WINGS OF THE SUN

THE WINGS OF THE SUN
Traditional Jewish Healing in Theory and Practice

Perhaps it was just a minor ache or pain at first, or a lump you preferred to ignore... until eventually you had to see a doctor. And then, when the results of the tests came back, suddenly everything changed. You have a life-threatening illness - a gaunt fact that overshadows all else. Will you ever again be able to enjoy anything without having to think about this knife held at your neck?

How many different thoughts and feelings pass through the mind of a person who has just found out that he or she has a dangerous illness! Gut fear. Images of death and the grave. Grief. Anger: "Why me?" Disbelief: "It can't be true! There must be some mistake!" A sense of betrayal by the body. Nightmare images of attacking snakes and spiders. Worries about what's going to happen: "Will I suffer pain? Will I be disfigured? Incapacitated? How are my dear ones going to manage... without me?" Strange feelings of recklessness: "I don't care! I'd rather die than go through the pain, the torment of all the treatments, the shame of disfigurement and disability!" Terror and helplessness. "Get somebody to do something! Cure me! Just take this illness away!"

Since God is beyond nature and runs the world providentially, Rebbe Nachman rejected the materialistic notion that a life-threatening illness must inevitably take its course. It is a fact that by no means do all cases of dangerous illness lead to death. There are many long-term survivors from serious heart disease. At least fifty percent of those diagnosed with cancer recover from it, and modern medical diagnosis and treatments are extending survival time in many cases of other serious illnesses.

But no one can give you any guarantees. With a knowledge of your history, your general state of health and the type and stage of your illness, doctors may offer an assessment of the possible course of the disease based on statistical probability. But no doctor alive can honestly predict exactly what is going to happen to you. Nor is the Torah healing pathway of faith, prayer and joy a magical solution offering greater certainty of physical recovery. Indeed, the Torah reminds us that our lives are totally in God's hands: "I kill and I make alive, I wound and I heal, and there is no one that can deliver from My hand" (Deuteronomy 32:39).

King Hezekiah said: "Even if a sharp sword is pressing on your neck, don't despair of pleading for God's mercy" (Berakhot 10a). Rebbe Nachman taught us always to be positive and optimistic. But this does not mean engaging in wishful thinking and pretending there's no threat. The foundation of Rebbe Nachman's pathway is truth and honesty. In the case of serious illness this entails facing your fears and accepting the reality. Being positive means searching for the good in the situation as it actually is. This is the only sound basis for true joy, for only when we accept the reality of death can we really live.

In our societies, serious illness and death are subjects most people don't like to talk or even think about, preferring to lead their lives in the pretense that death will never come. From the news with which we are being constantly bombarded about fatal accidents, war, terrorist attacks, epidemics, famine and other disasters, we are all aware of death in theory. If a close relative, friend or acquaintance dies, it brings the meaning of death home in a far more powerful way. But serious illness brings us face to face with the stark reality of our own mortality. "My life is going to end!" Yet the fact is that, seriously ill or not, in this world we are all condemned to death, and none of us knows when his or her time is going to come - "who will die at his destined time and who before his time, who by water and who by fire, who by the sword, who by a wild beast, who by famine, who by thirst, who by a storm, who by plague, who by strangulation and who by stoning..." (from the High Holiday liturgy).

The Rabbis said, "Repent a day before your death" (Avot 2:10) - which means every day, since we never know which day will be our last. The ancient Rabbis wanted us to keep our mortality at the forefront of our minds. So did Rebbe Nachman, who reminds us about it in conversation after conversation (see Rabbi Nachman's Wisdom #51, #77, #83, #84, etc.). This is because only when we know clearly where this life leads to - the grave and the Next World - can we really make the most of our lives in this world. Only when we understand that our time here is limited do we truly value it.

We must be willing to face our deepest fears and come to terms with the prospect of death in order to use the time we have left in the best possible way. For the fact that we cannot control death does not mean we cannot choose how to live in the face of it. The idea is not that you should spend all your time morbidly preparing for death. On the contrary, you should shift from being a passive victim of fear and anxiety to actively taking charge of your life. Take stock of yourself. Where have you been and where are you going? Work out your priorities. Drop whatever is meaningless and wasteful. Say what you want to say to your friends and dear ones. Fix what is in your power to fix in this world - and live.

The purpose of life is to come ever closer to God, and indeed, death is simply the next stage in life. It is death only in relation to the material world. But for the essential you - your soul - death is the gateway to a higher, more intense and infinitely more joyous level of life. This is because of the greater intimacy of the soul's connection with God when divested of the physical body. If the prospect of death is so fearsome, essentially this is because God Himself is fearsome. The proximity of the encounter with the Living God is awesome. Serious illness thrusts upon us the awareness that the next step up in life is ahead of us.

Illness is a call to live, and it should be taken as such: as a call to live fully in this world and the next. This is the true healing. There can be no guarantee of physical healing: it may come about and it may not. But even if you recover, fully or partially, the only purpose of being well is to live - to strive to come ever closer to God day after day. By making the decision to live in every way possible, even under the limitations of serious illness, you are indeed preparing yourself to live in better health. The decision to live is thus the key to healing: to live every moment as best you can, coming closer to God in every way, in thought, word and deed.

The last thing Rebbe Nachman would have wanted would be for anyone who genuinely needs medical treatment to feel guilty and anxious about taking it because of the Rebbe's comments against doctors. The medical profession is still open to many criticisms, but without question medical knowledge, techniques and standards of care have vastly improved since Rebbe Nachman's time. Contemporary medicine saves many lives and can also often greatly improve the quality of life of the seriously ill and chronically sick. Even as you go for medical treatment, the most important thing to remember is that everything is only in God's hands.

Many patients try to ignore that first ache, lump or sign of bleeding, putting off visiting the doctor as if pushing the problem out of mind will somehow make it disappear. This is very foolish and dangerous, because the more a disease spreads in the body and the later it is diagnosed, the more of a threat it becomes and the harder it is to treat. Don't ignore unusual developments in your bodily functioning because you are afraid of finding out what they might mean. This would be a flight from reality. It is better to face up to the truth, however unpleasant, than to be confronted with a far more catastrophic situation later on. Knowing exactly what is happening enables you to take positive action to deal with any problem instead of just worrying about what it might be.

As we have seen, Rebbe Nachman's main advice to those needing medical treatment is to make sure to get the very best (Siach Sarfey Kodesh I:8). Many patients take far more care in deciding where to go out to eat or which clothes to buy than they do in choosing a practitioner who may have a major influence on the length and quality of their lives. More often than not, they select a hospital or clinic merely because it happens to be the nearest, and the institution itself chooses a physician for them from its roster of specialists. For financial reasons and because of the limitations imposed by insurance companies, etc., it is often difficult for people to insist on the medical treatment of their choice. But remember: it is your life that is at stake. You owe it to yourself and your dependants to do everything in your power to get the best possible treatment.

Today's medical market offers a bewildering variety of approaches to illness and treatment: orthodox, naturopathic, herbal, homeopathic, chiropractic, osteopathy, acupuncture, reflexology, kinesiology and shiatsu to name but a few. There is growing acceptance even in the orthodox medical establishment that so-called alternative therapies may often successfully complement conventional surgery and drug therapy. However, in many cases the different approaches to treatment are based on radically different theories of illness. Even in orthodox medicine most courses of treatment involve difficult decisions about risks versus benefits.

Rebbe Nachman did not offer any guidance about the merits or lack of merits of different approaches to medical treatment. As in all the agonizing decisions we face in life, we must first and foremost pray to God for true guidance. As we have seen, the Talmud tells us that Heaven decrees which medicine and doctor will be the agents of healing in each individual case of illness (Avodah Zarah 55a). Turn this into a prayer that God should help you find the doctor and treatment you need quickly and easily, and that he should do his work with the utmost proficiency. Make enquiries wherever you can and discuss your problem with reliable people who have experience with similar problems. Many rabbis encounter a wide variety of medical problems in the course of their duties, and it may be helpful to consult with them. In the Torah-observant community there are a number of well-known figures who have made it a specialty to keep abreast of current medical developments and who can often give advice about the best specialists and clinics in various areas.

