Working in the Orthodox Jewish Community: An Interview with Leah Rokeach, LCSW

This month I spoke with Leah Rokeach, LCSW a social worker in Brooklyn who works primarily with the Orthodox Jewish community. Leah is a long-time member of ISPS and holds the position of Secretary for the United States chapter. She is also highly active in our Membership Committee and with the Hearing Voices Network in New York City.

Tell me a little about yourself

I was brought up in Montreal, Canada. My father was an Orthodox (Chasidic)  Rabbi. I went to public school, because in those years in Montreal there were no Jewish religious schools for girls. I had a difficult time integrating both worlds, my religious background and the secular education.  However this laid the foundation for  being able to integrate the two worlds as I grew up and continued my secular education.

I am married to an Orthodox Rabbi from New York, who also had a secular education, graduated from college. He is an active Rabbi of a synagogue in Brooklyn, great writer of Talmudic topics, and very scholarly. I have a BA from Queens College and an MSW from Yeshiva University, Wurzweiler School of Social Work. I have my LCSW.

From 1985, close to twenty five years,I was the Assistant Director of the Adult Mental Health Services Program at Ohel Children’s Home and Family Services. This is a very large Social Work Agency in Brooklyn that provides services to the Orthodox Communities. It was during those years that my interest and passion for helping individuals with psychosis developed very strongly.  In 2009 I retired from Ohel, and decided that it was time for me to open my own private practice and pursue my passion for helping individuals with psychosis in that setting.

In my spare time I love the New York Philharmonic and try to get to Lincoln center whenever I have a chance. I am an exercise fan and go to the gym three to four times a week. I have three children who are married and have a few grandchildren whom I enjoy spending time with. My son is an attorney and a  partner of a prestigious law firm in New York City.

How did you first become interested in psychosis?

It is very interesting, I became interested in psychosis before I went to college and graduate school. After I married, my husband was a pulpit rabbi in a small town in PA. We settled there so he can also finish his college education at the nearby city which had a university. In my role as a Rabbi’s wife, I met many people and tried to help, did volunteer work, and “good deeds.”  I met a couple who had a 29 year old daughter diagnosed with “schizophrenia.” This young woman isolated herself, stayed home all the time, didn’t go anywhere, just looked out of a window, smoked cigarettes or slept. I took a liking to her and started to visit her. She only travelled with parents to a psychiatrist every 8 weeks. Of course he  gave a very poor prognosis.

At first, she totally ignored me, but I just couldn’t give up on her. I knew, what everyone knows, that connection with others is critical in life. One day, after about four months of visiting, she agreed to go for a walk to the park with me.  We developed a routine for going on a walk three to four times a week.  I knew she needed more to get her out of the house and into life, but I didn’t know how to do it.  The family seemed to give up on her, having the assumption that that this is her life and nothing will ever change.

This young woman, loved to paint and draw, but didn’t pick up a brush or pencil for 10 years. She had started college and hoped to to graduate with a BA in Fine Arts and to continue her education further along. However, her dreams were shattered when she developed psychosis in her first year at college. I did some research and discovered an arts instructor, half an hour away, in another town. It took a while to convince her parents and convince her, to just meet the instructor, who was very welcoming and warm. After their meeting, this young woman showed an interest in restarting  painting instruction, for the first time in 10 years. By the time my husband and I moved away, this young woman and her parents became more hopeful. They eventually moved to a larger city, where their daughter was given the opportunity to move on with her life.

This young woman made an impact in my life, paving the road to begin my professional career as a social worker.

What challenges do you think are specific to the Orthodox Jewish community?

The challenges are: fear of stigma, marginalization of persons with psychosis, and, most important, which is very specific to the Jewish Orthodox community, fear of not being able to marry off their children because of the stigma.  Marriage and raising a family is central to the Jewish Orthodox culture.     Psychosis possess a challenge to marriage and raising a family, because of the stigma,and other fears. However, the Jewish Orthodox community has become  more open. There are many Jewish Orthodox mental health professionals specializing in all aspects of mental health, many outpatient clinics serving the Orthodox community, and now many professional weekend trainings that start on Sundays to accommodate the Jewish Orthodox professionals. There is also now a new  OnTrack New York for Jewish Orthodox clients. But it still has not minimized the fear of stigma when it comes to marriage and raising a family!

