There are a lot of things that can make you feel like you’re going nuts when you travel–delayed flights, missing luggage, clumps of tasteless airline food. But for some people , travel can actually induce a rare psychosis–especially if their destination is Jerusalem. Tourists afflicted with the condition called “Jerusalem Syndrome” have been found wandering in the Judean desert wrapped in hotel bed sheets or camped in front of the Church of the Holy Sepulcher, convinced they will soon be birthing the infant Jesus.

Over the last few months, there has been a media frenzy about the malady that is only slightly less bizarre than the illness itself. On the Wednesday afternoon when I visited Dr. Bar-El, the “father of Jerusalem Syndrome,” at Kfar Shaul Hospital in Jerusalem, I was bumping microphones and digital tape recorders with journalists from Norway, France and Los Angeles. Inquiring minds around the world want to know what, exactly, is Jerusalem Syndrome and will there be more of it during this millennial year.

Gray-haired Dr. Bar-El looks spookily like Dr. Freud as he leans back in his chair, puffing on a cigar, with his glasses perched on the tip of his nose. He didn’t invent Jerusalem Syndrome, which has been described by foreign visitors over the last few hundred years. But he is the pater neurosis who is promoting treatment for and research into the illness.

Bar-El explains that there are three categories of tourists who get Jerusalem fever. The first is individual visitors to Israel who were already mentally ill in their countries of origin. They come to Jerusalem with psychotic ideas that they feel they must act upon in the Holy Land. The second group–the largest one–is pilgrims who arrive with deep religious convictions. In some cases, they belong to bizarre fringe groups rather than regular churches. They believe they must do specific things to bring about major events like the coming of the Messiah, the appearance of the anti-Christ, the war of Armageddon, or the resurrection of Jesus Christ.

The third group is the REAL Jerusalem Syndrome. It affects completely sane tourists without any psychiatric or drug abuse history. They arrive with normal tour groups and suddenly they develop what Bar-El calls a “specific imperative psychotic reaction.” In all cases, the same clinical picture emerges. It begins with general anxiety and nervousness and then the tourist feels an imperative need to visit the holy places. First, he undertakes a series of purification rituals like shaving all his body hair, cutting his nails and washing himself over and over before he dons white clothes. Most often, he lifts the white sheets from his hotel room. Then he begins to cry or to sing Biblical or religious songs in a very loud voice.
The next step is an actual visit to the holy places, most often from the life of Jesus. The afflicted tourist begins to deliver a sermon–which is frequently a confused oration–where he exhorts humanity to change their behavior by becoming calmer, purer, and less sophisticated or worldly.

Dr. Freud–whoops, Dr. Bar-El, says that from the psychiatric point of view, the most interesting thing is that besides this curious psychotic reaction, the patient doesn’t see strange things or hear voices, and he recalls everything that happens. He knows he is John Smith or Will O’Casey, he doesn’t lose his own identity, and the illness passes completely in five to seven days. Sometimes, the afflicted visitor is on a package tour of the Mediterranean which includes Greece, Egypt and Israel. He may be completely sane in Greece, he develops Jerusalem Syndrome in Israel, it passes in five days, and then he continues on with the group to Egypt.

From a religious point of view, the Syndrome seems to favor Protestants, who account for 97 per cent of all cases. Their current religious practices aren’t very important; the essential element seems to be an ultra-orthodox upbringing where the Bible was the book of choice for family reading and problem solving. Several theologians who are fascinated by Jerusalem Syndrome speculate that Catholics have intermediaries like the Virgin Mary and saints. They also have other geographical locales that are important to them, like the Vatican, which is presided over by the Pope. But for Protestants, the only personification in the Bible is Jesus Christ, and the Holy Land is the only place where they can go to follow his life. So they are very concentrated on Jesus and this sets the stage for the advent of the strange, temporary Holy Land aberration.

