Wisdom is considered so valuable in the Bible that it is compared with precious jewels and other riches and is a common theme in the Bible. It is especially prominent in the book of Proverbs which form the Bible’s “wisdom literature” along with Ecclesiastes, Song of Solomon, the Book of Job and others. What is wisdom? The Merriam-Webster dictionary defines it as “the ability to discern inner qualities and relationships”.

Wisdom depends on knowledge and understanding but it is more than those attributes. It also includes discernment, insight and judgement and seems to develop only after substantial life experience.. She notes that “Woman Wisdom”—What else is required and how does wisdom relate to psychiatry and mental health in general?

DOES NOT WISDOM CALL?

Let’s see what we can learn from the “Wise Woman” whom Proverbs describes in terms of personified Divine Wisdom. She is described as existing before the world manifests, is present and intimately involved with the Creator in the creative process as a joyful, even playful, master architect. For those interested in the theological and historical of this fascinating concept is described by expertly by biblical scholar Claudia V Camp (Woman Wisdom Bible) Here is Wise Woman at the beginning of Proverbs Chapter 8 of calling out to the people from a prominent place above the city:

“Does not wisdom call,
and does not understanding raise her voice?
On the heights, beside the way,
at the crossroads she takes her stand
beside the gates in front of the town,
at the entrance of the portals she cries out:
“To you, O people, I call,
And my cry is to all that live.
O simple ones, learn prudence;
Acquire intelligence, you who lack it.
Hear, for I will speak of noble things,
and from my lips will come what is right”—Proverbs Chapter 8:1-6

I’m not sure about you, but Wise Woman already has my attention. She continues speaking out, here making the remarkable point that wisdom is more worthwhile than material riches:
“Receive my instruction, and not silver; and knowledge rather than choice gold.
For wisdom is better than rubies; and all the things that may be desired are not to be compared to it” [8:10-11]. Wise woman then declares that “counsel” is hers, that she has strength and she is understanding [8:14]. By wisdom “kings reign, and princes decree justice” [8:15]. Here and earlier in Proverbs, seeking wisdom is put forth as a primary task, something to pursue first before all other activities. For example Chapter 4 has this remarkable sequence I never tire of reading:
“Get wisdom, get understanding…Forsake her not, and she shall preserve thee; love her, and she shall keep thee.
Wisdom is the principle thing; therefore get wisdom; and with all thy getting, get understanding” [4: 6-7]

ARE PSYCHIATRISTS WISE AND CAN SEEING ONE MAKE US WISER?

What does wisdom have to do with psychiatry? Well, as I look back to when I trained in psychiatry (1985-1989), I don’t recall any reference to wisdom. Nor do I recall any discussion of it until a few years when Dilip Jeste, MD, former president of the American Psychiatric Association started reporting on research in the approach to mental health known as “positive psychiatry”. This approach tries to identify patient strengths rather than just focusing on what’s mentally, emotionally or biologically wrong with the patient ). In reviewing the psychiatric literature over almost 40 years from the 1970’s to 2009, Dr Jeste notes that there was a sevenfold increase in the use of the keyword search term “wisdom”. In the course of his research, he identified six components associated with wisdom all of which we can find in Proverbs:

Prosocial behavior, or socially positive behaviors like empathy, compassion, and altruism
Social decision-making, or the ability to make decisions effectively in complex social situations
Self-reflection, or insight
Healthy impulse control and emotional regulation
Decisiveness during uncertainty
Spirituality

As a psychiatrist with over 30 years of clinical experience—or what I refer to as the “laboratory of human experience”—I feel that I have accumulated a fair amount of wisdom, though of course, there is always plenty of room for improvement! Sometimes a challenge arises that makes me wonder how much progress I’ve made but fortunately, I have usually been able to use these challenges as an opportunity to grow in insight, judgement and yes, wisdom. And at my best, I think I’ve been able to help my patients grow in these qualities too. Having a wide array of therapeutic tools available to me has helped in this endeavor. I realized early on in my career (even before going to medical school while on a training course to become a meditation instructor) that to truly help others I needed to have more tools at my disposal than just medication and conventional psychotherapy those these modalities can be important and even necessary at times. Skilled psychotherapists can often help dedicated patients develop aspects of wisdom but most people simply don’t have the time it takes for this process. On the other hand, everyone can benefit from meditation, reading scripture and other spiritual pursuits. We’ll return to these issues in subsequent posts.

WELCOME TO THE LABORATORY OF HUMAN EXPERIENCE

I realized years ago that every person I see in my clinical practice provides something new for me to learn. Technical competence (e.g. knowledge of medication, co-occuring medical issues, etc) is important for a psychiatrist but often not nearly enough. One also needs to learn to be disciplined enough to not react in a non-therapeutic fashion. The goal is to always try to respond in a professional and therapeutic fashion even when the patient may seem to be trying to illicit a different response. Self-control and patience are key components in this regard along with understanding. But we also need skill to help patients develop insight into the meaning of their responses. We also have to become skilled at providing our patients with hope which often challenging when things seem (and sometimes are) rather bleak.

SPIRITUAL FOOD FOR THE JOURNEY

All this requires wisdom. And of course, it’s not just psychiatrists and counselors and therapists who need wisdom and all its associated attributes. We all could use more of these precious gems in our lives. I look forward to continuing on this journey of learning with you all and welcome your comments. Meanwhile, here is a poetic call to the pursuit of wisdom from Proverbs 23:23 which I find particularly potent. May it help keep you on the path:
“Buy truth, and do not sell it, Get wisdom and instruction and understanding”.