Susan Lustig was diagnosed with breast cancer in 2007 and after a lumpectomy she is now in remission. But the experience left her emotionally scarred and constantly fearful of the cancer resurfacing. So she began attending a series of classes and workshops at an organization called Life's Door-Tishkofet, geared towards spiritual wellness and helping patients cope with existential issues.
Nearly every day for the past two years, she has participated in yoga, dancing, water aerobic therapy and a class on "mindfulness" in its Jerusalem center on Tel Hai Street. Her newest favorite: "bibliotherapy" - a group that discusses the Torah portion of the week as it relates to illness, coping and death.
"Tishkofet has been a life-saver for me - a home away from home," she says.
Life's Door-Tishkofet, founded in 2003 by Dr. Benjamin Corn, an oncologist originally from Brooklyn, and his wife Dvorah, a marital and family therapist, is a leader here in the field of spiritual care for patients with terminal illness or life-threatening illnesses. This includes patients who have recovered medically from illnesses but continue to need emotional and spiritual support. Its Hebrew name, Tishkofet, means "perspective."
The field has emerged in the last several years in Israel and is similar to what is commonly known as pastoral care, or chaplaincy, in the United States and Europe, and part of a broader movement of supportive care, a somewhat amorphous area ranging from psychiatric and social work counseling to acupuncture, tai chi, massage and music therapy. Spiritual care may focuses on helping patients cope emotionally and spiritually with their illnesses and reducing the sense of isolation that often comes with serious sickness or injury.
In recent years, a growing number of hospitals and organizations in Israel have begun to actively integrate spiritual care into their core work, says Elisheva Flamm-Oren, planning director at the UJA-Federation of New York's Israel office.
The federation has spent $2 million building the Jewish Spiritual Care Network, which it formed in 2005 and numbers 18 Israeli organizations, including Life's Door-Tishkofet. Life's Door is one of several dealing with life-threatening illness; a second is B'Ruach/By Spirit, which runs a program in Shaare Zedek Hospital. Tel Hashomer, Rambam and Herzog geriatric hospitals also employ spiritual counselors.
The spiritual care trend coincides with some hospitals enhancing supportive care services. As reported recently in Haaretz, the Ezer Mitzion organization will launch its "Starting Anew" center, in Petah Tikva, the first cancer survivorship clinic in Israel.
"Until 2005, there were no institutionalized services in Israel addressing this need. In the U.S. and Europe, chaplaincy is part of standard care and therefore most hospitals and many other health and human service institutions employ chaplains. This is what we want to replicate here," says Flamm-Oren, whose father was a chaplain in the U.S. army in World War II. "I think part of the reason the field never took off until now is the fear of religious coercion here, but our purpose is to create non-denominational care giving to suit the needs of the patient."
Hebrew Union College also started a program called Mezorim several years ago to train social workers, rabbis, educators and nurses to become "the first generation of Israeli pastoral caregivers," according to Dr. Ruchava Weiss, Mezorim's director.
Its first 11 graduates included many Anglos but its second (current ) cohort is nearly all native Israeli, "an indication that spiritual care-giving for the sick is starting to enter the Israeli mainstream." But because few jobs exist in the field, HUC set up a clinic on its campus for patients to receive care from Mezorim-trained professionals.
"There is no word in Hebrew for chaplain," says Benjamin Corn, who also heads the Institute of Radiotherapy at Ichilov Hospital. "Most rabbis here were not trained in pastoral care; they were trained in text study. But there is a great need in Israel for spiritual care - not just offering a blessing at a patient's bedside in the hospital, which is certainly an important thing, but for servicing the spiritual, emotional and interpersonal needs of patients facing serious diseases."
Life's Door-Tishkofet employs 14 core staff, many of them Americans with expertise in psychology, social work and other fields, and 30 additional part-timers including music and art therapists, yoga, tai chi, Feldenkreis and qigong teachers. It runs 38 weekly classes at its Jerusalem center; its other centers are in Ra'anana and Zichron Ya'acov.
It sees some 3,000 people per month in all, mostly patients but also family members or friends of patients. It also trains rabbis and other professionals in spiritual care for people coping with life-threatening illness, and runs retreats for couples, such as one next week at Ein Gedi.
Some 70 percent of Life Door-Tishkofet's funding comes in small doses from local residents, many of them patients or their relatives. And it's growing: it recently started a program in Ashdod geared toward the Russian community in which volunteer caregivers visit patients in their homes, and it just launched a training program for caregivers so as to replicate the Ashdod model in other Russian communities. A group in Los Angeles and one in Sydney, Australia, are launching similar programs modeled on the organization.
The Corns, who live in Jerusalem, began thinking about establishing such an organization well before moving to Israel 13 years ago. When Benjamin Corn was 11, his father died of prostate cancer. Both the death and the difficulty his family, friends, rabbis, and his father's doctors had in addressing the subject of his father's death - both leading up to it and also after it - impressed upon him the importance of talking about and preparing for death.
When he met his wife at Boston University years later, recalls Dvorah Corn, "We clicked on this subject because I'm from a family of Holocaust survivors and because we were both preparing ourselves for careers in the medical professions. It sounds weird for two 19-year-olds to have been discussing this stuff but we did." Dvorah was an occupational therapist in the U.S. and became certified in marital and family therapy after immigrating.
Sharon August-Dalfan helped open the Ra'anana branch of Life's Door a year ago after having thyroid cancer and following several cases of illness in the community. Yad Sarah has donated space for the new center, and it offers six groups per week. "Our whole community has come together" in launching the center "and there's so much need that we're really just starting to address."