Jerusalem syndrome
Encyclopedia
The Jerusalem syndrome is a group of mental phenomena involving the presence of either religiously themed obsessive ideas, delusion
s or other psychosis
-like experiences that are triggered by a visit to the city of Jerusalem. It is not endemic to one single religion or denomination but has affected Jews
, Christians
and Muslims
of many different backgrounds.
The best known, although not the most prevalent, manifestation of the Jerusalem syndrome is the phenomenon whereby a person who seems previously balanced and devoid of any signs of psychopathology
becomes psychotic after arriving in Jerusalem. The psychosis is characterised by an intense religious theme and typically resolves to full recovery after a few weeks or after being removed from the area.
The religious focus of the Jerusalem syndrome distinguishes it from other phenomena, such as the Stendhal syndrome
, which is reported in Florence
, Italy
, or the Paris syndrome
, which has been reported predominantly in Japanese
individuals.
In a 2000 article in the British Journal of Psychiatry, Bar-El et al. claim to have identified and described a specific syndrome which emerges in tourists with no previous psychiatric
history. However, this claim has been disputed by M. Kalian and E. Witztum. Kalian and Witzum stressed that nearly all of the tourists who demonstrated the described behaviours were mentally ill prior to their arrival in Jerusalem. They further noted that, of the small proportion of tourists alleged to have exhibited spontaneous psychosis
after arrival in Jerusalem, Bar-El et al. had presented no evidence that the tourists had been well prior to their arrival in the city.
Jerusalem Syndrome is not listed or referenced in the DSM IV
.
Heinz Herman, one of the founders of modern psychiatric research in Israel. Whether or not these behaviors specifically arise from visiting Jerusalem is debated, as similar behaviors have been noted at other places of religious and historical importance such as Mecca
and Rome
(see Stendhal syndrome
). It is known that cases of the syndrome had already been observed during the Middle Ages
, since it was described in the itinerary of Felix Fabri
and the biography of Margery Kempe
. Other cases were described in the vast literature of visitors to Jerusalem during the 19th century.
One case often mentioned in relation to the syndrome occurred in 1969, when an Australian tourist, Denis Michael Rohan, overwhelmed with a feeling of divine mission, set fire to the al-Aqsa Mosque
. His act was followed by citywide rioting. These events helped form the premise of a movie called The Jerusalem Syndrome.
Bar-El et al. suggested that at the approach of the year 2000, large numbers of otherwise normal visitors might be affected by a combination of their presence in Jerusalem and the religious significance of the millennium, causing a massive increase in the numbers of Jerusalem syndrome admissions to hospital. Despite a slight increase in tourist hospitalisations with the rise in total tourism to Jerusalem during the year 2000, the feared epidemic of Jerusalem syndrome never materialised.
In response to this, Bar-El et al. classified the syndrome into three major types to reflect the different types of interactions between a visit to Jerusalem and unusual or psychosis-related thought processes. However Kalian and Witztum have objected, saying that Bar-El et al. presented no evidence to justify the detailed typology and prognosis
presented and that the types in fact seem to be unrelated rather than different aspects of a syndrome
.
Jerusalem syndrome imposed on a previous psychotic illness. This refers to individuals already diagnosed as having a psychotic
illness before their visit to Jerusalem. They have typically gone to the city because of the influence of religious ideas, often with a goal or mission in mind that they believe needs to be completed on arrival or during their stay. For example, an affected person may believe himself to be an important historical religious figure or may be influenced by important religious ideas or concepts (such as causing the coming of the Messiah
or the second coming of Christ
).
ideas. This does not necessarily take the form of mental illness and may simply be a culturally anomalous obsession with the significance of Jerusalem, either as an individual, or as part of a small religious group with idiosyncratic spiritual beliefs.
Bar-El et al. reported 42 such cases over a period of 13 years, but in no case were they able to actually confirm that the condition was temporary.
in Jerusalem were analysed, it was reported that 1,200 tourists with severe, Jerusalem-themed mental problems were referred to this clinic. Of these, 470 were admitted to hospital. On average, 100 such tourists have been seen annually, 40 of them requiring admission to hospital. About two million tourists visit Jerusalem each year. Kalian and Witztum note that as a proportion of the total numbers of tourists visiting the city, this is not significantly different from any other city.
Delusion
A delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...
s or other psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
-like experiences that are triggered by a visit to the city of Jerusalem. It is not endemic to one single religion or denomination but has affected Jews
Judaism
Judaism ) is the "religion, philosophy, and way of life" of the Jewish people...
