israel. Carrying the weight of our sins, bearing our burden of guilt, this poor animal was delivered to the desert to a demon. No wonder William Tyndale, translating the Bible, gave this pitiful creature a fitting name: the Scape Goat. The Scape Goat—a once joyful, noisy mammal—was isolated, separated from its family and banished to the desert by anxious Israelites hoping he would atone for their sins. When that scapegoat was forced into the wilderness, the crowd let out a roar so loud it carried many miles back to the Temple in Jerusalem. Yom Kippur was anything but quiet.
How our ancient ritual differs from our present practice. The whole noisy affair of sending a scape goat to Azalel to atone for our sins seems to have nothing to do with tonight’s quiet evening of self-reckoning. Sending a poor creature to battle its demons so we never have to hear from it again, so we are freed from worry: it seems so primitive. But I’m afraid we aren’t as advanced as we might think. Actually—terrifyingly—we enact this ritual every day: we drive poor overburdened creatures to deal with their demons in utter isolation, and then move on with our lives. I’m not talking about sacrificial goats. I am talking about human beings. I am talking about human beings struggling with mental illness: the suffering so quiet it is often unseen, the suffering so stigmatized we hesitate to speak its name, the suffering so scary, even our Talmud describes it as “battling our demons”.[iii] We do not like to talk about mental illness, least of all in public. That is why it seems to me as if we do send those who suffer to battle their demons in private so we can feel healthy. Though Kol Nidre has become a night of quiet, tonight I would like to end our silence about mental illness.
We are often too quiet about mental illness; tonight, I will talk. I begin with a disclaimer, a qualification about my intent, my own lack of qualifications. I am no expert: I am neither trained in the diagnosis nor the treatment of mental illness.[iv] Reform Rabbis take courses in counseling, but we are taught to know our limitations, to recognize where our expertise ends, and to send people to professionals who can help. In that spirit, tonight is no time to talk about cures or types of therapy. With some wonderful exceptions, we are a congregation of individuals untrained in treating mental illness. However, in the eighteen years of my rabbinate, I have sat with too many individuals and families struggling with a wide range of mental illness. All of them shared with me one feeling: they felt alone. That is all I want to address tonight: I want no one to feel alone.
“It’s a big relief the truth is out there. It’s important to be open and honest so there’s not a cloud of shame in dealing with this.” These were the words Maggie McGuane shared after the suicide of her mother, Margot Kidder.[v] Stigma and shame too often accompany mental illness. This year, celebrity suicides momentarily opened communal conversations about mental health. But, far too often, we avoid discussing ailments that attack our psyche; even worse, we attach a demeaning stigma to those who suffer. Mental illness is often described as invisible, and our inability to normalize our conversations about it make its pain twice as isolating. This is how Matt Haig, whose depression led him on multiple occasions to consider suicide, describes his experience:
When you are depressed you feel alone, that no one is going through what you are. You are so scared of appearing mad you internalize everything, and you are so scared that people will alienate you further don’t speak about it…. And so—as depression is largely unseen and mysterious—it is easy for stigma to survive. Stigma is particularly cruel for depressives, because stigma affects thoughts and depression is a disease of thoughts.[vi]
Stigma is cruel for those who suffer in silence, who battle their demons in isolation. Stigma doesn’t only surround suicide. Alcoholism, Anorexia, Bipolar, Cutting, Depression, begin our alphabet of woe long before we reach Opioid Addiction, PTSD, and Schizophrenia. These are not just technical terms, DSM definitions: these are real people, real suffering. These are, from schizophrenia back to addiction, members of Chicago Sinai Congregation. We are sitting here tonight. Too many of you have sat and talked with me about your suffering, the suffering of your spouse, your children, your parents. In my office we can talk; outside, not so much. In public, we do not like to talk: but we should, we must. We are a community comprised of individuals battling our demons, struggling with mental illness. But to be a sacred community, to be all that towards which we aspire, we must connect to each other, we must talk to each other, we must overcome every stigma. We who are nowhere near professionals must learn how to listen and how to speak.
Let us start by removing the stigma of the illness most linked to mortality, suicide. Suicide kills more people than stomach cancer, cirrhosis of the liver, colon cancer, breast cancer, and Alzheimer’s; it kills more people than most other forms of violence—warfare, terrorism, domestic abuse, gun crime—put together.[vii] This we know. Yet when someone dies after a diagnosis of cancer, we are able to understand it, to say “Grandma died of pancreatic cancer,” and know our friends will understand and society will sympathize. But when people die of suicide, we often fail to realize they died of a disease every bit as powerful as the most malignant melanoma. The very few, terribly painful times I have sat with families after a loved one’s suicide, I am always asked the same question, “How do we tell people how he died?” The answer I try to share is, “He died because he was sick; he suffered from mental illness. You don’t need to whisper it quietly; you can say it out loud.” Still, stigmas are strong: shame, embarrassment, and guilt mix together in a painful combination that leads us from shouting out loud to, even as we mourn, sitting ashamedly silent.
