“You can pretend you’re okay so you can get married but what happens next? Certainly not happily ever after”

In 2016 alone Shana Aaronson helped seven girls and six yeshivah students report abuse get much-needed therapy and join international support groups. Victims of intrafamilial abuse in particular she says tend to come forward in Israel. “Once they feel safe they’ll often find the strength to say: I will not let my little sister go through this. I’m going to do something.”

Other times simply being extracted from the situation gives young women the clarity to say “This was not okay. I need help.”

On a more general level seminary is an ideal time for therapy because the goals overlap: both seminary and therapy aim to help you figure out who you are and where you’re going. “Seminary students are really open to growth” reports social worker Ariella Farkash. “Maybe that’s why they often show less resistance than typical clients.”

The year she points out is also a golden opportunity for a new start. “It’s a chance to say: what do I like about myself? What do I want to keep? What do I want to toss?”

For girls whose identities are wrapped up in roles—“good girl,” “class clown,” “oldest of twelve” – seminary challenges them to build a more authentic sense of self.

Breindy, a mother of five who attended a “top” seminary in Eretz Yisrael, remembers feeling insecure for most of the year.

“I was the smartest in the class, I was valedictorian, I was superwoman—that’s how I defined myself. Suddenly, everyone around me was all that--and more. So who was I? Looking back, I wish I had someone to speak to, to work through these feelings.”

Practically, therapy in Israel has many advantages: it’s easier to squeeze into a schedule, as sem girls have more time on their hands. It may yield faster results, since the girls—unburdened by dating/job/college/parnassah concerns—have the headspace to focus on the process. And perhaps most importantly, it is often significantly cheaper than US or European counterparts.

Making the Appointment

While most therapeutic set-ups in Israel are arranged extemporaneously, a significant percentage are coordinated in advance—by parents, high school teachers, and US-based therapists. This model, says Rivky, a Jerusalem therapist and former aim bayit in Michlelet Esther, is ideal, because establishing rapport with a therapist takes time. Momentum is important as well; if a student waits until the issue bubbles up Chanukah time, then goes home for Pesach four months later—only to come back to endless finals and tiyulim—the efficacy of therapy is compromised.

“The earlier you start, the better,” says Rivky. “If a girl thinks she might benefit from therapy in Israel, let her reach out to a high school teacher.”

Rabbi Yaacov Goodman is the founder and director of Yedidim, a non-profit dedicated to helping Anglo parents raise children in Israel. His team—based in Yerushalayim, Beit Shemesh, and Ranaana—regularly fields calls from concerned adults seeking treatment for young men and women, sometimes for preexisting conditions like eating disorders or obsessive tendencies.

In the 18 months since its launch, Yedidim’s Parental Guidance Center has made over 200 referrals to a cadre of carefully screened professionals, then provided case management and follow-up. Rabbi Goodman notes that unfortunately, many parents don’t want the yeshiva or seminary to know about the therapy.

“Full disclosure is in the best interest of the student, because the school can be more effective,” Rabbi Goodman says. “In some cases, it can even be dangerous if the school isn't aware. However, we respect parents’ rights to discretion. If we feel it’s necessary, we will try to convince them to tell at least one person in the school.”

In a majority of cases, however, therapy in sem is initiated spontaneously—by a teacher, aim bayit, or the girl herself. Social worker Mrs. Chana Rabinowitz says that many girls approach her early in the year.

“I tell girls during orientation: ‘I’m the designated staff person for anything difficult on your mind. This is a great year to work on family issues and stuff, so if you want to pursue therapy, come to me.”

Often, a particular class or workshop dredges up intense emotions, prompting girls to seek help. Mrs. Rabinowitz, for example, gives a popular series on topics of emotional health. Every Tishrei, she devotes one class to forgiveness.

“I bring up the fact that some behaviors seem unforgivable—what do we do about those? Every year, some girls make appointments with me afterwards. It’s not unusual for girls to reveal some kind of abuse.”

