Tuesday, 16 October 2018

Jerusalem Syndrome

(The following article was included for the autumn issue of the CPCA's newsmagazine INTERVALS.  Each Hallowe'en, I have chosen an odd psychological condition; Cotard's Syndrome; Alice in Wonderland Syndrome, etc just to offer something bizarre and spooky.  The Executive Director and  the Board of Directors have chosen to censor the article, for fear it may "offend religious people.
In the four decades I have written professionally, I have NEVER been censored, nor will I tolerate it now.  I have resigned as Editor, Art Director, and Feature Writer for the CPCA.  SO here is the original article for your consideration.)
Jerusalem Syndrome is a rare, temporary cluster of psychological phenomena comprised of religious obsession, delusions, and psychosis triggered when visiting the city of Jerusalem.  The syndrome can occur regardless if the person is Jewish, Christian, or Muslim.  Jerusalem Syndrome causes a psychotic episode in visitors who had may have never displayed any signs of psychosis, delusional, or obsessive thinking, although some clinicians dispute this; maintaining that visiting the city unleashes pre-existing latent psychotic tendencies.
The symptoms of Jerusalem Syndrome are diverse, but most centre around obsessive religious mania;
  • Anxiety, agitation, nervousness and tension
  • A desire to separate from family or their group in order to explore Jerusalem on their own
  • A sudden manic need to be ‘clean’ and ‘pure’; obsessively taking baths and showers; compulsively trimming fingernails and toenails
  • Using hotel bed linen to fashion an ankle length, toga-like gown, always white in colour
  • Shouting psalms or bible verses impulsively, or singing hymns loudly as they travel through the city
  • A ‘processional march’ to one of Jerusalem’s ‘holy’ places
  • Delivering a ‘sermon’ in one of the holy places, usually themed as a plea for humanity to adopt a wholesome, moral, and holier way of life - such sermons are typically disjointed and rambling
  • A paranoid delusion that a Jerusalem shadow organization is stalking them and causing their symptoms through medication and poisoning
From 1980 to 1993 the admissions to the Kfar Shaul Mental Health Centre in Jerusalem indicated that 1200 tourists with profound Jerusalem-themed psychological issues were referred with 470 requiring admission to stabilize them enough to transport them home.
The syndrome is classified under three types;
Type I
Jerusalem syndrome imposed on a previous psychotic illness referring 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 such as the new messiah, or be the person who will trigger 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. The psychosis is characterized 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’.
The fortunate aspect of Jerusalem Syndrome is that the symptoms are temporary and recede upon the person returning home.

Jerusalem Syndrome is not listed as a diagnosis nor mentioned in the DSM-V nor in the ICD-XI, and some scholars argue that some form of psychosis must be present prior to a visit to the city for it to occur.
Aaron D. McClelland, MPCC-S - www.interiorcounselling.com

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