To the Highest Degree| March 14, 2023
Dr. Shmuel Mandelman devotes his prodigious mind and big heart to his nation’s well-being
Photos: Naftoli Goldgrab, Personal archives
AS soon as Rabbi Grober saw Shloimy walking toward him, his highly trained mechanech’s antenna buzzed into high gear.
“Rosh Yeshivah,” Shloimy sputtered. “Today Dovid finally showed up, he was gone for days, remember? He said he had pneumonia.”
The Rosh Yeshivah nodded, well aware that the “pneumonia” was a coverup for what Dovid’s most recent therapist said was clinical depression.
“Anyway,” Shloimy continued, “today he walked into the beis medrash on fire. He was there before I was, shuckeling like crazy in front of the shtender. I said shalom aleichem, welcome back, and asked how he felt, and he yelled at me that I should stop schmoozing and start learning.”
The Rosh Yeshivah had seen enough in his life to know that this was a red flag. But what was there left to do? Dovid had been to a number of therapists, been diagnosed with everything from depression to anxiety to ADHD, had imbibed numerous medications, and things seemed only to grow worse.
There was one person he hadn’t tried yet. He reached for his phone, found MANDELMAN - PSYCHOLOGIST and hit “call.”
Rabbi Grober was met with a flurry of pointed questions, all slowly enunciated, but with no time in between, as if they had been prepared beforehand. Within just hours, Dovid had an emergency diagnostic session scheduled. Finally, there was clarity: someone had managed to find the precise diagnosis that had eluded all the other practitioners.
As the weeks passed and Dovid began looking healthier than he had in years, Rabbi Grober marveled at the heaven-sent angel who had no time at all in his daily schedule, but still found all the time in the world to help a Jew in need.
He’s not the only one to marvel.
Rabbanim, roshei yeshivah, dayanim, Hatzolah responders, school principals, and just about every frum mental health professional — all have watched Dr. Shmuel Mandelman in action and benefited from his knowledge, talent, and devotion.
He is perhaps the single most influential mental health professional in the yeshivah world today, nurtured and handpicked for his role by a gadol with intimate knowledge of both communal and individual struggles. In an increasingly complex landscape, he is an undisputed address for clarity and guidance. And as daunting and draining as this work can be, he keeps at it — because taking responsibility is a mandate he received from his rebbi.
I don’t live in the tri-state area and every visit is a whirlwind of figure-outs. During my most recent visit, I had an interview in Brooklyn, and the following day, was scheduled to meet famed psychologist Dr. Shmuel Mandelman at his office in Brick, a township right near Lakewood. How to get from Brooklyn to Lakewood? The solution was perfect.
Dr. Mandelman actually lives in Brooklyn, but he commutes almost every day to Lakewood, leaving home at nine a.m. and returning many hours later, usually also in the a.m. So the plan was to meet up with Dr. Mandelman in Flatbush as he set out on his drive, and get in an extra hour-and-a-half of interview time.
But that wasn’t the only extra thing I’d get. At a quarter to nine, a text came in: “What do you want for breakfast?” Caught off guard and not sure what was expected, I tried a tentative “bagel?” The response was swift. “What do you want on it?”
“Anything but mayonnaise” I replied (my lifelong mantra, but I digress).
Pretty soon, a black Honda Pilot pulled up and I hopped inside, gave a brief shalom aleichem to my interviewee, and opened the bag waiting on the passenger seat. Two bagels with eggs, a muffin and orange juice. A point-blank demonstration of the magnanimity that characterizes Dr. Shmuel Mandelman.
Now, full disclosure. Dr. Mandelman’s appearance didn’t surprise me. I knew about the large yarmulke, bushy beard, enormous Brisker peyos — nothing about his visage spelled “double PhD.” And, as I’d later come to learn, those doctorates are only part of his academic pedigree.
I ran back inside to wash and as soon as I returned, Dr. Mandelman pulled away from the curb. I gave him a sidelong glance, trying to detect what I knew to be true, the story of a man who has seen it all, taking thousands of cases by the reins, guiding through knowledge and so much concern. The grim expression revealed little, but for a moment, I caught a glimpse of his eyes.
He may maneuver through Brooklyn’s morning gridlock with a practiced tough-guy persona, handle a schedule far past the limits of human endurance, take calls at all hours with utmost professionalism and zero drama — but the compassion glinting in his eyes tells the true story.
The unexpected should come to be expected when it comes to Dr. Mandelman, so let the jolt be minimal when you learn that the rough and tough Brooklynite grew up in…Milwaukee, Wisconsin. His eight years in the community elementary school formed an educational trajectory that he isn’t proud of. “I made lots of trouble and spent plenty of time in the principal’s office,” is his only comment.
But even if he didn’t realize it then, Shmuel’s elementary school experience would inform a lifetime’s dedication to the field of education and the philosophy thereof, particularly as it pertains to gifted children, a condition he clearly contended with.
