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

101 Ways to F*ck Up Your Kid

#99: Factory Kids

It has been the norm since the Industrial revolution that parents send their kids to school often with the best intentions.  School is necessary to prepare them for the journey toward being productive and happy adults, right?

Maybe not.

The modern school system has not changed since its creation by factory owners in the late 18^th century.  This act by this new breed of industrialists was not one of altruism or civic humanism, but based solely on greed.  

Factories were built in large cities to take advantage of shipping and export hubs.  To man the factories, owners enticed able-bodied adults in from rural areas with the promise of modern homes, a steady wage, and year round employment.  To their dismay, the industrialists discovered that only men came to work while their wives stayed home to care for children and elderly parents. 

To solve this dilemma and entice women to come work in the factories as well as their husbands, the industrialists created Poor Houses for the elderly (now ‘retirement care homes’) and schools where children could be sent while mom worked.  They based both on the factory model.

Modern educators will scream blue-bloody-murder at this, but today’s schools are still factories; the raw material is pushed into one end, treated the same throughout the process, and the finished product is wave after wave of identical people.

These factory schools have - and are - failing our children.

Schools are a top-down, teach and test system, and restrict freedoms more than any adult would tolerate in their workplace.

Schools remain a law unto themselves, tolerating violent crimes within their halls and choosing to deal with those crimes internally, thereby depriving children of the rights for justice and law that adults demand.

Schools produce students who are burned-out by unrealistic demands and excessive hours of imposed homework. 

Mihaly Czikszentmihalyl and Jeremy Hunter fitted more than 800 sixth - through 12th - graders, from 33 different schools across the United States, with special wristwatches that provided a signal at random times of day. Whenever the signal appeared, they were to fill out a questionnaire indicating where they were, what they were doing, and how happy or unhappy they were at the moment. The lowest levels of happiness, by far, occurred when they were in school and the highest levels occurred when they were out of school playing or talking with friends. In school, they were often bored, anxious or both.

Twenty-five percent of students from grades one through twelve have a diagnosable anxiety disorder and the second leading cause of death for children and adolescents is suicide, often due to bullying at school.

Children are naturally driven to learn by their own innate curiosity.  Prior to attending school they learn how to crawl, walk, climb, and speak their native language independently and with that learn to converse, argue, tell jokes, and ask questions. 

As they grow, they begin to explore and learn experientially about the world that surrounds them, and develop skills and knowledge with little or no help from adults.  Many children learn to read before they begin school, studying the letters and words as their parents read to them.

That spark of natural learning is extinguished the moment a child sets foot within a factory school, and any child following their innate curiosity is punished.

There is a growing movement amongst parents to accommodate their children in self-directed learning as opposed to the factory model of education.

These parents base their child’s education in the home environment devoid of set curriculums and testing, connecting their children with community activities where they can learn on their own, such as museums, community centres, and libraries.  Parents who began this alternative to standard schooling decades ago have adult children who are now thriving in higher education and careers.

A recent survey of 232 of these families found that their children maintain their curiosity and passion for learning and have stronger bonds with their families.  One mother stated; “As an educator I see that my daughter has amazing critical thinking skills that many of my adult college students lack … My daughter lives and learns in the real world and loves it. What more could I ask for?”

Another study of these families found that older children who had pursued higher education (about 75% compared to an average of 32% for factory schools) reported no particular difficulty getting into the schools of their choice and doing well there once  admitted. Some, including a few who had never previously taken a formal course, had gone on successfully to highly prestigious colleges and universities.

Our factory-based schools are failing our children, seeing lower grade averages and crushing our children’s natural curiosity which in turn stifles their desire for a higher education, not to mention the psychological damage a factory school environment causes.