What makes a "good" doctor? We can gain some insight into this from a comment by the Maharsha on the mishnaic dictum that "The best of doctors are destined to go to hell" (Kiddushin 82a). The Maharsha explains (ad loc. s.v. tov): "The `best of doctors' means a doctor who considers himself to be the best. He relies only on his own expertise. There are times when his haughtiness and conceit cause him to diagnose an illness mistakenly, resulting in the death of the patient. The doctor should make it a habit always to consult another physician, because a life has been placed in his hands."

Presumably a "good doctor" is one with the greatest medical expertise, but from the Maharsha's comment it is clear that expertise itself depends not only on profound study and rich experience, vital as these are, but also on humility. A true healer is always conscious of the awesome responsibility he bears and his own human limitations. He recognizes the amazing intricacy of the human body. Knowing the difficulty of diagnosing accurately and determining the most suitable treatment, he weighs every decision he makes with the utmost care.

Another factor is the doctor's optimism. On the saying of the Rabbis that "the Torah gave the doctor license to heal" (Berakhot 60a), the Tzemach Tzedek (the third Lubavitcher Rebbe, 1789-1866) noted the Torah gives him authority only to heal, not to make the patient despondent" (Refuah Shelemah p.25).

To a large extent, judgments about different doctors' levels of expertise, humility and optimism are bound to be subjective. In any case, a doctor who is good for one person may be useless for somebody else. Which characteristics are important to you? Would you feel comfortable with a male or female? A young person or someone with more maturity? Which count more to you: impressive medical credentials and aggressive style, or affability, compassion and good bedside manner? Is it important to you that your doctor should have a feel for religion?

Many people develop all kinds of complexes about their doctors, becoming strangely inhibited in their presence and wary of raising their doubts and questions for fear of antagonizing them. Perhaps this is because, consciously or unconsciously, they look to the doctor as their savior, investing him with a power he does not possess. If you always keep in the forefront of your mind that God is the only healer, this should enable you to relate to doctors and other medical personnel as human beings and to interact with them in the same way as you would with professionals in any other field. Especially where you face serious decisions about treatment options, it is your absolute right to consult more than one doctor. If you are uncomfortable with your doctor, whether for professional or personal reasons, find someone with whom you feel more comfortable.

Don't be shy. Don't be afraid of imposing on the doctor's time: it's your life that is at stake, and the doctor is being paid to serve you. List your questions in advance of your appointment in order not to forget anything. Ask about anything you need to know. Don't hide any symptoms. Speak frankly about any anxieties you have, such as whether you face disability or disfigurement, will you suffer pain, etc. Everybody has worries of one kind or another; this is nothing to be ashamed of. The doctor may be able to dispel some of your fears or offer practical suggestions for dealing with any problems that are likely to arise. Don't forget to express your appreciation to your doctors and other members of the healthcare team.

Having chosen your doctor and course of treatment, take good care to carry out the doctor's advice. Don't use Rebbe Nachman's negative comments about doctors and medicine as an excuse to be lax in taking medications and following other instructions. If you don't trust your doctor's judgment or have doubts about the value of the treatment you are receiving, go to another doctor and get a second opinion. But be sure to persist with medical treatment if that is what you need. Following the prescribed course of treatment conscientiously is part of the mitzvah to "take care of yourself, and guard your soul diligently" (Deuteronomy 4:9).

That is not to say that, having found a doctor, you can simply leave your health entirely in his hands and wait for the treatment to take effect. More and more orthodox doctors and clinics now accept that in many different illnesses, lifestyle changes by the patient in such areas as diet, exercise, relaxation, etc. play a major role in restoring health. Even when it comes to medical treatment per se, the doctor may be the agent and the medications the means, but for true and complete healing, you must look only to God. This is another aspect of the mitzvah to "guard your soul diligently."

Try to turn your thoughts to God at every stage of treatment. Take a copy of the Psalms with you to the clinic and read from it while waiting. Pray for an accurate diagnosis. Ask God to guide the doctor in prescribing the best course of treatment. When taking medicines or receiving treatment, believe not in the means but in God, and recite the prayer for healing. Where possible, choose a hospital that can provide you with kosher food and take account of your need to observe Shabbat and other religious requirements. Wherever possible, use medicines that are kosher, and try to avoid treatments that may lead to sterility or otherwise affect future mitzvah observance.

Doctor's appointments, visits to clinics and hospitalization provide many opportunities to serve God. Your primary purpose may be to receive treatment, and you may be uncomfortable or in pain. But you can still use those of your faculties that are still intact - your speech, your smile, and so on - to sanctify the name of God. Talk about Torah and serving God. Share your faith with nurses, doctors and other patients. Offer comfort and encouragement to those who are also suffering. You can make use of your own experience to help others and to deepen your human relationships, elevating yourself in the process.

Every doctor will first seek to diagnose the problem or illness - to give it a name. However, it is vital to recognize that the doctor's diagnosis is nothing but a way of classifying your physical condition: into which category of known medical problems does it fall? Your physical condition is unquestionably of the utmost importance, having a decisive effect on everything else in your life. Yet the physical is only one plane of your being as a whole. Just as the state of your body is affecting the way you feel, think and act, so your thoughts, feelings and activities in the past have played their part in influencing your current physical condition. And so too, how you direct them now will affect your state of health and the course of your healing both now and in the future.

Don't let the medical label become the definitive statement of who you are - a "case" of this or that - because this will limit the way that you (and others) look at yourself. As a soul, a whole person living in multiple dimensions, your situation goes far beyond the strict medical diagnosis of your physical condition. As you work on yourself, be sure to take into account the broader ramifications of the physical problem. Bodily illness generally indicates disharmony in other planes of life besides the physical, such as the stress bound up with career and livelihood, long-standing tensions in the family or other close relationships, deep inner frustrations and other emotional and spiritual wounds. The healing you need is not only healing of the body but healing of the soul.

As we have seen, Rebbe Nachman emphasized that all the spiritual pathways of healing are ultimately founded on faith. But no one should say, "Well, I just don't have sufficient faith, so how can I follow these pathways?" For the very process of healing itself is precisely about developing and deepening our faith. In times of health we often take our bodily functioning for granted. Only when our bodies fail in some way and we become sick do we suddenly see how frail and helpless we are, and we begin to recognize how totally dependent we are on God's mercy. Illness is thus a prompt to reach out to God, and we must direct our cries of pain and suffering to Him.

Use your mouth to affirm your faith. You can do this even if you feel your faith to be shaky, or even non-existent. "Even if you have doubts about your faith in God, say out loud: `I believe with perfect faith that God is One, first, last and always'" (Rabbi Nachman's Wisdom #142). The Jewish mystical tradition associates the mouth with malkhut, kingship. Use your mouth to lead and rule over yourself; your thoughts and feelings will eventually follow. When talking about your illness and treatment and hopes of recovery, be sure to use phrases like "im yirtzeh HaShem, God willing," "everything is in God's hands," and "God is the Healer."

Have firm trust that every detail of your illness and recovery is in God's hands. God controls the entire universe, and nothing can stand in His way. The Lubavitcher Rebbe wrote to one sick person: "Regarding your quotation from the Rambam that the Holy One, blessed be He, does not perform miracles going beyond the bounds of nature for a single individual, the fact is that we have seen with our own eyes miracles beyond nature performed for individuals, especially in the last few years, and especially in the case of medical problems in the interior of the body. Again and again the doctors have been wrong in their diagnoses even after all the tests" (Refuah Shelemah pp.35-6).

