Jerusalem syndrome

Last updated
Man who claims to be the messiah in Tel Aviv, 2010 Jerusalem Syndrome.jpg
Man who claims to be the messiah in Tel Aviv, 2010

Jerusalem syndrome is a group of mental phenomena involving the presence of religiously-themed ideas or 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. It is not listed as a recognised condition in the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases .

Contents

The best known, although not the most prevalent, manifestation of Jerusalem syndrome (classified as Type III) is the phenomenon whereby a person who seems previously balanced and devoid of any signs of psychopathology becomes psychotic after arriving in Jerusalem.[ not verified in body ] 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 Jerusalem syndrome distinguishes it from other phenomena, such as Stendhal syndrome in Florence or Paris syndrome in Paris.

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 abnormal psychiatric history. [1] However, this claim has been disputed by M. Kalian and E. Witztum. [2] [3] Kalian and Witztum 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.

History

View of Jerusalem Jerusalem Dominus flevit BW 1.JPG
View of Jerusalem

Jerusalem syndrome has previously been regarded as a form of hysteria, referred to as "fièvre Jérusalemienne". [4] It was first clinically described in the 1930s by Jerusalem psychiatrist Heinz Hermann, one of the founders of modern psychiatric research in Israel. [5] 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.[ citation needed ] Other cases were described in the vast literature of visitors to Jerusalem during the 19th century.

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. [1]

Types

The classic Jerusalem syndrome, where a visit to Jerusalem seems to trigger an intense religious psychosis that resolves quickly after or on departure, has been a subject of debate in the medical literature. [2] [3] [6] 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 [1] 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.

Type I

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, affected persons may believe themselves to be important historical religious figures or may be influenced by important religious ideas or concepts (such as causing the coming of the Messiah or the second coming of Christ).

Type II

Jerusalem syndrome superimposed on and complicated by idiosyncratic 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. It can include a paranoid belief that an agency is after the individual, causing their symptoms of psychosis through poisoning and medicating. [7]

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 Center in Jerusalem were analysed, it was reported [1] 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 three-and-a-half-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. [2] [8]

"The Jerusalem Syndrome", a theater play by Joshua Sobol, deals with the fanaticism that led the destruction of the Jewish Second Temple. [9]

In The X-Files (Season 3, Episode 11, "Revelations," released in 1995), the perpetrator is depicted as having "Jerusalem Syndrome" after a visit to the city. He returns to the US and goes on to kill a child who has signs of stigmata.

The 2001 song "Jerusalem" was composed by James Raymond on the topic of the Jerusalem Syndrome. It appears on the 2001 record Just Like Gravity, by CPR (David Crosby, Jeff Pevar, James Raymond).

A 2006 film by Victor Braun titled "Jerusalem syndrome" tells the story of a Christian pilgrim with the syndrome.

In The Simpsons 2010 episode "The Greatest Story Ever D'ohed", Homer develops Jerusalem syndrome while visiting Israel with his family as part of a tour group from Springfield. The illness and its effects on him become a central element of the episode's plot. Eventually, most members of the tour group are overcome with Jerusalem syndrome, each one proclaiming that he/she is the messiah. [10]

In the 2014 ABC series Black Box , the episode "Jerusalem" (Season 1, Episode 5) features a character diagnosed with Jerusalem syndrome after he becomes suddenly and compulsively religious during a trip to Israel. [11]

The 2015 movie Jeruzalem features a character that is suspected to have the Jerusalem syndrome. [12]

"Jerusalem", the twelfth story in Neil Gaiman's 2015 collection, Trigger Warning , centres around a British woman who comes down with the syndrome on holiday. She believes God is speaking to her and eventually flees her home to return to Jerusalem. [13]

The catalog of the Metropolitan Museum of Art's 2016 show about an earlier era of the city's history used the syndrome as the "organizing metaphor" for the first paragraph of the introduction, per a review. [14]

In 2023 the York Theatre Company produced "The Jerusalem Syndrome," [15] a musical comedy written by Kyle Rosen, Laurence Holzman and Felicia Needleman, and directed by Don Stephenson. The 14-person cast included Farah Alvin and Lenny Wolpe.

See also

Related Research Articles

Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior that is inappropriate for a given situation. There may also be sleep problems, social withdrawal, lack of motivation, and difficulties carrying out daily activities. Psychosis can have serious adverse outcomes.

A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other misleading effects of perception, as individuals with those beliefs are able to change or readjust their beliefs upon reviewing the evidence. However:

Schizoaffective disorder is a mental disorder characterized by abnormal thought processes and an unstable mood. This diagnosis requires symptoms of both schizophrenia and a mood disorder: either bipolar disorder or depression. The main criterion is the presence of psychotic symptoms for at least two weeks without any mood symptoms. Schizoaffective disorder can often be misdiagnosed when the correct diagnosis may be psychotic depression, bipolar I disorder, schizophreniform disorder, or schizophrenia. This is a problem as treatment and prognosis differ greatly for most of these diagnoses. many people with schizoaffective disorder have other mental disorder including anxiety disorders

Richard Bentall is a Professor of Clinical Psychology at the University of Sheffield in the UK.

