PARIS — For many travelers, going abroad means taking a break, going on an adventure. But sometimes, the adventure take a disastrous turn and leisurely exploration becomes a true clash of cultures. This phenomenon has a name: "the traveler syndrome," and can range from feeling merely off to severe bouts of delirium. Tourists in India, Jerusalem or Florence suffer from it. In Paris, Japanese people have been found to be the most likely to experience psychological trouble after exploring the city.

In the collective psyche, Paris is a symbol of romance, luxury, elegance and fashion. This is especially true in Japan where the media continuously conveys fantasized images of France, and especially its capital.

Olivier Bouchaud, head of the travel medicine unit of Bobigny Hospital, in a northeastern suburb of Paris, explains that he's faced cases of Japanese tourists coming to Paris "with a ‘romanticized' image of it" who had to face the reality of the city and its chaotic traffic, "people in a rush, pushing each other." Bouchaud adds: "Some were brought down to earth with a bang so badly they suffered from bouts of delirium or from a severe depressive syndrome caused from disappointment."

Overwhelming Florence — Photo: Heidi Kaden

France is the top tourist destination in Europe for Japanese — with nearly 500,000 visits in 2018. Olivia Goto-Gréget, a clinical psychologist in Paris, says she regularly treats Japanese patients suffering from psychological disorder, at different levels, related to their adjustment problems — regardless of the length of their stay. "Being fascinated by France is one thing, living here is another," she says. "Imagination can be blinding."

If some of these situations may seem harmless at first, they can cause real psychological consequences. "In France, we kiss each other on the cheek, we ask intimate questions. In Japan, when you first meet someone, you keep your distance, you don't talk politics. It's considered rude and it makes them feel uncomfortable," says Goto-Gréget. The psychologist says these cultural differences can be difficult to face for Japanese people whose social conventions are at opposite ends of the French. "They fear judgment, other people's opinions, the idea they could lose face."

Imagination can be blinding.

Still, says Bouchaud, "these are extreme and rare situations". Experts have observed that patients suffering with "traveler syndrome" of such a scale usually have a natural predisposition towards mental health issues, and the travel itself only acts as the trigger. For Goto-Gréget, some may have "dormant conditions" they would not have "developed in Japan because they feel safe there."

The "Jerusalem syndrome" — Photo: Tim Mossholder

Although this syndrome remains present, the ever-growing flow of information across the Internet and social networks makes it less common. To date, no study has been able to measure the number of people affected by it — particularly given that the syndrome is not recognized within the scientific community. "I would be exaggerating if I said this was a fully recognized scientific concept. Every situation is different, quantifying the phenomenon is impossible," says Bouchaud.

Tourists in Florence were overwhelmed with extreme emotions before the beauty of the city.

Paris is not the only city challenging the mental health of its guests. Other emblematic destinations have their own syndromes. In the early 1980s, psychiatrist Graziella Magherini counted some 100 tourists in Florence who were overwhelmed with extreme emotions before the beauty of the city's works of art and monuments. It was called "Florence syndrome" or "Stendhal syndrome" (for the French writer had described a state of euphoria in recounting his travels of Rome, Naples and Florence). Bouchaud says such "euphoric outbursts can go as far as bouts of delirium. Out of the blue, someone becomes completely exuberant and manic."

Then there is the "Jerusalem syndrome," which has been qualified as a "mystical delirium." People think they are a prophet, or Jesus, or they believe they have a mission," says Goto-Gréget. The "India syndrome," on the other hand, affects mainly Westerners. Psychiatrist Régis Airault, who worked for several years in the consular office in Mumbai, described several interesting cases in his book "Crazy about India" (Fous de l'Inde, 2000).

Expats can also suffer when they go back home. The readjustment period can take some time and be demanding, depending on the duration of the stay abroad and the cultural differences between the countries. This also has a name: the "return syndrome" or "expat syndrome."

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