, Christians
Christianity
Christianity is a monotheistic religion based on the life and teachings of Jesus as presented in canonical gospels and other New Testament writings...
and Muslims
Islam
Islam . The most common are and . : Arabic pronunciation varies regionally. The first vowel ranges from ~~. The second vowel ranges from ~~~...
of many different backgrounds.
The best known, although not the most prevalent, manifestation of the Jerusalem syndrome is the phenomenon whereby a person who seems previously balanced and devoid of any signs of psychopathology
Psychopathology
Psychopathology is the study of mental illness, mental distress, and abnormal/maladaptive behavior. The term is most commonly used within psychiatry where pathology refers to disease processes...
becomes psychotic after arriving in Jerusalem. The psychosis is characterised by an intense religious theme and typically resolves to full recovery after a few weeks or after being removed from the area.
The religious focus of the Jerusalem syndrome distinguishes it from other phenomena, such as the Stendhal syndrome
Stendhal syndrome
Stendhal syndrome, Stendhal's syndrome, hyperkulturemia, or Florence syndrome is a psychosomatic illness that causes rapid heartbeat, dizziness, fainting, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly beautiful or a large amount of art...
, which is reported in Florence
Florence
Florence is the capital city of the Italian region of Tuscany and of the province of Florence. It is the most populous city in Tuscany, with approximately 370,000 inhabitants, expanding to over 1.5 million in the metropolitan area....
, Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
, or the Paris syndrome
Paris syndrome
Paris syndrome is a transient psychological disorder encountered by some people, in most cases from Japan, visiting or vacationing in Paris, France. It is similar in nature to Jerusalem syndrome and Stendhal syndrome....
, which has been reported predominantly in Japanese
Japanese people
The are an ethnic group originating in the Japanese archipelago and are the predominant ethnic group of Japan. Worldwide, approximately 130 million people are of Japanese descent; of these, approximately 127 million are residents of Japan. People of Japanese ancestry who live in other countries...
individuals.
In a 2000 article in the British Journal of Psychiatry, Bar-El et al. claim to have identified and described a specific syndrome which emerges in tourists with no previous psychiatric
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
history. However, this claim has been disputed by M. Kalian and E. Witztum. Kalian and Witzum stressed that nearly all of the tourists who demonstrated the described behaviours were mentally ill prior to their arrival in Jerusalem. They further noted that, of the small proportion of tourists alleged to have exhibited spontaneous psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
after arrival in Jerusalem, Bar-El et al. had presented no evidence that the tourists had been well prior to their arrival in the city.
Jerusalem Syndrome is not listed or referenced in the DSM IV
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...
.
History
Jerusalem syndrome has previously been regarded as a form of hysteria, referred to as "Jerusalem squabble poison," or fièvre Jerusalemmiene. It was first clinically described in the 1930s by Jerusalem psychiatristPsychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
Heinz Herman, one of the founders of modern psychiatric research in Israel. Whether or not these behaviors specifically arise from visiting Jerusalem is debated, as similar behaviors have been noted at other places of religious and historical importance such as Mecca
Mecca
Mecca is a city in the Hijaz and the capital of Makkah province in Saudi Arabia. The city is located inland from Jeddah in a narrow valley at a height of above sea level...
and Rome
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...
(see Stendhal syndrome
Stendhal syndrome
Stendhal syndrome, Stendhal's syndrome, hyperkulturemia, or Florence syndrome is a psychosomatic illness that causes rapid heartbeat, dizziness, fainting, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly beautiful or a large amount of art...
). It is known that cases of the syndrome had already been observed during the Middle Ages
Middle Ages
The Middle Ages is a periodization of European history from the 5th century to the 15th century. The Middle Ages follows the fall of the Western Roman Empire in 476 and precedes the Early Modern Era. It is the middle period of a three-period division of Western history: Classic, Medieval and Modern...
, since it was described in the itinerary of Felix Fabri
Felix Fabri
Felix Fabri - often erroneously referred to as Faber ["Erroneously referred to" is incorrect. "Faber" is the Latin nominative singular form of his surname. He is often referred to as "Fabri," the Latin genitive singular, i.e...
and the biography of Margery Kempe
Margery Kempe
Margery Kempe is known for dictating The Book of Margery Kempe, a work considered by some to be the first autobiography in the English language. This book chronicles, to some extent, her extensive pilgrimages to various holy sites in Europe and Asia, as well as her mystical conversations with God...
