Jewish American Heritage Month: Judaism in Eating Disorder Treatment
May is Jewish American Heritage Month, a national observance in which we pay tribute to the generations of Jewish Americans who helped form the rich fabric of our history, culture, and society. This month, we sat down with Rabbi Tzvi Steinberg, who serves at all Eating Recovery Center (ERC) nationwide locations. As Rabbi of the landmark synagogue Congregation Zera Avrohom – which has served Denver, Colorado for over 135 years – Rabbi Steinberg is the Presiding Judge of Neve Tzedek Rabbinical Court, Founder and Director of Areivim Mental Health Taskforce of Denver. Rabbi Steinberg additionally directs the Jewish Experience Program for patients at ERC Baltimore.
Why did you initially become involved with eating disorder (ED) treatment?
Well, it’s simple. Because I care. As a rabbi in Denver, my position involves meeting the needs of Jewish people in the town – even if they aren’t associated with my synagogue. This also relates to people who come from out of town to our hospitals, and that initiated my involvement with the ACUTE Center for Eating Disorders at Denver Health and with ERC.
It began with a very simple inquiry from a friend of mine whose son was in the adolescent program at ERC. He wanted a haircut: a Jewish haircut. So I picked up one of the young men from the yeshiva here, and my friend’s son received a haircut.
After my first contact with ERC, it became immediately apparent that I could be helpful in providing context to their clinical teams about the Orthodox Jewish culture, and my entry in the ED field began with that effort.
Tell us more about the ways in which behavioral health impacts the observant Jewish community.
Behavioral health and mental health issues are severely and detrimentally stigmatized in the Orthodox Jewish community, and therefore a patient and their family are often less likely to act in the immediacy required. Many EDs come with comorbidities such as depression, anxiety, or trauma, and those co-occurring conditions will largely be addressed as “let’s not seek professional help yet.” Both ultimately worsen, and then everything exacerbates until the patient requires a higher level of care like residential treatment.
Food is a cornerstone of Judaism and Jewish culture. Tell us how that plays a role in ED treatment.
Our community is heavily centered around food. Food is central in Judaism; it’s an enormous part of our culture. So many of the holidays are centered around food, and there are many symbolic foods associated with each. Of course, preoccupation with food can aggravate ED issues, and it’s possible those thoughts and pressures can be stronger during holiday times.
There is still a blind dating – or matchmaking – system among observant Jews. Do you see any consequences from that among young men or women who struggle with EDs?
Yes, that is another factor among this community, and I think it has a big impact. The Shidduch is a matchmaking system in which Jewish singles are introduced to one another in Orthodox Jewish communities for the purpose of marriage. Women may be expected to look a certain way – often dressing formally, no matter their vocation. This can also create a trigger and focus on appearance.
Are there other cultural factors that you find unique to this community?
Well, I think we’re culturally conditioned to overachieve. It seems to me that the personalities of the young men and women I meet are almost without exception type A, brilliant, creative, ambitious, and tending toward perfectionism. There is an expectation to excel, and when you must excel, there’s a certain quest for perfection.
Why don’t people with an ED need to fast on traditional Jewish fast days/observances?
The concept of fasting in Judaism with an ED is simple: you don’t. At the same time, I try to support the young men and women who grapple with that, or who feel isolated from their families and communities as a result.
On Yom Kippur – our holiest day of the year, on which we fast – I distribute a prayer that was composed in the Warsaw Ghetto. A particular Hasidic rabbi indicated to his followers not to fast, and he authored a prayer for his community. The prayer I distribute is somewhat modified, but many find a lot of solace in that. It’s essentially a message that you aren’t alone, we’ve had some trying times…and this is the right thing to do.
I’m also not in favor of eating less on a fast day; oftentimes, these young men and women receive such a ruling from their family rabbi. There is a certain minimum that someone must eat on Yom Kippur to be held “liable” – so some elderly people are told to have an ounce of juice every 9 minutes. They’ll be encouraged to do it that way so that it obviates the actual transgression. Some rabbis will issue such a ruling for a young person with an ED. I am opposed to that because it can be very triggering.
Really, so much of this comes down to education. Are others in our community receiving accurate information so that we can best support our men and women? That’s a large part of my role: ensuring that my peers, fellow rabbis, and the entire community at large are educated.
Eating Recovery Center offers treatment for the kosher consumer and Shabbos observer, working to eliminate any cultural barriers or struggles for observant Jewish patients. ERC is committed to integrating as many rituals and customs as possible, including working toward providing an engaging, robust, and immersive Shabbos and Yom Tov experience.
We work with a culturally sensitive team that collaborates with patients, families, and loved ones. Our singular focus is to create a welcoming environment in which observant Jewish patients feel comfortable, included, supported, and – most importantly – at home.