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Rabbi Dr. Abraham J. Twerski

The Limitations of

Psychotherapy

arly in my practice, it became devoted. I was my father’s favorite, achieves its goal to render a person
evident to me that virtually and I succeeded in everything I did. dysfunctional. Thus, when I think of
Eall of my patients harbored I excelled in chess. I graduated high- myself as inadequate, I must realize
negative-self feelings: low self- school at 16. I was ordained as a Rabbi that this feeling is the work of the
esteem, inferiority, inadequacy, at 20. I graduated from medical school yetzer ra, and I must dismiss it just
unlikeability, low self-confidence. at 29, and several years later, I was as I reject its tempting me to violate
Some had grandiose feelings, which board-certified in psychiatry. I had a Shabbat or eat non-kosher food.
were a desperate attempt to escape great career in psychiatry, authoring
painful feelings of low self-esteem. more than 80 books. I founded a It is futile to argue with the yetzer
Furthermore, from my perception, major alcohol and drug rehabilitation ra just as one cannot reason with a
these feelings did not appear to be institution. Yet that negative self- paranoid person, whose delusion that
justified and were of a delusional image kept on haunting me. My the FBI is recording his every move
nature. I wrote a book, Life’s Too awareness of my accomplishments is not subject to rational disproval.
Short, in which I described some of gave me only momentary relief. The cure for a paranoid would be
the more common defense maneuvers his recognition that his ideation is a
utilized to avoid the discomfort of low My first significant relief came from delusion. Similarly, a person with a
self-esteem. an essay by Rebbe Simcha Zissel Ziev negative self-image could be relieved
of Kelm. We know that G-d instilled of his distress if he realized that the
The causes of negative-self feelings two opposing forces in man, the yetzer yetzer ra is implanting false ideas
are frequently cited as poor parenting, tov, the inclination to do good, and the about him, and that he should not give
childhood illnesses, failures in early yetzer ra, the inclination to do wrong. them any credence.
life, and sibling rivalry, which have It is generally assumed that the yetzer
cast a pall on the young child. Therapy ra incites people to violate the wish of It is not the role of a therapist to teach
can be helpful in clarifying these G-d as expressed in the Torah. Rebbe a client about the yetzer tov and the
origins of the negative self-image, but Simcha Zissel says that this is too yetzer ra, but both the therapist and
whereas the client may have some narrow an understanding of the yetzer client should be aware of the source
relief, the negative delusions often ra. Rather, the yetzer ra seeks to make of self-degrading thoughts, above and
persist. a person dysfunctional by making beyond the traditional sources.
him feel inferior and worthless. This Rabbi Dr. Abraham J. Twerski is a
Having suffered from low self-esteem can paralyze a person to whatever psychiatrist and rabbi, and founder of
myself, the usual explanations did not degree, and rather than incite him to the Gateway Rehabilitation Center in
suffice. My parents were loving and commit a particular sin, the yetzer ra Pennsylvania

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