Does this imply that having faith means believing you will definitely be completely cured and everything will turn out as you wish? This kind of thinking is dangerous because it can lead to crushing disappointment if the situation deteriorates. Some people might feel guilty for not having believed strongly enough, while others might conclude that their "faith" didn't work, which might lead them to abandon it altogether. To insist that everything will turn out exactly as we might choose is not faith but wishful thinking. True faith means knowing that whatever happens is from God, and that everything God does is for the very best. Our task is to search for God's goodness. Have faith that every last detail of what is happening to you is sent by God - every ache and pain, every twist and turn, and every step in the healing process. Know that God is good, and therefore everything will turn out for the best, even if you cannot see how right now.

Believing that everything is for the best does not mean that you are not allowed to feel bad. The pressure put on ill people to keep their spirits up and think only good thoughts can make them feel very isolated from those trying to "cheer them up." They may even come to feel ashamed if they see that things are getting worse rather than better. The last thing you need is to feel bad about feeling bad. Don't feel guilty if you feel miserable and sorry for yourself. But turn your cry of pain and misery to God: "Ayeh mekom kevodo? Where is the place of Your glory? Where are You? Come down to me and help me!" We should believe that everything God sends is for good, but that does not mean we may not ask for what we believe to be better!

The essence of a positive attitude is not to pretend that you're fine if you're far from it, but rather to keep yourself from sinking into a quagmire of morbid negativity by having faith in God's goodness even at the hardest moments. The worst suffering is easier to bear when you know that it comes for some purpose, such as to cleanse you of your sins. In the words of Rebbe Nachman: "When things are very bad, make yourself into nothing. Close your mouth and eyes - and you are like nothing. Sometimes you may feel overwhelmed by evil thoughts, finding it impossible to overcome them. You must then make yourself like nothing. You no longer exist, your eyes and mouth are closed. Every thought is banished. Your mind ceases to exist. You have nullified yourself completely before God" (Rabbi Nachman's Wisdom #279).

It is striking that in the last of Rebbe Nachman's tales, "The Seven Beggars," not only are all seven heroes the lowest of the low on most people's scale of success, since they're all beggars. In addition, each of them appears to have a terrible disability. One is blind, another deaf, another dumb, one has a crooked neck, one is a hunchback, one has no hands and one has no legs. Yet each one has turned his apparent disability into a most amazing advantage in the world of truth. And they all owe their success to their very social disadvantage, because, being beggars, they all know that they have nothing in this world and must depend on God for everything. This comes to teach us that we must ask God to show us how to take advantage of even the worst situations, including severe disability and chronic illness.

Can you still talk? Use this divine faculty to pour out your heart to God and reach out to Him as never before. Sing. Cheer yourself up. Speak to the people around you and cheer them up. Talk on the phone: call people you know who are lonely and unhappy. Use your own experience to help you understand what other people are going through. Encourage them to talk. Be a good listener. Talk about faith and simchah.... And if it's hard for you to talk, you can still think about God and pray to Him in your heart. And when you do this you are alive, because faith and prayer connect us with the Life of life.

All illness has a spiritual as well as a physical dimension, and in order to heal you therefore need not only your physician but also a doctor of the soul - a tzaddik - both to intervene on the spiritual plane through his prayers, and to give guidance about tikkunim, changes in your life or shifts of emphasis that may help bring long-term health to the whole person.

The first priority is pidyon nefesh, redemption of the soul, because the sick person is under a cloud of dinim, heavenly judgments, as manifest in the pain, discomfort and mental constriction that accompany so many illnesses. The Talmud says, "Someone who has a sick person in his house should go to a Sage and ask him to request mercy for him" (Bava Batra 116a). The true Sage is the Tzaddik, who works to "sweeten" the harsh judgments. As we have seen, Rebbe Nachman taught that "when a person is sick, a redemption is the prerequisite of any cure. Only after the redemption has been made does the Torah give the doctor permission to cure" (Likutey Moharan II, 3).

It is not necessary to wait until illness strikes before giving money for a pidyon. This can be done at any time. In the words of Rebbe Nachman: "It is a good practice to give money regularly for a pidyon. This sweetens any harsh judgments and gives constant protection against them. Even when no one in the house is sick and you have no particular problems, it is still good to give money for a pidyon in order to prevent any problems or illness, God forbid" (Tzaddik #539). A suitable time to give money for a pidyon is on the eve of Rosh Hashanah (Rabbi Nachman's Wisdom #214). Some may wish to do so when they feel themselves to be in a rut or face particularly difficult problems, after a frightening dream or some other bad experience, such as a near accident, a mugging or terrorist attack, etc.

How much money should one give? In some cases a tzaddik may suggest an appropriate sum, but it is impossible to lay down general rules. How much is your life worth? In many cases illness brings heavy expenses leading to acute financial pressures, especially when the patient is the main bread-winner. At such a time a sizeable contribution for a pidyon may seem out of the question. But considering the massive sums that are often spent on medical treatment, it is strange how tight-fisted some people with means become when it comes to charity. Yet "charity saves from death" (Proverbs 10:2 & 11:4, and see Tzaddik #10).

To whom should one give the pidyon money? Rebbe Nachman spoke about the great wisdom and effort required to accomplish a redemption. Some people wonder whether any known tzaddik today has the power to do everything necessary to bring about a pidyon. However, "The Bible compares Gideon, Samson and Jephthah to Moses, Aaron and Samuel. This is to teach you that Gideon was to his generation as Moses was to his; Samson was to his generation as Aaron was to his; Jephthah was to his generation as Samuel was to his. This comes to teach you that no matter how lowly a person may be, once he is appointed leader of the community he is like the noblest of the noble" (Rosh Hashanah 25b). Thank God, there are many saintly tzaddikim in the various Jewish communities. The Breslover Chassidim often send money for a pidyon to leading elders of the movement.

By his own testimony, Rebbe Nachman himself possessed the power to bring about redemption of the soul (Rabbi Nachman's Wisdom #175), and "the tzaddikim are greater after their death than during their lifetime" (Chullin 7b). For this reason, in cases of serious illness, many Breslover Chassidim endeavor to send someone to pray at Rebbe Nachman's grave in Uman.

Rebbe Nachman writes that "filling the mouths of Torah scholars with wine has the same power as a redemption and can sweeten harsh judgments" (Likutey Moharan I, 41). On the literal level this would mean presenting a gift of wine for genuine Torah scholars to drink. In addition, since "`wine' refers to Torah" (Tanchuma, Vayechi 10), this can be taken to mean that a pidyon nefesh can be effected by helping to spread the ``wine'' of the Tzaddik's teachings as widely as possible so that they are on the lips of multitudes of Jewish souls.

Rebbe Nachman also teaches that "rising for Tikkun Chatzot, the midnight prayer, has the same power as a redemption" (Likutey Moharan I, 149). Tikkun Chatzot clearly has an important place in Rebbe Nachman's healing pathway. This is because the purpose of the midnight prayer is to initiate the restoration of Jerusalem by mourning over the destruction of the Temple. As we have seen in "Sound the Shofar - Dominion," the "rebuilding of Jerusalem" is the foundation for the redemption of prayer that brings true healing. Mourning for the Temple, which is the source of da'at, is bound up with mourning over the concealment of the true Tzaddik, who is the very embodiment of da'at (Likutey Moharan II, 67). Since it is the Tzaddik who brings about pidyon nefesh, there is a close connection between tikkun chatzot and pidyon nefesh.

The quiet that reigns in the small hours of the morning can be most conducive to clear insight and heartfelt prayer. Many people with serious illnesses find that their sleep patterns are disturbed, and they often lie awake for long periods during the night. It can only be beneficial to take the opportunity to recite a few portions of tikkun chatzot and offer your own personal prayers to God.

