A Not So Pleasant Fairy Tale: Investigating Alice in Wonderland Syndrome
Is “Alice in Wonderland” a pathological product, the result of a single man’s “nerve cells and associated molecules” running amock? The tendency to reduce artistic, religious, or philosophical achievements to bodily ailment was aptly named by William James in “The Varieties of Religious Experience.” “Medical materialism,” he wrote, “finishes up Saint Paul by calling his vision on the road to Damascus a discharging lesion of the occipital cortex, he being an epileptic. It snuffs out Saint Teresa as an hysteric, Saint Francis of Assisi as a hereditary degenerate” (9). And, I might add, Lewis Carroll as an addict or migraineur.
Author Lewis Carroll wrote of some truly bizarre events in his books "Alice in Wonderland," and "Through the Looking Glass and What Alice Found There." Alice goes through all kinds of metamorphic changes; she gets larger or smaller after ingesting certain liquids from labeled bottles, or experiences visual discrepancies such as double vision or hallucinations of smiling cats.
Imagine: You're hallucinating, and you know it. Time is messed up. First it seems slowed, and then it seems to be speeding up. Even more noticeably, when you look at your body, it seems to be morphing. You're getting smaller. Minutes later, you're growing larger and larger (6). That's a description of "Alice in Wonderland" syndrome, a rare form of Migraine aura. The most distinctive symptom of "Alice in Wonderland" syndrome is this type of metamorphosia, a distortion of body image and perspective, which Migrainer's know is not real. (1) "Alice in Wonderland" syndrome can occur at any age, but is more commonly experienced by children.
Migraine researchers suggest Carroll was actually a Migraineur, and Alice's manifestations in the book were representative of his Migraine auras. Alice in Wonderland Syndrome (AWS) was first described by CW Lippman in the Journal of Nervous and Mental Disease in 1952 and named by John Todd in the Canadian Medical Association Journal in 1954 (5). Some noted symptoms of AWS include false orientation of objects in space, one object appearing as two or more, inverted vision, impaired sense of time, feeling detached and personality changes.
Alice's adventures seem to parallel Carroll's suffering as a Migraine patient. Alice being blinded by moonlight could refer to a Migraineur's sensitivity to light; other references are to medications and hallucinatory side effects. For example, from "Alice's Adventures in Wonderland:" "In a minute or two the Caterpillar took the hookah out of its mouth and yawned once or twice, and shook itself. Then it got down off the mushroom, and crawled away in the grass, merely remarking as it went, 'One side will make you grow taller, and the other side will make you grow shorter.' 'One side of what? The other side of what?' thought Alice to herself. 'Of the mushroom,' said the Caterpillar, just as if she had asked it aloud; and in another moment it was out of sight” (8). In a study published in 1998 in Contemporary Pediatrics, AWS might be seen as a Migraine equivalent; a Migraine without head pain. This study describes the typical patient as between five and 12 years old whose auras last between 10 and 60 minutes. The child can function without disability and usually has a family history of Migraine. Other literature notes this phenomenon among children and rarely among adults (7).
One example of a child who has this rare disease is nineteen-year-old Katie O’Brien. Her view of the world can change in the blink of an eye. She can feel as if she is living in a world that has shrunk to the proportions of a dollhouse or other times, ordinary objects seem surprisingly large. Katie describes, “Right when I wake up, that’s when I’ll start to see things differently. I was looking at the couch once and it looked like the couch just was growing. It was really weird. It was really horrible” (3).
Another case of AWS is seen in a twelve-year-old girl named Ana Ryseff. In Seattle, radiologists and researchers are attempting to capture, for the very first time, an actual “picture” of this rare syndrome in her brain. Ana’s auras last just a few minutes and only seem to happen when she is concentrating hard on a printed page. She explains, “Sometimes when I’m really focusing on a piano piece, the notes will just zoom, zoom up, so they’re just really big, like as if you were using a camera and you zoomed up on someone” (3). Ana had no clue what was happening to her, but she was about to discover some new information. In the scanning room, researchers used a black-and-white checkerboard pattern to mimic the black-and-white printed page that seemed to cause Ana’s hallucinations. Neurologist, Dr. Sheena Aurora, hoped to trigger Ana’s aura inside a scanner and get a functional image of her brain. It worked and Ana and her mother were able to see a picture of a brain where an Alice in wonderland Aura takes over ones vision. Two areas of the brain lit up. A burst of electrical activity caused abnormal blood flow in the area vision and the part of the brain that processes texture size and shape. Dr. Aurora explained, “That’s why [Ana] saw things become really small and really big. This activity definitely can explain the differences in size and shape and form” (3).
We are all prisoners of our mortal minds and bodies, vulnerable to various kinds of perceptual transfigurations. At the same time, as embodied beings we live in a world that we explore, absorb, and remember — partially, of course. We can only find the “out there” through the “in here” (the brain). And yet, what the philosopher Sir Karl Popper called “World 3” (4), the knowledge we have inherited — the science, the philosophy, and the art — stored in our libraries and museums, the words, images, and music produced by people now dead, becomes part of us and may take on profound significance in our everyday lives. Our thinking, feeling minds are made not only by our genes, but also through our language and culture.
I have been fond of Lewis Carroll’s Alice when I first read it when I was younger. She may have started out as words on a page, but now she inhabits many people who have this rare syndrome’s lives. (One could also say her story has been consolidated in memories through important work done by hippocampuses.) It is possible that headache episodes from such girls as Ana and Katie have made them particularly sympathetic to the girl’s adventures and her metaphysical riddle. I dare say countless people have lifted her from “World 3”, a kind of Wonderland in itself, and taken her into their own internal landscapes where she continues to grow and shrink and muse over who in the world she is.
7) Shevell, Michael, M.D., "A guide to Migraine equivalents," Contemporary Pediatrics, 71, June 1998.
8) "Alice's Adventures in Wonderland," chapter 5. Quote researched by Mark Burstein, Vice-President and Knight Letter Editor; The Lewis Carroll Society of North America.
9) James, Williams. The Varieties of Religious Experience: A Study in Human Nature. Toronto: Random House, 1929.