Kathleen M. Pike, PhD

Passover: An Allegory for Psychotherapy

As the sun sets this evening, millions of Jewish people around the world will open the Passover Haggadah and recount the story of the exodus from Egypt – one of the most ancient, quintessential stories of the journey to freedom. It is a story filled with drama, contradictions, symbolic images, and profound teachings.

I love this narrative because there is something in it for everyone; a veritable mental health jewel box.

1. Slavery. The Jewish people were slaves in Egypt. Like the Black South Africans during Apartheid that I wrote about last week, when people have no rights, they have no voice, and change is near impossible. People with mental ill health are frequently silenced by the stigma associated with mental illness. Some are silenced by the mental disorder itself. People with mental health problems of all sorts run enormous risk of languishing in silence and in the shadows of society like the slaves in Egypt. 

2. The Plagues. The Jewish people didn’t leave Egypt until boils, hail, locusts, frogs, and worse – 10 atrocities in all plague the people of Egypt. When people come to therapy, a central question is “why now?” since typically they have been suffering for a long time before seeking help as compared to other health conditions. Why is it that we don’t hesitate to call the doctor when we have a child running a fever, but when we notice or experience problems like anxiety and depression, we hesitate to make a big deal of things and hope it is a phase that will just go away on its own?

3. The Four Questions. There is a tradition of inviting the youngest child at the Passover Seder to ask four questions. They are all “why” questions – why do we eat certain foods in certain ways and follow certain practices? Psychotherapy starts with lots of “why” questions. Why are you here? Why now? Why are you hurting? The answers are important but the questions are more important – they are the essence of opening of the mind and the beginning of finding a voice.

4. The Four Children. The Passover Seder talks about four children: the wise, wicked, simple and the one who doesn’t even know how to ask. Of course there are many other kinds of children who we could add to the list: challenging, skeptical, artistic, or indifferent for example. This is true in psychotherapy too. We come to the process of psychotherapy with varying degrees of engagement, insight and investment, and we each have moments of personally knowing and being each of these children at heart.

5. The Journey to Freedom. The Jewish people leave Egypt in search of a better life. It is not a journey for the faint of heart. In haste, they do not have enough time for their bread to rise, they are chased by Pharaoh’s army, and they arrive at the Red Sea wondering how they will ever get across to the other side. So it is with psychotherapy. Not for the faint of heart. In psychotherapy the journey is not geographic (changing zip codes is rarely the solution since, as Jon Kabat-Zinn says, Wherever You Go, There You Are). Instead, if you are willing to ask the questions, engage all the many children of your self, and tolerate a diet mixed with matzah (so to speak), you will find similar rewards to the Jewish people who found their way to freedom. Just don’t wait for 10 plagues to get started!

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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