Meir Ekstein
A review of Yonatan Rosensweig and Shmuel Harris, Nafshi BiShe’elati – The Halakhot of Mental Health (Maggid books, 2025).[1]
Rabbi Yoni Rosensweig and Dr. Samuel Harris’s Halakhic book, Nafshi BiShe’elati – The Halakhot of Mental Health has recently been translated into English from the Hebrew edition by Maggid press.
The book presents a comprehensive Halakhic treatment of mental illness, offering the first systematic approach to applying Jewish law to mental health issues. While a few articles have addressed some of these halakhic questions, this work stands out for its thoroughness and scope. The book’s strengths and multidisciplinarity are reflected in the diverse and laudatory approbations (haskamot) it has received.
Rav Eliyahu Abargel praises its scholarship, summaries, and novel interpretations of rabbinic literature. Rav Baruch Gigi and Rav Eliezer Melamed emphasize its practical utility for issuing halakhic rulings for mentally ill individuals, noting R. Rosensweig’s extensive consultations with contemporary poskim. Rav Re’em Hacohen and Rav Yuval Cherlow view the work as essentially developing a new area of Halakha, attributing the previous lack of such a treatise to recent advancements in psychiatric diagnoses and our more sophisticated understanding of psychology, genetics, and mental health treatment. In the English translation, there are additional approbations from Roshei Yeshiva at RIETS: Rabbi Michoel Rosensweig (the author’s uncle), Rabbi Hershel Schachter, and Rabbi Mordechai Willig.
Nafshi Be-She’eilati is structured in three sections, with only the first two translated into English. The first part is a legal handbook, written in the style of guides like Shemirat Shabbat Ke-hilkhatah, which first lays out concepts such as Shoteh (mental incompetence) and addresses what the Halakhic obligations are for people suffering from mental illness. It addresses Halakhic attitudes to treatment and practical questions such as laws of prayer, rules for holidays, kashrut, family laws including niddah, obligations to parents, and gossip laws. Some examples of questions the book deals with are whether someone with OCD must pray, whether an anorexic patient must fast on fast days, and whether a depressed person can listen to music on Shabbat. The second section provides extensive annotations citing a wide range of Halakhic sources for each legal question and decision. The untranslated third section contains lengthy Halakhic discussions of critical sources along with R. Rosensweig’s interpretations and innovations. There is also a survey of accounts of mental illness in rabbinic literature, and a comprehensive table and discussion that translates DSM-5 categories and risk factors for each mental illness into Halakhic categories.
The authors state that they wrote the book to help patients suffering from mental illness. R. Rosensweig hopes the book will further legitimize the suffering of mental health patients and their need for support, and Dr. Harris writes about helping rabbis provide Halakhic guidance and hopes that the book validates the suffering and destigmatizes the symptoms of mental illness. However, despite the book’s virtues, one might wonder about its true contribution, given that many of its conclusions, for example that the principle of Pikuach Nefesh (preservation of life) overrides other commandments in mental health situations, seem intuitively obvious.
In his Iggerot (1:31), Hazon Ish points out that Halakhic decision-making involves two components: Halakhic principles and metziut (reality). He suggests that Halakhic principles, such as Pikuach Nefesh, are usually clear, with most questions arising in their application: what situations are defined as Pikuach Nefesh? R. Rosensweig’s book clarifies the reality (metziut) of mental illness. What situations arise, and what are their implications? Mental illness presents a unique challenge: the Halakhic applications are underdeveloped, and the psychiatric realities are complex and vary by situation. This results in ignorance of the dangers and realities of mental illness, compounded by the perplexing and uncertain prognosis in many cases. The book is therefore peppered with terminology from DSM-5, reflecting the latest diagnostic categories, and is accompanied by recent research on risk factors for various mental illnesses. In addition, the book cites extensively from the entire range of relevant rabbinic sources: the Talmud, sometimes-obscure Rishonim and Acharonim, the world of She’eilot and Teshuvot. Due to the relative scarcity of existing sources, R. Rosensweig includes consultations with present-day Halakhic experts as an additional source. The bi-focal view of Halakha and psychiatry is the successful outcome of a book written jointly by a rabbi and a psychiatrist.
R. Rosensweig’s approach involves borrowing Halakhic principles from other areas and applying them to mental health realities. He maps the concepts of Holeh she-ein bo sakana (non-life-threatening illness), Holeh she-yesh bo sakana (life-threatening illness), and Pikuach Nefesh (preservation of life) to mental health contexts. By codifying how to deal with mental illness using Halakhic medical models, R. Rosensweig effectively treats mental health issues in a medical framework.
