Playing Scared (22 page)

Greenberg draws his own seven examples from a caseload of five hundred ultra-Orthodox male referrals. One young man, identified as “Ezekiel,” came self-diagnosed to the psychiatrist’s clinic. “I was asked to be hazan [leader of prayers] on the Sabbath and practiced for a few weeks, but I have
aymat zibur
with a stutter, and did not want to shame myself in front of the Holy Ark, so my mother agreed it is unnecessary to shame myself,” Ezekiel told the psychiatrist. “As a child, I knew the tunes, but the pressure and fear ruined it all. My brother also doesn’t lead prayers—there are many with ‘fear of the congregation.’ ”

Aymat zibur
becomes a problem when it thwarts fulfillment of the very obligations that mark ultra-Orthodox Jewish men as members of their community. Fear of performance may prevent them from leading prayers (a religious duty expected of every adult male) and reciting the blessings over the Torah (which is considered an honor). “If, as a result of this problem, a sufferer does not attend public prayer, he is avoiding an
integral part of religious life,” Greenberg writes. “If a mourner does not lead the prayers during the year of mourning, this will be immediately noted. He has first right to the honor, and will feel uncomfortable at not doing so.”

For the man called Benjamin, the distress is simultaneously chronic and anticipatory. When his daughters become pregnant, he worries well in advance of the birth that if a boy is born, he—the grandfather—will have to assume a role in the bris, or ceremonial circumcision. He frets about the eventuality of his parents’ deaths (“May they live many years”), anticipating that he will have to lead the congregation in the daily Kaddish, or prayer of mourning, in the year that follows a loved one’s demise. His blushing signals the onset of a domino effect: His voice chokes, his legs tremble, he becomes convinced that everybody within eyesight sees and stares at him, which makes him blush all the more.

Many men who suffer from
aymat zibur
appear to have been shy or anxious children. Their anxieties were overlooked, probably because a timid and taciturn personality blends smoothly into a culture that shuns secular society and values above all else the keeping of Jewish law. Teenage boys commonly study Torah to the near exclusion of all other activities. The ancient teachings are filled with exhortations discouraging social intercourse and easy conversation. “Whoever stops studying Torah in order to engage in conversation is fed the embers of a broom fire,” a passage in the Talmud warns. In the ultra-Orthodox world, a man’s worth is measured by the study of Torah, and any conversation that takes away from that study is discouraged. Greenberg quotes Maimonides thus: “A person
should excel in silence and should not speak, unless to say matters of wisdom or matters to do with physical needs.”

But while a natural reserve may be admired and even encouraged, a man’s ultimate standing in the community rests largely on his voice. The
talmid haham
, or wise student, is sought after for public speaking (on religious subjects, naturally) at social gatherings and ceremonies. And in the world of the ultra-Orthodox, teaching Torah confers the highest status of all; it’s the equivalent of being a cardiologist in the secular Jewish world. Effectively barred from so many activities integral to religious life, some of the younger men in the Jerusalem synagogue have tried group therapy to improve their public-speaking skills. In some cases, according to Greenberg, they have turned to a
shidduch
, or matchmaker, perhaps hoping that a wife would help ease their way into society. Benjamin turned to his rabbi. When that proved unhelpful, he sounded out Kabbalists—mystical sages—for counseling, blessings, and remedies. “Sorcerers,” he told the psychiatrist dismissively. “If not for this problem, I would have opened a school.”

The term
aymat zibur
is barely known outside ultra-Orthodox Judaism, but its effects permeate well beyond those confines. Corinne Blackmer is a member of Beth El-Keser Israel Congregation, a Conservative synagogue in New Haven, Connecticut. BEKI, as it is known, is an egalitarian congregation where women are allowed and encouraged to read from the Torah. Blackmer regards it as her second home and regularly attends Saturday services. But put her on the bimah, the podium from which the Torah is read, and she exhibits many of
the same symptoms as the ultra-Orthodox Israeli men who suffer from
aymat zibur
. The last time she stood for the honor she opened her mouth, blurted out a few words, and fled the synagogue. The Hebrew language isn’t her problem. Blackmer speaks it fluently. She lived in Israel for several years and fought with the Israel Defense Forces during the Yom Kippur War of 1973. Nor is she afraid of public speaking. A professor of English and Judaic Studies at Southern Connecticut State University, she routinely lectures before hundreds, loves to speak before large groups, and earns excellent ratings from her students.

