Passover 5775

By Maharat Ruth Balinsky Friedman

Each Passover we are required to participate in a seder. We join our family, friends, and community to recount the horrors of slavery, and celebrate the miracles with which God delivered us from Egypt and into freedom. As we sing together, the ultimate goal of the seder is to arrive at the point where we all see ourselves as though we were the Israelites who fled Egypt in the middle of the night.

In keeping with the theme of the seder, we must ask a question: Why? Why must we relive the experience of slavery and redemption?

We must relive the experience of slavery and redemption because our collective memory of slavery in Egypt serves a critical role in defining our peoplehood. Throughout the Torah, God commands us to love and protect the stranger, “for you were strangers in the land of Egypt.” In parashat Mishpatim, this commandment is placed in the middle of a series of laws that God has given us to govern our society, sending us the clear message that our law and order is defined by our ability to recognize the vulnerability in others, and that we must embrace and support it.

The stranger often appears in our text along with the orphan and the widow. Together, these three groups form the trifecta of the most vulnerable members of our community. It is no surprise that these are the three groups that we are commanded to protect - in a patriarchal society, the widow and orphan lack a male figure to support them financially. The stranger does not have a familial and communal structure to offer him guidance and support. Because they lack these basic resources that the rest of us have, we are obligated to provide these resources for them.

The Rambam contributes a fascinating voice in this discussion. In the Mishneh Torah, Hilchot De’ot 6:10 he writes, “A person is obligated to show great care for orphans and widows because their spirits are very low and their feelings are depressed. This applies even if they are wealthy. We are commanded to [show this attention] even to a king’s widow and his orphans as [implied by Exodus 22:21]: ‘Do not mistreat any widow or orphan.’”

With this statement, the Rambam dispels a potential and likely misconception - that the commandment to protect the most vulnerable in our society only applies when those individuals appear to be suffering. We may think that wealthy orphans and widows do not need our care, but we would be mistaken. The commandment applies regardless, because we should never assume that individuals in our midst are thriving just because they appear to be.

This is a powerful lesson for us to remember this Passover. Many believe that domestic abuse has an obvious and detectable effect on its victims, and therefore unless an individual’s suffering is readily apparent, everything is assumed to be alright. Tragically, the opposite is often true. As we know, not all abuse is physical and victims of domestic abuse often are able to conceal their suffering and lead others to believe that they are fine. Learning the potential warning signs of domestic abuse is key to raising our own awareness and sensitivity to the needs of others. This Passover, let us remember the lesson of the commandment to care for the stranger, orphan, and widow in our midst - we must care for the most vulnerable people in our community, even if they don’t appear to be suffering. And as we celebrate the seder let us all see ourselves as though we were slaves in Egypt, and remember our obligation to support others in need. We wish you a meaningful and joyous holiday.

Maharat Ruth Balinsky Friedman currently serves at Ohev Shalom: The National Synagogue and as the Conversion Coordinator for the Beltway VAAD. For more information on how to recognize the warning signs of abuse, visit http://jcada.org/WarningSigns.

EMDR: An Alternative Trauma Treatment

By Tracie Doherty, JCADA Clinical Intern, & Rahel Schwartz, PhD, LCSW-C, JCADA Clinical Director

As Abby* enters the intake room at JCADA, she makes sure to secure the seat closest to the door. She scans the room and nervously wrings her hands as she assesses the safety of the office. Abby reports that although she left her abusive marriage two years ago, she doesn’t feel like the abuse stopped. She describes the fear that she experiences whenever she smells a man wearing the same aftershave as her ex-husband. When out driving, passing a car with the same make and model as her ex-husband’s instantly brings her back to the times he would erratically drive their car at high speeds though she begged him to stop. Abby started to weep as she confided in her therapist that she did not even feel safe at home. She recounts waking up from nightmares that feel so real that she has to remind herself out loud that she got away before struggling to fall back asleep. As if living with such panic and recurring nightmares isn’t bad enough, she struggles with chronic pain that interferes with her ability to be active. Though she has had some success with therapy before, Abby wonders if she will ever fully recover from the trauma she has experienced.

Abby is representative of many of JCADA’s clients who continue to suffer from the effects of the abuse they endured even years after leaving the relationship. While traditional talk therapy has demonstrated effectiveness in reducing clients’ symptoms, sometimes alternative interventions are necessary. JCADA already offers our clients Trauma-Focused Cognitive Behavioral Therapy, Art Therapy and Biofeedback, but hopes to secure funding for training our clinicians in Eye Movement Desensitization and Reprocessing (EMDR).