This shift moves away from a past inclination in general society to blame patients for their symptoms, which was reflected in the approach of some earlier poskim and Orthodox therapists. Past studies of Orthodox use of mental health services have described clients’ fear of stigmatization and of feelings that they should overcome the problems themselves because the symptoms indicate moral weakness. Dr. Abraham Amsel, an early Orthodox therapist, in a representative passage, described mental illness as resulting from sin in the following manner: “A sin is associated with a spirit of madness because irrational choosing momentary pleasure instead of permanent good makes for the beginnings, the kernels of madness. Since the sinner had free choice at the start between good and evil, he is, of course, punishable.”[2] R. Rosensweig (66) in his book writes that some early poskim saw psychotherapy as emphasizing “the anthropocentrism of treatment, at the expense of Judaism’s Theocentrism and submission to God’s will,” also implying that psychotherapy can be a way of avoiding one’s obligations.
The book is innovative in further developing Halakhic concepts related to preventative care and probabilistic risk assessment in mental health. For example, if a patient isn’t suicidal at the moment but there is a chance they will be in the future, can one violate Shabbat to help prevent the patient from becoming suicidal soon? The book’s overall orientation adamantly upholds the principles of Pikuach Nefesh (preservation of life) and sustaining well-being. However, it carefully balances this approach with the weight of Halakhic obligations, emphasizing that each case requires individual evaluation through professional and/or rabbinic consultation. This dual consultation helps determine whether a situation constitutes Pikuach Nefesh and whether relaxing religious obligations will aid treatment.
Regarding treatment, the book argues that, despite reservations of poskim in the past, patients should seek psychotherapy due to new developments and professionalism, adding that some poskim even regard it as a Mitzvah. They offer broad guidelines including permitting behaviors normally discouraged, such as expressing anger, if they are therapeutic, while simultaneously upholding Torah obligations and values when it isn’t therapeutically helpful, and in some cases limiting who an observant therapist should treat. They support a range of therapies leaving the details up to the decision of the professionals and the patient.
The written style of the book is also noteworthy. The guidebook format makes the Halakha accessible and user-friendly. However, this technical approach is less likely to engender empathy. A narrative approach presenting complex dilemmas, similar to those described on R. Rosensweig’s Facebook page, might have enhanced its emotional impact. Perhaps a future edition of the book can add more rich real-life stories and their Halakhic resolution to illustrate some of its principles. However, and perhaps ironically, the familiar and straightforward procedural guidebook style helps normalize mental health challenges as illness and anchor them in a clear Halakhic language and framework.
Even though some of the conclusions are intuitively obvious, the significance of this work extends beyond serious Halakhic scholarship. Many rabbis have limited exposure to mental illness, and this book helps destigmatize and frame mental health issues within a medical model. It emphasizes the potential risks in mental health situations and therefore provides the basis for appropriate leniencies. It may also alleviate the concerns of Orthodox Jews who feel self-conscious, constrained, or guilty regarding their condition. Perhaps most importantly, as reflected in the approbations, the book’s value lies as much in fostering a more empathic and understanding approach to mental illness among rabbis and Orthodox Jews as in its Halakhic innovations. The book excels in three areas: translating the reality of mental illness into Halakhic principles, clarifying the Halakhic obligations of patients with mental illness, and explicating the broad Halakhic areas where leniency may be appropriate.
Cultural understandings of mental illness have changed over time and have contributed to different assumptions and interpretations of its reality. We have seen a shift from a moralistic model of mental illness where the patient is at fault and all they require to improve is better willpower, to a medical model where the illness is externalized and the patient needs outside help such as medication, support, and therapy to overcome their sickness. We have also seen, in the past few decades in the Orthodox community, a greater willingness to treat mental illness, reduced stigmatization of symptoms, and a greater awareness of the risks. This book reflects and catalyzes these trends by providing a Halakhic language for mental health challenges.
In conclusion, although the book’s Halakhic decisions may seem intuitive to some, Nafshi Be-she’eilati contributes by systematically addressing the place of mental health challenges within a normative Halakhic framework. This allows for accessible practical guidance, but perhaps more significantly, plays a crucial role in shaping a more compassionate and informed approach to mental health in Orthodox Jewish communities. Despite the procedural language the book adopts, it reflects a Halakha that isn’t limited to delineating what is permitted and prohibited; the book encourages and fosters values such as compassion, hesed, and caring for people’s well-being and lives. In the same vein, R. Rosensweig, in addition to authoring this book, has become an address for psak Halakhah on mental health issues and founded an organization to train, educate, and sensitize rabbis to challenges of mental health and Halakha. Placing mental health patients at the forefront of this Halakhic caring is innovative, and is an important and necessary reminder of Halakha’s underlying values.
[1] Parenthetical citations refer to this volume.
[2] Abraham Amsel, Judaism and Psychology, (Feldheim Press, 1969), 93.
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