Aaron D. McClelland, MPCC-S - www.interiorcounselling.com

101 Ways to F*ck Up Your Kid

#29: Parentification

Parentification - sometimes known as ‘emotional incest’ - occurs when a child under the age of 18 is compelled to assume the physical and/or emotional care-taking of a parent or younger siblings at the expense of their own developmental needs.  It can range from an older child being told to help the family by taking care of a younger sibling, to becoming the pseudo partner and confidant of a parent.

No matter which end of the scale this may fall on, forcing a child to assume any adult role is a hidden form of child abuse and exploitation.

Parentification most often occurs after a divorce; during family unpredictability; with parental alcohol or drug abuse; with parents who are chronically emotionally or physically unavailable; with parents struggling with mental or physical health issues; and within rigid cultural and religious practices.

Having our children take some responsibility in the family home is a healthy part of childrearing; ‘you help make the mess, therefore you help clean it up’, yet parents must be ever mindful of a child’s capabilities at their current age and stage and not exceed them.  There is a vast difference between parentification and teaching children responsibility and many parents blur that line.

Dr Alice Miller in her book ‘The Drama of the Gifted Child: The Search for the True Self’ highlighted the cultural and religious based form of this form of abuse;

“Child abuse is still sanctioned - indeed, held in high regard - in our society as long as it is defined as child-rearing.” Miller said.

Through the abuse of parentification, Miller gives examples of the inner dialogue that may arise in such a child;

• "If I'm a really, really, good girl then mother will finally see me and take care of me"
• "If I stay strong and protect mother, she will see me”
• "If I give mother what she wants, she will stop abusing me."

At the age of six, one woman became the principal caregiver of her drug addicted mother and her infant brother simultaneously.  Her baby brother’s crib was placed next to her own bed so she could assume the role of surrogate mother and forced her to become his parent and protector to the detriment of her own emotional health.

“During dope sickness, she would unleash a lot of fury onto me,” she said of her mother, “I became the buffer or scapegoat of her rage to divert it from my younger brother.”

Eventually, at age nine, her grandparents took in her and her then 3-year-old brother, but the trauma of their former living situation stayed with both children. By the time she was 14, she was suffering from daily panic attacks, OCD, and depression. It wasn’t until she was an adult that she began to understand the connection between her childhood experiences and numerous chronic illnesses.  Her brother went on to become addicted to drugs and his relationship with his older sister shattered.

Parentification can become a matter of life and death for children navigating their teenage years.  When an adolescent should be resolving Erikson’s crisis stage of ‘Identity vs Identity Diffusion’, but find themselves cast in the role of principal care-giver to their younger sibling(s), they can often feel stuck and unsure of who they really are.  Their reactions to this false identity being thrust upon them can swing two ways; resentment of their young sibling(s) accompanied by the guilt and shame they experience from the resentment; to feeling conflicted and trapped in a life that is not their own, resulting in suicidal ideation or even completing suicide.

“I began to hate my little sister, then I’d feel guilty for that because it wasn’t her fault” one such adolescent girl said, “I couldn’t make my mom understand that I just wanted to love my little sister, not raise her.”

This teen girl developed an emotional urgency to care-take those around her; frantically trying to resolve the interpersonal clashes between her friends, and when she was unable to do so, feeling a crushing sense of failure that drove her to the brink of suicide.  She was measuring her sense of worth against a role she’d been cast into that she was ill prepared for.

Survivors of childhood parentification can carry that artificial sense of self throughout their lifetimes and become life-long caregivers to those around them, even  choosing spouses who they believe need ‘parenting and protection’ and never experience the unfettered joy of genuine love.

Children need to be left to be children; to navigate their developmental stages with the support and nurturing of loving parents.  Anything less than that is at best exploitation and at most child abuse.

Aaron D. McClelland, MPCC-S - www.interiorcounselling.com

Shameless Self Promotion

I know you come to this blog for enlightenment on mental health issues from a science-based perspective. This post will be a bit of departure from that ...

