It would seem that in the near future when you are asked to 'show your papers' it is going to mean you are to produce your prescription card and if it is short of a 'list' you will be taken in if you act in a way that could be classified as being somewhat like the 'Jerusalem Syndrome'
Types
The 'classic' Jerusalem syndrome, where a visit to Jerusalem seems to trigger a intense religious psychosis that resolves quickly or on departure, has been a subject of debate in the medical literature
2,
3,
4. Most of the discussion has centred on whether this definition of the Jerusalem syndrome is a distinct form of psychosis, or simply a re-expression of a previously existing psychotic illness that was not picked up by the medical authorities in Israel.
In response to this, Bar-El
et al. classified the syndrome
1 into three major types to reflect the different types of interactions between a visit to Jerusalem and unusual or psychosis-related thought processes. However Kalian and Witztum have objected that Bar-El
et al. presented no evidence to justify the detailed
typology and
prognosis presented, and that the types in fact seem to be unrelated rather than different aspects of a
syndrome.
Type I
Jerusalem syndrome imposed on a previous psychotic illness. This refers to individuals already diagnosed as having a
psychotic illness before their visit to Jerusalem. They have typically gone to the city because of the influence of
delusional religious ideas, often with a goal or mission in mind which they believe needs to be completed on arrival or during their stay. For example, an affected person may believe themself to be an important historical religious figure, or may be influenced by important religious ideas or concepts (such as causing the second coming of
Christ).
Type II
Jerusalem syndrome superimposed on and complicated by idiosyncratic ideas. This does not necessarily take the form of mental illness, and may simply be an culturally anomalous obsession with the significance of Jerusalem, either as an individual, or as part of a small religious group with idiosyncratic spiritual beliefs.
Type III
Jerusalem syndrome as a discrete form, uncompounded by previous mental illness. This describes the best known type, whereby a previously mentally balanced person becomes psychotic after arriving in Jerusalem. The psychosis is characterised by an intense religious character and typically resolves to full recovery after a few weeks, or after being removed from the locality. It shares some features with the diagnostic category of a 'brief psychotic episode', although a distinct pattern of behaviours has been noted:
- Anxiety, agitation, nervousness and tension, plus other unspecified reactions.
- 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.
- A need to be clean and pure: obsession with taking baths and showers; compulsive fingernail and toenail cutting.
- Preparation, often with the aid of hotel bed-linen, of a long, ankle-length, toga-like gown, which is always white.
- The need to scream, shout, or sing out loud psalms, verses from the Bible, religious hymns or spirituals. 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.
- A procession or march to one of Jerusalem's holy places.
- 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.
Bar-El
et al. reported 42 such cases over a period of 13 years, but in no case were they able to actually confirm that the condition was temporary.