After Shmuel finished his early years of schooling he headed east, to Yeshivah Ohr Hameir of Peekskill, New York. “Things worked until the end of tenth grade, but it was growing apparent that the yeshivah wasn’t doing it for me. I felt that I needed something else.” That “something else” ended up being seven different yeshivos over the course of the next seven years; wherever he went, the prodigiously brilliant Shmuel found himself consistently restless.
The years-long experience appears to weigh heavily on Dr. Mandelman, but the burden lifts as he describes its happy ending. “After taking seven farhers in seven days and getting seven rejections, it was suggested that I try out the Mirrer Yeshiva of Brooklyn,” he relays. “The rosh hayeshivah, Rav Shmuel Berenbaum, gave me the farher and I was accepted to attend his shiur, despite being young for it. But Rav Shmuel was finishing a sugya while Rosh Yeshivah Rav Elya Brudny was beginning a new one.”
So he took a “detour” to Rav Elya Brudny’s shiur — which was clearly providential. Dr. Mandelman smiles at the memory: “I hit it off with Rav Elya right away.”
At long last, the prolonged journey of dashed hopes, retraced steps, and ultimate dead ends had reached its destination.
For Shmuel, joining Rav Elya Brudny’s shiur truly meant a new sugya.
Shmuel Mandelman still refers to Rav Elya as “the Rebbe,” infusing the phrase with humility and admiration each time he repeats it. “I learned with Rav Elya for a few years,” Dr. Mandelman recalls, “and I had the opportunity to serve as his personal driver on many occasions. In the smallest encounters there was so much gadlus.”
The two spent hours together, working through the various sugyos learned in the yeshivah. Shmuel accumulated a wealth of Torah knowledge during this time but, even if his near-photographic memory would somehow go haywire, there is one lesson from Rav Elya that he would never forget. His fingers seem to grip the steering wheel just a little tighter as he shares it:
“The Rebbe always drove home that ‘der ikkur eichus fun a mensch iz achrayus fahr yenem — the primary value of a person is his sense of responsibility for another.’”
Dr. Mandelman explains that this is actually a paraphrase of a well-known idea that Rav Itzele Volozhiner writes in his introduction to the sefer Nefesh Hachaim in the name of his father, Rav Chaim Volozhiner: “For this is all of man; he was not created for himself, rather, [he was created] only to help others to the degree that his capabilities allow him.”
“Rav Elya would quote this line frequently. It was a concept that he would always try to hammer home.”
It was a lesson for all his talmidim — but he had singular expectations for this young prodigy.
“We are generally reluctant to release a student’s transcripts until they complete four years of beis medrash,” says Rav Elya Brudny. “But in Shmuel’s case, the hanhalah believed that there’s a talent there that can be used for Klal Yisrael and we felt that we shouldn’t hold him back from his training.”
This realization didn’t come as a sudden epiphany; it was a reality the hanhalah was long aware of. “Even as a very young person, Shmuel’s brilliance was manifest,” Rav Brudny continues. “He understood people very well. What we’re seeing today, after his training — that he’s so on target, and so understanding — the shorashim were all there. He just had to fill in some blanks.”
Young Shmuel’s cognitive capabilities weren’t the only qualities of note. “His ahavas chesed, his selflessness was also there as a young person,” Rav Brudny recalls. “Americans today are called the Me Generation. Shmuel’s life doesn’t revolve around his ‘me.’ It’s only about what he can do for other people.”
And it seems that all the divinely gifted blessings are put to good work. “His accomplishments are legendary,” Rav Brudny says. “For many, many mishpachos, things are working out because of his intervention.”
Rav Elya Brudny taught the lesson and Shmuel listened well. “Der ikkur eichus fun a mensch iz achrayus fahr yenem,” he would repeat. “The primary value of a person is his responsibility for another.’”
We’ve wrestled free from concrete-heavy Flatbush and glide onto a gleaming Verrazano Bridge, the passageway into a less polluted reality.
Dr. Mandelman’s cell phone lights up several times. He glances at the number. “This Yid is going through a very hard time with his child,” he sighs. “I see 600 scheduled patients a year, and I spend the rest of the time, often into the wee hours of the morning, on the phone dealing with cases such as these — often speaking to their rabbanim as well.”
At some point during the drive, there’s a crackling sound, and the calm-yet-charged voice of a dispatcher describes the nature and address of an emergency. My eyes travel to the two-way radio positioned to the left of the steering wheel.
“I run the Hatzolah Crisis Response Teams for both Lakewood and Brooklyn,” Dr. Mandelman explains. “This is in addition to the Lakewood Bikur Cholim’s mental health division, which is also under my auspices. It totals over 1,000 calls a year.”