As those of you who follow my personal social media presence already know, I have completed and published three novels about the evolution of a gangster from 12 years of age to 52, all three stories told in the voice of the protagonist; Denny. They are ;

Little Gangsters

(1959)

Bigger Gangsters

(1969)

Millennial Gangsters

(1999)

I’m currently working on a fourth book in the series titled;

Gangster’s Girl

(2015)

... told in the voice of Jessie, Denny’s adopted daughter who is on the verge of becoming a psychologist but is forced to take a little detour.

For those who know me personally, the first book - Little Gangsters - is semi-autobiographical and based on my childhood in East Vancouver.  Yes, my grandmother was a bootlegger; yes, we were connected to one of three powerful crime organizations in Vancouver; and yes, I grew up not knowing that most of the adults in my life were career criminals. Even when I grew old enough to understand these things I couldn’t reconcile other people’s opinions about the gangsters I knew - I only saw men who lived, laughed, and loved large, and were devoted husbands and fathers, not the criminal reprobates so many labeled them as.

All three novels are published online as ebooks, and I have done my best to ensure each one can stand on its own and doesn’t require you to read the book that precedes it, although you may have more insight into Denny’s evolution and life-long search for love and belonging if you do.

So, dear reader, this is where you come in, and here is where I make my ask;

I need help to build interest in the books, and the best way to build interest is to sell copies and to have people rate and critique them in the comments section of the online stores that carry them.

I promise you; the books are entertaining; they will tell you stories about being a gangster you’ve never heard before; and - going by the responses of the few friends who have read them - they will make you laugh, make you cry, and hopefully help you come to the realization that gangsters are just like the rest of us; human beings who love and mourn, who have aspirations and self-doubt, who question their abilities and their morality, and have a burning desire to keep the people they love safe.

The characters you will meet are not free of mental health issues either, and the stories explore addiction, dissociation, post-traumatic stress, anxiety, panic disorder, depression, suicidal ideation, unresolved grief and all the human conditions that sometimes plague each of us.

I encourage you to visit the website; GangsterStory and read the synopsis for each book, and if you like what you see, to read the sample chapters provided there, and if it seems like a good investment (each book costs less than a cup of coffee at Starbucks) then click on the links at the bottom of website that will lead you to a page where you can visit your preferred online ebook store where you can buy one or all of my books.  Or you can click on any of the book titles below for the same options;

Little Gangsters

Bigger Gangsters

Millennial Gangsters

You’ll notice that different retailers charge different amounts for my books despite me setting a low price, and for those of you without a credit card, Kobo will accept PayPal for purchases.

So, please have a look at GangsterStory and if it leads you to purchase one or all the books in this saga, please know it will mean the world to me.

Best regards,

Aaron D McClelland

101 Ways to F*ck Up Your Kid

#65: Over Functioning

At the closing ceremony of Woodbadge training in Scouts Canada many years ago, one of our trainers - Troop Scouter Gordon Innes - offered the finest advice I have ever received regarding the development of children; “Pay your Scouts the courtesy of allowing them to make their own mistakes.”

Following this advice, our Scouts were encouraged to think and experiment by being given only the basic information on how to complete a task - such as cooking a meal - and we watched Leaders of other Troops using a hand-over-hand, step-by-step instruction approach.  It became apparent which was more effective as the year progressed; the Scouts in our Troop became ‘bush gourmets’ and regularly turned out creative complex meals, while the Scouters who employed the hand-over-hand/step-by-step method grew frustrated as their lessons didn’t seem to sink in.

I applied this even when teaching Cub aged children how to build and light a campfire.  They were given three pieces of information;

1. Fire requires fuel, oxygen, and heat
2. Little things burn easier than big things
3. Heat goes up

I then pointed out piles of paper, twigs, and sticks and handed each Cub two matches and told them to go build their fires.  In 12 years of instructing campfire safety I never had a Cub ask for a third match.  This minimal teaching method only provided the basic information and resources, it was up to the children to transform those into action; they had to think and experiment to be successful.