According to Rebbe Nachman, pidyon nefesh is the very key to healing. But the object is not to throw all the responsibility for healing onto the Tzaddik and simply wait for salvation to come. People make the same mistake about medicine - "Doctor, cure me!" - hoping that the treatment will make the patient well again without his having to take the trouble to make any changes in his lifestyle, drop bad habits, quit smoking and drinking, modify his diet, exercise properly, etc. Turning to the Tzaddik for spiritual healing involves more than just asking him to pray. One must also make a deep study of his teachings as a guide to the changes one must make in one's life in order to bring about true healing on all levels.

The first shock of discovery of a life-threatening illness usually passes within a few days, but is often followed by a phase of anxiety and depression as the news begins to sink in. This period may be marked by a loss of interest in eating and other activities, sleep disturbances, difficulties in concentration and general apathy. But in most cases these reactions tend to become less intense within a couple of weeks or so as you adapt to the new reality, resume some of your normal activities and actively confront the various problems you face, such as those involving treatments and their effects on day to day life.

Still, it is very likely that you will continue to experience many different kinds of fears: apprehensiveness about visits to the doctor or medical tests and their results, nervousness about treatments and their side effects, dread of pain, disfigurement and disability, trepidation about the future, and, most of all, fears of death. Every new ache or pain may give rise to further worry about what is happening. Fears for oneself are often complicated by other factors, such as anxiety about the impact of the illness on other members of the family or financial worries at a time when income may be seriously reduced.

There is nothing unusual or improper about such fears. Everyone with a serious illness wonders whether he will die of it. Fear of pain and other anxieties are only natural. Indeed, confronting your fears and coming to terms with them are important parts of the healing process. Some of your concerns will be able to be dispelled through frank discussion with your doctor, family members, friends, rabbis and counsellors who may be able to give you support, offer practical advice or provide you with valuable information about options you may not be aware of. When it comes to the possibility of physical deterioration and death, these are an inescapable part of our existential situation. Those who are willing to confront and accept them with equanimity are immeasurably enhanced as human beings.

In order to release yourself from the grip of fear and escape the paralytic sense of helplessness it engenders, the first step is to learn to stand outside the feeling. If you find yourself in the throes of an attack of fear, accept that you are afraid and recognize the intensity of the feeling. But at the same time, remind yourself that your degree of fear is not necessarily a reflection of the severity of the real problem. In order to think about your problems more rationally and to develop a practical strategy for coping, it can be most helpful to discuss your concerns openly and honestly with others.

You should discuss any anxieties about possible pain and disability with your doctors, because they may well be able to set your mind at rest. Contemporary medicine offers highly sophis- ticated techniques for controlling pain and overcoming disability that did not exist in the past. If you are worried about what is likely to happen in the event that your illness worsens, ask your doctor for clear information about what you might have to face. You may find it helpful to work out contingency plans for dealing with situations that concern you, such as what medical treatment you would want to receive if your physical and mental stamina declines to the point where you are unable to make decisions. Many people facing serious illness find one of the best forums for dealing with their fears and concerns to be support groups made up of those in similar situations. Your clinic or hospital should have information about suitable groups.

If you are worried about family matters, financial problems and so on, try to discuss them openly with those concerned, or talk them over with a good friend or a rabbi, etc. Owing to the strong taboos in our society against speaking about illness and death, even very close friends and family may feel inhibited about discussing sensitive issues. You may sense that some of those around you are simply unable to deal with the situation. But with those to whom you feel you can talk, you may be able to set the tone for serious discussion by bringing up words like "illness" and "death" yourself in order to let them know that such topics are not taboo. Be prepared to cry together and express strong feelings with dignity.

As far as possible, try to resolve outstanding family matters and attend to unfinished business. Settle old grievances and say what you need to say to loved ones and friends. One of the most positive things that can come out of a serious illness is the open expression of feeling and support it can engender, leading to greater intensity and cohesiveness in family and other relationships. On the other hand there are some relationships that cannot be deepened, and you should learn to say "no" to social obligations that are devoid of any real value in order to invest your energies in relationships and activities that are more meaningful.

Try to attend to what needs doing sooner rather than later. Even those in the best of health are advised to consider the purchase of a burial plot, which in Jewish lore is regarded as a segulah for long life. Write a will stating exactly how you wish your possessions to be distributed. It is desirable to attend to such matters not because you are necessarily going to die soon, but on the contrary, because when all your affairs are in order you can live to the fullest without having a clutter of unresolved issues weighing on your mind.

No matter how much support you have from those around you and how many issues you resolve, it is very likely that many of your fears will rear their heads again and again, including some you thought you had overcome. Many of our deepest fears are necessarily private. Pain, disability and, most of all, death are all things that we ultimately face alone. Indeed they are fearsome, especially death, which is not just a matter of ceasing to live in this world, but of going before the heavenly court and facing the Creator of the universe.

Fear is one of the main ways in which God's attribute of stern justice - to which the sick person is particularly subject - manifests itself in his or her consciousness. Indeed, fear is sent to us precisely to bring us to a deeper awareness of and connection with God. Chassidism calls the experience of gut fear "fallen fear" - fallen, because it is on a lower level than the faculty of reverential awe of God that is the mark of the mature soul. The point is to elevate gut fear and turn it into awe of God and awareness of His presence. Fear is a signal to repent and to fix what has to be fixed in order to attain a deeper connection with God. This does not mean getting into a morbid state of waiting to die, but rather preparing yourself to live, by reaching out to God through intense prayer and devotion, Torah and mitzvot.

Rebbe Nachman taught that the way to elevate fear and turn it into awe is through self-judgment: examining yourself, surveying your life and evaluating your behavior, activities and involvements.

You may well feel bad about certain aspects of yourself or guilty that you didn't do this or that differently. But does this mean you should feel guilty about being ill, as if it's your fault? People certainly do often perceive illness as a punishment because of the associated suffering and the unpleasantness of many of the treatments. In some cases one can identify specific activities or habits that brought on the illness. But the point is not to castigate yourself for having caused your illness: God's ways are ultimately inscrutable, and it would be presumptuous for anyone to state definitively what purpose He has in sending a particular illness. Far more important is to view the illness as a prompt to fix what lies within your power to fix now, and to bring your relationship with God to a new level of intensity.

Make your peace with God. Look back over your past and confess what you know to be your sins, mistakes and personal shortcomings. You should feel contrition, certainly, but this does not mean that you should engage in an orgy of self-castigation. After taking responsibility for past mistakes, ask God to help you understand what He wants of you now and how you can come closer to Him through your illness. This process of introspection and self-judgment may be a lengthy one. Even after you have worked hard to use your fears to bring you to teshuvah, don't be surprised if they return again and again. Each time you experience fear and anxiety, know that they are nothing but a prompt to cry out to God again now, for "Now, Israel, what does God ask of you except to fear God, to walk in all His ways and to love Him and to serve God with all your heart and all your soul" (Deuteronomy 10:12).

Illness can bring many trials besides the physical pain and suffering which are often a part of it and which can be so exhausting and enervating. To those for whom even the simplest everyday activities such as going to the toilet, washing, dressing, etc. are suddenly impossible, the sense of helplessness and dependence on others can be a source of terrible humiliation. Because of the emphasis we put on our physical appearance, even minor disfigurement can cause extreme embarrassment, as can the need to use a wheelchair, catheter or other external apparatus.

Then there are the more subtle trials. Other people often don't know how to react appropriately to those who are sick and in pain. Even close friends may have little understanding of what you are going through, leaving you feeling estranged and isolated. Cancer and certain other illnesses are so feared that even the best-intentioned people often tend to shy away from those afflicted as if they were contagious. Ironically, the feeling of having been reduced to the status of a second-class citizen is often most pronounced when having to deal with the medical system itself. No doubt unwittingly, doctors, nurses, medical secretaries and insurance company staff often treat patients with the grossest insensitivity and lack of understanding.

