Cross-cultural encounters between careproviders: rabbis’ referral letters to a psychiatric clinic in Israel

This paper explores the meaning and social functions of referral letters sent to a mental health clinic in Israel by Haredi (ultra-orthodox) rabbis. The letters exemplify social mechanisms by which various institutions and individuals (careproviders, therapists, and other social actors) negotiate different therapies, advice, and interventions in cross-cultural encounters. We argue that beyond the practical functions of the letters, the rabbis—representatives of a “popular” and religious social sphere—use them to negotiate their position in relation to the psychiatric clinic as a representative of a professional and secular sphere. We show that the rabbis “submit” to the professional and secular therapists by using a local adaptation of Western psychological and psychiatric discourses (instead of a religious or mystical discourse), but also that by choosing a letter as their preferred medium of communication (instead of a personal visit to the clinic), they distance themselves from it. We suggest that the rabbis reconstitute, via the letters, social boundaries within their religious community and between their community and secular society. Hence, through analysis of discourses of mental illness in a cross-cultural encounter we examine ways in which illness is practically managed among diverse groups in society. Specifically, we analyze such discourses as part of a power relationship between careproviders who belong to different therapeutic social spheres, using a phenomenological exploration of how mental illness is perceived and constructed as both “a medical problem” and as “social deviance”.