JERUSALEM SYNDROME: causes, symptoms and treatment

Traveling around the world is an activity that allows us to get to know different cultures, customs and places. During the holidays, people like to travel, spend a few days in different environments than the routine ones and break the monotony. Now, what if traveling to certain places could lead to the development of psychopathological symptoms?

Jerusalem, Paris, Nepal, India, Florence and Hawaii are destinations in which the development of this type of symptoms has been observed. The "Jerusalem syndrome" is, of all of them, the one with the highest percentage of psychotic symptoms. Keep reading this Psychology-Online article in which we talk about the Jerusalem syndrome, its causes, symptoms and treatment.

Index

1. What is Jerusalem Syndrome?
2. Types of patients with Jerusalem syndrome
3. Symptoms of Jerusalem Syndrome
4. Causes of Jerusalem syndrome
5. Jerusalem syndrome treatment

The jerusalem syndrome understands the appearance of

The psychiatrist Yair Bar-El named this syndrome after detecting that these problems were not an isolated case and appeared in a small number of tourists.

The “Kfar Shaul Mental Health Center” hospital is the place associated with the care of tourists who develop this type of symptomatology and where they receive psychiatric and psychological help. Yair Bar-El's team observed that in the period between 1980 and 1993, an average of 100 people a year attended with symptoms of the syndrome, of which 40 required hospital admission.

Yair Bar-El's working group identified different types of patients based on his clinical experience.

Type I

The first group would be made up of people who had already been diagnosed with a psychotic disorder prior to his trip to Jerusalem. In fact, it is the disorder itself, in which we could find delusional ideas, which would have motivated the trip to the holy land, a place where these patients would like to complete “their mission”.

In turn, within this type we can find other subtypes:

• First, there are patients who either identify with a biblical character or they are convinced that this character is themselves.
• Second, we can observe patients who identify themselves, this time, with a political or religious idea.
• A third group is made up of people who attribute to the Israeli destiny healing properties.
• A last group is made up of patients who show their mental problems in the form of family problems.

Type II

A second type of patient includes patients who show idiosyncratic ideas and they may show psychological problems, even if they do not form a disorder or disease (for example, they may present obsessive ideas even though they cannot be diagnosed with a obsessive compulsive disorder).

This group can also be divided into two subcategories depending on whether we are talking about:

• Groups of people: they tend to attract attention although, due to their symptoms, it does not cause them to receive specialized care.
• "Lonely" people, this subgroup being smaller than the previous one.

Group III

This would be the group in which we would find the syndrome as such. In it, we group patients who do not have a previous psychiatric history (not at least like in the previous groups).

These are patients who suffer an acute psychotic break when they arrive in the city (or one of its holy places). In them they are not usually given visual or auditory hallucinations.

Yair Bar-El's group developed a series of criteria to identify these types of patients. The patients have no previous history of psychiatric illness (there are no previous psychotic episodes, substance use or significant problems related to family or work life). They arrive in Jerusalem like any other tourist, without any "special mission" or any other related purpose. They usually travel accompanied by family members and / or as part of a group of people.

The patients suffer from an acute psychotic reaction in which 7 stages can be differentiated:

1. Appearance of anxiety symptoms, agitation, nervousness and tension.
2. Wish manifesto of traveling the city in a solitary way.
3. Obsession related to hygiene.
4. Preparation of a white robe, often with the help of hotel bedding.
5. Need to yell, yell, or sing Biblical verses, psalms or religious hymns.
6. Carrying out a march or procession to holy places within the city.
7. Conducting a public sermon Somewhere holy This speech can be confusing and in it they ask humanity to adopt more moral and healthier lifestyles.

After recovery, these patients are able to remember everything that has happened, although it is usually something that embarrasses them and they avoid talking about it.

In this article you will find more information about the psychotic break.

We must consider the causes for Jerusalem syndrome based on the different groups of patients that we have mentioned:

• For the first two groups (in which there was a previous psychiatric history or previous psychological problems) their previous problems or disorders play a fundamental role in the development of Jerusalem syndrome. " As we have seen, the trip to Jerusalem can be either the consequence of its problems or the trigger for a latent situation.
• On the other hand, the third group (in which there is no previous psychiatric history or previous psychological problems) the cause would be more related to the spiritual and religious dimension of each person and the trip to a religiously emblematic place such as Jerusalem.

In the case of group III, made up of patients with no psychiatric history, there seems to be a good spontaneous recovery in less than a week, that is, its recovery occurs naturally (even more so the further away from the city and the holy places).

Despite the existence of a high rate of spontaneous recovery, the treatment would consist, according to Yair Bar-El's experience, of:

• At the psychiatric level, they would use minor tranquilizers and / or melatonin.
• Improvement and strengthening of family relationships and facilitation of back to the tour group.
• Psychological attention in times of crisis.
• In some cases, the collaboration of a priest could be requested.

On the other hand, according to the doctor and his team, prevention that can be carried out by part of the tour guides, so that they are trained in the detection of possible symptomatology.

The Jerusalem syndrome bears some resemblance to the Stendhal syndrome and the paris syndrome.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Jerusalem syndrome: causes, symptoms and treatment, we recommend that you enter our category of Clinical psychology.

• Anna Poleszczyk, Lukasz Swiecicki (2013) Jerusalem Syndrome. Psychiatria Polska. 47(2), 353-360.
• Louise Howard (2000) Correspondence. British Journal of Psychiatry (176) 492-498
• Regis Airault, MD and Thomas H Valk, MD (2018) Travel-Related psychosis (TrP): a landscape analysis. Journal of Travel Medicine, 25 (1) doi.org/10.1093/jtm/tay054
• Yair Bar-El, Rimonda Durst, Gregory Katz, Josef Zislin, Ziva Strauss and Haim Y. Knobler (2000) Jerusalem Syndrome. British Journal of Psychiatry (176) 86-90 doi.org/10.1192/bjp.176.1.86