Jews and Psychiatry?

The fifth edition of the American Psychiatric Association’s “bible of psychiatry,” the Diagnostic and Statistical Manual of Mental Disorders, is coming out on May 18. The first edition in 19 years, the DSM-5, as it is known, has already gotten its share of attention and criticism.

The satirical Diagnostic Manual of Mishegas–created by the fictitious Dr. Sol Farblondget–sends up the DSM with its listing of Jewish disorders.

CATEGORIES OF MISHEGAS

1.0  NERVOUS CONDITIONS OF EVERYDAY LIFE

Nervous conditions are part of the human condition, and thus are as different in their variations as human beings are different from one another. Still, it is helpful to understand what form of nervousness you are experiencing, or what type of tsuris-addict is torturing you with tales of woe, and to thereby figure out how to tell the feeling, or the person, to gei avek (get lost!), gei shluffen (go to sleep), or—our number one suggestion, especially when the meter is running out on your patience for listening to yet another mournful Oy Vey-drenched soliloquy—to tell the tsuris-addict to fardrai zich deyn kopf (literally: ‘Go turn your own head around’—i.e., to leave me alone and make yourself nuts!)  Also: a good hot pastrami sandwich, don’t skimp on the mustard, with a nice, fat sour pickle on the side, can’t hurt.

Here follow a list of common nervous conditions that, though different in kind, one from the other, have many qualities in common and, depending on a particular day’s Dow Jones Industrial Average or the state of your kishkas (intestines), can sometimes be used interchangeably.

1.01 Tsuris Reactions and Sequelae

Although Jews like to claim a monopoly on tsuris, the truth is that this condition (troubles, aggravation, worries, suffering) befalls everyone, and most of what passes for mishegas is a natural reaction to life’s vagaries and pitfalls. Thus, when a 54-year-old woman becomes depressed because her accountant husband, also 54, has taken up with an 18-year-old hotsie-totsie, she is not mishugah and in need of psychotropic medications. What she needs, we believe, is to shack up with an 18-year-old lifeguard or tennis pro, and to leave her husband a note, informing him that as an accountant he should realize that 18 can go into 54 many more times than 54 can go into 18.

The point is not to moan, groan and carry on about the tsuris that has befallen you, but to do something about it. Remember: when the Children of Israel fled from Egypt and came to the Red Sea with the Egyptians in hot pursuit, and they complained to God that he had delivered them from slavery into something worse than slavery, and Moses, who did not even ask for a retainer, went to God on their behalf and transmitted his tribe’s complaints, God laughed. “Wherefore criest thou unto me?” God said. “Go forth!” And it was only when the Children of Israel stopped kvetching, and plunged forward into the Red Sea, that the waters parted.

1.02  Tsuris-addiction

Tsuris addiction is a wide-spread condition which, by cutting people off from their innate capacity for pleasure and encouraging kvetching (complaining), enables them to spread gevalt-laden gloom and doom everywhere. In an iconic example, four elderly Jewish women are wading ankle-deep in the waters at Brighton Beach. “Oy,” says Ethel. “Oy vey,” says Molly. “Oy vey iz mir,” says Lillie. “Please, ladies,” says Annie. “We promised not to talk about our children.”

People who have life-long love affairs with, and attachments to, misery, wind up living in what we think of as The Village of Oy Vey Iz Mir at whose center is the Shtiebel of Gornish Helfin. Tsuris addicts spend their lives holding on to every morsel of real or imagined bad news they ever had—kvetching, for example, about how unfair it is that they had to grow up near people with bigger houses, better time-shares, more cashmere sweaters and fancier cabanas than theirs. In Oy Vey Iz Mir, any and every event is cause for weeping and wailing. 

That tsuris addiction is a regrettable and an oft-considered natural part of life is not even mentioned in the D.S.M. (Nor is tsuris attachment, which is pretty much the same thing, except that you can send it to someone in an e-mail.) While some studies show that tsuris addicts may take what they consider genuine (if perverse) pleasure from being miserable, the price of their pleasure is often to plunge many of us into a desire to rip out their vocal cords.

1.02A: The Wisdom of Gornish Helfin

Although the D.S.M. makes a big deal out of attachment theory, we are advocates of de-tachment theory, since experience convinces us that what proves most helpful both to those addicted to tsuris, and those who must suffer from relationships with tsuris addicts, is the concept of Gornish Helfin (meaning, literally, “Nothing will help”), which can be explained by the following archetypal example.

When the great Yiddish actor Mendel Kupietzky fell down in the middle of a Yiddish-language performance of King Lear, and a doctor rushed to the stage and began examining him, a man in the balcony started yelling, “Give him an enema. . . . ! Give him an enema. . . . !” And when, a moment later, the doctor threw out his hands in a gesture of helplessness, and announced that Mendel Kupietzky was dead—still the man from the balcony kept yelling “Give him an enema . . . ! Give him an enema. . . . !” and would not stop despite pleas from other actors and members of the audience. Only when the theater manager appeared alongside the doctor and looked up at the man in the balcony and said, “He’s dead, sir.  An enema can’t help.  Gornish Helfin . . . Gornish Helfin . . .

—only then did the man in the balcony change his tune. “Give him an enema!” he cried one last time. “It can’t hurt . . . .  ”

Once we understand that no matter what we do to and for some people, they will not change—that Gornish Helfin, and therefore the best thing is to leave them be—we free ourselves from the quintessential American illusion, pragmatic to its core, that there is no problem for which there is not a happy solution. What we believe is that for many situations and conditions, including most forms of mishegastsuris addiction at the top of the list—there is nothing to be done. Thus, any engagement with the tsuris addict—especially telling the addict that kvetching about tsuris is not such a hot idea—merely brings on ever-rising levels of tsuris-addiction.

For tsuris addicts, insatiability is the name of the game. Nothing will ever please them, and it is a waste of time—truly mishugah!—to point out that they have no real reasons for being miserable, or to urge them to find ways to be happy.

Therefore, when engaged in relationships with tsuris-addicts, and you sense an impulse to enter into dialogue with them, the suggestion here is to cock your head to the side, furrow your brow in feigned sympathy, and stare through or past the addict while silently repeating, “Gornish helfin . . . Gornish helfin . . . Gornish helfin . . . ”  This way, if by some miracle these people ever do change, you have not destroyed whatever good will may exist between you, and they remain ready to embrace you.

3 thoughts on “Jews and Psychiatry?

  1. Ronald Pies MD says:

    Mazel tov to my colleagues on this wise book of woe!

    But tell me…do you cover the concept of “tsuchepenish”? I have had trouble unearthing the exact meaning of this, but I recall that it may refer to an annoying and persistent thought, akin to what psychiatrists would call an “obsession….” or a kind of mental “tic”. Perhaps reader with stronger Yiddish may want to comment?

    Best regards,
    Ron Pies MD [Psychiatry]

    1. Susan Tanur Ellman says:

      You have great recall. According to the 2001 edition The New Joys of Yiddish (p. 409, paperback) it is a “blend of Russian, tchupat, “to touch,” and German, zu, “to.”
      1. Something irritating, undesirable, that “attaches itself”; an obsession. “He has a tsutshepenish that is driving everyone else crazy.”
      2. Someone who becomes a persistent, unshakable nuisance. “She turned into a tsutshepenish I never expected.”
      See also nokhshleper.

  2. Ronald Pies says:

    Many thanks for confirming my hunch, Susan….I was beginning to develop a little
    tsutshepenish over this! —Regards, Ron

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