Lisbon, Mental Health & Jewish History

Lisbon is all the rage right now. Most visitors come to see the seven hills and Tagus River Harbor, the moorish architecture and historic cobblestones, and to taste bacalhau and pastel de nata. I am here for the annual World Psychiatric Association World Congress.
 
 
Although I spent most of my time at the convention center engaged in proper professional activities, my friend and I played hooky this morning for a walking tour of Jewish history in Lisbon, something I like to do when visiting new cities. This time it struck me — the story of individuals with mental illness and the story of the Jews in history are somehow totally distinct yet kindred dramas.
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1. Special Quarters: Jewish Ghettos and Psychiatric Institutions. In the wake of two mass shootings, the President of the United States announced this week the possibility of setting up the Health Advanced Research Projects Agency or HARPA. This would be a new government agency that, if established, would sit inside the Health and Human Services Department. Its core mission would be to identify cases of neurobehavioral signs that suggest the risk of violent explosive behavior and move individuals to a safe home, effectively removing them from society. The same thing has happened time and again in Jewish history. In Portugal, the Jews enjoyed peaceful citizenship for thousands of years, but ultimately, Jews were shuffled to three walled quarters (which the guide refused to call ghettos) and then, ultimately, presented with the option to convert to Catholicism or leave Portugal. One way or another, the message is, if you have mental illness, if you are Jewish, get out of sight.

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2. The Portuguese discovery of Brazil was thanks to the Jewish navigator and explorer, Pedro Alvarez Cabral. Of course, Brazil existed before the Portuguese “discovered” it. In the same way, the community of mental health professionals are “discovering” all kinds of truths and successful strategies to promote and facilitate health for individuals with mental illness from individuals with lived experience. Funny how this happens. It is not widely known that the explorer responsible for linking Portugal to what is now Brazil was Jewish. Similarly, knowledge about community mental health exists, waiting to be “discovered” if only we are open to exploring what we do not know.

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3. When things go bad, we need someone to blame. In 1506, drought and deadly epidemics ravaged Lisbon. By April of that year, public sentiment settled on blaming the Jewish people for the plight of the city. Five hundred years later, a memorial sits in the square where 2000 Jews were massacred as a result. In the US today, we have a serious problem with gun violence. It is bad. Really bad. The mass shootings make headlines, but they represent only the tip of the iceberg in terms of lives lost due to guns in America. Like the leaders of Lisbon 500 years ago, US leaders feel compelled to “do something” both for the public good and to safeguard their political office. They engage in reactionary efforts to identify evildoers and then make a show of getting rid of them. Of course, the Jews did not cause the drought or deadly epidemic, and the vast majority of individuals with mental illness are not violent. In fact, they are much more likely to be victims rather than perpetrators of violence. Doesn’t matter that the logic doesn’t hold. Something has to be done, so scapegoats have to be found.

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4. Not to be seen. The Jewish walking tour was fascinating and our guide was extremely knowledgeable, but the sign in the photo above is about the only physical remnant of the history of Jews in Lisbon. Yes, there are two synagogues in the city, but they are outside the center of the city and were not on the tour. The story of the Jews in Portugal is mostly invisible at this point. Hearing it takes intention. Similarly, at the World Psychiatric Congress, very few individuals with lived experience were given the opportunity to be seen and recognized for the ways in which they are part of and essential to our community. The experience brought home for me the conscious intent required to be sure that vulnerable and marginalized groups are not lost in the shadows.

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5. Who tells the story. Our guide was not Jewish. He was extremely knowledgeable. He took it upon himself to develop a special tour of the history of the Jews in Lisbon, a topic that was covered not at all in his studies to be a licensed guide. He was passionate and respectful. He has a legitimate voice. He really is an authority on the topic. But he is not Jewish. In the same way, our field of mental health is filled with professionals who are passionate and respectful experts, but we don’t all have lived experience on the topics we study or in our areas of practice. I am okay with that. Most oncologists have not had the cancer they treat. Most physical therapists have not had the injuries they rehab. But I do feel strongly that the whole story and full understanding of any health condition, including mental health, depends on hearing from those who know the story intimately and personally.


I am smitten with Lisbon and unabashedly join the rapidly growing fan club. It’s been a great few days of learning both inside the Congress Hall and on the cobblestones of this beautiful city.