The Jerusalem syndrome

The Jerusalem syndrome affects travelers to the Holy Land. It is not specific to any single religion or denomination, and has affected Jews and Christians of many different backgrounds. Dr Bar-El of Jerusalem has described subtypes of this disorder.

Type I: Jerusalem syndrome imposed on a pre-existing psychotic illness before visiting Jerusalem. They typically travel because of delusional religious ideas, with a goal or mission which they believe needs to be completed on arrival or during their stay.

Type II: Jerusalem syndrome superimposed on and complicated by idiosyncratic ideas . This is more a culturally anomalous ideation with Jerusalem, either individually, or part of a small religious group with idiosyncratic spiritual beliefs.

Type III: Jerusalem syndrome as a distinct form, with no previous mental illness who becomes psychotic after arriving in Jerusalem. This is characterized by an intense religious character but typically resolves to full recovery after a few weeks, or after being removed from Jerusalem.

1.   Anxiety, agitation, nervousness and tension.

2.   Declarating to split away from a group or family to tour Jerusalem alone. This alerts tour guides aware of the Jerusalem syndrome to refer this person to an institution for psychiatric evaluation to prevent further stages,

3.   A need to be clean and pure: obsession with taking baths and showers; compulsive fingernail and toenail cutting.

4.   Preparation, often with the aid of hotel bed-linen, of a long always white ankle-length toga-like gown.

5.   Shouting psalms or verses from the Bible, religious hymns and spirituals. These are red flags to hotel personnel and tourist guides, who may attempt to take tourist for professional treatment.

6.   A procession or march to one of Jerusalem's holy places.

7.   Delivery of a ‘sermon' in a holy place. Usually a plea or mankind to adopt a wholesome, moral, and simple way of life.

From 1980 to 1993 it was reported that 1,200 tourists with severe, Jerusalem-themed mental problems were referred to the Kfar Shaul Mental Health Centre in Jerusalem. Of these, 470 were admitted to hospital. On average, 100 such tourists are seen yearly, 40 requiring hospital admission.

But other psychiatrists have criticized that 2 million tourists visit Jerusalem each year and these hospitalizations are not different from any other city. Their dramatic behavior after they encounter the “living history” of Jerusalem make it more noticeable. They stress that Jerusalem is no more toxic than any other city and that all the cases seen have preexisting mental illness and there is little evidence for type 3.

People are often moved emotionally by the historic sites they see. People act in ways they normally would not because they are “given permission to do so” in the altered social context. The Jerusalem syndrome could be a form of self hypnosis being distinct from a fixed delusion, psychosis or any type of intoxification.

Other syndromes occur in travelers'

Stendhal Syndrome has been described in Florence among travelers visiting fine art like the Uffizi gallery and developing fixations on art.

Paris Syndrome occurs in Japanese tourists where they become overtaken by the Louvre. In this case cultural differences between the Japanese and French might be also a factor.