I ’m not exactly chassidish in the classic sense. True, I have a big beard and I get inspired by niggunim, but when people ask me if I have a connection to any particular rebbe, I tell them that I’m a chassid of HaKadosh Baruch Hu.

I occasionally went to Friday night Toldos Aharon tishen back when I was in yeshivah and once waited in line to get a brachah from the Belzer Rebbe, but my exposure to chassidus was mostly limited to seforim. At least until I made aliyah and started working as a psychiatrist in the various chareidi communities of Jerusalem and its environs.

I’m not sure if I expected everyone to be saints, and truth be told, this societal grouping — in terms of mental health — was pretty much like any other group of folks I’d met. Baruch Hashem, there is less substance abuse in the chassidish world, but it still exists. Like in the rest of the population, there are chareidi/chassidic patients with serious mental illnesses such as schizophrenia and bipolar disorder, although in my experience they do have better outcomes than patients in nonreligious communities due to the overwhelming support the community provides for their kehillah and neighbors.

In general, chassidish patients are not more resistant to taking medications than any other patients I’ve worked with. While a Chinese patient might want to try a traditional herbal supplement before taking meds, and a hippie from San Francisco might only take a medication along with a daily Yoga class, a Gerrer chassid might want to get a brachah before trying a pharmacological treatment, and a Breslover patient (one not resistant to medication altogether, as some interpret the words of Rebbe Nachman) might only agree if the pill won’t interfere with his yearly pilgrimage to Uman.

But my patients who were followers of a particular great rebbe in Jerusalem, inculcated with a beautiful emunah peshutah, always said the same thing when the question of medication was raised: “Do I have to be worried that this means I’m not a maamin if I turn to pills? Do you think the Rebbe will be maskim?”

“Of course he will,” I’d say. “This is a medical treatment like any other.”

In this circle, it was still not totally understood that illnesses such as OCD, postpartum depression, and psychosis were due to neurochemical and hormonal imbalances and not “going crazy.” I would further encourage them, explaining how mental illness doesn’t mean that you‘re a crummy person who needs to do teshuvah. It means that you have a biological condition that needs a biological treatment. For the sake of honesty, I’d finish by saying, “I’m just a shaliach of HaKadosh Baruch Hu, trying to help you to be the best parent/child/spouse and Yid that you can be.”

Then they’d tell me, “When you put it like that, it’s clear to me that the Rebbe would be maskim.”

And so it went. After I’d heard “the Rebbe would be maskim?” a few times, I figured that I should make sure. Luckily, I had an “in” with the Rebbe through my own rav, who happened to spend his summer break in the same spot in a town in the north. So at the end of the summer, I made a trek to visit my rav, and hopefully to find the Rebbe as well and have an audience with him.

I found the Rebbe at Maariv. He was dressed in a frock, had a majestic white beard, and had brought his special chair and shtender out from the city to daven in the local shul. It was truly inspiring to daven in his presence. After Aleinu, I politely approached and waited for his gabbai to ask me who I was and what I wanted.

“I’m the psychiatrist,” I answered, not thinking that this might sound a little strange.

The gabbai looked at me crossways, but then shrugged his shoulders and whispered to the Rebbe, who had meanwhile cracked open a massive, leather-bound book of the Arizal. The Rebbe closed his sefer and stood up to shake my hand, at which I was very surprised and embarrassed.

I kissed his hand and introduced myself.

“So you’re my psychiatrist?”

“Well, no, not exactly, but I happen to have had the zechus to work with several of your chassidim,” I said, beginning to sweat.

“And? How did you find them?” he asked. I had no doubt that these ardent chassidim had discussed their treatment protocol with the Rebbe, but knew the personal connection would be helpful to both doctor and patient.

“They were all real maaminim, Rebbe. Baalei middos, appreciative, and gracious people,” I responded honestly.

“Were you able to help them?”

“I hope so. But in the end, I’m just a shaliach with the tremendous zechus of being able to work in the mental health field.”

“Hmmm,” thought the Rebbe out loud, stroking his beard and then continuing, “tell me your thoughts on medications.”

“I’ve spent a lot of time studying this over the past decade and have consulted with many rabbanim. In short, my understanding both medically and halachically is that people who need them are chayav to take them, but that people who wouldn’t really benefit from them shouldn’t be prescribed them.” I hoped this was the right answer.

“And where did you study?”

“At Harvard Medical School. I mean, I was at Aish HaTorah a long time ago and then I learned by the rosh kollel in Boston while I was completing my training... is that what you’re asking, Rebbe?”

“And you’re just a shaliach, you said? Not some kind of ‘world expert’ who has the right to manipulate the mind of a suffering patient?”

“Just a shaliach. Psychiatry is actually a very humbling field, Rebbe,” I answered. I hoped I was heading in the right direction — after all, I believed every word I said.

“Okay then, Dr. Yaakov. You can tell my talmidim in my name that I’m maskim,” said the Rebbe. “Tell them that I’m maskim — and I’ll do my part and daven that you should indeed be a good shaliach in helping Klal Yisrael.”

Originally featured in Mishpacha, Issue 677. Jacob L. Freedman is a psychiatrist and business consultant based in Jerusalem. He serves as the medical director of services for English-speakers at Bayit Cham, a national leader providing mental health treatment and outreach within the religious community. Dr. Freedman can be reached most easily through his website www.drjacoblfreedman.com.