Sometimes, therapy is set in motion by a red-flag behavior noticed by the staff, such as:

• not eating
• not sleeping
• not making friends
• crying much of the day
• speaking endlessly with Mom
• arguing a lot on the phone
• resisting friendly overtures by sem staff
• being overly physical with peers
• or consistently breaking rules.

Mrs. Rabinowitz reports that in her experience, girls are almost always receptive to a therapy recommendation. When a girl is less inclined, staff members might urge her to try it for a short time. “You are not signing your life away,” Rivky recalls telling students when she served as aim bayit. “Everyone has challenges. Sometimes we can cope on our own; sometimes we can’t.”

Where Are the Parents?

What’s the role of the parent when a child decides to seek therapy thousands of miles from home?

For students younger than 18—a minority—parental consent is a must. All other students can insist on confidentiality, but if a girl is open to including her parents in the process, she’s greatly encouraged. Especially when therapy heavily focuses on childhood, communication between therapist and parents —about background, not confidentially shared information — can provide critical context. (In cases of clear physical danger, therapists are required to breach confidentiality, and parents would be immediately notified.)

Some parents feel understandably vulnerable: their daughter is “telling all” to a faceless person 6,000 miles away. Mechaneches Deena Heisner has been on the receiving end of irate calls from parents who’d gotten wind of their daughters’ clandestine therapy.

“How would you feel?” some mothers have challenged her. “Could you imagine someone sending your daughter for help without telling you?”

Deena does her best to respond with empathy: “It’s so painful. I greatly encouraged her to apprise you, but she didn’t want to. Hopefully, she’ll reach a healthier place where she’ll feel comfortable or interested to talk to you about it. That’s one of the goals.”

Mrs. Chana Rabinowitz reports that in her experience, most parents have been cooperative and grateful, even willing to foot the bill. “We always emphasize to our girls: the goal is to make things better. You’ve got to make peace with your family; you’ll never replace them.”

In cases where parents refuse to bankroll therapy or cannot afford it, or when the student does not want parents involved, funding comes from non-profit subsidies or specially-earmarked funds maintained by seminaries.

Yedidim offers subsidies on a case-by-case basis, as do a number of other non-profits. GetHelpIsrael.com, a new resource launched by therapist Tanya Prochko this year to facilitate mental health treatment for Anglos in Israel, maintains an updated list of organizations that offer subsidies or free counseling.

Brachie, a vivacious young woman who recently pursued therapy in sem, didn’t want her parents to know. Her principal arranged a part-subsidy through an organization, and Brachie financed the rest by landing a weekly job. At the end of the year, perhaps in acknowledgment of her dedication to the process, the organization mailed a check to “pay her back” for the money she’d laid out.

“It was a tremendous gift of love,” she says.

Sometimes, if the issue doesn’t warrant a highly specialized therapist, the student is referred to a clinic like the Neve Family Institute, where low-cost treatment is provided by therapists-in-training under expert supervision. In the absence of such options, a selfless teacher or aim bayit might shoulder the burden, offering her often-meager personal income towards the cause.

“So many of the people who work in seminaries are tzaddikim,” asserts Shana Aaronson of Jewish Community Watch. “Angry parents sometimes cut off all financial support, and I’ve seen numerous teachers taking it upon themselves to support girls – food, board, everything.”

Avigail, a recent sem alumna who grew up with divorced parents in a difficult home environment, says her father’s initial reaction to therapy was “no way.” Eventually, Avigail’s mechaneches convinced him to allow it, but he refused to pay. Avigail was forced to beg her personality-disordered mother for the money.

“It was the biggest mistake, as she later used it to manipulate me and hurt me,” she shares. “I wish my school had some fund to help me out, but they didn’t. One day, I hope to be able to set up this kind of fund for my seminary.”

