Jerusalem Syndrome: What is it and who is susceptible?

“I am Elijah,” claim many more. The Christian version of this assertion is “I am one of the two witnesses prophesied in Chapter 11 of Revelation.” (Notably, virtually none of them know the identity of the second “witness,” although one man did say it was his wife, who could not afford to make the trip to Israel.)

Those who do not live in Israel are often unaware of phenomena like these. As a result, most are unprepared for their manifestations when they visit today’s City of David.

Could they infect anyone?

What can be done to protect against them?

It is impossible to live in Jerusalem and not encounter people like those mentioned above and in examples below. Everyone here has a story. Still, because of the mix of political, religious and cultural dynamics, the underlying dynamic is difficult to define. What is this thing?

Although there are countless cases of sibling eccentricities throughout the centuries, it was first diagnosed as a psychiatric disorder in 1937 by Dr. Heinz Hermann. At the time, he was the medical director of Ezrat Nashim, a private Jewish mental hospital in Jerusalem.

He called the phenomena Jerusalem fever, a label that, in time, morphed into Jerusalem Syndrome.

Writing about Hermann in an essay titled Beyond Jerusalem Syndrome: Religious Mania and Miracle Cures in British Mandate Palestine, Chris Wilson notes that Hermann’s assertion of a unique psychiatric condition linked to the uniquely holy city of Jerusalem “would go on to enjoy a long career.”

Today’s understanding of Jerusalem Syndrome is defined by a professional article published by The British Journal of Psychiatry in early 2000. Authored by Israeli psychiatrists Yair Bar-El, Rimona Durst, Gregory Katz, Josef Zislin, Ziva Strauss and Haim Y. Knobler, it is simply titled “Jerusalem Syndrome.” When the article was published, all six authors practiced at the Kfar Shaul Mental Health Center located in the forested hills on Jerusalem’s western boundary. Virtually every case of Jerusalem Syndrome that requires professional intervention is treated at Kfar Shaul.

The article’s most important contribution is its description of the syndrome. Instead of a single phenomenon, the article argues that it is a group of delusions, obsessions and psychoses triggered by visits to, or life within, Jerusalem.

What are the delusions and psychoses of Jerusalem Syndrome?

This is the category that describes the most colorful – and sometimes dangerous – examples of the syndrome, with individuals dressed in bed sheets, bathrobes and costumes brought from home. These are individuals, invariably on their own, who assume the identity of a biblical character. Popular figures include Elijah, King David, Jesus and Mary – like the naked “Mary” flooding her room in the guest house while walking back and forth, claiming to cross the Jordan River.

It is important to note that, contrary to popular belief about Jerusalem Syndrome, these are manifestations by those with previous psychiatric issues. For those who have not been diagnosed with such issues, it can appear that bed sheet episodes are spontaneous delusions by otherwise healthy people. Regardless, at least according to these therapists, there is at least one preexisting mental problem.

Another expression of Jerusalem Syndrome in this category is “psychotic identification with an idea.” It often includes claims of instructions by God to engage in some kind of mission. 

For the wealthy businesswoman from an island country in the East, this entailed manufacturing a Guinness World Record-size flag of Jerusalem and laying it out on the Valley of Megiddo in the summer of 2009. Her mission was bizarre but benign.

Not so for 29-year-old Denis Rohan. On August 21, 1969, convinced he was commissioned by God to build the third Temple, Denis set fire to al-Aqsa Mosque. In the aftermath of his “holy arson,” Islamic countries erupted in outrage, claiming then as some today, like Fatah and Hamas, that Israel intended to destroy al-Aqsa, that Israel intended to replace it with the third Temple prophesied in the biblical Book of Ezekiel.

In his book The Hidden Hand, Daniel Pipes describes the aftermath of Rohan’s act. Islamists proclaimed a Jewish conspiracy, renaming Rohan as Cohen.

