Call Me Mara
“When my wife was diagnosed with breast cancer, we ate well. Mary Beth and I had both read the terrifying pathology report of a tumor the size of an olive. The surgical digging for lymph nodes was followed by months of radiation. We ate very well…. Our family feasted for months on the lovingly prepared dishes brought by friends from work and church and the neighborhood: chicken breasts encrusted with parmesan, covered safely in tin foil; pots of thick soup with hearty bread; bubbling pans of lasagna and macaroni and cheese. There were warm home-baked rolls in tea towel-covered baskets, ham with dark baked pineapple rings, scalloped potatoes, and warm pies overflowing with the syrups of cherries or apples…. Although few said the word breast unless it belonged to a chicken, many friends were familiar with the word cancer and said it often, without flinching. They asked how we were doing, sent notes and cards, passed along things they’d read about treatments and medications, emailed links to good recovery websites and the titles of helpful books, called frequently, placed gentle if tentative hands on shoulders, spoke in low and warm tones, wondered if we had enough food. The phrase we heard most was: “If there’s anything I can do ... ”…
Almost a decade later, our daughter, Maggie, was admitted to a psychiatric hospital and diagnosed with bipolar disorder, following years of secret alcohol and drug abuse. No warm casseroles. At 19, she was arrested for drug possession, faced a judge, and was placed on a probation program…. No scalloped potatoes in tinfoil pans. Maggie was disciplined by her college for breaking the drug and alcohol rules. She began an outpatient recovery program. She took a medical leave from school. She was admitted to a psychiatric hospital, diagnosed, released. She began years of counseling, recovery meetings, and intensive outpatient rehabilitation. She lived in a recovery house, relapsed, then spent seven weeks in a drug and alcohol addiction treatment center. No soup, no homemade loaves of bread… Friends talk about cancer and other physical maladies more easily than about psychological afflictions. Breasts might draw blushes, but brains are unmentionable. These questions are rarely heard: “How’s your depression these days?” “What improvements do you notice now that you have treatment for your ADD?” “Do you find your manic episodes are less intense now that you are on medication?” “What does depression feel like?” “Is the counseling helpful?” A much smaller circle of friends than those who’d fed us during cancer now asked guarded questions. No one ever showed up at our door with a meal.”
The title of this essay by Larry Lake is “No One Brings Dinner When Your Daughter Is an Addict.” In it, he vividly captures the stark contrast between the way people react to physical illness and the way they react to mental illness. The author and his family clearly belong to a loving, caring community, and yet, when facing the pain of their daughter Maggie’s bipolar disorder and addiction, they are left alone, feeling invisible or, worse, shunned. The family’s suffering because of Maggie’s illness is compounded by the stigma of mental illness.
This stigma is nothing new. In ancient cultures, people often attributed symptoms of mental illness to evil spirits. And from ancient times until today, people with mental disorders have been seen as weak-willed, untrustworthy or otherwise morally deficient, and dangerous. Recent studies have shown that these beliefs are widespread and persist even in people who are knowledgeable about mental health issues and in those who have a mental illness themselves. Here are just a few statistics from a study published in the Journal of Health and Social Behavior, to put this in perspective: 33% of Americans say they would probably or definitely not want to make friends with someone who has a mental illness; 58% would not want to work closely with such a person; and 68% would not want someone with a mental illness marrying into his or her family. The most disheartening statistic from this study in my opinion, though, is that 56% of respondents would not want to spend an evening socializing with someone with a mental illness. Over half of those surveyed would not want to spend even a single evening with a person who has a mental illness. Imagine what it feels like to be a person with a mental illness hearing these statistics.
Many of us don’t have to imagine because we are that person. 20% of adults in the US have a mental illness. 4% suffer from a serious mental illness like schizophrenia or bipolar disorder, and 10% suffer from addiction. Chances are, even if you were among those who said they were unwilling to socialize or work with someone with a mental illness, you already are! But because of the stigma associated with mental disorders, we don’t identify ourselves. It’s no surprise that this stigma causes greater isolation and a lower quality of life for people with a mental illness. It also results in poorer treatment outcomes because we are more reluctant to seek help. In fact, only about 40% of Americans with a mental illness receive treatment.