Our temptation to over function for children is driven by myriad personal motives; we may be impatient for them to learn; we may want to spare the child frustration; we may want the job done a specific way; we may have a desire to feel needed by our children and we may mistake it for helpfulness.  We have to differentiate between teaching a child and over functioning for them.

Experiencing failure, disappointment, or discomfort after making mistakes are essential life experiences that motivate children to experiment and develop new skills.  To be rescued after each failure breeds learned helplessness in a child, but children who fail and are encouraged by their parent or teacher to try again fare far better in life and improve their self-esteem.

I often give Babe Ruth’s baseball career as an example; During his career, Babe Ruth batted a record 714 home runs, but what many don’t know is that he also set a record by being struck out 1,330 times.  Babe Ruth never gave up, after each failure he returned to the dugout, regrouped, and waited for his next opportunity.

Over functioning for children not only instills that learned helplessness and contributes to low self-esteem, it also lays the foundation for future power struggles.  A parent who helps a young child too much with their homework in their primary years can expect power struggles from that child when they are in their teens through procrastination and resistance.

A colleague once had nightly power struggles with her sons over their bedtime.  She decided to hand all the responsibility to them and told them they could choose when to go to bed on their own.  Their first choices with this new found freedom was to stay up late, but the immediate result was feeling miserable the next day, missing school, getting lower grades, and no longer enjoying their preferred activities.  My colleague offered no comment or judgment on their choices resulting in these obvious outcomes - she remained silent and let the lessons kick in.  In the end, all three boys started going to bed earlier than their previously imposed bedtimes.

If a child forgets her homework, coat, or lunch when leaving for school and the parent brings the missing item to school for them they are denying the child the opportunity to learn.  Getting marks deducted for late homework, being cold during recess, or missing a meal are not life altering experiences, but will provide the child motivation to learn time management, responsibility, and self discipline.

My advice to parents and teachers is this;

1. Ask yourself why you are performing a function for a child; in other words -whose needs are being met?
2. Assess if the child is capable of doing this for themselves; if so; teach them how
3. Ask what would happen if you didn’t do it for them; will it only result in the learning experiences of failure, disappointment, and discomfort?
4. Create a milieu where failure is a shameless part of life; a way to learn and overcome - we all fail and by failing we learn to adapt and improve

Children have insatiable appetites for exploration, knowledge, and mastering new skills, we just have to get out of their way while loving and encouraging them as they fail and learn and succeed.

Aaron D. McClelland, MPCC-S - www.interiorcounselling.com

Misguided & Harmful School Officials

As a mental health practitioner who specializes in helping adolescents overcome Non-Suicidal Self-Injury (NSSI), I was appalled to read of an Okanagan/Skaha School District 67 School Board ruling “ordering a grade-nine student to wear long sleeves at all times to cover scars”.  It is short-sighted and puritanical actions like this that continue to vilify those struggling with mental health issues, resulting in those who need help being fearful of reaching out for it.  On the flip-side, I am heartened by the wise and outspokenness of the students who are standing up to this repulsive action.

NSSI is a process mostly used to counter overwhelming emotional and physical distress and only ‘works’ for 16.9% of the population.  A smaller percentage use it to escape feelings of dissociation or depersonalization; feeling numb physically and emotionally.  Most importantly, 50% use it to avoid suicide, so in many cases NSSI is the only thing keeping them alive.

NSSI is NOT ‘contagious’.  In her longitudinal study of self-injury, Dr Mary Kay Nixon of the University of Victoria found that 72% of adolescents who self-injure believe they came up with the idea on their own, while under 10% learned of it through friends, family or television.

Mental health issues are one of the largest crises our society faces today, with 25% of children and adolescents developing an anxiety or mood disorder in their school years; 1 in 3 girls and 1 in 5 boys being sexually abused before they graduate high school and the resultant post-traumatic symptoms that go with it.