"Though Israeli firefighters quickly extinguished the blaze and Rohan soon after confessed to setting it, Muslims around the world convinced themselves that the Israeli authorities had paid Rohan between $50,000 and $100 million to burn the mosque. Bellicose pronouncements echoed from all parts of the Middle East, and rioting erupted in India, leading to widespread loss of life. King Faisal of Saudi Arabia capitalized on these passions to convene 25 Muslim heads of state at a meeting in Rabat, Morocco. Out of that meeting came the OIC [Organisation of Islamic Cooperation]."

Jerusalem Syndrome: Group manifestations fueled by religious beliefs and behaviors

Bar-El and his colleagues contend that this category represents a “relatively large number of Jerusalem Syndrome sufferers.”

But it is also a difficult and controversial category. Most often, the word groups refer to small communities that embrace belief systems that, in the eyes of mainstream culture, are extreme. Think cults. Regardless, because these groups are expressing religious beliefs and do not pose an existential threat to other people, their thoughts and behaviors do not reach today’s psychiatric threshold of delusion.

However, certain beliefs and behaviors are regarded as psychologically unhealthy. The difficulty is identifying when genuine religious convictions cross the boundary into the realms of unhealthy thinking and conduct – especially, in this case, when they are ignited, amplified and distorted by Jerusalem Syndrome.

In Jerusalem, September 28, 2015, marked the first day of Sukkot, also known as the Festival of Booths. All across Israel, individuals and businesses set up temporary structures according to the commandment given in Leviticus 23. Because the prophet Zechariah says that Sukkot will be celebrated by all nations in the Messianic Age, the holiday is infused with keen anticipation by religious groups which regard both the command and its prophesied observance as literal truths.

In 2015, the appearance of a blood moon at the outset of Sukkot only served to amplify eschatological hopes. Biblical prophecies about a blood moon found in the books of Joel and Revelation directly link it to the militant initiation of a literal time when the Jewish Messiah will begin a global reign. The appearance of a blood moon amplified that anticipation around the world, especially by conservative evangelicals and Christian charismatics. Among the former, there often is an emphasis on biblical prophecies about “end times,” and among the latter a focus on “signs and wonders,” things like miraculous healings, speaking in tongues, prophetic “words,” ecstasy in worship and signs in the skies. 

Beginning at about 3 o’clock in the morning on that September day, crowds of journalists, curiosity seekers and religious tour groups gathered at a popular lookout just below the Seven Arches Hotel on the Mount of Olives. The blood moon, when it appeared, was impressive but not imposing. Seeing it up close required a good telephoto lens. The sight that did impose was groups of tourists dressed in elaborate costumes, some as Roman-like soldiers, including capes and swords; others in wedding gowns. Their hope was to greet the Messiah as he descended on the Mount of Olives, joining him in warfare and marriage as he began his global reign.

These apparent victims of a collective form of Jerusalem Syndrome soon left for their homes elsewhere in the world. Other groups, however, make their homes in Jerusalem. 

One such group was founded by Horatio and Anna Spafford. Together with eleven other adults and three children, they moved from Chicago to Jerusalem, where they founded the American Colony, today a well-known hotel.

Many Christians know about the tragic loss experienced by the Spaffords when, on November 22, 1873, Anna Spafford and her four daughters were traveling to France aboard a steamer called the Ville du Havre. In the middle of the Atlantic Ocean at about 2 o’clock that morning, the Ville du Havre was struck across the bow by a British iron clipper called the Loch Earn. In less than 12 minutes, the Ville du Havre sank beneath the sea, taking the lives of 226 passengers.

Among the dead were the Spaffords’ four daughters. One of the 87 who survived was Horatio’s wife, Anna. Found unconscious and floating on a piece of wood, she was rescued from the sea. Nine days later, after landing in Wales, she sent a telegram to her husband. “I alone survived,” it read. “What shall I do?”

Immediately departing to join his wife, the captain of Horatio’s vessel made a point to tell him when the ship was at the spot where his four daughters drowned. It was then and during the remainder of his voyage that Spafford penned a poem that has since become a beloved Christian hymn.