The Hatzolah programs began a few years back, he explains. As the influx of psych-related calls began to rapidly increase, Hatzolah realized that they would need a special unit trained in, and dedicated to, crises that were psychiatric in nature. Dr. Shmuel Mandelman was tapped as the man for the job and, busy schedule notwithstanding, he took on the responsibility. This involved creating a specific protocol to deal with the most sensitive psychiatric cases and conducting training sessions to educate EMTs.
“Historically,” Dr. Mandelman explains, “EMT responders dreaded taking on psychiatric emergencies. These cases are painful and time-consuming and, given the lack of knowledge and understanding, members have struggled to gain a clear sense of direction.”
But the trend is shifting, says Dr. Mandelman. The protocols and training courses have helped those tasked with the responsibility to understand what is expected of them and what they can do to act as efficiently as possible. Today, Dr. Mandelman weighs in on every Hatzolah call where, based upon the information provided, he will decide the appropriate course of action.
“In Lakewood, beyond a specially trained men’s group, we have a specially trained group of female responders as well,” he tells me, explaining that this initiative was specifically requested by a group of Lakewood rabbanim who understood the sensitivity in responding to psychiatric crises specifically involving women. Dr. Mandelman has also given lectures to other Hatzolah chapters on how best to approach psychiatric emergencies.
Yoel Tesser, Captain of Hatzolah of Lakewood, provides more specific insight into Dr. Mandelman’s contributions. “Every call that is psychiatric in nature comes with a very weighty layer of complexity,” he explains. “Unnecessarily putting someone in a psychiatric ward can have terrible repercussions. On the other hand, should the patient need hospitalization, not sending them could be crippling. It’s a great achrayus, and we need someone highly trained to help guide us into making the right decision.”
Dr. Mandelman stepped up to be the man for the job, in many more ways than one. “We have two psych teams,” Yoel explains, “one for men, one for women. Each has 20 members. Dr. Mandelman gave extensive initial training and frequent follow-ups to our teams. But since every case is so specific, and so nuanced, there’s really no such thing as a cover-all training session.”
And so, to address the problem that his services are essentially needed on every single call, Dr. Mandelman came up with a solution. He would be there. On every single call.
“We’ll arrive at a given emergency,” Yoel describes, “and we’ll make a quick assessment of the situation. Dr. Mandelman has trained us as to what should be said to the subject of the emergency and which sensitivities should be taken into consideration. Once we have a general sense of where things are at, we’ll put the call through to Dr. Mandelman.”
And Dr. Mandelman will answer the phone, Yoel says, no matter what time.
“Like, you can call at two a.m. and he’ll answer, just like that?” I ask, trying to paint the picture.
Yoel laughs. “Two a.m.? He hasn’t even gone to bed yet!”
Either way, whatever time it is, for every call that comes in, a flurry of responsibilities comes along with it.
“To make a proper determination,” Yoel continues, “Dr. Mandelman needs to know everything about the case. He needs to know who the psychiatrist is, what sort of medication the patient is on, what the family dynamics are. Dr. Mandelman’s ability to help comes, not only from his vast knowledge of medicine and psychology, but also from his familiarity with his colleagues in the field. His relationships with practically every psychologist and psychiatrist are what allows him to get so much done in so little time.”
In addition to his work with Hatzolah, Dr. Mandelman has faculty appointments at both Jersey Shore University Medical Center and Monmouth Medical Center, so that working alongside Lev Rochel Bikur Cholim of Lakewood, he can help educate hospital liaisons on the specific needs of psychiatric patients.
And, just as a side bonus, Yoel adds a detail. “He gets paid for none of this. This is all chesed. He is a totally selfless person, plus his wife and kids get so much of the credit because they allow him to do all that he does for Klal Yisrael.”
Dr. Mandelman echoes that appreciation for his wife, Mrs. Chavie Mandelman. “Do you understand what kind of mesirus nefesh she has?” he asks rhetorically. “Throughout my years of schooling or training, she would never hold me back from doing whatever was needed. Today, I’m barely home — I can get back to Flatbush at two a.m. and then get a Hatzolah call. But she’s extremely supportive through it all.”
The years he’s referring to are not insignificant. They span 12 years and multiple states, but when the dust settled, Dr. Shmuel Mandelman had four master’s degrees and a double PhD. He holds a Master of Education in Administration and Supervision; Master of Arts in Cognitive Studies in Education; Master of Education in Educational Psychology: Cognitive, Behavioral, and Developmental Analysis; and a Master of Philosophy in Cognitive Studies in Education. Dr. Mandelman then earned a doctorate from Columbia University in Educational and Developmental Psychology as well as a specialty in Clinical Psychology/ Neuropsychology.
But even the head-spinning display of degrees doesn’t fully reveal the extent of his academic prowess. “After my second semester in Columbia I was invited to join a research lab at Yale,” he tells me, “where we studied various aspects of intelligence and authored many papers. After finishing my PhD at Columbia I was offered a faculty position at Yale. I turned it down.”