Our school board needs to wake up to the fact that right now among the 4000+  population of their students between the ages of 12-18 years, 680 are engaging in NSSI and will do so for an average of 21 months; 286 will continue into adulthood and 8 will complete suicide within 15 years of the onset of self-injury.  Only an open dialogue without shame or judgement can help these students come forward to ask for the help they may need.

We look to our educational authorities such as SD 67 to provide education based on current and best practice; to be leaders in the field of helping our young people navigate life; to nurture and promote inclusivity amongst our student population.  Certainly not to vilify and shame a young woman for doing her best to cope.  I applaud the students who are leading the charge to change the outdated and harmful attitudes of SD 67 administrators, and remind them of the words of cultural anthropologist Margaret Mead;

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.”

Aaron D. McClelland, MPCC-S - www.interiorcounselling.com

101 Ways to F*ck Up Your Kid

#17: Shame & Guilt

“Nothing is more wretched than the mind of a man conscious of guilt.”

~ Titus Maccius Plautus

Instilling lasting shame and guilt in a child is not only emotional abuse, but if successful, can cause mental disorders and brain damage.

As parents, our most important responsibility is to nurture our children, not only meeting their physical needs but their emotional ones as well.  Learning from our past transgressions or poor choices is a good motivator to change our behaviour.  However, shame and guilt is not a practice of learning, it is emotional baggage that we carry that impedes our growth and has a large negative impact on our self-esteem and social interactions.

At times parents employ shame and guilt without even knowing that they are doing so, often in the form of a “feel-bad-game”; a three year old refuses to give a parent a kiss or hug, so the parent pretends to cry or pout.  This causes the child to take on a sense of responsibility for their parent’s emotional state and feel shame to have caused that parent to feel bad.  It also teaches the child that they have no choice whom they hug or kiss because it will hurt the other person if they don’t.

Just let that sink in for a moment; is teaching your daughter that she has no right to resist intimate physical contact with another person the lesson you want her to learn?

Shame and guilt instilled in childhood can cause us to be immobilized in the present for an action in the past.  Far too often, parents use shame or guilt to correct behaviours - and it often appears to work in the short term, however it lingers in the mind of a child and may manifest itself throughout their life span.  Shame and guilt not only impacts children emotionally, it can have a negative impact on brain development.

In a 12 year study conducted by Joan Luby, MD and her team at Washington University School of Medicine - Psychiatry, researchers looked at a part of the brain called the anterior insula, which regulates perception, self-awareness, and emotion. Smaller anterior insulas have been linked to anxiety disorders, depression, other mood disorders, and schizophrenia.

Researchers took brain scans of 145 school-aged children and asked their caregivers whether their kids exhibited any symptoms of excessive guilt, such as apologizing repeatedly for minor misbehaviour or feeling guilty about things that had happened in the past. The researchers found that feelings of extreme guilt correlated with smaller anterior insulas.

"In the kids who had high levels of guilt, even the kids who weren't necessarily depressed, they had smaller anterior insula volume, and that smaller anterior insula volume is predictive of later occurrence of depression," said Luby,  "This research suggests that early childhood experiences impact the way the brain develops."

Michelle New, PsyD, an associate professor at George Washington University Medical School in Washington, DC, praised Luby’s research for helping pinpoint brain anatomy that place shame and guilt-ridden children at high risk of developing mental disorders later in life.

"This research is really new and exciting because you can look at changes in the brain, and it shows that early intervention is really important. Dismissing early symptomatology is dangerous." New said, going on to explain that mental disorders are often latent in children between the ages of four and 12, so being able to identify high risk children through a brain scan can help parents and therapists take preventative measures early in development.

A vital lesson all social beings must learn is how their behaviour impacts others, but being shamed or weighed down by guilt for their actions can echo through an entire life span.

Aaron D. McClelland, MPCC-S - www.interiorcounselling.com