Hockenbury Discovering Psychology 5th txtbk

564 CHAPTER 13 Psychological DisordersFOCUS ON NEUROSCIENCEThe Hallucinating BrainResearcher David Silbersweigand his colleagues (1995)used PET scans to take a“snapshot” of brain activityduring schizophrenic hallucinations.The scan shown herewas recorded at the exact instanta schizophrenic patienthallucinated disembodiedheads yelling orders at him.The bright orange areas reveal activity in the left auditory and visualareas of his brain, but not in the frontal lobe, which normallyis involved in organized thought processes.CULTURE AND HUMAN BEHAVIORTravel Advisory: The Jerusalem Syndromedirected at her. In contrast, delusions of grandeur involve the beliefthat the person is extremely powerful, important, orwealthy. In delusions of persecution, the basic theme is that othersare plotting against or trying to harm the person or someoneclose to her. Delusions of being controlled involve the belief thatoutside forces—aliens, the government, or random people, forexample—are trying to exert control on the individual.Schizophrenic delusions are often so convincing that they canprovoke inappropriate or bizarre behavior. Delusional thinkingmay lead to dangerous behaviors, as when a person responds tohis delusional ideas by hurting himself or attacking others.Among the most disturbing experiences in schizophrenia arehallucinations, which are false or distorted perceptions—usuallyvoices or visual stimuli—that seem vividly real (see Figure 13.4).The content of hallucinations is often tied to the person’s delusionalbeliefs. For example, if she harbors delusions of grandeur,hallucinated voices may reinforce her grandiose ideas by communicatinginstructions from God, the devil, or angels. If the personharbors delusions of persecution, hallucinated voices or images may be extremely frightening,threatening, or accusing. The content of hallucinations and delusions may alsobe influenced by culture and religious beliefs.Whether it occurs in Baltimore or Beijing,Minneapolis or Moscow, schizophrenia isusually characterized by delusions and hallucinations.However, the content of theperson’s delusions and hallucinations is ofteninfluenced by cultural factors, includingthat culture’s dominant religious beliefs.Consider one interesting example:the Jerusalem syndrome, which has beendescribed by psychiatrist Yair Bar-El and hiscolleagues (2000) at Kfar Shaul MentalHealth Center in Israel.Christians, Jews, and Muslims regard thecity of Jerusalem as a richly historical andholy city. Annually, about 2 million touristsfrom around the world visit the city. But for about 100 visitorsevery year, arriving in the famous holy city triggers a psychoticbreak that involves religious delusions and hallucinations—theessence of the Jerusalem syndrome. About half of these peoplerequire psychiatric hospitalization (Fastovsky & others, 2000). Thedisorder occurs frequently enough that Jerusalem tour guides andhotel personnel are familiar with it and will notify authoritieswhen they spot someone displaying the symptoms.Identifying with biblical characters is a common feature of theJerusalem syndrome. As a general rule, Christians tend to believethat they are Jesus Christ, the Virgin Mary, or John the Baptist.In contrast, Jews tend to gravitate toward a Hebrew hero likeMoses, Samson, or King David. And Muslims simply tend to saythat they’re the Mahdi (Messiah).Usually, the person has a history of serious mental disorders,such as previous episodes of schizophrenia or bipolar disorder.But in about 10 percent of Jerusalem syndrome cases, the personhas no history of mental disorders. Instead, the personA Pilgrimage Gone Awry Being in thepresence of a historic religious site likethe Wailing Wall in Jerusalem is anoverwhelming emotional experiencefor many tourists. In some vulnerablepeople, such experiences trigger a temporaryepisode of psychological instabilityand religious delusions.spontaneously experiences a psychoticepisode while in Jerusalem.For example, a Swiss lawyer was ona three-week group tour of Greece,Israel, and Egypt. Everything was fineuntil the tour visited Jerusalem. Onthe first night in Jerusalem, the man became nervous and agitated,withdrew from the group, and became obsessed with becomingclean and pure, taking many showers. Then, using thewhite hotel linen to make a biblical-style, toga-like gown, hemarched to one of Jerusalem’s holy sites and delivered a rambling“sermon” about how humanity should adopt a moremoral and simple way of life. Fortunately, within a matter ofdays, the syndrome passed and the man’s symptoms abated.What causes the Jerusalem syndrome? One possible explanationis that the disruptions of travel temporarily influence aperson’s mental state. According to Bar-El and his colleagues(2000), factors such as time-zone changes, unfamiliar surroundings,and exposure to strangers and foreigners probablycontribute to the transient psychological instability. In a vulnerableperson, encountering cultural differences in behaviorcombined with being on a spiritual pilgrimage to one of theworld’s great holy cities can trigger an acute psychoticepisode.