From Falling Into the Fire: A Psychiatrist’s Encounters with the Mind in Crisis, by Christine Montross

“The third category of tourists afflicted by Jerusalem syndrome…is the most mind-boggling. This category is described as the “pure” form of the syndrome, because its sufferers have no history of mental illness. These tourists experience an acute psychotic event while in Jerusalem; they recover “fairly spontaneously, and then after leaving the country, apparently enjoy normality.” * As a result, they are considered to be mentally well, but for these isolated episodes. However, what episodes they are!

Tourists with the third subtype of Jerusalem syndrome succumb to a sequence of identifiable stages that are consistent, characteristic, and highly specific.

First, such sufferers exhibit “anxiety, agitation, nervousness and tension.” They then announce that they wish to split off from their tour group or family and explore Jerusalem on their own. They authors write, “Tourist guides aware of the Jerusalem syndrome and of the significance of such declarations may at this point [preemptively] refer the tourist…for psychiatric evaluation.” They add ominously, “If unattended, [the following] stages are usually unavoidable.”

People afflicted by Jerusalem syndrome will then demonstrate a “need to be clean and pure,” becoming obsessed with bathing or compulsively cutting their finger- and toenails. Next is my favorite step in the sequence: the “preparation, often with the aid of hotel bed-linen, of a long, ankle-length, toga-like gown, which is always white.”

Once appropriately clad, the person in question will proceed to “scream, shout, or sing out loud psalms, verses from the Bible, religious hymns or spirituals.” He or she will then proceed to a holy place within the city and deliver a sermon, which the authors describe as “usually very confused and based on an unrealistic plea to humankind to adopt a more wholesome, moral, simple way of life.”

The affected person typically returns to normal within five to seven days, feels ashamed about his behavior, and recovers completely.”

[Ref. A piece in the British Journal of Psychiatry by Yair Bar-El and colleagues entitled “Jerusalem Syndrome”].


  1. A puzzling excerpt from what appears to be a puzzling book about puzzled doctors. From The LA Times book review linked above: "Sometimes, Montross discovers, it is her job to overcome "the inherent discomfort doctors have with helplessness.""

    What do you think? Spiritual realities or the Twilight Zone?

  2. Hey there, Respectful Reader! I actually wasn't purporting to give a review of the LA Times review of the book; I was just bringing to folks' attention the (to me) strange and interesting phenomenon of the Jerusalem syndrome.

    I did in fact read the book, and I think for doctors to even acknowledge/admit they feel discomfort with their patients' helplessness is basically a good thing. I know for myself when I'm with a friend or family member who's in pain, I, too, tend to feel terribly helpless. So I do think it's interesting to look at our efforts to fix, to cure, to shut the person up and be done with them. Which is not, as we come to know, how life really works…I think any effort for a doctor to see his or her patients as a human being rather than an object–yes, I do think that's a good thing…

    1. I wonder if the author has information as to what kind of people, in terms of race and//or religion experiences this syndrome. I never heard about it and I am glad I didn't experience any of the symptoms while I was there. the symptom must be pretty common for the Drs. to acknowledge that it is something that will pass in a few days and it is not the person that is totally crazy!
      I also find hard to console a person, to fix what I think is wrong with the person. I believe it is in our culture (north american) to come up all the time with something meaningful or intellingent to say when a hug, holding a hand, could be more consoling than words.

    2. I already brought the book back to the library, but there are different versions of it. Certain Japanese people experience a similar phenomenon upon traveling to Paris, for example. (!)

    3. You got to be kidding! I could think of other kind of "phenomenon" while staying in Paris!
      Thank you for an interesting information.

    4. I find it incredible that these manifestations are so common that they have been identified as a syndrome. Surely the "victims" aren't behaving this way intentionally, even if subconsciously? I figure these manifestations are spiritual, which leads me to wonder: friend or foe? "There are more things in heaven and earth, Heather, than are dreamt of …"

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