You can certainly be forgiven for being upset and distressed by this added suffering. "A person cannot be called to account for the way he reacts at his time of suffering" (Bava Batra 47b). But if you can bring yourself to accept these trials with patience, you will draw rich blessings upon yourself, as the Rabbis taught: "Of those who suffer their humiliation without humiliating others, who hear themselves insulted yet do not answer back, who act out of love and rejoice in their suffering - of them the verse says (Judges 5:31): `And those who love Him are as the sun when it comes out in its might'" (Shabbat 88b etc.).

In order to experience God's glory, which as Rebbe Nachman teaches is the ultimate destiny of the Jew, it is necessary to set aside our own dignity. We are often so full of our own of self-importance and so determined to be in control of our lives and environment that we lose our awareness of God's presence and His power and control over us. But the humiliation and suffering that are so often part and parcel of illness whittle away this pride, opening our hearts to God.

"You must make yourself into nothing, like a wasteland that people trample over. Pay no attention whatever to any opposition or to the contempt with which people may treat you. Be aware of the wrong you have done and accept that even the suffering and murderous opposition you may have to encounter in your quest for truth are perfectly just. Train yourself to be silent and to be able to hear yourself insulted without answering back. Someone like this is called `wise' and will come to complete teshuvah, Keter, the Crown, which is the highest of the sefirot. This is the way to true and enduring glory, the glory of God" (Likutey Moharan I, 6:2).

Lingering pain can be totally debilitating, making it virtually impossible to enjoy most of the activities that give pleasure and meaning to life, leaving one irritable, helpless and depressed. Thank God, the medical resources for managing pain are far better and more sophisticated than they were even a couple of decades ago, especially in cases of acute pain, where the underlying cause can usually be rapidly identified and treated. Yet, effective as modern analgesic medications and surgical or other techniques may be, they are certainly not a panacea. Analgesics do not always work, and they sometimes have troublesome side effects, such as drowsiness and confusion. In many cases of chronic pain, even the most sophisticated diagnostic tests may give little indication about the causes, and people often come to the end of long and frustrating courses of treatment involving surgery and drugs of all kinds, only to be told by their doctors that they will have to "learn to live" with their pain.

Physical and occupational therapy, acupuncture, massage and the like can often help alleviate certain types of chronic pain. But experience in growing numbers of stress and pain reduction programs continues to confirm the value of psychological techniques such as relaxation, meditation, visualization and self-hypnosis in increasing control over pain and reducing the physical tension that often accompanies mental anxiety.

By utilizing the power of the mind over the body many patients find that they can cut their dosages of analgesics, reduce the undesirable side effects of chemotherapy and other treatments, rehabilitate faster after surgery and control a wide range of other problems, from back pain and asthma to warts, psoriasis and irritable bowel syndrome. On average, psychological techniques can reduce pain by some 10 to 40 percent, and while this may not seem very much, those suffering from chronic pain find comfort in the knowledge that they can modulate it to a point where it is manageable.

Before embarking on the use of psychological techniques to reduce pain, it is vital to understand that pain is one of the body's most important messengers. At times, pain may be the body's way of telling us that there is a serious problem that requires immediate medical attention. Pain control should be used not as an alternative to medical treatment where this is called for, but as a complement to it.

In learning to control pain, it is valuable to grasp the distinction between pain and suffering. Pain is a physical signal, while suffering is one of many possible responses to such a signal. Even a mild pain can produce great suffering if we are afraid it may indicate a tumor or some other dangerous condition. But the very same pain may be seen as nothing more than a minor inconvenience if all the tests turn out to be negative. This shows that it is not necessarily the pain itself so much as the way we react to it that determines the degree of suffering we experience. This does not mean that the pain does not exist and is all "in your head." What it does imply is that while your pain may be a very real physical sensation, you can influence the way you experience it by mobilizing your mental and spiritual resources.

If your pain is causing you anxiety, this can produce muscle tension that may itself increase the pain. You can see this from the fact that you can produce painful sensations in an uninjured part of your body simply by tensing your muscles. Since muscle tension can increase the physical component of pain, you have it in your power to reduce your pain by consciously relaxing your muscles. Progressive relaxation techniques are now taught in many pain and stress control programs (and see Under the Table pp. 65-69). Deep relaxation can be greatly enhanced by the use of visualization, such as imagining your body floating somewhere safe and comfortable. One of the most important principles in pain management is to deal with an attack early. It is far more effective to employ relaxation and other techniques to deflect an attack of pain before it becomes established than to reduce severe pain that has been troubling you for some time.

We are constantly exposed to unending streams of stimuli of all kinds, external and internal. However, we are not consciously aware of most of them because our minds are focussed elsewhere. Pain is the most compelling of all sensations. Yet it is still possible to reduce the amount of pain you actually feel by learning to shift your attention away from the physical signals. Rather than insisting that the pain should go away, try to imagine yourself taking a warm bath or using ice or cold water or some other remedy that usually works for you. Alternatively, try concentrating on the sensations in other, non-painful parts of your body, such as the delicate sensations in your fingertips as you rub them together. Another technique is to picture yourself in some place you particularly enjoy or engaged in some pleasurable activity. The principle is the same as when you are so caught up in a good book that you lose all awareness of your surroundings. The more engrossed you are in one object of attention, the more likely you are to ignore others.

Two generations ago, in the days before sophisticated anesthetics, R. Chaim Ozer Grodzenski of Kovno (d.1941) went through a lengthy surgical operation without drugs of any kind by mentally working through an intricate talmudic sugya with the utmost concentration. Such a feat may be beyond the capabilities of most of us, but the average person can learn to focus his or her attention on a familiar passage, such as Psalms 23 and 121, Adon Olam, etc., concentrating intently on each of the words in turn in order to shift conscious awareness away from pain. The deeper trust and faith engendered by intense prayer at such a time will also aid muscular relaxation. One present-day chassid successfully endured a series of treatments that most people find excruciating by singing a succession of lively nigunim at the top of his voice from the beginning of each session to the end!

We have seen how techniques like visualization and the wilful focussing of attention can utilize the power of the mind to counter physical pain. Can the power of the mind and soul also be harnessed to promote actual physical healing in the body? It would seem that if mental and spiritual factors have the power to bring on illness then they should have an influence in healing it as well. This of course is the principle behind Rebbe Nachman's statements that the main reason why people become sick is because they are depressed, and the great healer is joy (Likutey Moharan II, 24).

In recent years there has been a burgeoning of interest, not only among psychologists and alternative practitioners but also among growing numbers of conventional physicians, in the use of specific mental techniques that appear to promote healing. Foremost among them is "meditation." This is a word that different people understand in different ways. Basically, meditation simply means "thinking in a controlled manner... deciding exactly how one wishes to direct the mind for a period of time, and then doing it" (R. Aryeh Kaplan, Jewish Meditation p.3). According to this definition, there are as many different types of meditation as there are ways of directing the mind. The kinds of meditation that have received most attention in connection with healing essentially involve non-doing - relaxing the body and, rather than trying to direct one's thoughts, detaching oneself from them in order to attain a state of inner calm.

It is obvious that relaxation and meditation of this kind directly affect the somatic nervous system, which is under our conscious control, reducing tension in the skeletal muscles, leading to a greater sense of tranquillity. But the implication of recent studies is that meditation can also influence the autonomic nervous, endocrine and immune systems, which are generally thought of as being less subject to our conscious control, yet which play a vital role in many aspects of bodily functioning, directly affecting the working of organs like the heart, lungs, blood vessels, stomach, intestine and bladder.