To accept a faculty position at Yale, he explains, would be a failure to fulfill Reb Elya’s vision. Value it has, but not enough of it. “The primary value of a person is his sense of responsibility for another.”
The research stint at Yale came with challenges. Dr. Mandelman tells of an instance where a paper he was tasked to write on the genetics of intelligence mandated inclusion of evolutionary biology. “I asked Rav Dovid Feinstein what to do,” he says. “Rav Dovid gave me very specific directions as to what can be said and what must be avoided. Using that guidance, I managed to write the paper without violating any of our sacred principles in emunah.” Using Rav Dovid’s outline, Dr. Mandelman even managed to teach an advanced doctoral seminar in developmental genetics, all within the guidelines of hashkafas haTorah.
Rav Dovid Feinstein was not a random choice for Dr. Mandelman. Prior to pursuing his doctoral degrees, Shmuel pursued a degree of a different sort: semichah from Rav Dovid through Mesivtha Tifereth Jerusalem’s semichah program. “Rav Elya encouraged me to do that as well,” he tells me. “He said he doesn’t want me to walk down to the chuppah without semichah.”
But in what seems to be a trend at this point, one semichah was not enough. Shmuel had long been intrigued by the great gaon and venerated posek, Rav Nota Greenblatt ztz”l. Although Rav Nota lived in Memphis, Tennessee, and was known not to grant semichah, Shmuel was not deterred. “I went to Memphis and a friend of mine introduced me to Rav Nota, who told me to visit him in his home study.”
Shmuel arrived at the Greenblatt home, waiting for Rav Nota to enter and present him with the conventional set of questions typically assigned to semichah students. That didn’t happen. “Rav Nota walked in, leaned far back in his chair, and asked me to say a shtickel Torah. I did, he loved it, and bounced back with a shtickel of his own.” This continued, with the tennis-like exchange lasting for a whopping eight hours, whereupon Reb Nota made a rare exception to his general practice and granted Shmuel semichah.
And so, along with four master’s degrees and a double doctorate, Rabbi Doctor Shmuel Mandelman earned semichah certificates from two of America’s leading poskim (along with two years of shimush under the renowned posek and talmid of Rav Moshe Feinstein, Rav Elimelech Bluth ztz”l).
In 2006, he married Chavie Goldenberg of Detroit, Michigan, and the couple settled in Chicago. By that time, Shmuel had already received his semichah and first master’s degree and he now wanted to pursue a doctorate. While in Chicago, he applied, and was accepted to Chicago’s prestigious Choshen Mishpat Kollel for the city’s rabbanim headed by Rabbi Zev Cohen.
After one year in Chicago, the Mandelmans moved to New York, settling in Flatbush, as Shmuel set out on his whirlwind of academic accomplishments. The last of his educational degrees received, Dr. Mandelman completed his clinical training at Weill Cornell Medical Center in the departments of neurosurgery and psychiatry.
Finally, equipped with the finest credentials and training, he began to work in private practice with Dr. Shloimie Zimmerman Psy.D., a well-known clinical psychologist and chairman of the Clinical Advisory Board for Amudim and Magen New York. After a few years working alongside Dr. Zimmerman, he realized there was a hole that needed to be filled.
“I saw that there was something critically lacking in the field. I wanted to establish a practice that would be guided entirely by diagnostically informed intervention.
“We have many wonderful therapists and clinicians,” he qualifies, “but without a methodology to ensure proper diagnoses, we are severely limited in the help we can offer.” Too often, clients were spending time, money, and effort on treatments that were not a perfect match for their true issue. Dr. Mandelman envisioned opening a practice that would focus on precisely pinpointed diagnoses.
With this in mind, Dr. Mandelman established The C.L.I.N.I.C., an acronym for “Clinical-psychology, Learning, Intelligence, Neuro-behavioral, Intervention Center.” The C.L.I.N.I.C. is modeled after the academic medical centers that Dr. Mandelman trained in: the Yale Child Study Center, as well as the Weill Cornell Psychiatry Specialty Center. It’s a multi-specialty practice that brings leaders in related fields together to be able to offer the highest level of diagnostically informed care, using an integrated and collaborative approach. The C.L.I.N.I.C. offers complex differential diagnosis, neuropsychological assessments, psychiatric care and pharmacological management, psychotherapy, speech-language pathology and academic coaching.
The diversity of services, high level of professionalism, and integrated collaboration allows for quality of care that is continual and fully informed. “The C.L.I.N.I.C. is blessed to have a team of the highest caliber clinicians,” Dr. Mandelman says proudly. “Their commitment to clinical excellence and to their patients is simply unmatched. We are constantly collaborating with each other and there is mutual respect among the team. Each clinician’s skill set complements the others, allowing for the best clinical outcomes.”
I’m marveling at the 12 years of academia, the thousands of phone calls, the endless hours of chesed as Dr. Mandelman turns off the highway and arrives in Brick. We turn into a parking lot hugging the periphery of a trademark Lakewood-style office building, with the blend of glass and siding assembling a mold of humble, gracious, and perfectly sub-corporate.