Her anxiety is specific to liturgical Hebrew. Though she knows the prayers by heart, she is afraid to get up and chant them. “I feel intimidated by the congregation since there are so many accomplished people there. Even though they are incredibly nice.” In a sense, chanting Torah is not all that different from performing a classical music recital, with its zero tolerance for error. The instant a reader mispronounces a word in the Torah, or even stresses the wrong syllable, the members of the congregation are duty-bound to correct her—literally stopping the performance and forcing her to acknowledge and redress her mistake. For Blackmer, the delicacy of the parchment scroll itself creates an added anxiety. “I don’t want to hurt it,” she says. “I’m afraid that I might take the Torah pointer and jab it through. I’ve literally thought of that.” Though she can easily read the daily prayers, she is studying them intensely, hoping to one day stand up and recite them comfortably.

The most examined of culture-specific anxieties is the Japanese
taijin kyofusho
, which translates as a fear of interpersonal
relations.
Taijin
is almost the flip side of performance anxiety as we know it in the West. Instead of fearing that you are going to embarrass yourself with your behavior, you fear that you will embarrass or even offend others by your very presence. In the Japanese diagnostic system, there are four subtypes of the disorder:
sekimen-kyofu
(the fear of blushing),
shubo-kyofu
(the fear of a deformed body),
jikoshisen-kyofu
(the fear of eye-to-eye contact), and
jikoshu-kyofu
(the fear of one’s own foul body odor). Most sufferers experience only one of these fears.

Taijin kyofusho
is especially prevalent among adolescent boys and young men; studies report that 10 to 20 percent of Japanese males say they suffer from it. When a Japanese psychophysiologist, who examines the impact of fear and other emotions on the body, confided to me that she had
taijin
, I wondered if she was joking. It turned out that she had studied to be a concert pianist until perfectionism got in the way. “If there is a very small mistake, it ruins my performance,” she said, explaining that a serious case of focal dystonia—pianist’s cramp—forced her to quit the piano entirely. The physical problem was exacerbated by her
taijin kyofusho
. “I worried that if I played bad music, people would be embarrassed.” Now here she was, studying those very symptoms in other people, in her role as psychophysiologist.

The disorder was first described in 1919 by Japanese psychiatrist Shoma Morita, who classified it as part of a nervous temperament called
shinkeishitsu
, a condition that involves a high degree of perfectionism. Morita regarded it as a distinctly Asian disorder, and psychiatry has generally endorsed that
view. According to a paper
²
in the 2010
Journal of Depression and Anxiety
, “Social fears are very much dependent on a particular culture.” In other words, a culture is expressed through its specific disorders just as surely as it is expressed through its art and music. “We are an individualistic culture, in which the individual is at the center of everything,” said Stefan Hofmann, a Boston University psychologist and one of the authors of that study. “Japan is a collectivist society, and it’s been shown in studies that these relationship fears, the fear of offending others, are unique to Japan, where close attention is typically paid to other people’s thoughts and feelings.”

Morita prescribed a treatment plan that combined a traditional form of Japanese psychotherapy with mindfulness meditation practices, physical activity, and self-acceptance techniques. The eponymous Morita therapy began with a period of isolated bed rest, during which patients were forbidden to read, listen to the radio or television, or indulge in conversation. In the second stage, they remained isolated but could leave their beds and engage in light work and simple chores. Under a therapist’s guidance, they wrote in journals and read classical poetry out loud. Slowly and gradually, their freedoms were returned to them until eventually, usually by the sixth week, they attended lectures and meetings on self-acceptance. The original treatment plan lasted forty days, which sounds practically biblical. But when strictly followed, it was reported to have a success rate of 93.3 percent.

In India and Nepal,
dhat
, or semen-worry, is a folk term that describes a form of clinical depression in young men who suffer from premature ejaculation and impotence. The syndrome is
bound up in a traditional Hindu belief system that deems semen the elixir of life, a fluid that is vital in the physical and mystical sense of the word. Young men with
dhat
seek medical help when they become convinced that they are passing semen in their urine, often during wet dreams. In some cases, they report that their penises have diminished in size. Their fear translates as a loss of male power. Doctors say there is no physical explanation; the cause is obsessive rumination.