A number of studies have indicated that regular meditation can reduce hypertension (high blood pressure), which is implicated in the vast majority of heart attacks and strokes, and that it can also lower abnormally high levels of cholesterol in the blood (another primary risk factor for heart attacks, since excess cholesterol in the blood is directly linked to the fatty plaque deposits that clog the arteries leading to the heart). Other studies indicate that regular meditation may substantially increase blood levels of certain important immune-system hormones, while reducing levels of the stress hormones that have been linked to many diseases. In addition, meditation is said to be of benefit for migraine, various kinds of back pain, digestive disorders, arthritis, diabetes and thyroid problems.

That the salutory mental states induced by relaxation and passive meditation have a positive effect on physical functioning and health only confirms the truth of Rebbe Nachman's teachings about the vital role of simchah in physical well-being. But besides passive meditation, can more active kinds of meditation and the like be used as ways of "communicating" directly with the autonomic nervous and immune systems, etc., in order to stimulate the healing process?

One of the most often discussed techniques is visualization, in which the patient enters a state of deep relaxation and concentrates on vivid mental images representing the physical effect he or she wishes to achieve. For example, some patients imagine their immune system cells "swallowing up" invaders in the body. Visualization practitioners claim that the imagination can be used to influence physiological processes as varied as salivation, skin resistance, muscle tension, respiration, heart rate, blood pressure, gastrointestinal activity, blood glucose levels and blister formation.

Rebbe Nachman discussed the power of intense concentration and visualization, though not specifically in connection with healing. He said: "Thought can bring about many things.... When thought is intensely concentrated it can exert great influence. Every faculty of the mind, both conscious and unconscious, down to the innermost point, must be focussed without distraction. To accomplish this, the concentrated thought must spell out every step of the desired result in detail" (Rabbi Nachman's Wisdom #62).

Although Rebbe Nachman does not appear to have directly addressed the subject of visualization as a method of healing, the Bible itself provides an instructive example of what might be called a visual cure. In the course of the Children of Israel's forty years of wandering in the wilderness, the people complained against God and Moses, causing a plague of poisonous serpents. In response to Moses' prayer for help, God told him to make a serpent and place it on a pole. "And everyone who has been bitten will see it and live. And Moses made a bronze serpent and put it on a pole, and if the serpent had bitten a man and he gazed at the bronze serpent, he lived" (Numbers 21:8-9). After the Jewish People came into Eretz Israel, the bronze serpent was preserved. However, in later times it turned into an object of cult worship, and we find that King Hezekiah, besides putting away the Book of Remedies, also "broke in pieces the bronze serpent that Moses had made, for until that time the Children of Israel used to make offerings to it" (Kings II, 18:4).

Hezekiah's objection to the bronze serpent can perhaps be understood in the light of the famous rabbinic comment on the episode in the wilderness: "Does a serpent kill and does a serpent give life? No! When the Jewish People looked upwards and submitted their hearts to their Father in Heaven they were healed, and if not, their bodies rotted" (Rosh Hashanah 29a). It was not the bronze serpent that healed. Its only value lay in helping the sick to direct and focus their attention on God as the true source of healing. As soon as people attributed healing power to the image itself, they turned it into an idol, the negation of our faith, and as such it had to be destroyed.

The story of the bronze serpent teaches that true spiritual healing is not a matter of attempting to employ spiritual techniques in place of drugs, surgery, etc. as a way of making adjustments in the natural world: this would turn spirituality into little more than a form of magic. Rather, spiritual healing means opening ourselves to the beneficial spiritual influences God is constantly sending into the world to bring harmony, health and healing. They will indeed do this if we will just allow them to work without interference. God created the human body to be healthy, and He revealed a code of conduct - the Torah - that, when faithfully and joyously observed, fosters balance on every level, spiritual and physical. Diverging from this code leads to imbalance, which may cause physical illness. In order to be healed, it is necessary to turn our eyes back to God and His Torah in order to open ourselves to the spiritual influences that can restore harmony.

Rather than trying to manipulate nature, the spiritual approach is to put our main effort into seeking to influence that which most lies within our power to affect - our own hearts. Our task is to re-establish and deepen our attachment to God and to the Torah code that brings balance and health. Perhaps it is significant that the meditation practices that have proved the most effective in promoting healing (and are also the least disputed even among orthodox practitioners) are those that are more passive, involving non-doing - opening oneself to salutory mental states and leaving the divinely created body to adjust itself without interference, rather than actively trying to manipulate the physical realm through some kind of spiritual technique.

Visualization has proved itself in fields as wide apart as athletics, salesmanship and childbirth. Rebbe Nachman advocated the use of visualization as an aid in accomplishing spiritual goals. "For example, you can concentrate on the fact that you want to complete the four sections of the Shulchan Arukh (Code of Jewish Law). If you study five pages each day, you will finish all four sections in one year. Picture in your mind exactly how you'll go about this course of study. Concentrate so strongly that you are literally obsessed with the thought. If your desire is strong and your concentration intense enough, your plans will be fulfilled. This same concept can also be applied to other areas" (Rabbi Nachman's Wisdom ibid.).

Here visualization is being used to gear oneself for dynamic action, which can be of tremendous value as a part of healing when it comes to rehabilitation or making necessary lifestyle changes. In these cases one is trying to change oneself and enhance one's own performance as opposed to seeking to affect autonomic bodily processes. It may be that visualizations for the latter purpose can sometimes be effective. If you feel that they are of value for you in your personal healing pathway you should certainly use them. But it would be a mistake to believe that you can force your body to heal through the intensity of your visualizations - "my strength and the power of my hands" (Deuteronomy 8:17). Rather you should use mental images as a means of focussing your sight on God's healing power and allowing it to work within you.

The same distinction between working to open oneself to God's healing power as opposed to trying to manipulate physical processes would also apply in the case of the most potent of all spiritual weapons: words. As we have seen from "Sound the Shofar - Dominion", the power of speech is at the very core of Rebbe Nachman's healing pathway. Does this mean that words can be used to channel healing directly into the physical body?

Rebbe Nachman told R. Shmuel Isaac, one of his most prominent followers, that "during hisbodedus he should speak in turn to each of the limbs and organs of his body, explaining to them that all material desires are futile, because in the end man is destined to die. Eventually R. Shmuel Isaac reached a level where any limb or organ he spoke to individually was so responsive to his words that the very life would ebb out of it, leaving it completely devoid of strength or sensation. This was actually visible in the case of his external limbs, such as his fingers and toes. Regarding the vital internal organs, such as his heart, etc. he actually had to hold back when speaking to them for fear that the life would quite literally leave them, God forbid" (Tzaddik #442).

This passage implies that through words alone a person has the power to influence the vitality or lack of it, not only in his external limbs but even in his internal organs. This might suggest that someone who is sick could try talking to (or singing to or otherwise communicating with) the affected body parts in order to encourage them to heal and function properly. There is indeed evidence that for certain types of physical conditions, sounds or vibrations of various kinds can be used to promote healing. Sounds, chants, prayers and music play a role in many healing traditions. Soundwaves may well have a direct effect on certain aspects of bodily functioning. But when it comes to the use of words to "communicate" with the body, far more important than seeking to affect physiological processes would be to try to influence the spiritual soul that animates the body - the nefesh - and to fire yourself with a will to live and to use your physical faculties to fulfil the Torah and mitzvot.

Jewish law strictly forbids addressing prayers, psalms or other biblical verses, etc. to the body or particular body parts, as this is akin to using spells and witchcraft. "Those who whisper biblical verses over a wound or to stop a child panicking, or who place a Torah scroll or tefilin on a child to make him sleep, are not only sorcerers but heretics as well, because they want to use words of Torah as a form of treatment for the physical body, whereas they are essentially a remedy for the soul, as it is written `And they will be life for your soul.' However it is permissible to recite verses and psalms in order that the merit of one's recitation should protect one from harm and suffering" (Rambam, Mishneh Torah, Hilkhot Avodat Kokhavim 11:12).