Lean on Me

Teachers play a critical role in the therapy process as well. Mechaneches Deena Heisner sums it up pithily: help your student want to go, then hold her hand between sessions.

Rabbi Aaron Stengel*, a popular rebbi in a well-known yeshiva who requested anonymity to protect student privacy, shares that in three years of working with a small group, he’s facilitated mental health treatment for at least 10 students. A trained rebbi, he feels, can jumpstart the process by gently helping boys own the problem.

“A good rebbi gets a boy to a place where he’s able to say ‘Rebbi, I need help,’” Rabbi Stengel asserts.

Following this monumental admission, the teacher’s job is to make it happen: research the options, determine the best “shidduch,” and help figure out funding. Rabbi Stengel reports that in cases where a psychiatrist was also required, he accompanied his student to the initial appointment, giving much-needed emotional support.

If the student agrees, the therapist might speak with the teacher to accelerate introductions. And once sessions start in earnest, teachers often serve as invaluable sounding boards.

“Therapy can be overwhelming, even more so when you’re juggling the heavy-duty sem experience,” says Mrs. Heisner. “Girls need a lot of chizuk and empathy.”

Avigail describes how she felt at the start: “I was so nervous, I could barely talk. I had become very close to my madricha and went to speak to her before leaving for my first appointment. She gave me a hug and told me she believed in me. She got me through the roughest times of therapy.”

In cases of trauma, when festering wounds are being cleaned, lack of support can be dangerous. A girl pursuing EMDR therapy, for example, might go for a session, reliving excruciating pain that was suppressed for over 10 years. Then she comes back to the dorm, only to face a nosy roommate and an irritated friend who can’t understand why she hasn’t yet finalized Shabbos plans.

“You are opening up very painful experiences,” therapist Rivky says. “You need solid support.”

Mechaneches Mrs. Heisner found that she also becomes the go-to “hashkafa consultant,” for students trying to reconcile a therapist’s words with their spiritual presuppositions.

“My therapist says I should focus on my enmeshment issues, but everyone else is taking on kabbalos in tznius and shmiras halashon,” a conflicted girl might share. Mrs. Heisner will reassure the girl that her most precious work right now is ensuring emotional health.

Sometimes, a girl might lament that she’s missing out on seminary; she’s too busy with therapy. To this, Mrs. Heisner will respond empathically, while stressing that this is what Hashem wants from her.

“Emotional health is the precursor to spiritual growth,” she says. “But sometimes, that’s hard for girls to accept.”

The Drawbacks

Advantages notwithstanding, therapy in seminary also presents unique challenges. For girls who want to keep things hush-hush, slipping discreetly out of the dorm—on a weekly basis—can prove difficult.

Chaya, who sought therapy for a traumatic childhood experience, learned to evade questions. “If anyone asked where I was going or why I couldn’t join them, I’d make up stories,” she recalls. “That was hard.”

Timing can also be tricky. Chaya’s sessions, while enormously healing, were draining. Initially, she’d meet her therapist at 9 a.m. over Pesach vacation, to be back in time for all-day outings with friends. But after some time, she realized she was too drained to enjoy the fun. “My eyes burned from crying so long,” she says. “It was a good kind of cry, but it was a heavy way to start my day.”

Chaya switched to an evening slot, which posed other challenges: she was less refreshed and couldn’t join her friends on longer trips.

Transportation is another common issue. Many girls travel 40 to 60 minutes by bus for therapy, resulting in a three-hour time investment. On the plus side, sem alumna Tova points out, the long ride can enable students to mentally transition back to seminary life.

In some schools, therapy is provided by a trained and licensed faculty member who serves as the in-house therapist. This less formal setup skirts the money issue, but introduces other snags. Suri reports that she didn’t always get the full hour (the faculty member was overwhelmed with other responsibilities), the sessions were frequently interrupted by phone calls or pop-ins, and they weren’t totally private (Suri saw which girls came before and after).

“But these were minor problems in an overall good experience,” she stresses.