EMDR allows traumatic memories to be processed through exercises that engage both sides of the brain. Our memories are linked in networks that contain related thoughts, images, and emotions.¹ The goal is for the client to develop a more adaptive set of beliefs, emotions, and physical responses to allow for those traumatic memories to be adequately integrated into other memory networks.

EMDR has proven to be effective in treating trauma. Leading trauma researcher Bessel Van Der Kolk discussed a study he conducted in which subjects who were treated with EMDR

did substantially better than those given Prozac or a placebo. Furthermore, the EMDR group continued to improve after treatment ended while the group treated with Prozac relapsed

when they went off of the drug. Clinical researchers also found that EMDR successfully reduces sensitivity to physical pain, a benefit to victims and survivors who experience chronic or intermittently-triggered physical symptoms.² While there is no miracle cure for reversing the harmful effects of abuse, EMDR is recognized as one of the most effective treatments for post-traumatic stress disorder (PTSD) developed as a result of trauma experienced as an adult.³ EMDR can be beneficial for both clients who have left an abusive relationship and for those who would like to process past trauma prior to entering into a new relationship.

As it stands, an estimated 100,000 mental health practitioners have been trained in EMDR since its development in 1989. Due to its success rates, a number of domestic violence and sexual assault organizations have adopted EMDR as one of their preferred methods of intervention.

*Name has been changed to protect the identity of client.

1 Grant, M., & Threlfo, C. (2002). EMDR in the treatment of chronic pain. Journal of Clinical Psychology, 58(12), 1505-1520.

2 Ibid.

3 Van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard review of psychiatry,1(5), 253-265.

Asking for Help

By Selena Snow, Ph.D., Licensed Psychologist

My son’s basketball coach frequently calls out to the kids, “Look up and see what you got!” When the boys get the ball, they often think that they have to get it back down to the other end of the court and score all on their own. Their coach tries to remind them to look up from dribbling and see who on the team can help them to score. Often in life, we too forget to look up and see who is available to help us. Even when we know who is there, it can still be difficult to ask for help. Just as one player isn’t wholly responsible for achieving the win, we also do not have to accomplish our goals all on our own. We can turn for help to the rest of our team, be it friends, family, community members, religious leaders, professionals at JCADA, or mental health professionals in the community at large.

Our willingness to ask others for help at times is what can truly make us independent. For example, when an older adult is willing to accept help with meals and housekeeping, he or she may be able to continue living on his or her own in the community. Similarly, when I ask my accountant for help managing the financial aspects of my psychology practice, I am then able to successfully continue running an independent private practice. The same thing holds true for seeking psychological help when we are struggling with depression, anxiety, trauma, or domestic violence. Asking for help is the first step to empower ourselves to overcome challenges and emerge with new tools and skills that can be applied throughout our lifetimes.

Unfortunately, we are often held back by misconceptions that others will judge us negatively if we let them know about our personal struggles and challenges. Yet the more we isolate ourselves with our difficulties, the more alone we feel and the less we are able to tap into the rest of our team for the strength and support that we need. It is important to remember that mental illness is quite prevalent. Government surveys have found that 1 in 5 American adults experience a mental illness in a given year.[i] It is not shameful to struggle with emotional difficulties; rather, it is a shame not to get the help that is available. Research has shown that it can take a long time to ask for that help.[ii]

One of the barriers to asking for help is lack of information. Who should I ask for help? How will I know if they are any good? A friend recently asked me for a referral for her child, as many of my friends have done over the years. Once she was able to get past her discomfort of asking, she was able to get connected to helpful resources. Use your team to find out where to go for help. Try asking mental health professionals you may know, checking online information sources, or asking medical providers for referrals.

Other barriers to asking for help include fear of rejection and fear of failure. What if I ask someone for help and they say no? What if I try to make improvements in my life and I don’t succeed? These are the types of thoughts that can prevent people from accessing help and hold them back in other spheres of life as well. 

Try to challenge negative thoughts and ask yourself what it would mean if these feared events occurred and if there are other ways to think about them. For example, “I can handle it if someone says ‘no’ and it won’t be a catastrophe. It may not even have anything to do with me.” You can also try the double-standard-exercise of asking yourself what you would say to someone else contemplating getting help. You would likely imagine saying something kinder and more encouraging to others than what you would have said to yourself. 