We can no longer afford our silence. Families are at risk, lives are at stake. In talking, in eliminating stigma, we must start by admitting that, in many ways, it is appalling even to speak of mental illness; it sounds absurd to speak of physical illness. But often physical ailments are normalized because they are visible: we can see a man riding a wheelchair, a woman walking with a blind cane. How do we know which person walking down State Street battles unbelievable agoraphobia? How could we even learn about someone suffering such deep anxiety they can’t leave their apartment? One reason for talking about mental illness in normalizing it; by making it seen and heard we can conquer its invisibility. So let’s do a thought experiment:
Imagine depression, anxiety and addiction manifest as visible physical ailments. And imagine you’re walking right down Michigan Avenue. What would happen if OCD manifested as cold sores, ADHD as a hacking cough? If mental illness were visible, you would notice that just about every person walking down Michigan Avenue had maybe the sniffles or a cough, or a splint on a finger, or a broken arm, a bruised eye or a bloody nose. You just might see signs of sickness on every single person you just passed.[viii]
Just because we don’t see people’s pain, their invisible injuries, doesn’t mean they aren’t sick. Yet what see colors our perception, affects our language. We speak of sickness and of mental illness as if they were two separate things. With illness, it doesn’t matter if the symptoms are in the ear, the nose, the throat, the pancreas, the kidney or the kneecap: we say someone is sick. Yet when we confront depression or schizophrenia, we modify our definition: a person is mentally ill. We force ourselves to put a conditional on a condition: maybe the person is sick, you know, but not in the usual, the “normal” way. Just having a category of mental illness reduces the profile of these already invisible diseases. We make a mistake when we attempt to separate our bodies from our minds.
Judaism sees no such separation of mind and body. 2,000 years ago, one Rabbi explained this to no lesser luminary than Marcus Aurelius, Emperor of Rome.[ix] Fittingly for this Atonement Eve, Rabbi Judah explained to the Emperor that human beings are responsible for their actions and their thoughts, that God judges body and soul together, as one. Since Talmudic times, Judaism has known the physical and mental are inseparable: it is impossible for the body to exist without the mind.[x] One Sage explains it perfectly, “Anyone who struggles with their inner demons is, simply, sick: ill.”[xi] In contemporary terms, Judaism cannot categorize sickness into physical ailments and mental illness: any person suffering needs our attention, our sympathy, and every attempt at healing. It is as human to contract strep throat as it is to develop OCD; nearly twice as many Americans have been diagnosed with anxiety than with cancer.[xii] Yet stigma survives, and our culture—except for the weeks following celebrity suicides—shuns mental health into dusty corners where conversations are avoided, facts not faced.
We need to face facts. Fact is, walking down every street of every city are folks suffering in countless ways, most of which are invisible. It is time to talk about mental health; talking is what we must do. As one who suffered depression once shared:
Depression is not something you “admit to,” it is not something you have to blush about, it is a human experience. A boy-girl-man-woman-young-old-black-white-gay-straight-rich-poor experience. It is not you. It is simply something that happens to you. And something that can often be eased by talking. Words. Comfort. Support.[xiii]
No one is embarrassed to ask for a tissue; petty pride aside, a boot on your leg or a cast on your arm rarely prevents a public appearance. But would you call into work “depressed”? We cover our colleagues’ work when they are in chemo; are we willing to step up when an unnamed psychic syndrome keeps them from their desk? If a friend is recovering from surgery, we rush over with flowers, fill refrigerators with food. But when that same friend battles depression for months, do we schedule lunch a little less often? Limit our time with someone who is such a downer? We diminish, we downplay, we avoid.
We avoid dealing with mental illness. Part of the reason is that it is scary. Really scary. The Talmud doesn’t call it battling your demons for nothing. People with psychiatric disorders, especially severe ones, frighten us. Think about the homeless person shouting back at his voices, or menacingly demanding a dollar while you dine outdoors. On a more personal level, when someone we love suffers, it is heart-wrenching to witness their struggles—which often make them seem to be somebody else—and feel overmatched and unable to help. On the most prosaic level, we avoid anybody who seems strange, who can’t explain their inability to go to work, to quiet their thoughts, or to stop blaming themselves.[xiv] Mental illness is so scary we often run and hide.
