The Jerusalem Post has an interesting article on illness and mourning in Israel. While in the US (and in most other western countries) rabbis visit sick and console mourners, in Israel this really is not true.
In America, when rabbis are chaplains of hospitals or long term care centers, their primary duties are related to pastoral counseling.
In Israel, rabbis assigned to hospitals and nursing homes spend their time in the kitchen, doing kosher supervision. Israel completely lacks the concept of pastoral counseling.
I think the reasons for this are as follows:
- Despite hasidic tales and ArtScroll to the contrary, historically rabbis did not personally visit every the sick and counsel the troubled. For most of history, rabbis functioned as minor kings. They ruled on matter so Jewish law and taught advanced students. The daily life of the people was not their primary concern
- Hessed was generally left to women and to committees of lay people. (This same pattern can be seen in today's American hasidic and haredi communities.)
- Outside of YU and Chovvei Torah, few yeshivot teach pastoral counseling.
- Historically, American yeshivot like YU that do teach pastoral counseling do so because the congregations that hired their graduates demanded a proficiency in counseling, and rabbis dropped into a congregation without that proficiency suffered until they got themselves up to speed.
- The economics are different in Israel. In America, the consumers – Jews – demanded and for the most part got rabbis trained in counseling. In Israel, the consumer is in effect the state, not the front line consumer. The state pays the salaries of hospital rabbis and its state-funded rabbinic apparatus chooses who those hospital rabbis will be. The state-funded rabbinic apparatus does not see pastoral counseling as a rabbi's job, because for most of Jewish history, it was not. (See #1 above.)
- So, in effect, Israel is stuck in the 19th century.
Admirably, the UJA-New York Federation has stepped in to fund pastoral counseling training. Still, most Israeli rabbis from all groups still seem to be ignoring the issue, as the Jerusalem Post reports:
Most rabbis in Israeli hospitals and nursing homes focus on kashrut and Shabbat clocks, while rabbinical students generally spend the majority of their time poring over the Talmud. But patients suffering from pain and fear due to serious or terminal illness - as well as struck by the deaths of loved ones - don't have many professionals to turn to.
The use of chaplains, social workers, nurses and others to provide spiritual support - not necessarily based on religion - has become widespread in the US, and its glaring absence in Israel has induced American Jewish organizations and local volunteers to promote it here. Tishkofet, a voluntary organization that trains nurses, social workers, psychologists, rabbis, chaplains and others to provide spiritual support, recently held its fourth annual conference for professionals who want to learn more about the field. Two foreign organizations - the United Jewish Appeal-Federation of New York and the US National Association of Jewish Chaplains (NAJC, which has a branch here) - as well as Joint-ESHEL financed the latest conference at Kibbutz Ma'aleh Hahamisha outside Jerusalem; they also help finance Tishkofet.
RABBI MEIR NEHORAI, the rabbi of Kibbutz Masuot Yitzhak in Gush Etzion, graduate of the Netiv Meir and Mercaz Harav yeshivas and an activist in the Tzohar organization of moderate Orthodox rabbis, said in a lecture that "in yeshiva, we didn't learn much about giving spiritual support. This field is important to me. As a community rabbi, I go to mourners' homes frequently, and it's difficult to know what to say and how to support them, especially if their loved one died prematurely."
One of his pupils was a teenager who died in a road accident. "One has to know what to say to the family. Communities don't want their rabbi to talk politics but offer spiritual help. And I meet mine throughout the kibbutz, not only in the synagogue. There is a real need to cry," said Nehorai, "so when I see mourners, I tell them that crying during the shiva mourning period is the healthiest thing to do. There are parents who bury their children, and this is much more complex than burying one's parents." Training he received from Tishkofet (www.tishkofet.co.il in Hebrew and www.lifesdoor.org in English) provided Nehorai with tools along with the traditional Jewish sources.…
His kibbutz also has a nursing home where the founders of the kibbutz - including his own Holocaust-survivor mother - live, and many suffer from dementia or other serious problems and need complex nursing. "I didn't know how to talk to demented patients," Nehorai admitted. He turned to Tishkofet, which teaches how to use texts, music, photographs, conversation, aromatherapy, even gardening or animals to help people discover within themselves what makes them feel purposeful and meaningful.
TISHKOFET DIRECTOR-general Dvora Corn, a family therapist with a master's degree in clinical sociology and family therapy and founder of one of America's leading rehabilitation therapy and consulting organizations, came on aliya with her husband Prof. Ben Corn, who had served as vice chairman of one of the largest and most profitable oncology departments in the US. Prof. Corn is today head of radiation oncology at Tel Aviv Sourasky Medical Center, and daily sees patients with terminal illness. Both modern Orthodox, they live in Jerusalem with their four daughters.
The couple founded Tishkofet because they noticed the lack of such an organization. "Most Israeli rabbis and professionals in the healthcare professions receive little or no training in helping people satisfy their emotional and spiritual needs during crises," said Dvora during the conference. "I receive a few calls a month from rabbis who want to learn what to say to congregants who lost loved ones in tragic circumstances, or when an end-of-life decision must be made. Our programs are based on the understanding that, when provided with the proper blend of support, nurturing and education, the lessons of life perceived and understood by those facing life-threatening disease can be transferred to others. Such sharing can only occur when an open and honest environment is cultivated."
Participants in the Tishkofet conference were a motley group, mostly women. There were a couple of haredi rabbis and non-Orthodox male rabbis, secular women, modern Orthodox social workers and nurses - and even a secular non-Orthodox woman from New York, wearing a skullcap, who is a chaplain in a nursing home populated mostly by Hispanics and blacks.…
There are no job openings in institutions for "spiritual support providers" or chaplains, she said, but psychologists, social workers, doctors and others who already work there often want to get training to expand their tools in working with patients, said Dvora.…
The Health Ministry is "interested," Dvora said, "but in a system in which there isn't enough money for nurses and social workers, one can't say that chaplains are a recognized profession."…
The real reason there is no money for pastoral counseling I think is clear. 99.9% of Israeli Orthodox rabbis are not qualified to be pastoral counselors.
That means 99.9% of Shas, UTJ and Mafdal party apparatchiks cannot hold those jobs, and any moneys allocated to provide counseling – which would in all likelihood come from the budget for religious affairs – will have to go to others.
And rabbis – no matter their party affiliation – will never stand for that.