Greenberg D
Jerusalem Mental Health Center, Herzog Hospital, Ezrat Nashim, Israel.
Isr J Psychiatry Relat Sci. 1992;28(4):19-30.
The ultra-orthodox (haredi) community is a sizable proportion of the population of North Jerusalem. They are proportionately underrepresented among new referrals to the Community Mental Health services, tend to drop out of treatment early, and only present with severe psychopathology. Fear of stigma, contact with the irreligious world, "yihud" with opposite sex therapists, suspicion of irreligious healers of the Jewish "nefesh", and seeing such a need as a sign of weakness of faith all serve to deter the religious patient from seeking help. The therapist's anti-religious sentiments, his feelings of being belittled and used, and lack of attention to these feelings help diminish the therapist's changes of a successful outcome. Differences in communication style, language, concepts and interests affect the prospects of establishing a therapeutic alliance. The views of two Rabbis involved in the field of mental health are presented. Their views portray the structure of the ultra-orthodox society, and its expectations and misgivings concerning psychiatry, psychotherapy and therapists. Ten suggestions are proposed for improving communication between the Community Mental Health services and the ultra-orthodox community.
极端正统派（哈雷迪）群体在耶路撒冷北部人口中占相当大的比例。在社区心理健康服务的新转诊患者中，他们所占比例相对较低，往往过早退出治疗，且仅表现出严重的精神病理学症状。对污名化的恐惧、与非宗教世界的接触、与异性治疗师的“独处”、对犹太“灵魂”非宗教治疗师的怀疑，以及将这种需求视为信仰薄弱的标志，所有这些都阻碍了宗教患者寻求帮助。治疗师的反宗教情绪、被轻视和利用的感觉，以及对这些感受的忽视，都不利于治疗师取得成功的治疗效果。沟通方式、语言、观念和兴趣上的差异影响着建立治疗联盟的前景。文中介绍了两位从事心理健康领域工作的拉比的观点。他们的观点描绘了极端正统派社会的结构，以及其对精神病学、心理治疗和治疗师的期望与疑虑。针对改善社区心理健康服务与极端正统派社区之间的沟通，提出了十条建议。