Another impediment to asking for help is not prioritizing self-care. We’re all so busy taking care of family, jobs, and myriad responsibilities, that our own needs fall very low on the priority list. Learning to carve out time to tend to our own well-being in spite of the many demands upon us can ensure that we continue to successfully meet those demands. Taking that first step of asking for help is already creating a shift in beginning to prioritize self-care. Hopefully, the thoughts in this article will encourage us all to ask for help when we need it, as well as be there for others when they reach out.

Dr. Selena Snow is a licensed psychologist in the state of Maryland. She earned her Ph.D. in Clinical Psychology in 1999 from the University of Maryland and a B.A. in Psychology from the City University of New York. She is currently in private practice in Rockville, MD, and specializes in treating adults and adolescents for depression, anxiety/stress, anger management, relationship issues, and adjustment to life transitions, such as childbirth, divorce, death/loss, medical illness, and changes in school or work status.

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[i] Results from the 2011 National Survey on Drug Use and Health: Mental Health Findings. 2012.

Results from the 2013 National Survey on Drug Use and Health: Mental Health Findings. 2014.

< http://www.samhsa.gov/data/sites/default/files/NSDUHmhfr2013/NSDUHmhfr2013.pdf>

[ii] Notarius & Buongiorno, 1992, as cited in Gottman, J. M., & Gottman, J. S. (1999). The marriage survival kit. In R. Berger & M. T. Hannah (Eds.), Preventive approaches in couples therapy (pp. 304–330). Philadelphia: Brunner⁄Mazel.

The Impact of Domestic Abuse on Child Witnesses

By Lora Griff, MSW, LCSW-C

In the 2014 released movie and 2012 best-selling book Wild, Cheryl Strayed shares her own story as a young woman bereft from the recent loss of her endearing mother and the demise of her own marriage.  Through a series of flashbacks, she recalls the events that led her to work through her loss by trekking the Pacific Crest Trail from LA to Oregon, over 1000 miles on foot. There are many sources of her personal struggle but one blatant factor is that she was a child witness to spousal abuse. Her father beat her mother and disciplined the children with threats of a knuckle sandwich. In one of the movie’s scenes, there is fear and desperation in the child Cheryl's eyes as she runs into the pharmacy to get medical supplies for her mother who is recovering from a recent beating.  Children who witness violence between their parents are the untold victims of domestic abuse. 

In early writings about women in abusive relationships in the 1970’s, theorists indicated that victims tend to withstand physical abuse until their children also become targets, at which point they are more likely to leave the relationship. What is now known in the domestic abuse field is that any exposure to abuse affects the children. Witnessing domestic abuse includes hearing the arguments and fighting noises from another room, watching the incidents of violence, observing the physical aftermath of abuse, and sensing the resulting fear and tension in the home.  More than 3 million children witness violence in their homes each year[1] and over 75% of children who live in homes with domestic abuse have observed violence at least once[2].

There are short- and long-term impacts on child witnesses of domestic abuse.  Short-term impacts include increased anxiety, depression, fear, anger, physical symptoms such as stomachaches and headaches, and poor school performance due to decreased concentration. Long-term effects include impaired future relationships in which they may identify with and assume the role of either the victimized or abusive partner. Without intervention, the cycle of violence often perpetuates with the next generation.

Over the last two decades, awareness has increased about the effects witnessing abuse has on children.  We now know that the severity of the impact depends on a variety of factors, including chronicity and severity of abuse, and the presence of other risk factors, including substance abuse, poverty and mental illness. Children who are best able to survive these situations demonstrate high self-esteem, have parents who are tuned into the impact of witnessing abuse, and have other protective adult family or community members in their lives. JCADA works with clients to empower them to create a safe home for their families and become role models for being survivors rather than victims of abuse. 

Lora Griff is a licensed clinical social worker in Maryland and Virginia. She was a clinical consultant and community presenter for JCADA and now serves on JCADA’s Clinical Committee. Griff is also a Board Certified Diplomate in Clinical Social Work and a member of the National Association of Social Workers and the Greater Washington Society for Clinical Social Work.

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[1] “Domestic Violence: Statistics and Facts.” Safe Horizon. http://www.safehorizon.org/page/domestic-violence-statistics--facts-52.html

[2] “For Caregivers: Understanding the Problem.” Child Witness to Violence Project. http://www.childwitnesstoviolence.org/facts--myths.html