Stendhal syndrome, the disorder that causes panic attacks in travelers

Looking at Leonardo Da Vinci’s “Adoration of the Magi” in the halls of the Uffizi Gallery in Florence, I began to feel strange.

My stomach clenched and my heart sped up; my knees buckled and the palms of my hands were clammy. Were they making me feel bad? crostini of chicken liver for lunch? Probably.

However, for some visitors to Florence these are the symptoms of a serious illness that has nothing to do with food poisoning. Apparently, it all has to do with the abundance of art in the city.

Stendhal syndrome is said to be a psychosomatic disorder caused by exposure to the amount of artistic riches from Florence.

It takes its name from the French writer Marie-Henri Beyle, better known by the pseudonym of Stendhal, who, in 1817, wrote about her trip to the Tuscan capital: “I experienced a kind of ecstasy at the idea of ​​being in Florence… I was overwhelmed a fierce pounding of the heart… The spring of life dried up within me, and I walked in constant fear of falling to the ground.”

The syndrome was clinically described as a psychiatric disorder in 1989 by Graziella Magherini, a psychiatrist at the Santa Maria Nuova Hospital in Florence.

Magherini observed 106 patients, all of them tourists, who experienced dizziness, palpitations, hallucinations, and depersonalization when looking at works of art such as Michelangelo’s sculptures and Botticelli’s paintings. They suffered from “panic attacks caused by the psychological impact of a great masterpiece and traveling,” Magherini said in 2019.

Between 10 and 20 cases per year

Cases of the syndrome are still reported today.

“It usually happens 10 or 20 times a year in certain people who are very sensitive [y] maybe they’ve been waiting their whole lives to come to Tuscany,” said Simonetta Brandolini d’Adda, president of the Friends of Florence art charity.

“These iconic works of art, the Botticelli, the David, it’s really overwhelming. Some people lose their way; it can be mind-boggling. I’ve often seen people start to cry.”

Some people lose their way; it can be amazing. I have often seen people start to cry.

Botticelli’s “The Birth of Venus” seems to be a particular trigger. “We had at least one epileptic fit in front of the Venus,” said Eike Schmidt, director of the Uffizi Palace and Gallery. “A gentleman also suffered a heart attack.”

That gentleman was Carlo Olmastroni, a 68-year-old from the Tuscan town of Bagno a Ripoli, who collapsed at the Uffizi in December 2018. “I walked up to Botticelli’s ‘The Birth of Venus’ and, as I admired that marvel, my memories disappeared,” Olmastroni told me.

His story was quickly picked up by the media in Italy and abroad and presented as the latest high-profile example of Stendhal syndrome.

However, it may more appropriately serve to illustrate something else: the rush of the media to propagate the romantic idea of ​​Stendhal Syndrome, despite the fact that it is a difficult condition to pin down. Certainly, in Olmastroni’s case, something else was at stake.

“The diagnosis was not Stendhal Syndrome, as some more romantically thought, but the occlusion of two coronary arteries. Perhaps, admiring ‘The Birth of Venus,’ they decided there was nothing more beautiful to look at and permanently contracted! “, told me.

Fortunately, Olmastroni made a full recovery, partly thanks to a defibrillator that had been installed (in the gallery) the day before his visit, and partly due to the close presence of four doctors, including two Sicilian cardiologists who were visiting the Uffizi that day. He calls them his “guardian angels”.

“Could be agoraphobia, not Botticelli”

Had he suffered the heart attack at home, it might have been a different story. Perhaps, far from making him sick, Florence’s art treasure saved his life.

The problem that many professionals have when describing Stendhal Syndrome as a psychiatric disorder of its own is that its symptoms are very difficult to differentiate from those of more general conditions that commonly affect tourists. “Sometimes at the Uffizi certain visitors have heart attacks or feel sick,” said Cristina de Loreto, a psychotherapist who lives and works in Florence. “But it could just be being in a closed space with hundreds of other people. It could be agoraphobia, not Botticelli.”

