Hineni: Looking for the Healers and Healing in Our Presidential Transition

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

As Leonard Cohen approached his own death right before the 2016 election of Donald Trump, he suggested his own mental disturbance. He seemed to want listeners, readers, and healers to know that he was “broken and lame.” In the poem “Alone At Last,” Prozac was not his answer this time¹:

“How bitter were

The Prozac pills

of the last

few hundred mornings”

Cohen goes on in “You Want It Darker” to suggest that the mental health needs were also historical and wider:

“A million candles burning for the help that never came.”

Given that Cohen was Jewish, that line seems to relate to the Nazi Holocaust. In a prophetic sense, 2 days ago 1000 candles were lit in Kiev to mark the 1000 days of their invasion by Russia. However, missile escalation on both sides has been the follow-up. Moreover, anti-Semitism has been rising once again for at least a decade, and we know have a Middle East war that has also been expanding. Authoritarianism seems on the rise worldwide.

Inevitably, these 2 current wars will increase the prevalence of such disorders as posttraumatic stress disorder and prolonged grief. The current divisiveness and results of our presidential election seems to be a rather ubiquitous topic brought up by patients in treatment. Though not necessarily known for it, effective mental health care increases freedom of thought. In contrast to Cohen bemoaning “the help that never came,” it is now up to us in psychiatry to prepare and provide it.

Three times, Cohen sings:

“Hineni, hineni

I’m ready, my Lord”

The song closes with 4 repeats of “hineni.” A Hebrew word, hineni means “Here I am.” It is repeated at least 17 times in the formal scripture of Judaism.

The challenge for psychiatry is: are we ready to help beyond our usual individual patient care and reliance on medications like Prozac, as helpful as it is sometimes? To do so would mean, among other things:

• The involvement of the World Psychiatric Association, the World Association of Social Psychiatry, and the Global Mental Health Caucus of the American Psychiatric Association.
• More psychiatrists engaged with reducing our social psychopathologies like the antis, isms, social phobias, violence, loneliness, and cultish thinking.
• Social prescriptions and lifestyle recommendations.
• More educational media presence.
• Finding ways to promote and produce peace.

Right now, as we finish our series on Leonard Cohen’s farewell songs, we are in a liminal transition political period in the United States where Cabinet nominations and other plans have not yet been put into motion. Indeed, as anticipated in our November 19 column, one nomination has already dropped out.

Let us then proclaim:

Hineni, hineni!

We are ready.

We are always ready for individual patient care. Can we also be ready for social psychiatric care?

Dr Moffic is an award-winning psychiatrist who specialized in the cultural and ethical aspects of psychiatry and is now in retirement and retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekday column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He was chosen to receive the 2024 Abraham Halpern Humanitarian Award from the American Association for Social Psychiatry. Previously, he received the Administrative Award in 2016 from the American Psychiatric Association, the one-time designation of being a Hero of Public Psychiatry from the Speaker of the Assembly of the APA in 2002, and the Exemplary Psychiatrist Award from the National Alliance for the Mentally Ill in 1991. He is an advocate and activist for mental health issues related to climate instability, physician burnout, and xenophobia. He is now editing the final book in a 4-volume series on religions and psychiatry for Springer: Islamophobia, anti-Semitism, Christianity, and now The Eastern Religions, and Spirituality. He serves on the Editorial Board of Psychiatric Times.

Reference

1. Cohen L. Book of Longing. Ecco; 2006.