Stimulant psychosis is a mental disorder characterized by psychotic symptoms. It involves and typically occurs following an overdose or several day binge on psychostimulants; however, one study reported occurrences at regularly prescribed doses in approximately 0.1% of individuals within the first several weeks after starting amphetamine or methylphenidate therapy. Methamphetamine psychosis, or long-term effects of stimulant use in the brain, depend upon genetics and may persist for some time.

Ganser syndrome is a rare dissociative disorder characterized by nonsensical or wrong answers to questions and other dissociative symptoms such as fugue, amnesia or conversion disorder, often with visual pseudohallucinations and a decreased state of consciousness. The syndrome has also been called nonsense syndrome, balderdash syndrome, syndrome of approximate answers, hysterical pseudodementia or prison psychosis.

<span class="mw-page-title-main">Emergency psychiatry</span> Clinical application of psychiatry in emergency settings

Emergency psychiatry is the clinical application of psychiatry in emergency settings. Conditions requiring psychiatric interventions may include attempted suicide, substance abuse, depression, psychosis, violence or other rapid changes in behavior.

<span class="mw-page-title-main">Paris syndrome</span> Form of tourist disillusionment

Paris syndrome is a cluster of psychiatric symptoms exhibited by some individuals when visiting Paris, that can be viewed as a severe form of culture shock.

<span class="mw-page-title-main">Victor Kandinsky</span>

Victor Khrisanfovich Kandinsky was a Russian Empire psychiatrist, and was 2nd cousin to famed artist Wassily Kandinsky. He was born in Siberia into a large family of extremely wealthy businessmen. Victor Kandinsky was one of the famous figures in Russian psychiatry and most notable for his contributions to the understanding of hallucinations.

<span class="mw-page-title-main">Grandiose delusions</span> Subtype of delusion

Grandiose delusions (GDs), also known as delusions of grandeur or expansive delusions, are a subtype of delusion characterized by extraordinary belief that one is famous, omnipotent, wealthy, or otherwise very powerful. Grandiose delusions often have a religious, science fictional, or supernatural theme. Examples include the extraordinary belief that one is a deity or celebrity, or that one possesses extraordinary talents, accomplishments, or superpowers.

Brief psychotic disorder—according to the classifications of mental disorders DSM-IV-TR and DSM-5—is a psychotic condition involving the sudden onset of at least one psychotic symptom lasting 1 day to 1 month, often accompanied by emotional turmoil. Remission of all symptoms is complete with patients returning to the previous level of functioning. It may follow a period of extreme stress including the loss of a loved one. Most patients with this condition under DSM-5 would be classified as having acute and transient psychotic disorders under ICD-10. Prior to DSM-IV, this condition was called "brief reactive psychosis." This condition may or may not be recurrent, and it should not be caused by another condition.

<span class="mw-page-title-main">Postpartum psychosis</span> Rare psychiatric emergency beginning suddenly in the first two weeks after childbirth

Postpartum psychosis (PPP), also known as puerperal psychosis or peripartum psychosis, involves the abrupt onset of psychotic symptoms shortly following childbirth, typically within two weeks of delivery but less than 4 weeks postpartum. PPP is a condition currently represented under "Brief Psychotic Disorder" in the Diagnostic and Statistical Manual of Mental Disorders, Volume V (DSM-V). Symptoms may include delusions, hallucinations, disorganized speech, and/or abnormal motor behavior. Other symptoms frequently associated with PPP include confusion, disorganized thought, severe difficulty sleeping, variations of mood disorders, as well as cognitive features such as consciousness that comes and goes or disorientation.

Mystical psychosis is a term coined by Arthur J. Deikman in the early 1970s to characterize first-person accounts of psychotic experiences that are strikingly similar to reports of mystical experiences.

<span class="mw-page-title-main">Kfar Shaul Mental Health Center</span> Hospital in Jerusalem

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. The hospital is Jerusalem's designated psychiatric hospital for tourists who display mental health disturbances, and is widely known for its research on Jerusalem Syndrome.

Spiritual crisis is a form of identity crisis where an individual experiences drastic changes to their meaning system typically because of a spontaneous spiritual experience. A spiritual crisis may cause significant disruption in psychological, social, and occupational functioning. Among the spiritual experiences thought to lead to episodes of spiritual crisis or spiritual emergency are psychiatric complications related to existential crisis, mystical experience, near-death experiences, Kundalini syndrome, paranormal experiences, religious ecstasy, or other spiritual practices.

Substance-induced psychosis is a form of psychosis that is attributed to substance intoxication. It is a psychosis that results from the effects of chemicals or drugs. Various psychoactive substances have been implicated in causing or worsening psychosis in users.

