Some city breaks leave a mark on you, uplifting your spirit, enlightening you with their landmarks, culture and people; others will go beyond this and trigger a mystical experience – literally
Although it hasn’t been recognised and listed as a mental disorder, because of its usually fast remission and sporadic occurrence, the Jerusalem syndrome is a mental phenomenon affecting visitors, mostly first-timers, of the Holy City with religious-themed obsessions, delusions and even psychotic episodes, regardless of the absence of underlining or ongoing mental conditions, and no matter their religious background or devotional depths.
A similar behaviour, albeit less intense, may be observed in Rome, especially in Vatican City, while mental health issues manifested in Mecca are connected to the sheer volume of pilgrims, constricted space, and repetition of rituals, if not collective hysteria, according to some psychological studies.
Jerusalem syndrome arises in subjects who have no known psychiatric history, displaying a balanced lifestyle and clean bill of mental health, enjoying a rational relationship with their religion, or lack of thereof, and visiting Jerusalem for purposes that aren’t strictly of worshipping.
Usually the person experiences a sudden, sometimes unpleasant urge, rather than a mystical calling, to step up their devotion, extending their itinerary to all or most churches, donating to charities, fasting or performing genuflection and flagellation, overspending on souvenirs and attending confession and mass obsessive-compulsively, forsaking the secular aspects of their trip, like dinners, theatre, shopping or spending time with their families.
Delusions are different from revelation of true vocation, and one must consider lucidly whether to pursue one’s newfound devotion, perhaps seeking expert advice once back home, before hastily signing up for the cloister. Jerusalem syndrome is a powerful suggestion that works on one’s mind only in the proximity of holy sites, so the persistence and consistence of beliefs weeks after the removal of the affected person should be an indicator of his or her true purposes.
In fact, acute symptoms drop once the visit to Jerusalem is over, with a very few cases persisting in their delusion beyond one week after their homecoming.
However, severe cases can produce psychosis and manifest in personality imbalances, schizophrenia or paranoia episodes, the impulse of joining a monastery, a yeshiva or a madrasa – not necessarily according to one’s familial background, though – or even go round preaching, convinced to be on a mission to pave the road for the second coming.
Jerusalem syndrome has been described in medical and travel literature since the Middle Ages, but then it was kind of expected and welcomed, while in the late Nineteenth Century it was considered a form of hysteria, and collective hysteria.
Nowadays it is regarded with academic curiosity as well as concern, when its consequences may put someone’s life in danger with zealot-fuelled irresponsible conduct.
Cases have been recorded in which the affected person, usually a male subject, would claim to be Jesus and demand to carry the cross, or St. Peter going around preaching loudly and causing disturbance of the peace, and even an improvised St. John the Baptist with a bottle of soda. These acute psychoses went into immediate remission when the subject was removed from the streets, administered mild medication or sedated.
Muslims may be struck by the urge of impersonating the Prophet or more simply just attending daily prayers with clockwork precision and dedicating extra time to scriptures reading. As well, the Jewish response prompts adherence to alimentary prohibitions, prayer times and religious studies, and the impulse of manically stuffing handwritten prayers in the Western Wall’s cracks.
Non-monotheistic religions adepts may be affected too, curiously, and more curiously, there aren’t so far scientific recordings or studies of equivalent psychological phenomena developing at Hindu or Buddhist sanctuaries, where nevertheless a large volume of pilgrims is attested, daily or on high holidays.
There are indeed patients who land in Jerusalem already predisposed to the onset, temporary or long term, of this condition, because of deep rooted idiosyncratic ideas and a cultural obsession on the symbolism of the Holy City.
When Jerusalem syndrome is spontaneous and uncompounded with underlining mental health issues, the psychosis is acute and brief. It resolves in full recovery, and relapse is unlikely, even in the case of a future return to the Holy City.
Symptoms start with uneasiness, anxiety, agitation and absentmindedness and extend to the desire of declaiming psalms or verses louder than appropriate and singing hymns all the time. This is the best telltale sign to alert hotels and holy sites personnel, as well as tour guides, about the potential triggering of a psychotic episode, which may end in hospital admission in 40% of the cases.
Relatives and friends must be alerted by someone’s insistent demands of visiting Jerusalem alone, or unannounced splits from the group, as well as the sudden obsession with cleanliness and purity, especially with toenail clipping, or the odd request of taking on tour with them white bed linen borrowed from the hotel.
As harmless as it might appear, this psychosis, no matter how temporary, can escalate in reckless actions, and put the sufferer’s life in danger, or endanger life around him or her, with unpredictability and diminished responsibility.
Men are more affected with the urge to deliver disjointed speeches in public places, while women tend to keep their worshipping private, and enjoy a serious church crawl and prayer marathon, from the crack of dawn to nightfall.
If the sub ject claims to be the Messiah, this shouldn’t be confused with the Messiah complex, which is a topographically unrelated, and often long-term, state of mind triggered by delusions of grandeur and the belief they’re destined to save the world in their lifetime, and perhaps act upon it by offering unsolicited and unqualified help, one ‘sinner’ at the time.
This article aims at being informative only, with no medical or diagnostic pretenses. Seek medical attention if you suspect you or a relative may be experiencing a psychotic episode while on holiday.