November 1st, 2011

Just one of those days?

“Hi, my name is Rex and when I’m not doing psychology, I climb mountains. This past season I summitted Everest for the third time.” Anyway, that’s what I thought he said. It probably just felt like he was living an impossibly adventurous life, especially on a day when I wasn’t much in the mood for going around the table and telling something about ourselves that isn’t related to work. We’ve all participated in these kinds of “getting to know you” exercises, usually at the start of a new work group, so I should have been prepared. On that particular day, I wasn’t and, as luck would have it, I was sitting next to Rex.

To my credit, I managed to remember my name, but that was about it. Well, that and the fact that I spend a lot of time commuting in my car. “Tell us what else you do,” a friendly voice urged and, when I still came up blank, the voice reminded me that I enjoy listening to books on tape. I agreed. “And what are you listening to now?” If only this exchange had occurred last month, I could have reeled off a title by Hemingway, Fitzgerald or Thomas Wolfe. “A murder mystery,” I replied, “a mystery about a mass murder in an isolated village north of the Arctic Circle in Sweden.”

After I had chalked up this unfortunate episode to being just one of those days, I received an email alert about little known psychiatric conditions that “we all learn about in med school” but rarely see in our practices. There was Jerusalem Syndrome, a collection of religiously themed psychotic symptoms that are either triggered by or culminate in a visit to Jerusalem. Stendhal Syndrome is characterized by anxiety, panic, dissociation, confusion and even hallucinations in certain individuals who become overwhelmed when they are exposed to works or art or, in some cases, to the beauty of the natural world. I had never encountered either of these conditions in my career as a clinical psychologist and I counted myself lucky to have escaped them in my personal life as well.

If I hadn’t succumbed to Jerusalem or Stendhal, I had no reason to fear falling victim to Paris Syndrome. For one thing, I haven’t been to Paris in more than 40 years; for another, I am not a Japanese national. It seems that Paris syndrome is a reaction exclusive to Japanese tourists visiting the French capitol. Among the approximately six million Japanese visitors to Paris every year, about twenty cases of Paris Syndrome are reported. The condition was first described in Nervure, the French journal of psychiatry in 2004, by Viala, Ota, Vacheron, Martin and Caroli. Symptoms include acute delusional states, hallucinations, feelings of persecution, derealization, depersonalization, anxiety and a wide variety of psychosomatic manifestations.

Despite the great variability in the way Paris Syndrome presents itself, the authors believe that a unifying common element is the experience of travelers who are confronted by things that they had neither experienced nor anticipated. To a certain extent, this is the lot of all travelers. It is the reason we leave home in the first place, to be surprised by something outside the realm of our ordinary lives. When the difference between expectation and reality is too great, however, the resulting stress leads to deterioration in mental, emotional and physical functioning. As to the question of why the condition affects only Japanese visitors to Paris, the authors theorize that cultural differences and misapprehensions are nowhere more pronounced than between these two groups. Very few Japanese speak French. Japanese media tend to idealize Paris in ways that lead to disappointment and even disorientation when the ideal meets the reality. Different levels of formality between the cultures and, finally, the exhaustion of the Japanese tourist in Paris all combine to produce this unique disorder.

My temporary lapse of memory in the getting acquainted exercise surely had nothing to do with Paris Syndrome but maybe it signaled the onset of an as yet undiscovered geographical variant. My professional career began in Boston decades ago and has since moved glacially westward settling in Worcester last year. Perhaps I am falling victim to Worcester Syndrome triggered by the stress of getting used to differences in language and formality of communication along with the shock of exposure to an idealized culture and the exhaustion of a demanding schedule. The language and communication variables are questionable but the exhausting schedule is real enough. So is my reaction to an idealized culture. Not every psychologist has the good fortune to work in a city built on seven hills that was once visited by Sigmund Freud during his only trip to America. So here I am in this hybrid of Rome and Vienna working hard at psychology with many terrific colleagues.

No wonder I sometimes forget what else I do.

Alan Bodnar, Ph.D. is a psychologist at Worcester State Hospital and a consultant in the field of leadership development.

By Alan Bodnar Ph.D.

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