There are several businesses operating inside the building, but the C.L.I.N.I.C. seems to take up the bulk of the first floor. It is quaintly appointed and the atmosphere of genial friendliness is punctuated with the more solemn tone of sympathy and understanding. There’s a conference room with a Nespresso machine and when Dr. Mandelman offers me a coffee, of course I have to accept — how else to wash down two egg sandwiches?
Dr. Mandelman shows me around the clinic. The traffic coming in and out is constant, he tells me, with referrals coming from multiple sources. “My referrals come from all over,” he says. “Roshei yeshivah, rabbanim, mechanchim, former clients, fellow therapists. I also work very closely with Relief Resources, which is the leading mental health referral agency in the community.”
Dr. Mandelman is very much a team player, maintaining strong and professional relationships with his colleagues in the mental health field. This, in fact, is central to The C.L.I.N.I.C.’s modus operandi. “The name of the game is not to amass as wide a clientele as possible,” says Dr. Mandelman. “We’re here to get the best results for the client.”
Dr. Mandelman’s role in the process is to conduct a diagnostic consultation, but that service isn’t the first resort. “I will only accept a case if I feel that a specialized diagnosis will help the process,” he says. “For example, if I’m simply told that someone is struggling with depression, I won’t take the case. So long as they’ve identified the problem, they don’t need me to weigh in. But if I’m told that the patient’s therapy has been consistently ineffective, or that he had an adverse response to medication, then, at that point, we must consider that something more complex lurks beneath the surface. That’s when I’ll step in to offer a diagnostic consultation.”
I ask Dr. Mandelman about the patient population at The C.L.I.N.I.C. and he responds matter-of-factly. “I am trained across the life span. In a single day I can see a young patient struggling with reading comprehension, and an hour later, see an older adult who presents with concerns about memory. This will then follow with a floridly psychotic patient, and after that, a couple who are uncertain about the future of their marriage.”
Neither the range of cases, nor their complexity, serve as a deterrent to Dr. Mandelman and his fellow clinicians. “We embrace the diversity, and the more complex, the better.”
Colleagues in the field can corroborate that claim; when complexity hits its zenith, Dr. Mandelman is the one for the job. “I reach out to Dr. Mandelman when I get stuck,” says Duvie Kessner, director of operations at Relief Resources. “His is the number I call when I have a case in which a client has seen a slew of psychiatrists, is on numerous medications, and the problems keep compounding themselves. At that point, I will have given up on conventional wisdom. I know that I’m out of my league. So I call Dr. Mandelman, describe the scenario, and almost instantaneously, he comprehends it fully and gives specific direction on how to proceed.”
Unfortunately, these scenarios are not uncommon, which means that Kessner reaches out to Dr. Mandelman frequently. “24/7, he will answer me,” he says, adding that “he doesn’t get paid for any of my calls.”
It’s been a long morning, but Dr. Mandelman is brimming with energy. He has clients to see, team members to advise, people to help. He escorts me to the parking lot and bids me goodbye. A ray of sunlight bounces off a nearby window and I steal a glance at Dr. Mandelman, catching a final glimpse of his eyes. In them I see that telltale glint of compassion flashing brilliantly, even as the sun disappears behind a cluster of clouds.
He doesn’t have to repeat the words for me to hear them, because it’s eminently clear that this man lives by his rebbi’s mantra.“Der ikkur eichus fun a mensch iz achrayus fahr yenem — the primary value of a person is his sense of responsibility for another.”
The Way I See It
When I reached out to Dr. Mandelman to request an interview, it took him a few days to respond. When he did get back to me, he apologized, explaining that he first had to consult with his rebbi. When Rav Elya heard the question, he said, “If the interview will be l’toeles, how can you say no?” With that directive in mind, Dr. Mandelman shares what he sees as the primary issues requiring awareness within the frum community.
Beyond the Classroom
The Role of Schools
Dr. Mandelman has a strong background in education and spends much of his time dealing with school and school-related issues, and he is very optimistic about the state of frum education today. “Schools have made massive gains in understanding learning-related issues as well as mental health awareness,” he says emphatically. “This applies to all stages of the system — elementary schools, mesivtas, post mesivta, and Bais Yaakov. I am in constant touch with roshei yeshivah, menahelim, teachers, and rebbeim. They have become so much more aware of what to look out for, and we collaborate constantly.”
Some of the credit for this goes to Dr. Mandelman himself. Under the auspices of Torah Umesorah’s Mashgiach/Mechaneches program, he’s conducted many training programs in schools, educating teachers on the basics of depression and anxiety.
But it’s not just general mental health issues found within the school system. There are components of mental health that are specific to schooling and will only materialize in the classroom. Learning disabilities are within the diagnostic and statistical manual of the American Psychiatrist Association, and much of the work at Dr. Mandelman’s C.L.I.N.I.C. focuses on various impediments that can hamper a student’s educational progress.
