Mendi Baron -Eating Disorders at the Intersection With Kosher – Not all eating disorders are created equal.

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Source: Psychology Today

It is a question that I get a lot. Not just from my community of Jewish mental health professionals but from my colleagues in the field:

How does having a Kosher facility impact your eating-disorder clients?

Is it more impactful on the eating disorder population than the populations in your other mental health and addiction programs?

What exactly does it mean to “work with the Jewish community?”

There are no simple answers, but there are a few basic premises that I have seen established that can give the basis for an educated answer.

1 . The Culture Conundrum:

We all know that who you are is often as important, and certainly often interrelated with where you came from. Nature vs. nurture is more of an agreed upon “recipe” for humanity and we strive to be controlled be neither of them.

Herein lies the rub: If you were brought up keeping kosher, even if you no longer “care” about it, and no longer “adhere” to it under your own roof, it still impacts your eating habits, choices, and even perception.

The fact is, if you were brought up with Kosher there are a few things you can count on.

Nick Clement/Unsplash
Kosher Eating Disorders Source: Nick Clement/Unsplash
  •  Your diet was very different nutritionally than others.
  •  Your diet was less diverse than others.
  • Your eating schedule was different than others.
  • You attributed more “value” into specific foods than others.
  • You stepped out of your comfort zone with foods at specific times and for specific religious reasons than others.
  • You may still attribute specific values and corresponding fear and guilt when not adhering to a Kosher diet.

And, as important as all the rest, you are likely to return to an environment where the six points discussed above are still active and prevalent and it is not as simple as “eating your own foods,” due to the complex nature of Kosher law.

Therefore, as competent treatment providers, you simply cannot ignore Kosher or work around it. To treat eating disorders and even general disorders in the Jewish community you must have a keen understanding of Kosher and its implications and embrace rather than fight this standard.

In this manner, eating disorder clients provide their own unique challenges over other clients, as they are very skilled at manipulating their eating habits, studying eating and nutritional nuances, and can use religious conviction as a mask. Knowing the facts and having a truly integrated team of medical and religious professionals who can separate fact from fiction is key.

2. The Reality of Belief:

In every religion and culture there are governing principles and beliefs that drive perception and decision making. It is not as simple as challenging a belief in therapy when that belief is only a small part of a larger system that is at the core of your clients’ entire self-concept. Further, challenging the beliefs of an Orthodox Jew (unless determined by a competent rabbi to be factually incorrect) can actually be counterproductive, as it set’s the client up for a larger faith struggle, internally, externally, and within the system to which they return post-treatment.

Jon Tyson/Unsplash
Jewish Eating Disorder Source: Jon Tyson/Unsplash
  • Beliefs around religious days and fasting
  • Beliefs around time frames for eating
  • Beliefs around modesty, body image, and dress
  • Beliefs around guilt and repentance
  • Beliefs about what one talks about and to whom
  • Beliefs about failure
  • Beliefs around what constitutes medical necessity enough to over-ride religious law from a religious standpoint.

As mentioned above, the key is having an integrated team that includes rabbinical support so that you can properly sift through what is a true requirement and belief and what is self-imposed and what can be modified for health and safety reasons.

This applies to addiction, mental health, and eating disorders.

3. The Stigma of Stigma:

The reality is that the Jewish community, like many, has come very far in its understanding and acceptance of mental health and addiction issues. However, the occasional outspoken challenger, and the fear of past stigmas has in itself created a stigma that is still hard to shake. Clients from the Jewish community tend to fear that they will be judged and that they won’t fit in upon return.

Taking note of this, and addressing it in treatment with the families is so critical and plays a crucial role in relapse-prevention.

It is key to be able to:

  • Know the specific resources within the community
  • Know the interplay between the client and the community
  • Be able to provide support for both the physical and spiritual during and after treatment
  • Know the practical limits of your clients’ ability to engage in specific interventions within the context of their family and religious expectations
  • Have a backup plan
  • Be able to be creative in your planning.

While the communities have come a long way, more likely than not, there will be fewer options that are a solid fit when it comes to aftercare planning, so start early.

This applies to addiction, mental health, and eating disorders.

4. The Need for Community:

Like many people and unlike many others, Jewish orthodoxy is very insular in that Jewish life is built around community. This serves many purposes including access to kosher food, synagogues, and schools, and also a way of keeping Jewish law, traditions, and culture alive and preserving the future of the Jewish people.

While many on the outside, and some on the inside categorize this in a negative light, in reality the community effect does much more good than bad.

 Melanie Rochester/Unsplash
Source: Melanie Rochester/Unsplash
It provides:
  • Emotional support
  • Social support
  • Often financial support
  • A familiar network
  • A life model and continuum
  • An educational system
  • Security
  • Community benefits

Understanding this means understanding that the answer can’t always be to leave and do your own thing. The tropes that many therapists fall back on in an effort to help a client “self-actualize” in reality can lead to self-destructive acts, as they have never been outside of their communities.

A culturally competent approach takes into account the community and community support, and integrates them into the team that supports the client during their journey through healing.

This applies to addiction, mental health, and eating disorders.

References

http://www.chabad.org/library/article_cdo/aid/528963/jewish/What-is-the-procedure-for-one-who-must-eat-on-Yom-Kippur.htm

Mendi is a passionate advocate for teens and adults in the mental health and addiction arenas. Mendi envisions and creates programs bringing a unique approach to mental health and substance use treatment.

Clinically trained, Mendi earned a BA with honors in psychology and social work at the University of Maryland and an MSW at the University of Maryland School of Social Work. His extensive experience as a therapist includes individual and group psychotherapy for children, adolescents, adults and families in various settings.

Mendi has gained insight and experience from his work at several treatment centers, which include the Chesapeake Center for Youth Development, the Carroll County Youth Services Bureau, Chabad Crisis Centers and the Center for Discovery and Adolescent Changes.

Prior to launching Hope Street, Mendi conceived and built multiple successful, high end adolescent and adult residential facilities and outpatient programs that include Ignite Teen Treatment, Eden Treatment and Elemental Treatment.

Mendi has appeared on the Dr. Phil show, is regularly featured in mental health and addiction publications and speaks around the country in person, on TV and on Radio shows on these topics.

With his newest ventures, Mendi instills a unique blend of energy, creativity and expertise to the treatment of teens, adults and their families dealing with trauma, addiction and mental health issues.

The son of a Rabbi and eldest of 11 children, Mendi is a part-time rock musician, boxer, cantor and father of four.

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