Although the whole problem of Jerusalem Syndrome may seem to us like a benign curiosity, it is taken very seriously in Israel where everyone involved in security, tourism, or health and welfare is on the lookout for afflicted visitors. In an average year, about 40 tourists require hospitalization for psychiatric illness. Most are from the first two groups, who had severe problems before they arrived in Israel. A few–perhaps 3 or 4–develop true Jerusalem Syndrome. At the millennium change, in 2000, there was a definite increase in cases.

Dr. Bar-El takes a long puff on his cigar and gets down to specifics. Recently, a woman was picked up by the police for kicking and hitting people at the Church of the Holy Sepulcher. “I am the Prophetess of the Olive Tree, ” she proclaimed. “I am very powerful, and I will announce the coming of Christ.” She was in a very anxious state, and she insisted she had to remain outdoors, under the influence of the sun and the moon so that her branches could grow green, which was a sign of the immediate return of Jesus. If she was moved inside, under a roof, her branches would grow black, and that would be a sign of the anti-Christ. Besides these claims and her aggressive behavior, everything else about the Olive Tree Prophetess was completely normal.

Another seemingly normal man is a teacher from Denmark. Every year he comes to Jerusalem because only there can he dialogue with the Virgin Mary. Lourdes and other miraculous sites don’t do it for him.

Bar-El talks about a memorable case which actually led to one of the first instances of collaboration between Palestinian and Israeli police. The Palestinians found a man without clothes, money or ID, and, after interrogation, they figured out he wasn’t a security risk. They had no idea what to do with him, so they contacted an Israeli officer. The Israeli asked only one question: “Is the guy really completely nude?”
“No,” answered the Palestinian, “he is wearing an animal skin.” “Oh,” said the Israeli, “you’ve got another John the Baptist.” It was the sixth John the Baptist the Israelis had run into. John the Baptists usually did days of purification between Jerusalem and the Galilee before ending up at the Jordan River to baptize Jesus or the first Christians..and part of the trek was through Palestinian territory.

John The Baptist heads the Jerusalem Syndrome list for Christian men. Christian women prefer the Virgin Mary. For Jews of both sexes, the identification is generally with the Messiah.

One day, Bar-El decided to perform a classical experiment. He put two would-be Messiahs in a room together to see if one would prevail. The experiment was a dismal failure because after the meeting each said, “I am the real Messiah. He’s an impostor.”

The good doctor pauses for a moment, and I ask him questions that are troubling me. How does he know that people with Jerusalem Syndrome aren’t having a past life experience or a spiritual crisis? How does someone giving a sermon about the need for people to change their ways differ from a prophet? There are no answers to my queries. We are, instead, taken to the units where the patients stay, and they are unremarkable. We meet Dr. Gregory Katz, a Russian psychiatrist who works with Jerusalem Syndrome patients and he tells about the treatment–which can include anything from melatonin for jet-lag to minor tranquilizers to anti-psychotic drugs. Also unremarkable. Dr. Katz tells us that they are equipped to treat tourists in many different languages, although no one in the unit has mastered Norwegian. He explains that the age of the afflicted ranges from l8 to 70, and the mean age is 35. Most of the patients have higher education and not all of them are connected to religious institutions, although many are.

What is incontestable is that Jerusalem Syndrome is posing an economic problem for Israel. Some people who fall ill come from countries where medical insurance is provided for all citizens , and they are covered for their treatment. Others hail from the U.S.A., and don’t have any medical coverage. The Israeli government must pay for their treatment, their hospital stay and then, if they are long-term patients who were ill before they arrived in Israel, the government must also provide a psychiatric escort to return them home. It is putting a drain on Israeli resources.

No one is certain about exactly what causes Jerusalem Syndrome. It has been posited that it can be very jarring for a serious Bible student to arrive in modern-day Israel where, instead of prophets in sandals, he hears businessmen discussing profits on cell phones. Another theory is that Jerusalem has always been a huge backdrop for delivering messianic messages and visitors can get temporarily carried away by the dramatic historic setting.

For the moment, there are no clear answers and the emphasis is on rapid and effective diagnosis and treatment.

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