Since 1949, May has been Mental Health Month, when mental health and other organizations try to raise awareness about mental health issues and lower the stigma associated with mental illness. As the National Alliance on Mental Illness or NAMI puts it, their aim is to “help ensure that no one is alone on their mental health journey.” The Beth Am community can share this mission: to help ensure that no one is alone on his or her mental health journey. And we have the tools of Jewish tradition to show us how.
In the Book of Ruth, Naomi and her family move from Bethlehem to the country of Moab because of a famine. Naomi’s husband and two sons die in Moab, leaving her with her two daughters-in-law, Ruth and Orpah. Naomi tries to send them away, saying, “Turn back, my daughters… My lot is far more bitter than yours, for the hand of the Eternal has struck out against me” (1:12-13). Orpah goes back to her parents’ house, but Ruth famously clings to her mother-in-law, and the two travel back to Bethlehem. When they arrive, the townswomen can hardly recognize Naomi, she is so changed by her grief. “Can this be Naomi?” they ask. And she answers, “Do not call me Naomi” (“pleasantness”), call me Mara (“bitterness”), for the Almighty has made my lot very bitter. I went away full, and the Eternal has brought me back empty.” (1:19-21). We might read this statement as one of mourning; Naomi certainly has suffered significant losses in her life. But we might also read her statement as a symptom of depression. She says, “I have nothing – no goodness, no pleasantness, only bitterness.” Poor Ruth is standing right next to her! But all Naomi feels is sadness and emptiness, hopeless that she could ever have a full life again. If we see Naomi as a person suffering from depression, then the Book of Ruth can be a guide for how we respond to mental illness.
When Naomi tells the townspeople that she is now “Mara” not “Naomi,” she is, in effect, being open about her condition. She doesn’t pretend that everything is fine, she doesn’t try to hide her suffering, as so many people with mental illnesses do. It may be obvious to everyone who sees her, but she does not deny it. She is brave enough to say, “I’m really struggling, and I want you all to know what I’m going through.” Unfortunately, the story doesn’t tell us how the women of the town respond to her, but I would like to think that they answered her with expressions of comfort and support.
Another lesson we can learn is from Ruth’s actions. When Naomi tries to push Ruth away, as many people who suffer from mental illness push away their loved ones or withdraw from social connection, Ruth refuses. She says, “I will go with you. I will stay with you. You are not alone.” She also doesn’t try to fix Naomi, she doesn’t say, “Cheer up, Naomi, it’s not so bad.” Ruth shows great chesed, compassion, and strength in bearing witness to Naomi’s suffering without turning away and without trying to minimize Naomi’s experience. When the two women arrive in Bethlehem, Ruth goes out to work in the fields so she can feed and support her mother-in-law, who is unable to care for herself.
Both Ruth and Naomi can be our models for how to give and accept help. Ruth doesn’t allow herself to be pushed away. She offers her presence and her aid with quiet insistence. She continues to help even when Naomi does not show much appreciation for her efforts. And Naomi shows her own strength by accepting Ruth’s help and by being open and honest about her struggles.
One more lesson from the Book of Ruth is that slowly but surely, Naomi gets better. At the beginning of the story, Naomi is in despair, hopeless, empty, and unable to see any of the good around her. But as the story progresses, she emerges from her depression and begins to have hope in the future. As Ora Horn Prouser describes it, “She starts to respond as if awakening from sleep…. At last, Naomi seems to notice the people and things around her, to come back to life…. [T]hrough the help of family and community, [Naomi] is able to find recovery and help….” Naomi’s story reminds us that recovery is possible. While some mental illnesses cannot be cured, most can be treated. One of the most important messages of Mental Health Month is that there is hope – help is available.
The Book of Ruth shows us the power of individuals and the community to offer support, comfort, and healing to those with mental illnesses. We can remove the stigma by bearing witness, sharing our stories, and asking questions. We can offer prayers and cook meals for families affected by mental as well as physical illness. We can attend or support Beit Refuah, Beth Am’s support group for people who have mental illnesses and their families. Larry Lake writes that “no one brings dinner when your daughter is an addict.” Let’s see if we can prove him wrong.
 Esau’s Blessing, 115.