Another prominent challenge of therapy during the gap year is its short-lived duration. Therapy often doesn’t start until November or December, only to be mottled with frequent interruptions like tiyulim, Pesach, and finals. Can anything be accomplished in six choppy months?

For less complex issues, therapist Ariella Farkash says, the answer is yes. A client with more complicated struggles probably won’t be able to work through things completely, but Ariella says a motivated girl can still find the process life-changing.

Most of the alumnae interviewed confirmed that notion. “When people see me now, they see a relaxed girl with a sense of humor and a joy for life,” says Brachie. “Once the pain is healed and the tools for survival learned, the world isn’t that scary.”

As a result of therapy, Brachie made a host of transformative decisions: she distanced herself from her unhealthy mother, moved  to a city with many supportive friends, and began boarding at a wonderful family. She says she has a much easier time letting go and being herself.

“I can say ‘no,’ which, surprisingly, has improved my relationships. I got rid of a lot of inner anger. And even though I don’t live at home, I still give my father lots of nachas. I feel as if I’m making up for lost time with him.”

Interestingly, for some girls who choose to stay for shanah bet, therapy is a prime consideration.

“The really good therapists pull the girls back,” says social worker Chana Rabinowitz. “It’s a huge motivating factor.”

Shattering the Stigma

In recent years, frum society has made great advances towards normalizing mental health treatment—but a shadow of stigma remains. Most girls who’ve pursued therapy, however, express no regret.

“I was worried about shidduchim,” admits Avigail. “But then I decided that going into shidduchim without therapy was my greater fear.”

Tova points out that a girl who doesn’t work through her issues will face greater ramifications later. “You pretend you’re okay so you can get married, but what happens next? Certainly not happily ever after,” she asserts.

Just ask Shana Aaronson of Jewish Community Watch. She receives numerous calls yearly from kollel wives who did not seek help before marriage—and now find themselves in crisis. While Shana sets them up with therapists, she stresses that it’s always easier to tackle problems before they blow up.

Mrs. Chana Rabinowitz concurs. “People should not be afraid,” she says. “If we see therapy as no different from any other treatment—speech, OT, medical—our girls will make better shidduchim, have better marriages, become better mothers, and lead richer lives.”

For the Sake of Stability

What happens when a mental health condition turns severe—and seminary staff can’t manage it?

In many cases, the student will be hospitalized…or sent home.

“It’s a disaster for her and her family,” says Dr. Shmuel Harris, director of the Psychiatric Clinical Service at Hadassah University Hospital, Mount Scopus. “She feels like a failure, and there’s the ‘shanda’ that goes along with it.”

Girls who fall under this category might suffer from severe anorexia, trauma, or personality disorders. In seminary, they might have been extremely emotionally unstable, at times demonstrating impulsive, addictive, and self-harming behaviors.

Dr. Harris had seen too many students hospitalized or sent home, missing out on the once-in-a-lifetime seminary experience and often deteriorating further. This pushed him to found Machon Dvir, an intensive Jerusalem outpatient service that provides treatment on an outpatient level, averting sudden crises while allowing students to get the most of their year.  The institute specializes in gender-separate dialectical behavior therapy (DBT), which is uniquely suited to young men and women who were victims of trauma, have mood or personality disorders, or exhibit potentially risky behavior

“We want to help these students stay in Israel,” Dr. Harris says. “Our goals are modest; we’re not aiming for a deep therapeutic process in the short time they are here. We just want to give them the tools and support so they feel safe and stable enough to get the most out of their year.”

Should a girl with serious mental health issues come to Israel in the first place? Dr. Harris says there’s never one correct answer; it depends on the case. Sometimes, the year away from home is the first opportunity to get help.

“Seminary is an important, formative year,” he says. “Assuming this young person will be physically safe—without the risk of severe self-harm, an uncontrolled eating disorder, or suicide—if we can give her the framework she needs, it can be a very positive year.”