Fear of heaven or pathological anxiety? - opinion

For so many of my patients, finding balance in life is the key to their recovery journey.

A depressed patient must rediscover happiness as part of their treatment. But if in their search for positivity and optimism they are too raw to connect with the pain and suffering of others, then something is clearly missing. An addict who is drug-free is on the right path. But an alcoholic who cannot attend a family wedding due to the fact that there will be wine and liquor served doesn’t yet have the strongest sobriety.

And what about my patients who have struggled with pathological anxiety and related disorders such as obsessive-compulsive disorders, trauma, and panic attacks? On one hand, so many of them want to live a life that is worry-free. On the other hand, the fear center of our brain can be a lifesaver when it comes to avoiding dangerous situations.

Furthermore, healthy anxiety is interconnected with being an effective, mature adult by reminding us to stay on top of our daily responsibilities. With this in mind, harnessing the productive aspects of anxiety while working to say goodbye to unhealthy anxiety and its symptoms is a major focus of the therapeutic process.

For a person with a history of anxiety, the High Holy Days of Rosh Hashanah and Yom Kippur can represent quite a conundrum. Much of the language used throughout the Bible and our rabbinical tradition revolves on yirat shamayim, which is most commonly translated as “fear of heaven.”

For example, over a thousand years ago, Rabbi Saadia Gaon taught, “The sounding of the shofar instills a sense of trepidation and fear that leads us to humble ourselves before God, as the verse (Amos 3:6) states: ‘If the shofar is sounded in the city, will people not tremble?’”

Between my patients, their families, and their teachers, the deluge of questions can be overwhelming at this time of year. A teenage student is nervous that his previous sins will result in divine retribution and cannot sleep at night. A young mother with a history of OCD is terrorized that her repentance will be incomplete and has been unable to stop reading Psalms in hope of salvation. A local rabbi is bombarded by phone calls from a father who feels that God hates him because his children don’t want to pray at synagogue on Rosh Hashanah.

What is the difference between a healthy fear of heaven and pathological anxiety?

All of these questions revolve around a fundamental distinction: What is the difference between a healthy fear of heaven and pathological anxiety? To help my patients and their loved ones think this through, I offer these three thoughts:

1. Fear of heaven brings us closer to the ones we love and improves our relationships; pathological anxiety makes us feel farther away from the ones we love and strains our relationships.

2. Fear of heaven makes us feel whole and connected to our innate spirituality; pathological anxiety makes us feel broken emotionally and disconnected spiritually.

3. Fear of heaven gives us strength to do good in our lives and within our communities; pathological anxiety makes us feel weak and is often associated with physical symptoms such as headaches, upset stomach, poor sleep, and muscular pain.

Many of my patients and their loved ones find these three rules to be quite helpful in both finding spiritual satisfaction and identifying their symptoms. High-quality and culturally sensitive mental health interventions combined with thoughtful spiritual guidance can ensure that everyone has a meaningful growth experience during the High Holy Days.

Shana Tova – a Happy New Year!

The writer is a psychiatrist and business consultant based in Jerusalem. After completing his training at Harvard Medical School, he and his family immigrated to Israel. His new book, The Things I Told My Patients, is available from Menucha Publishers. He can be reached via his website: drjacoblfreedman.com.