When peace like a river attendeth my way,

When sorrows like sea billows roll,

Whatever my lot, thou has taught me to say,

“It is well, it is well, with my soul.”

Eight years later, in 1881, suffering from apparent symptoms of complicated grief, the Spaffords and two daughters born after the shipwreck set sail for Jerusalem. After giving up his law practice, Horatio dove into religious convictions, especially with respect to redemption, life after death, and Jesus’s second coming. Upon arrival in Jerusalem, those convictions blossomed into significant social aid to Jews and Arabs – and into significant departures from mainstream evangelical beliefs. Firmly believing they would welcome Jesus upon his return, the community struggled with financial and relational issues, especially after October 16, 1888, when Horatio, regarded as an Elijah figure, died of malaria and without a second coming.

Although socially benign, the Spaffords’ story of likely Jerusalem Syndrome manifested by a group illustrates its complexity when superimposed on “idiosyncratic ideations,’’ in this case issues of theology and complicated grief.

“What does Hashem require of thee but to do justly, and to love kindness, and to walk humbly with thy God?”The prophet Micah

Jerusalem Syndrome: Symptoms without any previous psychiatric issues

This expression of Jerusalem Syndrome is its best known. In these cases, individuals, almost always Protestant tourists with no history of psychiatric disorders, devolve into “psychotic episodes” that disappear when they leave Israel and return home.

Interestingly, the onset of this kind of Jerusalem Syndrome occurs in identifiable stages. Virtually every case follows a common sequential course:

1. Anxiety, agitation, nervousness and tension, plus other unspecified reactions
2. Declaration of a desire to split away from the group or the family and to tour Jerusalem alone
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 scream, shout, or sing out loud psalms, verses from the Bible, religious hymns or spirituals 
6. A procession or march to one of Jerusalem’s holy places
7. Delivery of a “sermon” in a holy place. The sermon is usually very confused and based on an unrealistic plea to humankind to adopt a more wholesome, moral, simple way of life.

Perhaps the most significant gap is an understandable lack of diagnostic breadth. Only extreme cases of the syndrome are identified by licensed therapists. Under each category of the syndrome, there are whole swaths of victims who are never diagnosed or treated. It is not unreasonable to conclude that most who fall prey to Jerusalem Syndrome are not statistically identifiable.

Although of lesser magnitude or intensity than diagnosed cases, it is entirely possible that vast numbers of people are afflicted by the syndrome in varying degrees.

Another shortcoming is an ongoing lack of identified causes of the syndrome. Diagnosing it as psychotic, non-psychotic, delusional, with prior history or without prior history does not explain causes of various manifestations. 

Two questions beg themselves. Can anyone fall prey to Jerusalem Syndrome? And what can be done to protect against it?

One Bible teacher in Jerusalem addresses the questions like this. Paraphrased, he says:

There’s something about being in Jerusalem that amplifies and distorts biblical issues like the end times, the Messianic Age, prophetic anointing, and spiritual authority. In short, there is a tendency to go crazy and get deluded.

I remember I was sharing this in a leadership meeting and somebody said, ‘Yeah, it’s very important to watch out for that.’ 

I said, ‘Wait a minute, you don’t understand. This is like lust or pride. Everybody has a little bit of it, including you and including me.’

All of us need to recognize the temptation of delusion and self-grandeur, of thinking ‘I’m the one that everything’s going to come through.’ We have to watch out for that.

We resist the temptation of Jerusalem Syndrome by realizing that it’s in all of us – like nobody doesn’t have lust, doesn’t have pride; all of us have a little bit of it. Purposely, then, we seek to submit to one another in different environments. Humility in community is the key.

Indeed, lurking at the heart of every manifestation of Jerusalem Syndrome is hubris. Perhaps the beginning of protection against the syndrome is best articulated by the prophet Micah:

“What does Hashem require of thee but to do justly, and to love kindness, and to walk humbly with thy God?”  ■

Brian Schrauger is an American journalist living in Jerusalem.