. Other cases were described in the vast literature of visitors to Jerusalem during the 19th century.
Al-Aqsa Mosque
Al-Aqsa Mosque also known as al-Aqsa, is the third holiest site in Sunni Islam and is located in the Old City of Jerusalem...
. His act was followed by citywide rioting. These events helped form the premise of a movie called The Jerusalem Syndrome.
Bar-El et al. suggested that at the approach of the year 2000, large numbers of otherwise normal visitors might be affected by a combination of their presence in Jerusalem and the religious significance of the millennium, causing a massive increase in the numbers of Jerusalem syndrome admissions to hospital. Despite a slight increase in tourist hospitalisations with the rise in total tourism to Jerusalem during the year 2000, the feared epidemic of Jerusalem syndrome never materialised.
Types
The classic Jerusalem syndrome, where a visit to Jerusalem seems to trigger an intense religious psychosis that resolves quickly or on departure, has been a subject of debate in the medical literature. Most of the discussion has centered on whether this definition of the Jerusalem syndrome is a distinct form of psychosis, or simply a re-expression of a previously existing psychotic illness that was not picked up by the medical authorities in Israel.In response to this, Bar-El et al. classified the syndrome into three major types to reflect the different types of interactions between a visit to Jerusalem and unusual or psychosis-related thought processes. However Kalian and Witztum have objected, saying that Bar-El et al. presented no evidence to justify the detailed typology and prognosis
Prognosis
Prognosis is a medical term to describe the likely outcome of an illness.When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because...
presented and that the types in fact seem to be unrelated rather than different aspects of a syndrome
Syndrome
In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms , phenomena or characteristics that often occur together, so that the presence of one or more features alerts the physician to the possible presence of the others...
.
Type I
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
illness before their visit to Jerusalem. They have typically gone to the city because of the influence of religious ideas, often with a goal or mission in mind that they believe needs to be completed on arrival or during their stay. For example, an affected person may believe himself to be an important historical religious figure or may be influenced by important religious ideas or concepts (such as causing the coming of the Messiah
Jewish Messiah
Messiah, ; mashiah, moshiah, mashiach, or moshiach, is a term used in the Hebrew Bible to describe priests and kings, who were traditionally anointed with holy anointing oil as described in Exodus 30:22-25...
or the second coming of Christ
Second Coming
In Christian doctrine, the Second Coming of Christ, the Second Advent, or the Parousia, is the anticipated return of Jesus Christ from Heaven, where he sits at the Right Hand of God, to Earth. This prophecy is found in the canonical gospels and in most Christian and Islamic eschatologies...
).
Type II
Jerusalem syndrome superimposed on and complicated by idiosyncraticIdiosyncrasy
An idiosyncrasy is an unusual feature of a person . The term is often used to express eccentricity or peculiarity. A synonym may be .-Etymology:...
ideas. This does not necessarily take the form of mental illness and may simply be a culturally anomalous obsession with the significance of Jerusalem, either as an individual, or as part of a small religious group with idiosyncratic spiritual beliefs.
Type III
Jerusalem syndrome as a discrete form, uncompounded by previous mental illness. This describes the best-known type, whereby a previously mentally balanced person becomes psychotic after arriving in Jerusalem. The psychosis is characterised by an intense religious character and typically resolves to full recovery after a few weeks or after being removed from the locality. It shares some features with the diagnostic category of a "brief psychotic episode", although a distinct pattern of behaviours has been noted:- Anxiety, agitation, nervousness and tension, plus other unspecified reactions.
- Declaration of the desire to split away from the group or the family and to tour Jerusalem alone. Tourist guides aware of the Jerusalem syndrome and of the significance of such declarations may at this point refer the tourist to an institution for psychiatric evaluation in an attempt to preempt the subsequent stages of the syndrome. If unattended, these stages are usually unavoidable.
- A need to be clean and pure: obsession with taking baths and showers; compulsive fingernail and toenail cutting.
- Preparation, often with the aid of hotel bed-linen, of a long, ankle-length, toga-like gown, which is always white.
- The need to shout psalms or verses from the Bible, or to sing religious hymns or spirituals loudly. Manifestations of this type serve as a warning to hotel personnel and tourist guides, who should then attempt to have the tourist taken for professional treatment. Failing this, the two last stages will develop.
