| Off the Couch |

Time to Rend, Time to Mend

“How they let the ultra-Orthodox into Harvard is beyond me,” she sneered


Ms. Krishnamurthy was a Hindu woman whose family had fled their native Pakistan and moved to Britain during her childhood. She was a testy character, currently in Israel working for the UN investigating Israeli war crimes, and had been quite nasty in my office when she came in demanding a prescription for her ADHD meds the previous month. Part II


I wasn’t surprised to see Ms. Krishnamurthy back in my office. Plenty of people storm out of mental health treatment and come back at some point in the future, prepared to hear the painful truth, ready to accept treatment, willing to do the work. Their defenses down, they’re calm — even relieved — and open to working with their therapist. As a team, we often see great success. In fact, these are often the best patients to work with, as there is much room for optimism. A patient who’s had time to think about often-elusive personal goals and is willing to come back demonstrates the necessary motivation to succeed.

So I was feeling pretty positive when I saw Ms. Krishnamurthy on my schedule for the day. But that didn’t last for more than ten seconds once she entered the waiting area, sporting her trademark irritable scowl and a fury that left me wondering why she’d bothered to follow up.

Ms. Krishnamurthy had made it clear from the outset that she despised frum Yidden and the idea that they were actually living in Eretz Yisrael — both of which made it all the more peculiar to find her yelling once again into her smartphone in my waiting room. There were plenty of secular psychiatrists to choose from and even a few non-Jewish psychiatrists she could have worked with. And yet here she was a few feet away, screaming at some poor UN intern for “failing to submit the T.P.S. reports.” Whatever that meant.

“I’ll be with you in a minute,” she snapped as I came out to call her. My secretary’s eyes were nearly popping out of her sockets.  This woman was an angry young millennial dressed in business suit and screeching over what was probably nothing of earthshaking importance. “I just need to finish this discussion before I get my prescription from you and leave already, no thank you for wasting my time.”

When she finally entered the room 15 minutes late for her appointment (again), she didn’t even have the decency to greet me and promptly demanded a refill of her stimulant medication for ADHD.

“Does it hurt to ask nicely?” I smiled honestly.

“Does it hurt to be part of a patriarchal, misogynistic disaster of a culture that oppresses women at their every turn?”

“Ms. Krishnamurthy, I think you’re mistaking me for a Hamasnik somewhere deep in Gaza. Jewish women are deeply respected, and our community’s traditions are followed by willing participants. We don’t do burkas at gunpoint.”

“Well, of course you’re better than those maniacs,” she grumbled. “But you do have your women as second-class citizens. That’s why you talk down to me.”

I didn’t know where that came from — I’d barely said two words to her now, and it was about the same last time she was here. Her anger issues seemed to be fueled by no small amount of inferiority and low self-worth, coupled with her ADHD.

“I don’t talk down to you,” I said with the upmost sincerity, although I wondered if anything even registered from my little speech. “But if I did, it would be because you’re not a particularly pleasant person who lacks the fundamental respect for others and not because you’re a woman. And just as I’m not from a culture that coerces women into servitude, I’m also not from one that objectifies them like the rest of western society. We even sing a song to our wives each Sabbath night to let them know how much we appreciate them.”

“That sounds dumb,” she scowled, but I could see there was some crack, a flicker of something — was it a flash of pain? Longing?

“It actually sounds pretty nice when fathers harmonize with their sons and sing for their wives and mothers.”

“Okay, so then the reason you’re talking down to me is because I’m a gentile,” she rebutted me nastily.

“Ms. Krishnamurthy, I’m not sure there is anything suggesting that I’m talking down to you,” I said. “I trained at an American medical school and hold myself to the same professional codes that—”

“How they let the ultra-Orthodox into Harvard is beyond me,” she sneered as she looked at the diplomas and haskamos hanging on the wall.

I found myself flashing back to the disrespect I got over the years from a few hotheaded colleagues for “taking off every Friday night and never working on Saturday” even when it meant walking home at night from the hospital in the cold rain and snow. I found myself recalling the time when my direct superior told me in front of a group of peers, “You know, you look just like that hassidic reggae guy Matisyahu because you both have beards and yarmulkes,” and had no idea how offensive her statement was. I remember a really mean battle-axe “Nurse Ratched” who threatened to “rip the beanie off my head” in a parking lot one evening.

I was quiet for a long minute. “You know, that’s called racism in these parts, Ms. Krishnamurthy,” I gently told this social justice warrior who’d fled her childhood home from Muslim extremists only to work on their political behalf. A woman who claimed to be a defender of human rights and was now an investigator for the United Nations, an organization that empowered the same extremists that caused her own family to flee. It was almost like witnessing a case of Stockholm Syndrome.

“I’m sorry,” she said quietly once and then again. “I'm sorry. I have no reason to be so nasty to you, you haven’t done anything nasty to me.”

“Apology accepted on the condition that you hear me out for a moment?” I offered. “Ms. Krishnamurthy, believe me, I’m not trying to drum up extra business here, or, as you told me last time, ‘It’s how you cheat your way to a paycheck.’ But from our two brief meetings so far, I’m sensing an undercurrent of pain, maybe insecurity, and unmanaged anger issues that might be related to your ADHD. Aside from the medication, which you seem to be doing well with, would you consider addressing some of those issues? There are a lot of professionals out there — many of them more like you — who could help you to be your best self.”

She was quiet for a minute. “You know, I’ve been seeing this doctor in England for years, and he never even broached the subject — he just kept filling my prescription. Thanks, Dr. Freedman. For now, just give me the pills — and I’ll see you next month?”


Identifying details have been changed to protect the privacy of patients, their families, and all other parties.



Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman, whose new book Off the Couch has just been released in collaboration with Menucha Publishers, can be found learning Torah in the Old City or hiking the hills around Jerusalem. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.

(Originally featured in Mishpacha, Issue 878)

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