Dr Judith Guedalia

There are many topics that are not easily spoken about, death is one of them.
There are many topics that are not usually spoken about, death is one of them.   I imagine this ‘discomfort' with the topic stems from the fact that for each of us, someone's dying, brings to our awareness our own mortality.  Not infrequently we read about ‘accidents' at work, in the armed forces, ‘on the road', and in the home, that result in another's death.  I always wonder about what is generally not mentioned, which is: what happens to the person who causes the accident?  Recently in Israel the news reported a heart breaking incident._option_option_option_option_option_option_option_option_option_option_option_option_option

A young man, a soldier, was home sleeping.  He had returned for a break in his hectic and scary ‘schedule' as an officer in a special secret unit of the army.  He was safely at home sleeping; it was three a.m. in the morning when he heard noise outside his window.  He lives with his parents and brother on a small Yishuv, settlement, he knew his brother was in another unit in the army and his folks were sleeping.  He called out to find out if anyone was outside.  No one answered.  He saw the shadowy figure moving up to his window.  He grabbed his gun and shot.  The intruder turned out to be his older brother, who wanted to surprise his family with his presence.  Tragically, he was killed instantly.

In March of this year a paper I wrote with Yocheved Debow, M.A., a clinical psychologist, on the topic of accidental killing, was published in Bekho Derakhekha aehu, B.D.D., a Journal of Torah and Scholarship.  In the article we try to address the issue of what happens to the person or persons who are responsible for the accident.  Clearly this is after the incident is investigated and designated ‘accidental'.  Researching the phenomenon in secular literature we found very little information on methods of dealing/helping the causers of accidents.  There is a lot written about Post Traumatic Stress Disorder, PTSD, but most of it relates to people who have experience trauma, not caused it. 

In light of the ‘incident' I mentioned above, I was again reminded of the fact that there is no model for helping the perpetrators of accidental killing accept the consequences of their actions.

In my work as a director of the Neuropsychology Unit at Shaare Zedek Medical Center here in Jerusalem, Israel, I try to ‘synthesize' the many parts of my education, both secular and Jewish.   When presented with ‘unique' situations I work under the assumption that Judaism has over 5000 years ‘experience' with humanity beats any science in use today.  So when I was referred a patient with PTSD (Post Traumatic Stress Disorder) who was involved in an accidental killing, I turned to the model described in the Bible of the Ir Miklat 'city of refuge,' a place defined as a sanctuary to protect the 'accidental killer.' Based on an understanding of the psychic trauma experienced by accidental killers, and using the Torah model, I was sure I would get a deeper understanding of both the problem and the solution.

Who is considered an Accidental Killer - Rotzeach Bishgaga?              

An accidental death becomes a double-edged tragedy for both the bereaved family and the accidental perpetrator, whose experience often sentences him/her to a lifetime of turmoil.  In the Bible the concept of accidental killing is discussed along with both a legal and (we think) ‘therapeutic' solution to this difficult experience with the creation of  "city of refuge" (Hebrew: Ir Miklat).  The Ir Miklat, a sanctuary to protect the accidental killer, was one of these forty-eight cities established before the Jews entered the Land of Israel, the Rotzeach Bishgaga was ‘sentenced' to live there for an indeterminate period of time (Exodus 21:12-14; Numbers 35:9-29; Deuteronomy 4:42; 19:1-13).

According to professional psychological literature the Rotzeach Bishgaga goes through a ‘defined' process as a result of this horrifying experience. Shock comes first. Then a brief period of numbness, the mind hides from the full realization that one has caused the death of another human being. This is followed by preoccupation with the event/accident. In the struggle to make sense of the event, many accidental killers replay it over and over in their minds. Anger often engulfs the accidental killer, directed at every aspect and player in the accident, including the victim. Guilt is nearly universal, causing accidental killers to torture themselves for unfounded reasons as well as for error and oversight. Depression, also common, may occur in various forms. Their internal turmoil may cause them to withdraw from family and friends.  They usually experience some form of social tension/avoidance of social contact, often resulting from the failure of their friends and associates to respond or act supportively due to their unfamiliarity with the situation. Family stress occurs as well. At some point, virtually all accidental killers begin some process of healing/acceptance. Nevertheless, the aftermath of the event extends throughout their lives. Thus most accidental killers themselves become victims of the event.  Remarkably, all the described symptoms experiences by accidental killers are included in the accepted definition of Post-Trauma Stress Disorder.