Mental illness is scary. Unfortunately, despite that fear, I cannot tonight share a cure for any illness, mental or physical. I wish there was a pill to banish cancer, and I wish the pills that exist really did away with depression once and for all. Fortunately, helplines are at the ready, crisis interventions do help, trained professionals make a world of difference, and recovery is real. But those pathways, for most of us, involve other people. And the existence of incredible options doesn’t diminish our obligation to help those who suffer. What I have learned about mental illness, is that talking—words, comfort, support—really does matter. When there is nothing we can say to make someone feel less pain, our presence speaks volumes.[xv] Our talking, opening up conversations in place of stigmatizing, makes all the difference in the world.[xvi]
Words might not be the cure, but words matter to those who suffer; talking is likewise a tonic for those whose loved ones are ailing. Op-Ed columns teach us, “How to Talk About Depression”; sufferers and survivors comfort each other by tweeting positive thoughts with the hashtag #ReasonsToStayAlive.[xvii] Recently, a new coffeehouse opened in Logan Square in order to encourage conversations; called “Sip of Hope,” its baristas are trained not just in coffee craft, but also in mental health first aid.[xviii] As Senator Dick Durbin commented over his coffee on Sip of Hope’s opening day:
Over the years, we have seen the stigma that’s attached to [mental health]. For the longest time it was a matter that was greeted with silence, then for a while, whispers. Now, it’s being greeted with honest conversation.”[xix]
Honest conversation. That’s what we need to have, time and time again. We need to be honest about our feelings, and we need to be honest about our lack of answers. When we are depressed, anxious, suicidal, we need to talk. And when those we love are depressed, anxious, and—yes, suicidal—we need to respond to them. And then we need to talk to others, so they can give us the support we need. Letting stigma silence us keeps us all sick: we can no longer keep quiet; we need to talk. Ironically, the model for how we do this talking, on this great Holy Day of quietude, comes from our special Yom Kippur reading, the Book of Jonah. Famous for fleeing before God and being trapped in the belly of the whale, Jonah is the one whose final chapter teaches us all—those who suffer and those who help to bring healing—how to break the silence.
At the end of his prophetic mission, Jonah is depressed. It doesn’t matter that his mission was successful; in the backwards ways mental illness sometimes works, Jonah blames his success for his suffering. That is when Jonah takes an important step. Jonah speaks up. How important: suffering Jonah opens up about his pain, his depression, his suicidal thoughts. Jonah tells God he wants to die; “Ki tov moti meChayai: My death would be better than my life.”[xx] How does God respond? Not with judgment, not by telling Jonah to snap out of it, certainly not by leaving Jonah to suffer alone. God responds to Jonah with a compassionate question, “HaHeytev Charah Lach? Are you that deeply grieved?”[xxi] God keeps the door open, keeps Jonah talking, keeps Jonah engaged in the conversation, in life.
And while we don’t know the continuation of that conversation—although I doubt it took place over coffee in Lincoln Square—we know that it worked. We know God’s compassionate question worked because we have a record of Jonah’s next conversation with God. Here is where our literature is a little too eerily like life. If God was able to help Jonah see why staying alive was important, not even God could cure Jonah’s depression. And so the next conversation between Jonah and God is spookily similar. In deep anguish once again, Jonah cries out, “Tov moti meChayai: My death would be better than my life.” And once again—I imagine marshalling all inner strength and biting back the tears that Jonah’s depression has flared up yet again—God responds with that same compassionate question, “HaHeytev Charah Lach? Are you that deeply grieved?”[xxii]
Yes, we are that deeply grieved. All of us know pain and anguish; I doubt one of us is unstained by the blot of mental illness. Some of us suffer directly in inner anguish; others of us suffer second-hand as those we love battle courageously. Anyone confronting mental illness knows that any improvement can take a long time: cancer doesn’t go away after one treatment; suicidal thoughts aren’t banished by one positive conversation. Acute attacks might pass, but the work of overcoming mental illness is a long and painful road. That road is often exhausting: those who suffer tire of talking about it; those who love them can’t always summon the strength to say, “Are you that deeply grieved?” Like other diseases, the road to recovery is long and arduous.[xxiii] In a few weeks, myriad Chicagoans will fill the streets to cheer on thousands of marathon runners; those running the real race of recovery from mental illness need similar support. That is why we, as a community, must eliminate stigma and normalize our conversations to include mental health in all conversations about health: our talking gives people the power to move forward another day. Our talking helps exhausted individuals, afraid of hitting the wall, of having hope they can make it all the way to the finish line.