When Torah Umesorah launched its Diverse Learners Initiative, Dr. Mandelman was appointed as the founding clinical director. Designed to help bridge the gap between challenged students and their peers, the Diverse Learners Initiative includes intensive training and coaching programs as well as on-site supervision. Dr. Mandelman will then hold follow-up sessions with the school principals and learning specialists trained through the program to discuss the various cases they encounter.
That said, Dr. Mandelman calls for caution before issuing a determination that a student suffers from learning disabilities. “There isn’t any one label called ‘learning disabilities,’” he explains. “You need to be careful and specific in your diagnosis.”
It happens too often that a child will come to Dr. Mandelman’s office having already been diagnosed with ADHD, amply medicated thereof. “Not every behavior challenge is ADHD and not every solution is a pill,” he comments with barely veiled annoyance. In fact, he says, ADHD is not the most prevalent learning disability; that distinction is in fact held by language-based disabilities.
In unraveling a child’s struggle with language, Dr. Mandelman explains, three components need to be examined: how I understand the world around me, how I interact with the world around me, how I understand myself and what I’m experiencing. These arenas impact academic, social, and emotional function.
Language-based disabilities, Dr. Mandelman points out, are particularly challenging in the frum community. “We live in a very text-based culture. Literacy is a subcategory of language. If a student in the frum system struggles with reading, that means he or she cannot have direct access to our educational experience. When placed in such a predicament, a student suffers tremendously.” For this reason, the speech and language clinicians working at Dr. Mandelman’s clinic focus on language-based interventions pertaining to literacy-related issues.
And these issues carry ramifications outside the school setting. “Learning disabilities can have huge mental health impacts that extend far beyond the classroom,” he says. “Both socially and psychologically, these students are suffering. And once a boy hits yeshivah age, where athletic ability is no longer a social currency, the pain is significantly exacerbated.”
The ripple effects of learning disabilities are dramatic. Many instances of students falling out of our system are a result of individual differences in learning, he feels.
Still, the role of schools, crucial as they are, will always, in some way, be a partnership with the student’s parents. Dr. Mandelman defines the baseline division of powers. “It is neither the role nor the responsibility of parents to treat their children’s psychological or educational issues,” he says. “But it is their responsibility to see to it that they get their children the help they need.”
Mom’s Love and Dad’s Acceptance
“As a general rule,” Dr. Mandelman says, “children don’t misbehave because they want to. There is always a reason behind their behavior and it’s our job to figure out what that is.”
But in his experience, the complex diagnostic process is the easier part of the job. The monkey wrenches come from a different direction. “Dealing with the parents is often the real challenge,” he states emphatically.
There are a few reasons for this. Firstly, Dr. Mandelman explains, parents will oftentimes fail to follow through. “As part of my diagnostic process, I will give the parents specific guidance — parenting classes to watch, books to read, pamphlets outlining my expectation, or the like. My outline for parental guidance is informed by the specific nature of a child’s underlying issue. A parent’s failure to follow these directions makes it nearly impossible to effectively move the child forward.”
Some parents harbor an unspoken fear of their children’s reaction to parental redirection. But he insists that volatility in a child’s response will more likely result from a sense of unsettlement caused by inconsistency rather than anger or resentment.
“Children crave consistency,” Dr. Mandelman explains. “When parents are inconsistent in their approach to a child’s behavior, it sets off an insecurity that agitates the child. I see parents who are afraid to discipline. They are afraid of their child’s reaction, or they’re afraid of alienating their child. My response is, so long as your discipline is appropriate, and perfectly consistent, you will ultimately see a positive result.”
Consistency creates structure, he explains, and when children operate within an orbit of structure, it makes them feel safe and secure. Dr. Mandelman has coined the slogan that children need their parents to be “present and consistent.” Present means that when they’re with their children, their minds are fully focused and fully engaged while connecting with the child. Consistent means that the pattern of their interactions, specifically disciplinary, falls along steady and persistent lines.
But above all else, says Dr. Mandelman, children crave connection. The most critical and valuable leverage a parent has with their child is their relationship, he claims. And he makes an astounding comment. “If all of psychology can be condensed into a single line, it would be that a person’s ultimate desire is mom’s love and dad’s acceptance. When a child feels loved and accepted, it is the greatest protection against any other risk factor.”
To Become Your Real Self
The Truth about Meds
Over the years, Dr. Mandelman has encountered some critical misunderstandings regarding psychotropic medications. Tragically, these misunderstandings cause significant, avoidable suffering.
“People are afraid to take medication,” Dr. Mandelman says. “They think that psychotropic medication is for crazy people and that by taking them it means that they, too, are crazy. Similarly, there tends to be a fear that medication can alter your personality.” This conviction has caused many to avoid direly needed medication — and it’s all based on a gross misconception.