While the acculturation of medical conditions has sometimes been dismissed as a relic of European imperialism, the most current (fifth) edition of the
DSM
lists nine culture-bound disorders. One of them is the Cambodian
khyal cap
, a form of panic attack that typically ends in a dead faint.
Khyal
is said to be a windlike substance that rushes through the body, fills the lungs, impedes breathing, and enters the heart, causing palpitations. It surges through the brain, shoots from the eyes, and floods the ear canals.

A
khyal
attack is often triggered by
pul meunuh
, or “poisoning by people.” It can happen in any crowded space, but, like
aymat zibur
, it frequently occurs in a religious setting—in this case, a Buddhist temple, usually on festival days, when the devotee has to present an offering to the monk. Suddenly, he is in the limelight. All eyes in the temple are upon him as he kowtows, or bows, three times, presents his offering, and then raises his hands to receive a blessing from the monk.

“When they’re in large groups, they will often say, and be very articulate about it, that when they look from face to face, they smell the different people,” says Devon Hinton, a medical anthropologist and psychiatrist at Harvard Medical School, who
has written extensively on
pul meunuh
. A majority of his patients, who come from the Cambodian immigrant community in the Boston suburbs, complain of the disorder. “They will want to orient to the different smells that are present. They are overwhelmed by stimuli, as they put it. It induces dizziness, a very dramatic version of it. It can be debilitating. They can’t go to the temple, because they are afraid they can die from this.”

Pul meunuh
often manifests as a form of post-traumatic stress disorder, dating to the Cambodian civil war and genocide. Under the Khmer Rouge, whose regime lasted from 1975 to 1979, a quarter of the population died by starvation, forced labor, and execution. But even these experiences are only a catalyst. In fact, the history of
pul meunuh
extends back through many generations. “Even before Pol Pot, they would explain it as poisoning by people—the idea that you’re up there and suddenly you smell other people,” says Hinton. “It’s how they explain not being able to perform.”

Given the religious and existential overtones of such disorders, it should come as no surprise to find performance anxiety in pastors, preachers, and other religious leaders. Few publicly mention it or even acknowledge that their weekly sermons are performances of sorts. A number of divinity schools rebuffed my inquiries about programs to help young ministers get over their shakes. “We don’t have that problem,” one prominent Baptist dean informed me. Maybe not, but the physical manifestations of performance anxiety are exactly what one Kansas parishioner found so endearing about her new minister. She wrote about it on her blog: “Yes, our pastor suffers from stage
fright. His hands shake and his mouth gets dry and sometimes he loses his voice and has to pause. Which might sound like a bad thing, but it’s something I love about him. He could never be a pastor on his own power. But the fact that he gets up in front of the congregation every Sunday and teaches us something new is a testament to the power of God.”

The pastor’s name was Larry Smith, and when I tracked him down in Topeka and read him what his parishioner had written, he sounded taken aback. There was a long silence on the other end of the phone line. “Yes,” he finally said, “that sounds like me.” I flew to Topeka, where I shared my own issues with performance anxiety and learned that Smith had an even longer and more complicated story to tell—one that began with easy money, alcohol, and profligacy and culminated in born-again Christianity.

As a young man in the 1970s and early 1980s, he had it all: a construction job that paid a munificent $32.50 an hour, “plus $50 a day just to show up.” He and his wife, Laura, owned forty-five acres in Northern California, along with boats, cars, trucks, and tractors. But he was an alcoholic who daily washed down a fifth of gin with a twelve-pack of beer. He was also an obsessive gambler, “a very unhappy person.” Then, at age thirty-six, “the Lord took it all away,” the good and the bad. Smith was struck with a rare condition called thoracic outlet syndrome that numbed the nerves in his hands and arms. Complications set in, and his back swelled to twice its normal size. His neck muscles grew so large that whenever he laughed he passed out, he said. Smith was close to death when the doctors told his wife to get his affairs in order. Sitting beside
him in his hospital room, she told him that he had to “find the Lord.” And that’s when, with his wife’s help, he got down on his knees to ask forgiveness for his sins, was born again, and “wound up with this public-speaking problem.” In that order.