Perhaps I spent too much of this quiet night talking, trying to break the silence about mental illness. Perhaps I have not said enough. But I am haunted by the metaphor of sending beings burdened by guilt to battle their demons, all alone. On Kol Nidre, we can no longer create scapegoats. We can’t banish those who suffer; we must embrace them in love, in conversation. We must talk about mental illness, end its stigma, normalize the ailments that cripple our emotions. We cannot be quiet, whispering words like “suicide”. On this quiet night, on all other nights, we must raise our voice, loudly.
Since we must raise our voices together, I end my remarks with one last Talmudic image. That image, apropos of Yom Kippur, is of someone suffering mental illness sounding the shofar to cast away all their evil spirits.[xxiv] The secret of the image is that someone battling mental illness wants to shout so loud their suffering disappears forever. Imagine a person, losing hope but wanting a better tomorrow, stepping up to that great ram’s horn and giving it blast so powerful that all demons—all depression, all sadness, all illness—might literally be blown away. So life can start anew. So health can return. So recovery is reality. So demons are the only ones banished to solitude. All that hope focused on ending the silence through one resounding blare of the ram’s horn.
Such a miracle happens only in hopeful imagination. Since no such miraculous blast exists, we must be the ones who raise the volume. This year, may we be the ones who sound that shofar. May we keep in conversation those who suffer. May we stop the stigma. May we end the silence. May our quiet only come to a close when the suffering of all is banished as if by one miraculous blast of our shofar.
[i] See Leviticus 16 and Mishnah Yoma 2ff. for the full descriptions of the ceremonies contained in this paragraph.
[ii] Leviticus 16:20-22.
[iii] This description of mental illness as a struggle with demons [or evil spirits] begins in the bible with descriptions of a King Saul [I Samuel 16:14-16]. For rabbinic examples of people suffering mental illness as battling “demons”, see the Babylonian Talmud tractate Rosh HaShanah 28a or tractate Eruvin 41b.
[iv] This is one of many reasons both I and this sermon are indebted to the professional—and of course, personal—guidance provided to me by Dr. David Brody and Alexa James. Dr. Brody, in addition to be a past president of Congregation B’nai Yisrael in Armonk where I proudly served for 14 years, is also a well-regarded psychiatrist in New York City. Alexa James, MS, LSCW, is the Executive Director of NAMI [National Alliance on Mental Illness] Chicago, and a friend of mine as well as Chicago Sinai Congregation. Both Alexa and David read drafts of this sermon not only to provide their professional insights, but also to make certain I was following the primary rule of all treatment: first, do no harm.
[v] As quoted in Jacey Fortin, “Margot Kidder’s Death was a Suicide, Coroner Says,” The New York Times, August 8, 2018. https://www.nytimes.com/2018/08/08/movies/margot-kidder-suicide-death.html
[vi] Matt Haig, Reasons to Stay Alive, p. 2. I am indebted to my friend, Pastor Martin Wroe, for introducing me to this book when I shared with him the theme for this sermon.
[vii] This, according to the World Health Organization, and adapted from Matt Haig, Reasons to Stay Alive, p. 25. In a parallel statistic, suicide is the tenth leading cause of death in the United States [https://www.cdc.gov/nchs/fastats/deaths.htm].
[viii] This is the “thought experiment” of Alexa James, Executive Director of NAMI Chicago, which she shared in her address to the NAMI Out of the Darkness Dinner on April 19, 2018. Yet again, I am indebted to Alexa, this time for sharing the text of her remarks with me, which I have adapted for this sermon. Certain parts were so well-written that, with Alexa’s permission, I copied them completely!
[ix] The full allegory [printed below] is from the Babylonian Talmud, tractate Sahnderdrin 91. [It should be noted that the same story also appears, without the introductory inquiry from an Emperor, in Midrash Leviticus Rabbah 4:5.] The Emperor in the Talmud is referred to as “Antonine”, and a historical timeline indicates that if this exchange actually took place, then Rabbi Judah was in dialogue with Marcus Aurelius. Here is the full metaphor:
A king had an orchard of the finest figs. He wanted to protect them, and he stationed two guards in the orchard, one unable to walk, and one unable to see. Neither was capable of reaching the fruit on the trees in the orchard without the assistance of the other. One said to the other, “I see fine figs in the orchard; come and place me upon your shoulders. I will guide you to the tree, and we will bring the figs to eat them.” The one who could see rode upon the shoulders of the one who could walk, and they brought the figs and ate them.