“Psychotropics are just there to help you become your real self,” he explains. “People on medicine can be fully functional. There’s something going on organically that’s making it difficult for them to access their true selves. The medicine is there to help remove that obstacle.”
Not only is it normal to take medication, says Dr. Mandelman, it’s incredibly common. “Everyone seems to think that they’re the only ones being prescribed medicine for mental health conditions. The fact is, it’s all over the place. The fellow sitting next to you in shul could very well be on medication.”
Then there’s an almost converse misconception about medication: that’s it’s a fix-all, a magical pill that will make all your problems go away. This, too, simply isn’t the case.
“Medicine is there to make the healing process easier,” he clarifies. “Once the psychotropics address whatever organic issue is going on, they can make the process of talk therapy that more effective. It’s still a lot of work, but along with the medicine, talk therapy will allow the patient to navigate through whatever the struggle might be.”
Another common mistake: people think that finding the right medication and dosage is a one-and-done event, when in fact it’s an ongoing process that requires ongoing and proactive responsibility. Oftentimes, these medications need to be adjusted, managed, and monitored so that they can be maximally effective. Sometimes, based upon review of the medication’s effects, a prescriber will suggest a different medication entirely.
He further notes that one of the most common causes for psychiatric emergencies is when a patient discontinues medication without appropriate medical guidance. This can result in intense instability and can necessitate immediate intervention.
Marriage Is Not a Hospital
The Quest for Shalom Bayis
Another one of Dr. Mandelman’s many community functions is to work alongside the dayanim of the Lakewood’s Bais HaVaad Bais Din. “Before a beis din can let a couple get divorced in good conscience,” Dr. Mandelman explains, “they will usually seek a professional evaluation to determine whether marital resolution is a realistic possibility.
“Shalom bayis issues are much more complicated than two people who simply can’t get along,” Dr. Mandelman asserts. “They are very often linked to mental health issues. Our job in beis din is not to provide counseling. We are simply there to determine whether or not these problems can be addressed and if the marriage has viability.”
If ever I note the burden that weighs on Dr. Mandelman’s shoulders, it’s now. “The number of young divorces involving couples married for two years or less is heartbreaking,” he says. “The causes can vary, but typically there are previously undisclosed or unresolved issues that only begin coming to the fore after the chasunah.
“The maxim ‘marriage is not a hospital’ could not be truer,” says Dr. Mandelman. “The claim that ‘they will get married and all will be fine’ has been proven time and time again to be abjectly false. Not just false but damaging. People have gone ahead and gotten married based on the belief that their issues will straighten themselves out. The marriages end, leaving a trail of tremendous pain, damage, and suffering, in their wake.”
In a sense, the term “shalom bayis issues” is a misnomer. “Shalom bayis issues are really pathology in a marital dynamic,” he says. “That’s how mental health-based it is.” The causes can be a wide array of issues, including untreated psychiatric issues, addictions, trauma, and personality disorders, among many others.
A particularly tragic phenomenon that Dr. Mandelman deals with within the milieu of marital struggles is when one spouse begins to deviate from his or her religious status. “I’ve seen cases where a very typical yeshivah guy or Bais Yaakov graduate will suddenly stop keeping Shabbos,” he says, and explains that in his experience, these transitions are rarely, if ever, purely religious in nature. “When someone chooses to abandon their sociological group, something is going on.”
That “something” can be an old, unspoken trauma or something less dramatic but very painful, such as not feeling a sense of belonging, or a general sensation of disengagement. Human longing is a powerful force and people will take radical actions to achieve what they think they are looking for.
But the problems spurring the young divorce crisis aren’t exclusively psychopathological. “Another thing that we are seeing is grossly underdeveloped people getting married,” Dr. Mandelman says. “Both the yeshivah system and the Bais Yaakov system can work as a well-oiled machine. Assuming you fit the mold, you can enter in ninth grade and emerge after twelfth grade as a complete, and neatly designed, product.”
But this, Dr. Mandelman points out, is a lot less healthy than it looks.
“People have to grow as individuals in order to build healthy marriages,” he says. “Their development must be tailored to their own profile. So long as their ‘growth’ is limited to coasting through the system, they essentially remain at a ninth grade level of maturity for the rest of their lives.”
Two ninth graders would stand a hard time maintaining a healthy marital relationship and this, says Dr. Mandelman, is essentially what’s happening beneath the surface of the many shalom bayis issues that he sees.
To this problem, a solution is theoretically achievable. “Within the chinuch system, there has to be more emphasis on personal growth. As much as a system mandates widespread application, there still must be room, within that structure, to encourage a more focused and individualized process of maturation.”
A Tragic Need
Sitting on a desk in Dr. Mandelman’s office is a colorful brochure with the words “Lifespan Institute” blazed across its cover.
“This is for the trauma center that will soon be opening. I have assumed an advisory role,” he says in the same tone of voice as “here’s your coffee.”
