Rebbetzin Weingard was having a hard time explaining Shmuli’s problem.

“It’s not exactly that he’s depressed,” she told me over the phone. “But the self-imposed isolation is extremely worrisome.”

The Weingards were a chassidishe family from England who had moved to Israel when Rabbi Weingard was offered the position of av beis din in a community outside Jerusalem. Their aliyah went smoothly, as their older children were already married. But Shmuli was the youngest child by five years and hadn’t had an easy transition.

“Maybe it’s because we moved at this critical age for him… Shmuli hasn’t made a friend since we landed,” Rebbetzin Weingard lamented. “All he does is sit at home and look at maps from the moment he gets home from yeshivah. I hope you’ll be able to figure this out.”

I did have some ideas as to what was going on with this 15-year-old bochur, although I’d have to meet him in person to tell for sure. I offered Rebbetzin Weingard an appointment for later in the week, which she promptly declined.

“Absolutely not,” she said flatly. “You see, Shmuli won’t take an appointment unless he’s been given at least a few days’ notice. He’s never done well with change or unexpected scheduling, so we’ve got to give him at least a week in advance for this kind of thing.”

That was another clue I took note of as we scheduled an appointment for the following Wednesday, for both Shmuli and his mother.

“You know, he always had friends back in school,” Rebbetzin Weingard said as soon as we sat down, while Shmuli waited outside. “It’s not that he’s not a nice boy, it’s just that he doesn’t really fit in. Do you think it’s the school system, Dr. Freedman? After all, it’s always hard for teenagers to adjust.”

Whle Rebbetzin Weingard was focused on why Shmuli hadn’t been successful in his social endeavors, I needed to gather some more information.

“Did he have relatively normal childhood development aside from this?” I asked. “For example, did he walk and talk normally?”

“Well, sure. Hmm… actually he didn’t start talking until he was around three and we did a bit of speech therapy until he was five,” Rebbetzin Weingard answered, providing additional information that would serve to confirm Shmuli’s diagnosis.

We went on to discuss Shmuli’s history throughout grade school but the more I heard, it seemed as though his issue with finding friends began long before the family made aliyah.

“He had friends, but looking back, maybe they were cousins or other people that might have felt forced to play with him,” Shmuli’s mother admitted, “and now his whole map shtick started and there isn’t anyone who wants to do that with him.”

After a few more questions, I wanted to meet Shmuli face to face. The young man who walked into the room went straight for the chair next to his mother. He smiled a bit nervously and with some prodding from his mother, introduced himself, looked off to the side, and continued tapping his hands on his lap.

Shmuli wasn’t particularly interested in making conversation, but as a formality, we went through a standardized checklist of symptoms and eventually Shmuli told me, “Listen Dr. Freedman, I know my mother thinks that I need friends but I’m really fine. I have a chavrusa and I’m not interested in talking too much beyond that.”

“Talking with me? Or talking to folks in general?” I asked.

“Both, I guess,” he replied as he looked away and resumed tapping his hands on his lap.

“Shmuli, I’m sorry to bug you about this, but the tapping thing you’re doing — does that do something for you?”

“What?”

“The tapping, Shmuli. Your hands are going like this all the time.” I mirrored his behavior.

Shmuli smiled again and turned away. “I guess so.”

Shmuli wasn’t depressed or anxious, and his difficulty making friends most likely had nothing to do with his having made aliyah. He was in a Yiddish-speaking school and had grown up in a very similar community, so the transition to Eretz Yisrael wasn’t as big as it might have been for some others.

Shmuli was having a hard time making friends because friends weren’t as exciting as his special interests in the maps he poured over and memorized every evening. Shmuli had had enough of the interview and asked to excuse himself, which was fine by me.

“Has anyone ever brought up the diagnosis of Asperger’s syndrome before?” I asked as Shmuli left the room.

“You think he has autism?” asked Rebbetzin Weingard nervously.

“It’s a clinical diagnosis, not something you can call definitively based on a single visit. But I’m just wondering if Asperger’s has been brought up before as a diagnosis for you son. He has a lot of the classic symptoms: difficulty with social relationships, his special interests in maps, and the hand tapping.”

“But he’s exactly like his father, who’s a big talmid chacham,” she responded.

“Tell me, what’s his father like beyond the seforim?” I asked.

Rebbetzin Weingard proceeded to describe a man who was lacking many social graces and had limited interest in interactions with others — including his own children — beyond the she’eilos that he expertly answered. “In many ways I guess they’re quite similar,” she conceded. “So does that mean my husband has Asperger’s Syndrome also?”

“Well, there is a genetic component,” I answered noncommittally, not wanting to overburden her with something that was anyway out of her control. “But we’re here to focus on Shmuli. The main thing is to get him the necessary skills to interact effectively with the other people in his life. I think it would be a good idea to get your son involved in a social skills training group and set him up with a therapist who specializes in Asperger’s syndrome.”

Rebbetzin Weingard looked nervous. “What will that do?”

“It will give him the skills he needs to get along with other people and to get along in the world.”

“Dr. Freedman, will he learn to function normally?”

“Of course he will! He might not become a lecturer for Hidabroot, but your husband has become a successful rav with a great wife, kids, and grandkids in spite of a similar set of challenges.”

Rebbetzin Weingard was still somewhat in shock, so I continued. “Rebbetzin, I want to tell you, there were at least ten kids in my med school class who would have been terrible psychiatrists because they couldn’t talk to another human being to save their lives. But they’re great radiologists and liver-transplant researchers today. And your husband is such a successful dayan that they flew him over to help run the show here in Eretz Yisrael.”

Rebetzin Weingard blushed as the fear began to melt away. “Okay, so where do we start?”

I went out to the waiting room and sat down next to Shmuli to tell him about my colleague, a psychologist who has great success with bochurim like him. I wrote down his name and phone number, and made sure to draw a map with directions.

*Names and identifying details have been changed to protect the privacy of patients, their families, and any other involved parties.

Originally featured in Mishpacha, Issue 737. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.