The closing words of the biblical account of Creation speak of "His work which God created to do" (Genesis 2:3). God created the entire universe, but He left His work unfinished as it were, leaving it to man "to do" - to take an active role in completing the task so as to have a share in the work of creation. Yet paradoxically, man attains his highest dignity when he uses his God-given faculties of independent thought, speech and action not to assert his own ego and serve his selfish desires but rather to submit his will to God and work to reveal God's supreme power over creation. This revelation is itself the climax of creation, and this is what was left to man to bring about. Essentially it is accomplished through fulfilment of the Torah and mitzvot, all of which come to manifest God's sovereignty over the various facets of creation.

This is particularly true of the mitzvah of prayer, in which we declare God's kingship over all things, and especially over our own selves and all of our thoughts, feelings, desires, impulses, activities and involvements. This is why prayer is at the very center of the Torah path of healing. The Torah view is that sickness is an expression of some distortion in our relationship with God and a call to resolve it. As Rebbe Nachman explains it, illness comes because a person strays from the takhlit, the ultimate purpose of life, which is to know and be connected with God (Likutey Moharan I, 268). Prayer is the very foundation of our attachment to God: "Prayer is the main way in which to become connected with God. It is the gate through which we enter to God and come to know Him" (Likutey Moharan II, 84). Therefore prayer is the means to overcome any flaw in our relationship with God, and is thus the main avenue to healing.

What kinds of prayers? You should certainly pray again and again for refuah shelemah, perfect healing. By doing so you affirm your faith that your illness has been sent by God and that healing is ultimately in His hands alone. Can you still pray for healing if you have gone to a doctor for treatment? Given Rebbe Nachman's opposition to doctors, would he agree to praying for healing through medicine? Most definitely. Rebbe Nachman taught that we must pray for everything we need, including even the most minor things (Rabbi Nachman's Wisdom #233). This certainly applies to something as important as healing. The Rebbe knew that for most people healing comes "through a particular drug and a particular doctor" (Avodah Zarah 55a). With all the Rebbe's criticisms of doctors, he still said, "God is so great that He can send a cure even after someone goes to a doctor!" (Siach Sarfey Kodesh I-63) Rebbe Nachman certainly adhered to every detail of the Shulchan Arukh, which teaches us to offer a prayer whenever we take medicine or receive some other kind of medical treatment (Shulchan Arukh, Orach Chaim 230:4).

Yet even when we hope that a certain treatment will help, in our prayers for healing we should not insist that God send salvation this way. In the words of Rebbe Nachman: "Whenever a person prays, he should never try to force matters and insist that God do exactly what he wants Him to do. He should make his request and entreat God's love. If God grants it, well and good. And if not, then not" (Likutey Moharan I, 20:5). God has many ways of helping, and it could be that in His wisdom He knows that true healing will better come through some other means.

Are we allowed to pray for miracles? One may not rely on a miracle (Pesachim 64b), but this does not mean that it is forbidden to pray to God to send salvation even by miraculous means. A miracle brings great glory to God. As we have seen, a נס (ness, a miracle) is a "banner" pointing to the fact that "God is the King over all the earth": God is in control. When our prayers alter the course of events, negating the apparent inevitability of nature, this is visible evidence that God exists and listens to prayer (see Likutey Moharan I, 62:6).

Pray for what you need at every opportunity. Persist even if the situation seems to be deteriorating, and even when there seems to be no hope whatever. This we learn from King Hezekiah, who said, "Even if a sharp sword is pressing on your neck, don't despair of pleading for God's mercy" (Berakhot 10a). Not a single prayer is ever lost. Every prayer makes its mark, even though it may not be answered exactly as we might have envisaged according to our level of understanding. Sometimes people pray for someone to be healed and he or she dies. This does not mean that all their prayers were wasted, because God takes these prayers and may use them for the healing of that person's soul in the upper worlds, or for some other purpose.

As the principle spiritual pathway of healing, prayer involves far more than simply asking repeatedly for physical healing. True healing is the healing of the whole person. Our essential illness is our distance from God, and this is what prayer - the quest for connection with God - comes to heal. The pathway of prayer that brings healing is precisely the pathway Rebbe Nachman taught for all Jews at all times: putting all our strength into the set blessings and daily prayer services, reciting many psalms and other additional prayers, and talking to God in our own words in hisbodedus.

The set blessings and prayer services have an effect on at least two levels. For one thing, by con- centrating on the many different expressions of praise of God and His power as manifest in the Creation, we heighten our own consciousness of God's presence in our lives and in the world around us. This can only strengthen our attachment to God and our desire to follow His code of law, which is the key to balance and healing. But in addition to this, the very letters and words of the set prayers are a most powerful means of channeling divine influences to ourselves and to creation in general. The prophets and sages who arranged the prayers were masters of Lashon HaKodesh, the Holy Language, and provided us with sequences of holy names that bring divine blessing into all the worlds. The prayers "work" even without our understanding the mystical kavanot (intentions) that lie behind them (see Under the Table pp. 166-88). In the same way, the Psalms are not only profoundly inspiring in themselves but also bring all kinds of beneficial influences into the world in general.

Try to put as much strength and concentration as you can into your daily prayers and blessings. If it is not possible for you to recite the services in full, ask a competent rabbi for guidance as to which sections you should endeavor to say, and where possible, add any other passages from the Siddur, the Psalms, The Fiftieth Gate - Likutey Tefilot, etc. that are particularly meaningful to you. Depending on your condition, there may be times when it is hard for you to focus for very long. Pause whenever necessary, and allow your own thoughts to weave in and out of the text of the prayers. This will serve to keep your mind directed towards God.

In addition to the set blessings and prayers, your own private prayers in your own words are most important: not only your prayers for physical recovery, but also your prayers to live as a Jew, to refine your personality, develop your love and awe of God and other traits - kindness, generosity, truthfulness, honesty, moral purity, diligence, joy and so on - and to fully observe the mitzvot in all their details: charity, Torah study, Shabbat, Yom Tov, kashrut, tzitzit, tefilin, etc. Give voice to your longing and yearning to serve God. Even if at present you feel uncomfortable, sore, tired, weak, sick and disheartened, you can still quietly talk or whisper to God about all the holy tasks you would like to accomplish in your lifetime, and ask and plead with Him to help you complete them.

These conversations with God are the true "service of the heart" (Taanit 2a) in which you work to submit your innermost will and desire to God and His Torah. As we have seen, Rebbe Nachman taught that "the yearning and longing for something holy are themselves very precious. The soul of the Jew is actually formed through the yearning and desire which he feels for God and his good intentions to serve Him. Regardless of his level, each individual has a desire to reach a higher level. It is through this yearning that his holy soul is formed" (Likutey Moharan I, 31). Affirm your will to live and serve God joyously and with vigor. The expression of holy desire and longing in hisbodedus builds and strengthens the soul, and it is the return of the soul to the body that brings new vitality and healing.

Instead of focussing on the illness, this avenue of prayer concentrates on the life you look forward to when you will be well - life that you can already start living now by offering many prayers and carrying out as many mitzvot as you are capable of with as much strength and intensity as you can command. Don't eat, drink and breathe your illness. It may be an unwelcome part of your life, but don't let it take you over.

In the words of the Lubavitcher Rebbe: "As far as possible divert your attention from thinking too deeply about the subject of your health" (Refuah Shelemah p.31). "I stand by my opinion that one of the best medicines is to divert one's attention to other things. And since a person's thoughts are constantly racing around, the way to divert your attention is by focussing on Torah and service of God, and fulfilling the prescription to `serve God with joy' (Psalms 100:2). Service of God has to be constant, as it is written, `I have set God before me constantly' (ibid. 16:8). This is what the entire Code of Jewish Law starts with (Orach Chaim 1:1). Therefore you must contemplate something that will bring you to a state of joy, such as the thought with which we begin each day, `Modeh ani lefanekha - I gratefully thank You, living and eternal King....' Focus on the fact that we are constantly before the King" (Refuah Shelemah p.57).