And he explains: “Trauma is a very real, and very relevant problem. It’s a term that is tragically misused. Today, if someone stubs their toe they say they’re ‘traumatized.’ But it’s not a joke. Trauma actually means something and that thing is terribly painful.”
So, what is trauma? Its general definition, in Dr. Mandelman’s words is “when someone goes through an experience, series of experiences, or life circumstance that has an adverse impact on their ability to function emotionally.”
It’s a broad definition and can be applied in numerous directions. Trauma also operates on a wide spectrum of severity. The most obvious traumas involve abuse or neglect. But there are less well-known traumas such as relational trauma (triggered by a child’s sense of insecurity, or lack of parental affection) and developmental trauma (simply defined as a trauma resulting from a dramatic disruption within the framework of a child’s close relationships).
And trauma is also a problem that is overtaxing our community’s resources. “Trauma is an area where I believe our clinical infrastructure is lacking,” Dr. Mandelman says. “We, as a community, lack the number of appropriately trained trauma therapists to meet the tragically voluminous need.”
Failure to have properly trained trauma therapists, says Dr. Mandelman, isn’t just a matter of not being able to provide needed services. It results in providing inappropriate care, which can cause an enormous amount of damage.
“I have seen too much,” he says wearily, “too much pain. Too much damage that has happened due to our lack of training in this area. I simply can’t sit back and let it continue. We need to address the need.”
The training programs that Dr. Mandelman is helping to launch will call upon leaders in the field of trauma to train and supervise clinicians and will work to ensure that an adequate number of clinicians are trained appropriately to deal with the severity, and the number, of cases plaguing the larger community.
An Anxious Nation
When asked to name the most common mental health issue, Dr. Mandelman is quick with the response. “Anxiety is huge,” he says, but it takes knowledge and experience to understand the severity of anxiety’s nature. People who are suffering from anxiety are living with intense levels of discomfort that are impacting their ability to function properly, he explains.
And anxiety doesn’t exist in a vacuum. “Anxiety is a first cousin of depression,” he explains. “So ultimately, it’s anxiety and depression that is coming to us in huge volumes.”
Like many psychological terms borrowed by common parlance, anxiety doesn’t mean what many consider it to mean. It isn’t a passing emotion that crops up before an exam or a shidduch date.
“Anxiety,” he explains, “is defined as internal levels of discomfort that impact a person’s ability to function. It can take many forms and can be entirely debilitating. Adults, as well as children, can suffer terribly from high levels of anxiety.”
Dr. Mandelman is unconvinced of the argument that Covid alone is responsible for the uptick in anxiety cases. “Anxiety existed long before Covid did,” he says, “and it will continue to exist long after its departure.” If there’s been an influx of anxiety cases over the past few years, Dr. Mandelman believes this is more as a result of heightened awareness than a spike in the actual disorder. “I believe this is the case for many mental health issues. As awareness grows, more people begin seeking appropriate help.”
The good news is that the interventions available for anxiety disorders have been proven to be highly effective. The precise form of intervention will depend on the variety and stage of anxiety. “Cognitive Behavioral Therapy is one method of treatment used to help patients struggling from garden variety anxiety.”
But anxiety comes with many subcategories, one common one being obsessive compulsive disorder, better known by its acronym, OCD. OCD is a very painful disorder, which although exists throughout the general society, can be compounded by an emphasis on halachic precision. While dikduk b’halachah is a most commendable practice, OCD (called scrupulosity when referring to religious practice) is pathological in nature and has no spiritual value at all.
“For OCD,” Dr. Mandelman says, “we will typically use a methodology called Exposure with Response Prevention (ERP). We have seen ERP work wonders, helping OCD sufferers move past their total internal preoccupation. But there are times that these methodologies aren’t sufficient and pharmacological support is necessary.”
The Challenge of the Gifted Child
Dr. Mandelman carries a special place in his heart for giftedness, and in his many speaking engagements, he tends to give it significant attention.
“When we speak of children who struggle in the classroom, the term ‘Individual differences’ is not a reference directed only toward those who struggle to comprehend,” he says. “It includes intellectually gifted children as well.”
Dr. Mandelman explains that gifted children are a highly misunderstood contingency within the educational system. Where the axiomatic perception is that their academic capabilities grant them a free ride through school, Dr. Mandelman insists that this is very far from the truth. “Despite their intellectual capabilities,” he says, “these students have specific educational and emotional needs. It is not just about them being assigned more work or skipping grades. It’s about allowing their unique capacities to be developed.”
Exceptional levels of intellect, Dr. Mandelman says, add a layer of social complexity which can make it challenging for the child to succeed in the classroom. “Being markedly brighter than one’s peers can leave students feeling isolated and disengaged,” he explains. “It creates a misalignment between what the educational environment has to offer and what they, as individuals, need.”
(Originally featured in Mishpacha, Issue 953)
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