Zouhuorumo, also known as qigong deviation, is a Chinese-culture concept traditionally used to indicate that something has gone wrong in spiritual or martial arts training. The qigong community uses this term to describe a physiological or psychological disorder believed to result during or after qigong practice, due to "improper practice" of qigong and other self-cultivation techniques. The concept was highlighted in the social and political context of mass popularization of qigong in China. The Buddhist or Taoist community also uses this term when referring to people who practice esoteric techniques or meditation without the proper guidance of a teacher.

<span class="mw-page-title-main">Religious delusion</span> Delusion involving religious themes or subject matter

A religious delusion is defined as a delusion, or fixed belief not amenable to change in light of conflicting evidence, involving religious themes or subject matter. Religious faith, meanwhile, is defined as a belief in a religious doctrine or higher power in the absence of evidence. Psychologists, scientists, and philosophers have debated the distinction between the two, which is subjective and cultural.

The relationship between religion and schizophrenia is of particular interest to psychiatrists because of the similarities between religious experiences and psychotic episodes. Religious experiences often involve reports of auditory and/or visual phenomena, which sounds seemingly similar to those with schizophrenia who also commonly report hallucinations and delusions. These symptoms may resemble the events found within a religious experience. However, the people who report these religious visual and audio hallucinations also claim to have not perceived them with their five senses, rather, they conclude these hallucinations were an entirely internal process. This differs from schizophrenia, where the person is unaware that their own thoughts or inner feelings are not happening outside of them. They report hearing, seeing, smelling, feeling, or tasting something that deludes them to believe it is real. They are unable to distinguish between reality and hallucinations because they experience these hallucinations with their bodily senses that leads them to perceive these events as happening outside of their mind. In general, religion has been found to have "both a protective and a risk increasing effect" for schizophrenia.

Bouffée délirante (BD) is an acute and transient psychotic disorder. It is a uniquely French psychiatric diagnostic term with a long history in France and various French speaking nations: Caribbean, e.g., Haiti, Guadeloupe, Antilles and Francophone Africa. The term BD was originally coined and described by Valentin Magnan (1835–1916), fell into relative disuse and was later revived by Henri Ey (1900–1977).

References

  1. 1 2 3 4 Bar-el Y, Durst R, Katz G, Zislin J, Strauss Z, Knobler HY. (2000) Jerusalem syndrome. British Journal of Psychiatry , 176, 86–90. Full text Archived 2008-05-06 at the Wayback Machine
  2. 1 2 3 Kalian M, Witztum E. (2000) "Comments on Jerusalem syndrome". British Journal of Psychiatry , 176, 492. Full text Archived 2011-07-19 at the Wayback Machine
  3. 1 2 Kalian M, Witztum E. (1999) "The Jerusalem syndromefantasy and reality a survey of accounts from the 19th and 20th centuries." Isr. J. Psychiatry Relat Sci., 36(4):260–71. Abstract Archived 2017-12-21 at the Wayback Machine
  4. Elon, Amos.Jerusalem, City of Mirrors. Little, Brown, 1989, p. 147. ISBN   978-0-316-23388-0
  5. The Jerusalem Syndrome in Biblical Archaeology Archived 2012-01-14 at the Wayback Machine .
  6. Fastovsky N, Teitelbaum A, Zislin J, Katz G, Durst R. (2000) Jerusalem syndrome or paranoid schizophrenia? Psychiatric Services, 51 (11), 1454. Full text Archived 2021-11-06 at the Wayback Machine
  7. Fastovsky, Natasha; Teitelbaum, Alexander; Zislin, Josef; Katz, Gregory; Durst, Rimona (August 2000). "The Jerusalem Syndrome". Psychiatric Services. 51 (8): 1052–a–1052. doi:10.1176/appi.ps.51.8.1052-a. PMID   10913469.
  8. Tannock C, Turner T. (1995) Psychiatric tourism is overloading London beds. BMJ 1995;311:806 Full Text Archived 2006-05-14 at the Wayback Machine
  9. The Jerusalem Syndrome / Joshua Sobol at Israeli Dramatists Website. Accessed 6 Nov 2023.
  10. Saner, Emine (2018-01-16). "What is Jerusalem syndrome?". The Guardian. Archived from the original on 2018-05-21. Retrieved 2018-05-21.
  11. "Jerusalem". IMDb . Archived from the original on 2021-11-06. Retrieved 2018-10-28.
  12. "Jeruzalem". IMDb . Archived from the original on 2019-10-16. Retrieved 2019-11-09.
  13. O'Hehir, Andrew (2015-03-08). "Neil Gaiman's 'Trigger Warning'". New York Times. Archived from the original on 2020-08-29. Retrieved 2020-05-21.
  14. Namdar, Ruby, "400 Years of Jerusalem Culture" Archived 2016-12-08 at the Wayback Machine , New York Times , December 2, 2016. The catalogue is titled Jerusalem: 1000-1400: Every People Under Heaven, edited by Barbara Drake Boehm and Melanie Holcomb. Retrieved 2016-12-04.
  15. JerusalemSyndromeMusical.com

Further reading