Today blocked arteries can often be successfully opened. Certain cancers can be completely removed. Some types of infections can be totally eliminated and some chronic conditions successfully reversed. But there are still many cases of illness where the answer is far less clear: it may be possible to slow the advance of the illness or reduce the damage it causes, but the disease itself or the threat of its return cannot be altogether removed. This means that you cannot expect that your life will simply go back to what it was before you became ill.

Every cardiac patient worries what effect a little excess exertion or stress might have on the heart. Every cancer patient fears that some new ache or lump may mean the illness has come back or is spreading. Those with diabetes, arthritis, osteoporosis, multiple sclerosis and many other chronic conditions wonder what the future bodes. It can help to have a plan ready for what you would do in the event of a new crisis. If a pain or some other problem is on your mind, instead of just worrying about it, ask your doctor what it might mean and what, if anything, can be done. Often there may not be any simple solution. But even if there is nothing else to do, at least you can always use your aches and pains and your very fears as a reminder to keep your eyes turned towards God. See them as a spur to you to persist in your prayers, Torah and mitzvot.

Keeping happy does not mean that you have to deny any frustration you may have over the constraints imposed by your illness, or grief over your inability to do all the things you once did. Express your feelings openly and honestly to God, while at the same time being thankful for the gift of health you enjoyed in the past. You should also recognize that although you may be more limited in some ways, your intrinsic value as a person and a soul is unchanged. There are other ways you can build your life and serve God.

Look ahead to what you can do now. Concentrate on your good points: search for the good that remains. Remember Rebbe Nachman's Seven Beggars, who found ways to turn what others may have seen as disabilities into great advantages. For example, the fact that you have been through this experience puts you in a very strong position to help and support others in similar situations. When you encourage other patients and tell them, "You can get through this," you speak with an authority that even the most experienced doctor does not have. Use the tests and trials you have been through to deepen your human relationships.

Most people expect to be relieved when the immediate crisis passes, after surgery or when they complete a course of chemotherapy or other treatment. But ironically, when treatment ends and the reality of the situation begins to sink in, the experience is often one of renewed anxiety and loneliness. For some, leaving the womb-like security of a hospital can be a traumatic experience. Having made friends with the staff and having had everything done for you, you are suddenly on your own in the outside world facing a host of problems, new and old. Just when those around you are expecting you to be feeling better and to act accordingly, inside you may be feeling more vulnerable than ever.

This may be a good time to join a support group for those with a similar condition. Yet even with the best support from friends, family, doctors and therapists, there are still likely to be many challenges that you will have to face on your own, with only your faith and prayers to rely on. Every day may bring an endless succession of ups and downs in both your physical state and your morale. Each step in recuperation and recovery - going home, starting to do more for yourself, beginning to get out, going back to work, etc. - is likely to bring new stresses. After completing treatment, what many patients find most stressful of all is that they live in constant fear that their illness will recur, yet they feel they aren't doing anything to fight it.

Of course there are many things you can do to build your health, and you surely owe it to yourself to put extra effort into the mitzvah of "Guard your soul" (Deuteronomy 4:9). Make sure you take proper care of yourself. Eat properly and get your sleep. After serious illness, surgery, chemotherapy, radiation and the like, exercise must be approached with the utmost caution. But in due course, efforts at sensible regular exercise in consultation with your doctor may boost your health considerably. Take advantage of rehabilitation programs, which often provide excellent guidance and practical assistance in regard to suitable exercise, correct diet and the like.

Alternative therapies - diet therapy, massage, acupuncture, osteopathy, etc. - may also help in a variety of chronic conditions, whether as a complement to conventional medical treatment or instead of it. Among the conditions where such therapies may be relevant are: allergies, arthritis, asthma, chronic backache and postural faults, deafness, diabetes, heart problems, high or low blood pressure, irritable bowel syndrome, migraine, muscular dystrophy and atrophy, multiple sclerosis, osteoporosis, peptic ulcers, polio, psoriasis, rheumatic aches in muscles and joints, thyroid problems and vision problems.

As Rebbe Nachman taught, a serious health regime can be an important key to healing. This is because when a person "curbs his desires and submits to a medical regime, his soul sees that he has the power to control his impulses in order to achieve a certain goal. She therefore comes back to him and revitalizes his body in the hope that he will discipline himself in order to attain his true purpose - which is to carry out the will of the Creator" (Likutey Moharan I, 268).

A sensible program of diet and careful exercise can greatly enhance your sense of well-being and give you new strength and zest for life. But at the same time as you take steps to advance your physical healing, be sure to move forward with your spiritual healing, which will automatically benefit your body. Essentially this means living now. Living is what healing is ultimately all about - for why do you want your health if not to live and fulfil yourself? If this is what you want, you have to take the initiative and start living right now. It's like physical rehabilitation: when you're ready to start getting back the use of stiff, painful joints and muscles after injury, illness, surgery, etc., the way to do it is not by waiting for them to spring miraculously back to life. No; you must gently initiate the process with small but increasingly adventurous movements in the right direction, even when it is uncomfortable. In the same way, when you want to live, you must start now by taking small, sure steps despite the fact that you may still be feeling weak, tired and disheartened.

Real life is the life of Torah and mitzvot - "for they are your life and the length of your days" (Deuteronomy 30:20), because the mitzvot connect us with the Life of life, giving us long, full days in this world and the next. The ultimate healing is the day-to-day life of the Jew: the life of tzitzit and tefilin, prayer, Torah study, charity, family and community life, Shabbat and festivals, etc. These are what bring us to our true fulfilment and destiny.

It may be hard for you to concentrate on your prayers, open a Torah text or get up to do that mitzvah. But know that every single prayer or Psalm, each word of Torah you study and every other mitzvah you perform is a pill of life. Unlike mundane activities relating to the finite material world, every word of Torah and each mitzvah is a connection with the Infinite, kindling a lamp that shines forever. In the words of Rebbe Nachman: "Every single item of knowledge you acquire in Torah law - whether in the mitzvot between man and his fellow or those between man and God - brings success to the soul" (Aleph-Bet Book, Torah Study #10). "Every single mitzvah a person does becomes a lamp with which the soul can later search in the treasure house of the King, which is the ultimate delight of the World to Come" (Likutey Moharan I, 275).

Rebbe Nachman well understood how difficult it is to make a start. It's a new challenge every single day, every hour and every moment. "When you begin each day, at first the day is very short - in the sense that the spiritual tasks you must accomplish today seem to weigh so very heavily. It takes tremendous determination not to be discouraged as you feel the weight of the devotions you have to undertake today. But be courageous and don't lose heart! Make a start - even if at first things seem heavy, strained and difficult. If you are determined, they will become easier and you'll find that you can accomplish what you must in God's service. With every hour that passes, see to it that you enrich that hour and `lengthen' it by filling it with extra holiness. Do the same with every new day of your life. Let each day be filled with more holiness than the day before. Then you will be blessed with length of days - long life!" (ibid. 60:2)

Obviously you cannot expect to be able to take on a full routine of Torah observance right away. Recognize that your resources are limited, and allocate your energy where you need it most. Set realistic goals for yourself, and have a plan of action - at the same time being ready to grasp at unexpected opportunities. If your plans are not working, try something else. There are bound to be reverses. Just don't let them deter you. Set your goals for today, and pray to God to help you at every step. In the words of Rebbe Nachman: "As each day begins, I place my every movement in God's hands, asking only that I should do His will. I then have no worries. Whether or not things go right, I am totally dependent on God. If He desires otherwise, I have already asked that I should only do His will" (Rabbi Nachman's Wisdom #2).

By Rabbi Avraham Yehoshua Greenbaum
© AZAMRA INSTITUTE 5767 - 2007 All rights reserved