- A procession or march to one of Jerusalem's holy places.
- Delivery of a sermon in a holy place. The sermon is usually very confusing and based on a plea to humankind to adopt a more wholesome, moral, simple way of life.
Bar-El et al. reported 42 such cases over a period of 13 years, but in no case were they able to actually confirm that the condition was temporary.
Prevalence
During a period of 13 years (1980–1993) for which admissions to the Kfar Shaul Mental Health CentreKfar Shaul Mental Health Center
Kfar Shaul Mental Health Center , established in 1951, is an Israeli public psychiatric hospital located between Givat Shaul and Har Nof, Jerusalem. It is affiliated with the Hadassah Medical Center and the Hebrew University of Jerusalem...
in Jerusalem were analysed, it was reported that 1,200 tourists with severe, Jerusalem-themed mental problems were referred to this clinic. Of these, 470 were admitted to hospital. On average, 100 such tourists have been seen annually, 40 of them requiring admission to hospital. About two million tourists visit Jerusalem each year. Kalian and Witztum note that as a proportion of the total numbers of tourists visiting the city, this is not significantly different from any other city.
See also
- Culture shockCulture shockCulture shock is the anxiety, feelings of frustration, alienation and anger that may occur when a person is emplaced in a new culture.One of the most common causes of culture shock involves individuals in a foreign country. Culture shock can be described as consisting of one or more distinct phases...
- Mean world syndromeMean World Syndrome"Mean world syndrome" is a term coined by George Gerbner to describe a phenomenon whereby violence-related content of mass media makes viewers believe that the world is more dangerous than it actually is. Mean world syndrome is one of the main conclusions of cultivation theory...
- Paris syndromeParis syndromeParis syndrome is a transient psychological disorder encountered by some people, in most cases from Japan, visiting or vacationing in Paris, France. It is similar in nature to Jerusalem syndrome and Stendhal syndrome....
- Stendhal (or Florence) syndromeStendhal syndromeStendhal syndrome, Stendhal's syndrome, hyperkulturemia, or Florence syndrome is a psychosomatic illness that causes rapid heartbeat, dizziness, fainting, confusion and even hallucinations when an individual is exposed to art, usually when the art is particularly beautiful or a large amount of art...
- Jewish Messiah claimantsJewish Messiah claimantsThe Messiah in Judaism has a number of interpretations, including any king chosen by God; a holy king who will lead Israel; and someone who will usher in an idyllic age of peace and justice...
- List of messiah claimants
Further reading
- Kalian, M.; Catinari, S.; Heresco-Levi, U.; Witztum, E. "Spiritual Starvation in a holy space – a form of Jerusalem Syndrome", Mental Health, Religion & CultureMental Health, Religion & CultureMental Health, Religion and Culture is an interdisciplinary peer-reviewed academic journal published by Routledge. It publishes original articles that deal with mental health in relation to religion and spirituality of all kinds...
11(2): 161-172, 2008. - Kalian, M.; Witztum,E. "Facing a Holy Space: Psychiatric hospitalization of tourists in Jerusalem". In: Kedar, Z.B.; Werblowsky, R.J., Eds.: Sacred Space: Shrine, City, Land. MacMillan and The Israel Academy of Sciences and Humanities, 1998.
- Kalian, M.; Witztum. E. "Jerusalem Syndrome as reflected in the pilgrimage and biographies of four extraordinary women from the 14th century to the end of the 2nd Millennium". Mental Health, Religion and Culture 5, 2002.
- Van der Haven, A. "The holy fool still speaks. The Jerusalem Syndrome as a religious subculture". In: Mayer, T.; Mourad, S.A., Eds.: Jerusalem. Idea and Reality. Routledge, 2008, pp. 103–122.
- Witztum, E.; Kalian, M. "The Quest for redemption: Reality and Fantasy in the Mission to Jerusalem". In: Hare, P.A.; and Kressel, G.M., Eds.: Israel as Center Stage. Bergin and Garvy, 2001.
External links
- Article from Project X Magazine
- Ravitz, Jessica. "Homer Simpson isn't the only would-be 'Messiah' in Jerusalem." CNNCNNCable News Network is a U.S. cable news channel founded in 1980 by Ted Turner. Upon its launch, CNN was the first channel to provide 24-hour television news coverage, and the first all-news television channel in the United States...
. March 29, 2010. - Jerusalem syndrome