Jerusalem syndrome

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In the city of Jerusalem, there is a special ward in the mental hospital for those who represent a special danger to themselves and others. These deluded patients are the sufferers from the "Jerusalem syndrome." Police and security officers are trained to recognize them, though their mania is often concealed behind a mask of deceptively beatific calm. They have come to the holy city in order to announce themselves as the Messiah or redeemer, or to proclaim the end of days.
Christopher Hitchens, God Is Not Great[1]

Jerusalem syndrome is a rare psychiatric disorder described by Dr Gregory Katz (head of the Emergency Unit at the Givat Shaul Mental Health Centre) in the British Journal of Psychiatry in 2000.[2]

Sufferers arriving in Jerusalem are afflicted with the delusion that they are characters from the Bible, the Torah, or the Koran, or are, in some other sense, a messianic figure.

Clinical definition[edit]

Dr. Katz described 7 stages:

  1. Anxiety, agitation, nervousness and tension, plus other unspecified reactions.
  2. Declaration of the desire to split away from the group or the family and to tour Jerusalem alone. Tourist guides aware of the Jerusalem syndrome and of the significance of such declarations may at this point refer the tourist to an institution for psychiatric evaluation in an attempt to preempt the subsequent stages of the syndrome. If unattended, these stages are usually unavoidable.
  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, ankle-length, toga-like gown, which is always white.
  5. The need to shout psalms or verses from the Bible, or to sing hymns or spirituals loudly. Manifestations of this type serve as a warning to hotel personnel and tourist guides, who should then attempt to have the tourist taken for professional treatment. Failing this, the two last stages will develop.
  6. A procession or march to one of Jerusalem's holy places, e.g. The Western Wall.
  7. Delivery of a sermon in a holy place. The sermon is typically based on a plea to humankind to adopt a more wholesome, moral, simple way of life. Such sermons are typically ill-prepared and disjointed.

The Israeli police have set up a special unit to deal with such people and between 30 and 40 people a year are admitted, but only a few are diagnosed as having "genuine" Jerusalem syndrome. Bar-El et al. reported 42 such cases over a period of 13 years, and none of these cases seemed temporary in nature — thus, to be considered "genuine" Jerusalem syndrome.[2]

Most patients are middle aged from small towns in the USA or Scandinavia. Jet lag and lack of sleep could possibly be contributing factors, though travelers from Scandinavia barely leave their timezone.[3]

The inherent link between religiosity and mental illness[edit]

The late Christopher Hitchens doesn't fail to put the Jerusalem syndrome in context to the concept of revelation and an invisible being who influences people, writing on the topic of the syndrome:[4]

The connection between religious faith and mental disorder is, from the viewpoint of the tolerant and the "multicultural," both very obvious and highly unmentionable.

If someone murders his children and then says that God ordered him to do it, we might find him not guilty by reason of insanity but he would be incarcerated nonetheless.

If someone lives in a cave and claims to be seeing visions and experiencing prophetic dreams, we may leave him alone until he turns out to be planning, in a nonphantasmal way, the joy of suicide bombing.

If someone announces himself to be God's anointed, and begins stockpiling Kool-Aid and weapons and helping himself to the wives and daughters of his acolytes, we raise a bit more than a skeptical eyebrow.

But if these things can be preached under the protection of an established religion, we are expected to take them at face value.

All three monotheisms, just to take the most salient example, praise Abraham for being willing to hear voices and then to take his son Isaac for a long and rather mad and gloomy walk. And then the caprice by which his murderous hand is finally stayed is written down.

The implication that all religious people are mentally ill, or that religion is a mental illness, is absurd and unfair, but given the sorts of destructive and repressive antics hyper-religious people can and do get up to, regrettably understandable.

Rationalizations by the faithful[edit]

Dude, haven't you heard about Deuteronomy 22:11?

Because there are so many self-proclaimed messiahs arrested every year, rabbis had to define the messiah to exclude such people, without unintentionally condoning the arrest of the real messiah, should he appear. Their official explanation is that, by definition, the real messiah will be self-evident, and everyone will automatically know he is such. (This position, interestingly, disqualifies Jesus from being the messiah, because there were those who met him and still doubted him (e.g., the Sanhedrin and most Roman officials), but Jews don't believe Jesus was the messiah in the first place so whatever.)

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