Journal of Religion and Health

, Volume 57, Issue 5, pp 1702–1716 | Cite as

Psychiatry, Cultural Competency, and the Care of Ultra-Orthodox Jews: Achieving Secular and Theocentric Convergence Through Introspection

  • Aaron M. Bloch
  • Ezra GabbayEmail author
  • Samantha F. Knowlton
  • Joseph J. Fins
Philosophical Exploration


Several socio-cultural factors complicate mental health care in the ultra-Orthodox Jewish population. These include societal stigma, fear of the influence of secular ideas, the need for rabbinic approval of the method and provider, and the notion that excessive concern with the self is counter-productive to religious growth. Little is known about how the religious beliefs of this population might be employed in therapeutic contexts. One potential point of convergence is the Jewish philosophical tradition of introspection as a means toward personal, interpersonal, and spiritual growth. We reviewed Jewish religious-philosophical writings on introspection from antiquity (the Babylonian Talmud) to the Middle Ages (Duties of the Heart), the eighteenth century (Path of the Just), the early Hasidic movement (the Tanya), and modernity (Alei Shur, Halakhic Man). Analysis of these texts indicates that: (1) introspection can be a religiously acceptable reaction to existential distress; (2) introspection might promote alignment of religious beliefs with emotions, intellect and behavior; (3) some religious philosophers were concerned about the demotivating effects of excessive introspection and self-critique on religious devotion and emotional well-being; (4) certain religious forms of introspection are remarkably analogous to modern methods of psychiatry and psychology, particularly psychodynamic psychotherapy and cognitive-behavioral therapy. We conclude that homology between religious philosophy of emotion and secular methods of psychiatry and psychotherapy may inform the choice and method of mental health care, foster the therapist-patient relationship, and thereby enable therapeutic convergence.


Cultural competence Orthodox Judaism Mental health Introspection 



We acknowledge Dr. Kevin Paine for his assistance with the psychiatric literature search and thank Dr. Anthony M.C. Brown for his support of our research.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest

Human and Animal Rights Statement

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Aaron M. Bloch
    • 1
  • Ezra Gabbay
    • 2
    Email author
  • Samantha F. Knowlton
    • 3
  • Joseph J. Fins
    • 3
    • 4
  1. 1.Weill Cornell Medical CollegeNew YorkUSA
  2. 2.Hospital Medicine Section, Division of General Internal Medicine, Department of MedicineWeill Cornell MedicineNew YorkUSA
  3. 3.Division of Medical Ethics, Department of MedicineWeill Cornell MedicineNew YorkUSA
  4. 4.Solomon Center for Health Law & Policy, Yale Law SchoolNew HavenUSA

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