An emotional reaction to art, he said, does not constitute a psychiatric disorder, even if it leads to or contributes to distressing or dangerous symptoms. “The moment you look at a piece of art, there are specific areas of the brain that are activated, like when you see a beautiful man or woman. But it’s not enough to say it’s a syndrome. It’s not yet validated and it’s not you can find it in the DSM-5, our handbook of mental disorders.”

Di Loreto believes something else may be at play: that tourists’ expectations of Florence are so high, fueled by the ubiquity of its artworks in various media, that it all becomes too much when they finally visit. “It may be a self-fulfilling prophecy, making some tourists feel something in the Florence air,” she said.

Jerusalem, Paris…

In this sense, Stendhal Syndrome may be related to Jerusalem Syndrome, which causes visitors to that holy city to collapse into religious or messianic psychotic delusions; and the Paris Syndrome, which causes tourists to suffer acute psychiatric symptoms upon discovering that the French capital does not meet their unrealistically high expectations.

Stendhal’s own words, “a kind of ecstasy at the thought of being in Florence”, seem to lend some credence to this theory. Perhaps a self-fulfilling prophecy is also at play in the media coverage of alleged cases of Stendhal Syndrome, such as Olmastroni’s: journalists, enchanted by the romantic idea of ​​becoming “art sick”, diagnose people from afar.

“Here in Florence, like in Venice, you can breathe art,” Paolo Molino, a psychotherapist, told me over lampredotto (tripe) sandwiches in Florence’s Sant’Ambrogio market. “Everywhere you look downtown, you bump into something beautiful. It’s like getting slapped in the face.”

However, Molino agrees with Di Loreto that it is difficult to describe Stendhal Syndrome as a condition in its own right, or to separate its symptoms from those that might affect fatigued, dehydrated or overwhelmed travelers. His concern is not so much that Florence kills the tourists, but rather that the tourists kill Florence.

“Art Disneyland”

“Being in Florence is like being in Disneyland for art,” he said. “I don’t like that. I like vivid places. I like to come and see the guy with the lampredotto, to be able to walk without having to push my way through the crowd.” Having lived in Florence since he was in school, Molino is now one of many Florentines exiled to live in a belt around the historic core. “I never go downtown if I can help it,” he said. “It’s full of people”.

I was struck by Molino’s statement that Florence’s artistic richness, which we value precisely for what it tells us about life and the human condition, had relegated the city to no longer qualifying as a “vivid place.” The comparison of the cradle of Renaissance art and humanism to Disneyland, the world’s leading symbol of corporate artifice and stripped-down commercialism, was equally jarring. However, it is important to remember where much of Florence’s art comes from.

Michelangelo and Botticelli did not carve or paint in a dark attic. They were patronized by the wealthiest and most powerful people in Florence, who used their artwork as a display of financial and political power. In David’s original position in front of the Palazzo Vecchio, the statue gazed defiantly towards Rome, where the invading Goliaths of the Medici, an enormously powerful banking family, were based.

During the periods in which they exercised power in Florence, it was the Medici themselves who commissioned pieces such as “The Birth of Venus”. Botticelli included the Medici in the roles of the Magi in his paintings; and the same building that houses the Uffizi Gallery was built by the same family. These people used art to promote the mythology that surrounded them, consolidating their power and creating, as Disneyland philosopher Jean Baudrillard put it, a kind of hyper-reality.

The Medici are long gone, but the masterpieces they left behind in Florence still give the city something unreal and mysterious. However, Schmidt believes this is not unique to Florence. “Every time things like this happen in Florence, it’s in the papers, but while it’s seen as a Florentine phenomenon, the same could be true of places like Venice and Verona.”

As Schmidt pointed out, art, for the most part, is not a health hazard, but a tonic for body and soul. “In general, art is good for you, good for your heart and your mind.”