It is interesting to note the similarities of the process which accidental killers experience, with the classic model of the stages of mourning described in Elisabeth Kubler-Ross' seminal work, On Death and Dying. When we see patients with PTSD following accidents in which they feel culpable, it is striking to note that almost all of them do not experience the final stage: 'acceptance'.  They actually remain in the state of mourning. Could they be mourning not only for the victim who actually died but also for themselves, who are still alive, but no longer in their former state of innocence - the person they were before the ‘fatal moment'?

Accidental killers are frequently acquitted in court of the crime of manslaughter. Legal exoneration, however, cannot reverse the accident and return the dead person to life, nor can it render the Rotzeach Bishgaga a person who has not killed anyone, albeit accidentally. Often, an Rotzeach Bishgaga 's reaction after being acquitted is to say that the person is ‘still' dead, and "it was still my finger on the trigger."  Although the law has judged them to be not guilty, their own acute awareness of loss prevents them from accepting that judgment.

How the IR MIKLAT Model Addresses The Symptoms of Post Traumatic Stress Disorder (PTSD)?

What was the process of getting into the IR Miklat?

  1. The accident occurs. It should be noted that around the ancient Israel there were signposts directing one to the Cities of Refuge, making the ‘road' to them more ‘knowable' by the Rotzeach Bishgaga who is in a Numb and Shocked state.
  2. The person flees to the Ir Miklat were the family of the victim could not kill them. Outside the Ir Miklat a family member (Goel Ha'Dam-Blood Avenger) would not be guilty of murder for killing the Rotzeach Bishgaga.
  3. After immediate entry, the court examines the evidence and decides it was indeed and accident and the Rotzeach Bishgaga can remain in the Ir Miklat.         
  4. A man was accompanied to the Ir Miklat by his family, and his rabbinic mentor was also an option and changed the nature of the exile (A woman Rotzeach Bishgaga's husband could opt for joining her, or not do so.)  Perhaps its purpose was to demonstrate that one's lifestyle should not be altered.
  5. Finally, there is the arbitrary release time, on the High Priest's death the Rotzeach Bishgaga was released from ‘exile', possibly we posit, this reinforces the peripatetic nature of the accident itself.

 Who else lives in the Ir Miklat?   

          The Ir Miklat was primarily inhabited by Levites - an important sector of the community, mentors of the population. Thus the Rotzeach Bishgaga's knowledge that they where not being sent to spend their 'sentence' with a socially undesirable community, but were worthy of the company of Levites, may also have served to help them re-acquire a favorable sense of identity. It is interesting to note that the Levite community, who did not have land or animals to cultivate and care for, also served a primary role in preparing the sacrifices for the Temple. They were known to be people characterized by great precision.  It might also have been important for accidental killers to be exposed to this trait as part of their battle against the randomness of the event that had so dramatically changed them. 

How Can We Help A Rotzeach Bishgaga Today?

           The treatment of PTSD remains a challenge for not only friends and family, but also not the least, for the health profession as well. The complexity of the disorder underscores the difficulty in establishing a clear treatment of choice, or perhaps a constellation of treatments of choice, for patients suffering from PTSD.   There may even be existing facilities that could be redefined in line with the Ir Miklat model. The Israel Defense Forces presently has a facility that seems to have a similar aim. It could certainly serve as a basis from which to launch a more encompassing model that would take into consideration the various symptoms experienced in PTSD. Although the Levite Tribe no longer serves the functions it had in ancient times, the psychologists and social workers of today could serve similar functions, at least as a therapeutic staff, if not as a community in which Rotzeach Bishgaga could live.  The fact that biblical practice foreshadows many of the same techniques currently understood and used in modern-day psychotherapies for the treatment of PTSD seems to invite the use of ancient wisdom for those who still suffer today as accidental killers.

           Until then, if the community at large is familiar with the concepts in our wealth of Biblical literature for all-encompassing approaches to difficult problems, and the treatment of the specific trauma of accidental killers is just one of them, the world will be more therapeutic and understanding place for us all.

Tags: Acceptance | Accidents | Aftermath | Anger | Death | Depression | Family stress | Guilt | Numbness | Post Traumatic Stress Disorder | Process Of Healing/Acceptance | PTSD | Shock