Also known as Alice in Wonderland syndrome, this is a very rare mental condition that has at last been widely explored thanks to a study
In Gulliver's Travels (1726), author Jonathan Swift spoke of curious tiny beings inhabiting an imaginary place called Lilliput. The Lilliputians tied the hero Gulliver with ropes, in a Dantesque scene that surely sparked the imagination of the people of the time. To this day we have pictorial and cinematic representations of this scene, but in his day, what is it that led Swift to invent such a thing? Perhaps the hunch that sometimes men are tinier than they are to the naked eye was all too real?
This is the idea that led French psychiatrist Raoul Leroy to think that perhaps there were mental phenomena that could be conducive to a vision similar to the one Gulliver had on his journey. “Sometimes they occur alone, sometimes they are accompanied by other psychosensory disorders,” he explained in the description of one of the many cases he dared to investigate. He christened them “micropsia” phenomena (due to the union of the prefix “micro” with “optic”), and which today is widely studied and better known as Alice in Wonderland syndrome.
As defined, it refers to a sensory distortion of vision, with an alteration of the shape of objects so that they tend to appear smaller than they really are. Leroy, in particular, described that most of the hallucinations he had observed in his patient were of moving objects, with bright colors. There were also people who dreamed of human figures climbing chairs in groups or crawling under doors. In most cases, none of these tiny beings were aggressive, although, as Science Alert reports in an article, there was once a 50-year-old woman suffering from chronic alcoholism who went to the doctor's office and saw “two men as tall as a finger” wearing blue and smoking a pipe. Later, she began to hear voices in her head threatening her with death, only to have the hallucination disappear.
None of them represented anyone known to the patient. Some of them even projected themselves into the hallucination.
Undoubtedly, these “apparitions” are most curious and striking because they do not allude to a perceptive factor, but purely hallucinatory and imaginative. However, a man of science like Leroy did not put it down to simple delusions, but intuited from the beginning that these symptoms were due to mental illnesses that had yet to be classified. Years later, renowned psychologists and psychiatrists studied each of his writings and case descriptions to further refine the diagnosis of micropsia.
A 2021 study published in the journal Neuroscience & Biobehavrioal Reviews attempted to follow the path initiated by Leroy and go on to review past and present cases of mentally ill people reporting this kind of hallucination to reach a series of conclusions or see what they had in common. After arduous research, medical historian Jan Dirk Blom of Leiden University found 26 studies on hallucinations related to micropsies that, in turn, contained only 24 faithful, relevant or well-adjusted descriptions.
The vast majority were projective hallucinations, meaning they appeared in all three dimensions and interacted with the real world.
“During the 1980s and 1990s there were hardly any new cases, and Lilliputian hallucinations were forgotten,” Bloom said. However, when he turned to the historical literature, rather than the clinical literature, he did find many, many more, a total of 226 unique cases to compare and contrast. All of them had common features and minor differences. For example, most of the visions consisted of small beings dressed in bright, colorful, clown-like clothing. None of them represented anyone known to the patient. Some of them even projected themselves into the hallucination, looking very small, a most curious phenomenon indeed. Similarly, animals or objects reduced to a tiny size also appeared.
Of all of them, the vast majority (97%) were projective hallucinations, that is, they appeared in three dimensions and interacted with the real world. The rest appeared in two dimensions, as if they were a hologram. As for the psychological repercussions that the hallucinations had on the patients, almost half of them experienced fear or a feeling of anxiety. Only a third of them felt relieved or entertained by the experience. Interestingly, only one patient stated that “the visions were the only joy he had left“.
Now, what were the clinical diagnoses that gave rise to these hallucinations? Blom grouped them into ten distinct groups, the most prominent being psychiatric disorders, alcohol or drug intoxication and, of course, shock or injury to the central nervous system. He also speculated that some of them were caused by a distortion of the brain's visual system. Be that as it may, micropsia or Alice in Wonderland syndrome is a rarity within psychiatry, a rarity that undoubtedly arouses much interest from the literary, mystical or magical thinking point of view that suddenly assaults a person without warning.
In Gulliver's Travels (1726), the author Jonathan Swift spoke of some curious tiny beings that inhabited an imaginary place called Lilliput. The Lilliputians tied the hero Gulliver with ropes, in a Dantesque scene that surely sparked the imagination of the people of the time. Today we have pictorial and cinematic representations of this scene, but in his day, what made Swift invent such a thing? Perhaps the feeling that sometimes men are tinier than they are to the naked eye was all too real?
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