Sometime later the King returned to his orchard. He said to the guards, “Where are my figs?” One said, “Am I able to walk and take the figs?” The other said, “Do I have any eyes with which to see the figs?” What did the King do? He placed one upon the shoulders of other, just as when they stole the figs: the King judged them as one. So too, the Holy One judges body and soul together, as one.
[x] Midrash Tanhuma [Buber] Vayikra 11. שאי אפשר לגוף להיות בלא נפש .
[xi] See the Responsa of R. Betzalel Zev Spirn, Part II [Even HaEzer], 50. I discovered this text through a teaching on Judaism and Mental Illness prepared by Eliana Yashgur on sefaria.com.
[xii] Diagnosed with Anxiety: 40 million https://adaa.org/about-adaa/press-room/facts-statistics
Diagnosed with Cancer: 22 million. https://www.cdc.gov/nchs/fastats/cancer.htm
Despite these statistics, our society literally places a higher value on physical suffering: insurance both treats and allocates funds physical ailments at a much higher level than mental illness: see D. Brian Hufford, “Insurers have to pay for addiction therapy; Trump just has to enforce the law,” The Washington Post, November 8, 2017. https://www.washingtonpost.com/news/posteverything/wp/2017/11/08/why-wont-the-trump-administration-push-insurers-to-pay-for-treating-addiction/?utm_term=.96101cca3fb0
[xiii] Matt Haig, Reasons to Stay Alive, pp. 67-68.
[xiv] For the thoughts—and even language—of this paragraph, I am indebted to the contributions of my friend Dr. David Brody, who most helpfully provided comments to an earlier draft of this sermon. David also shared, regarding the topic of this secion, that his colleague, Dr. Lloyd Sederer, Medical Director for NYS Office of Mental Health, writes about this subject in Improving Mental Health : Four Secrets in Plain Sight.
[xv] This sentence in particular benefits from the wisdom of Alexa James generally, and specifically from her, “You are not Alone” email that NAMI sent the week after the Anthony Bourdain and Kate Spade suicides. That email shared the following important message:
When we do not talk about mental illness, we place the burden to reach out for help on those for whom just the thought of getting out of bed is overwhelming. We weigh down those who do not feel they want help with the responsibility of asking for it. We need to pick up these burdens. We need to do better so that they can do better. We need to do better even if we do not know what to say. We can be present. We can listen. We can make a connection, or a reconnection. We can be frank, and open, and honest about our own limits.
[xvi] Matt Haig, Reasons to Stay Alive, p. 122:
Things that have happened to me that have generated more sympathy than depression:
Scalding my hand on an oven, and having to have my hand in a strange ointment-filled glove for a week.
Accidentally setting my leg on fire.
Losing a job.
Breaking a toe.
Being in debt.
Bad Amazon reviews.
[xvii] Jennifer Finney Boylan, “How to Talk about Depression,” The New York Times, Friday, June 15th, 2018, p. A23. See Also Haig, Reasons, pp. 202-210 to read such tweets, like “Friends, family, acceptance, sharing, knowing the black dog will leave eventually,” and “Not everyone thinks you’re as much of a waste of space as you do when in the depths of depression. Trust others.”
[xviii] I had the pleasure of learning this first hand as I spent a few hours at Sip of Hope both editing this sermon and engaging in intentional conversations about mental illness with the wonderful staff.
[xix] This quote and other information about Sip of Hope are from Alexandra Arriaga, “Coffee with a conscience,” The Chicago Sun-Times, Friday, May 4th, 2018, p. 10.
[xx] Jonah 4:3: כִּ֛י ט֥וֹב מוֹתִ֖י מֵחַיָּֽי .
[xxi] Jonah 4:4: הַהֵיטֵ֖ב חָ֥רָה לָֽךְ .
[xxii] Jonah 4:8-9.
[xxiii] Just because renewal and recovery are possible does not mean they are always the best subject matter. Sometimes listening to someone who suffers is far more important than providing platitudes. There is no better example of choosing attentive listening over prescribing courses of action than the God of Yom Kippur. Just tomorrow morning we will be reminded by our Divine command: Choose life! In Deuteronomy 30:19, God makes it clear that between blessing and curse, life and death, we need to choose life. But the same God that unconditionally commands us to choose life knows better than to throw that choice before a person in the midst of their suffering. God doesn’t tell Jonah to choose life; God engages Jonah in conversation. God chooses conversation over command; God chooses compassion over direction. I hope all of us are strong enough to do the same.
[xxiv] Technically, BT Rosh HaShanah 28a contemplates, “The one who sounds for a song”. Rashi, in his commentary to this passage, explains the “Secret of the matter,” namely that this person is one suffering from mental illness trying to scare away the demons that torment them.