Social phobia in ultra-orthodox Jewish males: culture-bound syndrome or virtue?

Abstract

Social difficulties of the performing variety are reported by ultra-orthodox male referrals to a psychiatrist in Jerusalem and confirmed by key communal informants. Three cases of social phobia are presented, and the content concerns performing, either speaking on religious matters publicly, a role associated with status and authority, or leading prayers and ceremonies, a role of sanctity and duty. The absence of women sufferers may be understood as a consequence of the value placed on modesty in women and there being no expectation of women to participate in study and public prayer, while the absence of complaints of interactional social phobia may be a consequence of the general discouragement of social intercourse not related to religious study. Aymat zibur, literally meaning fear of the community, is a term used by ultra-orthodox Jews to describe these fears of performance, although in its original meaning the term expresses the respect that the leader of prayers is expected to have for his awesome role. The cases described, however, were motivated by personal shame, similar to social phobia of the performance variety found in other cultures, rather than fear and respect. The values of ultra-orthodox religious life are presented that invest a person who avoids interactional social behaviors with the status of zaddik (a righteous person) while one who avoids the performance behaviors of speaking publicly on religious matters or leading prayers suffers from an idiom of distress in this particular society. Religious law and societal mores appear to be critical factors in deciding whether symptoms of social phobia are perceived and experienced as idioms of distress.