For myself, the challenge as a Jewish Orthodox clinician is to always be mindful and careful of ensuring that I never say anything that might be contrary to my client’s religious life style. If I find myself in a position that is contrary to my Orthodox believes, I consult with a Rabbi who is a Torah authority. If my client has or brings up issues that I find questionable from a religious point of view, I will also consult with Rabbinic Authority. Most of my clients approve and give me their permission to do so.

What advice do you have for Orthodox people with psychosis and their family members?

Everything that I  learned since I joined ISPS-US, joined Hearing Voices NYC, all the many trainings I took, has been helpful for my professional growth, to understand better and to educate others, especially family members. I educate them about psychosis, instill hope of recovery and of finding the quality of life which they aspire to, even marriage. I share with them my experience of helping a few  couples, with various mental health issues, including psychosis, get married. I share with them stories, books, videos of individuals who recovered and moved on with their life. I share with them the research, information about how the effect of trauma and adverse experiences in someone’s life can develop into the symptom of psychosis. I gave a few  presentations to a group called Family and Friends for Mental Health that meets every months on various topic such as The Hearing Voices Network,  negative symptoms,  and living with voices.  I recently showed the film Healing Voices which was very well attended. I am planning to show the videos of the Family Plenary from the ISPS-US Portland  conference and the Expert by Experience videos.

However, in the Jewish Orthodox community there is still a strong belief in the medical model. Medication is most important to them. They always look for the “best ” psychiatrist who prescribe “best medications.”

How did you hear about ISPS and what made you want to join? 

In 2011 I met Brian Koehler at a Nefesh conference.  This is an organization of Jewish Orthodox mental health professionals. It has a large membership from all over the country, Europe and Israel. Brian gave a presentation which I attended, and at the end of his presentation I had some questions for him. I also remember telling him that I started my private practice in 2009 and felt I needed to know more about treating psychosis, not only use the Psychiatric Rehabilitation approach. He told me about ISPS, about their mission, and I decided to join. It was one of the best professional decision I have made.  Through ISPS-US I was introduces to the Hearing Voices Network, met Ron Coleman, and took a few trainings with him including “How to Start a Hearing Voices Group.”

I took the CBT for Psychosis training with Yulia Landa, took ACT and Compassion Focused training for Psychosis., and I recently took a course on EMDR and how it can be used for psychosis. My focus is to have knowledge and understanding of various psychological approaches that I can use to help people who are diagnosed with psychosis. My consultant is an ISPS-US member and we meet on a regular basis.

Can you tell us about your Hearing Voices groups?

I am very excited about the groups I co-facilitate. The Hearing Voices group for Orthodox men has been meeting regularly for the past two years twice a month. It also includes individuals who are experiencing unusual or extreme states of consciousness or beliefs. It is not a very large group, we have about five  regulars and another four or more individuals who don’t come on a regular basis. This group is non-judgmental, people are free to talk about their experience in any way they choose. There is also a group for Orthodox women, but it has not started officially yet, due to difficulties in finding space and time.  As of now, the plan is to start the group on Monday March 5th at 7pm to 8;00pm and we will meet  every second Monday.

What resources (books, websites, etc) do you find most helpful for learning more about psychosis?

There are so many books, articles websites that I use and continue to use.   Some of the first books that  I started to read was Bertram  Karon’s  Psychotherapy of Schizophrenia which I still reread; Psychosis as a Personal Crisis, edited by Marius Romme and Sandra Escher has been especially helpful  in starting my development to look at psychosis not from an illness or disease perspective, especially in regard to voice hearing.

Another important book that helped me  shift my thinking and understanding psychosis was Unshrinking Psychosis by John Watkins.

Other books include: Cognitive Therapy of Schizophrenia by David G. Kingdom and Douglas Turkington, Paul Chadwiwick’s  book Person-Based Therapy for Distressing Psychosis, Treating Psychosis by Douglas Turkington and other authors.

In terms of websites: Intervoice: The Hearing Voices Network, Dr. Rufus May, Ron Unger, and The Institute for Open Dialogue.

There are many more books and articles, too many to mention, that have been and continues to be very helpful in developing my competence as a therapist   helping people with psychosis.

Thank you for taking the time to speak with us, Leah! 

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