R

acheli Goldberg was a pleasant young woman from a very normal family with devoted, caring parents.

From the outside, their life looked picture-perfect. Mom and Dad had stayed on in Eretz Yisrael after their shanah rishonah and built a good life for themselves in Ramat Beit Shemesh. Dad was zocheh to learn every day before his work as a computer programmer and Mom had done an exceptional job raising seven healthy kids — including the four oldest who were happily married.

Racheli had excelled in Bais Yaakov and there hadn’t been any questions that she would continue at seminary like her older sisters and get married the following year. But then the obsessions with cleanliness began.

It started with a bit of extra carefulness around milk and meat that was tolerated by her family without any questions. When it became a nightly hour-long sponja ritual, Mom tried to intervene. She knew it was a problem because Racheli wouldn’t listen to reason, but she didn’t think Racheli needed psychiatric intervention — maybe just some herbs or other natural remedies to get her anxiety under control.

A friend had recommended Dr. Yishai, as a “talented mental health professional” who claimed to specialize in the treatment of anxiety problems using natural remedies. And so, the Goldbergs booked their initial evaluation and Racheli was off to meet Dr. Yishai.

The Goldbergs were impressed by his optimism and confidence, and Racheli began to take a daily cocktail of “herbs that have been used for thousands of years in many different cultures,” according to Dr. Yishai. Those herbs, though, were a special mix that could only be purchased through him — at a price that nearly gave her parents an anxiety attack.

Racheli’s sponga rituals didn’t get any better, though, and soon she was spending 90 minutes every night doing dishes “to prevent contamination.”

Dr. Yishai said he’d “seen bad cases before” and was happy to add his unpatented creams, which, he claimed, were “based on the teachings of the Rambam himself.” When Racheli’s parents asked him if the herbal therapy might not do better together with some counseling, Dr. Yishai simply waved off the suggestion. His potions, he said, were tried and true.

But soon Racheli’s nightly routine became two hours, and it was clear that things were spiraling out of control when Racheli was too tired for seminary due to her compulsive cleaning activities. Then Dr. Yishai pulled out all the stops and included his strongest remedy — “bio-resonance treatments” twice a week, at 600 shekels (close to $150) a session.

Racheli was turning into a mess and her parents were appropriately confused and frustrated. Dr. Yishai had come recommended and they’d already spent over 10,000 shekels over the past three months, without seeing any improvement. In fact, things had only gotten worse in spite of Dr. Yishai’s “strongest remedies.”

The Goldbergs weren’t the only ones who were concerned, and mercifully, one of the teachers Racheli’s seminary noticed her absences and erratic behaviors. Following a meeting with her parents, the rebbetzin facilitated a psychiatry referral, and a day later Racheli and her family were sitting in my office for a consultation.

The case was so classic that it could have climbed its way right out of an introductory psychology textbook. After hearing her describe the past few months, I was able to tell Racheli that she was experiencing a case of Obsessive Compulsive Disorder.

“We figured as much,” said Mrs. Goldberg. “It’s pretty clear that this has been happening for quite some time.”

“If you don’t mind me asking, what took so long for you to come for a consult?” I asked.

And then they described their experience with Dr. Yishai — the aura of expertise he portrayed, his faith in his “natural remedies,” and his dismissal of any other therapy techniques. They were calm, but I was furious. How could this happen yet again? I’d heard about this “Doctor” Yishai before. Why was this guy still in business after fleecing dozens of patients suffering from real-deal mental illness?

“So what would you have recommended, Dr. Freedman?” Mrs. Goldberg asked.

“Baruch Hashem, there are good, successful treatments for OCD that are basically standard,” I responded. “Treatment with an antidepressant together with cognitive behavioral therapy are the cornerstones of recovery.”

“But how do we know that your treatments will be any better?” Mr. Goldberg responded somewhat defensively.

“That’s a great question. Psychiatry isn’t cardiology where we can just measure your blood pressure and make a diagnosis immediately, but there have been decades of good studies documenting efficacy of this treatment plan for OCD.”

Mrs. Goldberg interjected, “But Dr. Yishai also thought his treatments would be successful. He has thousands of years of experience behind his treatments in many different cultures.”

Again, I didn’t want to show my frustration, so I took a deep breath and answered calmly, “Dr. Yishai prescribed his own special remedies that you had to buy from him, and he made a fortune on every bio-resonance treatment. But while his herbs might be effective in reducing anxiety — several herbs are known for their anxiety-reducing properties — he should know that herbs alone are never the best choice for healing obsessive compulsive disorder, which involves therapy to learn to combat negative thoughts.”

“But Dr. Freedman,” argued Mr. Goldberg, “you’re also a nogeia bedavar. You’ll get money each time we see you as well.”

Well, that was a fair question. Luckily, I had a very honest response. “First of all, I don’t make any money based on my recommendations since I don’t have stock in any drug companies. Second, I’d be happy to recommend you to any of my colleagues. Whether you’d go to Dr. Pesach, Dr. Shmuel, or Dr. Alex, you’d still get the same recommendations: CBT and an antidepressant as treatment for OCD. I’m happy to provide you with some phone numbers if you’d like a second opinion.”

All three of them nodded and it was Racheli’s turn to speak, “I like him, Mom. He’s honest. This makes sense. Besides, Dr. Yishai isn’t even a doctor anyways.”

I spent the next ten minutes describing the recommended treatment plan and providing Racheli with the names of some exceptional psychologists in the area.

As they thanked me and got up to leave, Mr. Goldberg stayed behind a minute. “You can’t blame us for wanting to try something natural.”

“I don’t.” And I didn’t. “I also recommend natural remedies and always prescribe mindfulness practice and daily exercise to my patients. Furthermore, I’ve recommended Passiflora, valerian, and many other herbal remedies at the right time to the right patient. But this is different. Your daughter is struggling with a psychiatric disorder, and Dr. Yishai did something inappropriate, and assur, by assuring you his stuff would work.”

“Yeah, I wish I could tell it to him. I mean, not only did he not help us but he also took a month’s salary from us in the process.”

Originally featured in Mishpacha, Issue 718. Jacob L. Freedman is a psychiatrist and business consultant based in Israel. When he’s not busy with his patients, Dr. Freedman can be found learning Torah in The Old City or hiking the hills outside of Jerusalem.  Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.