Noah 5780 – Did Noah Have PTSD?

By: Dr. Bill Sutker

In this week’s parashah we read the story of Noah. The parashah begins with the following statement: “Noah was a righteous man; he was blameless in his age.”  Rabbi Jonathan Sacks notes that Noah is the only individual in Tanakh described as righteous. No such praise is given to Abraham or Moses or any of the prophets. Yet the man we see at the end of his life is not the person we saw at the beginning. As we read the whole story, you will see it does not end well.

The flood changed Noah.  After a year on the ark, Noah is finally commanded by God to leave. A normal person would have been very anxious to get out of the ark. But Noah is hesitant to leave. Why? Eli Wiesel offers a poignant insight. He calls Noah the first” survivor.” The world had experienced a Holocaust, and Noah was reluctant to walk out of the ark because he knew that the entire world was one giant graveyard and he just couldn’t face it. The Torah tells us that Noah’s reaction to the flood is to plant. Planting after a great destruction is surely a meaningful and satisfying response. It represents hope and belief in the future. But what does Noah plant? He plants a vine and drinks the wine of the vineyard. He becomes drunk and wallows around in his tent.  Not only did Noah become drunk, but he was naked inside his tent which further debased him and led to family drama. Poor Noah. He cannot face the fact that everybody except himself and his immediate family was destroyed by the flood. He is unable to face reality. He needs an escape and resorts to alcohol. He becomes a drunkard.  He literally lost control of his life.

This is an uncomfortable episode in Noah’s life, but it serves as a reminder that even those saved by the grace of God are prone to sin. It is also a powerful warning about how just one careless decision can destroy the reputation of even the most Godly man or woman. The Bible does not specify why Noah became drunk. There are several possibilities but none of them change the fact that Noah was responsible for his own actions. One possibility is that Noah was haunted by his experiences during the flood.   The impact of the flood and the great loss of life began to sink in. Noah may have become depressed. He turned to alcohol to numb the emotional pain. Attempting to avoid negative feelings is one of the major reasons people abuse alcohol today. The key danger of alcohol is that it takes judgment to know when to stop, but good judgment is exactly what alcoholic tends to erode.

Rabbi Lance Sussman suggests that one possibility for Noah’s actions is that he developed the first reported case of Post-Traumatic Stress Disorder, or PTSD. The Torah tells us that Noah was psychologically sound prior to the flood, experienced tremendous trauma during the flood and, subsequently, failed to adjust to post flood life in basically every dimension of his life. Noah, it seemed, had a serious case of PTSD.

Feeling guilt after the experience of a traumatic event is serious and it has been linked to a number of negative consequences such as depression, shame, social anxiety, low self-esteem, and thoughts of suicide. In addition, it has been connected to the development of PTSD. The diagnosis of PTSD can be suspected in an individual who exhibits significant behavioral change after a traumatic event. It is described as a serious mental condition rooted in exposure to actual or threatened death, serious injury or sexual violation. The disturbance, regardless of its trigger, causes clinically significant distress in the individual’s social interactions, capacity to do work or other important areas of functioning and will be discussed in more detail later. One could say that in the story of Noah we can see different manifestations of severe psychological stress reaction consistent with PTSD. The midrash describes how burdensome life on the ark was for Noah. As mentioned, the Noah that emerges from the ark is not the same Noah that boarded the ark a year earlier. Gone is the righteous man we saw earlier. He is replaced by a broken man who has a drunken encounter with his son, after which we hear of him no more. After witnessing the destruction of the known world, it is not surprising that Noah turns to alcohol which is a common outlet for patients with PTSD.

Noah’s response to the flood is not dissimilar to the action of some Holocaust survivors. Noah experienced a kind of PTSD called survivor’s guilt. Survivor’s guilt is a type self-guilt that sometimes takes place after a traumatic event. This phenomenon can occur in a variety of life-threatening situations including car accidents, wars, natural disasters but it also can work its way into very personal tragedies, affecting friends and family of those who died by suicide, for example.

Survivors may find themselves wondering why they lived through the event or why they suffered less than others. The concept of survivor’s guilt achieved prominence during the 1960s when a number of psychologists described a similar set of symptoms experienced by survivors of the Holocaust. Some survivors were just not capable of facing the fact that they were singled out to live, while their beloved friends and relatives had been murdered. Survivors guilt can have a serious impact on a person’s life function. Survivors guilt may be viewed as one of the cognitive and mood related symptoms of PTSD, which include having distorted feelings of guilt and negative thoughts about oneself. Although survivor’s guilt was originally used to describe feelings that survivors of the Holocaust experienced, it has also been applied to other people and situations since that time. I saw this in my own practice in individuals who lived through the AIDS epidemic with feelings of guilt related to their own survival while others, including friends or family died. Also following a flood or tornado, people might feel a sense of guilt and wonder why their homes were spared while their next-door neighbor’s home was destroyed. Survivors guilt does not necessarily have to involve life or death situations.  Following a trauma, people may also experience feelings of regret. You ruminate over the events that took place and think about things they could have or should have done that would have altered the outcome. The rehashing of the events could further exacerbate the feelings of guilt, particularly if people feel their own actions or inaction may have worsened the consequences.

To review, Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. It was first described in 1980. Traumatic events that may trigger PTSD include violent personal assaults, natural or human caused disasters, accidents, or military combat. PTSD can happen to anyone.  It is not a sign of weakness.

The statistics on PTSD are alarming. In the United States, approximately 3.5% of the adult population has PTSD at any given moment. Cumulatively, as many as 9% are personally affected over a lifetime. PTSD is the most prevalent diagnosis among American military veterans, although it is estimated that only half of those with PTSD seek treatment. In one survey of 600 recent US combat veterans, it was reported that the rate of alcohol abuse was 39%, PTSD was at14% and drug abuse was at 3%. Among veterans, the correlation between PTSD and drinking problems can run as high as 80%.

There may also be profound religious implications associated with PTSD. For some victims, the circumstances leading to PTSD may lead to the questioning of important previously sustaining beliefs. This can lead to spiritual struggle or even loss of faith.

I want to mention another message of this parashah.  Question: what does Noah say to God when the decree is issued that the world is about the perish? The answer is: nothing. Noah is the paradigm of biblical obedience. He does as he is commanded. In Judaism, God does not command blind obedience. God wants us to be mature, deliberative, to do his will because we understand or because we trust him when we do not understand. He seeks from us something other and greater than obedience, namely responsibility.  Noah saved only himself and his family. At the end of his life, Noah was a drunk, disheveled, embarrassment to his children. This tells us that if you save yourself while doing nothing to save the world, you do not even save yourself. Noah could not live with the guilt of survival. It takes courage to rebuild a shattered world. That was the courage shown by those who built and fought for the state of Israel in the years after the Holocaust. They were different kinds of people, but they shared that intuitive knowledge that Noah lacked: that when it comes to rebuilding the ruins of catastrophe, you do not wait for permission. You take the risk and walk ahead. Faith is more than obedience. It is the courage to create.

If we find ourselves in Noah’s position, feeling alone, angry, or guilty about our life circumstances, it’s helpful to have coping mechanisms in place ahead of time or to seek professional help. It’s challenging to push through a traumatic experience but finding healthy ways to cope with emotions is essential.

So, in the end, Noah survived the flood, but drowned in the burden of his untreated PTSD. Let us learn from his tragic example.