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Elves blew his mind
http://www.lrb.co.uk/v35/n05/mike-jay/elves-blew-his-mindIn February 1758 the 90-year-old Charles Lullin, a retired Swiss civil servant whose sight had been progressively failing since a cataract operation five years before, began to see considerably more than he had become accustomed to. For the next several months he was visited in his apartment by a silent procession of figures, invisible to everyone but him: young men in magnificent cloaks, perfectly coiffured ladies carrying boxes on their heads, girls dancing in silks and ribbons. These visions were recorded and published in 1760 by his grandson, the naturalist Charles Bonnet, after whom the syndrome of hallucinations in the elderly and partially sighted would much later be named.
This famous case introduces Oliver Sacks’s survey of hallucinations, and sets his terms of engagement with the subject in distinctive ways. First, it predates the adoption of ‘hallucination’ as a medical term, and in that way escapes some of the ideological pressure the word would exert on the phenomenon from the 19th century onwards. Second, and crucially, it severs the link with mental illness: Lullin’s eyesight may have dimmed but his cognitive faculties were perfectly sharp, and he had no difficulty recognising his hallucinations as unreal. Sacks’s boldest move is to exclude hallucinations associated with schizophrenia, on the grounds that they demand ‘separate consideration, a book of their own’ that would approach them as one symptom among many of a radically altered mental world. He is still left with an extensive – even overextended and at times incoherent – field of inquiry, but one solidly directed at organic conditions such as neurological disorders and drug effects: the 19th-century category, paradoxical to modern ears, of ‘hallucinations in the sane’.
Much has been learned in the intervening century, but the old question remains: what, if anything, do such hallucinations have to tell us? Whatever it is, they announce it quite regularly and consistently, and for a wide variety of reasons. Miniature people, for example, are commonly seen by those with Charles Bonnet syndrome: Sacks recalls one patient who was accompanied for a couple of weeks by ‘little people a few inches high, like elves or fairies, with little green caps, climbing up the sides of her wheelchair’. Similar characters are just as commonly witnessed by sufferers from migraine, epilepsy or Parkinson’s disease, those on mind-altering drugs such as DMT (dimethyltryptamine) or magic mushrooms, or in withdrawal from alcohol or sedatives. In all these cases the hallucinated figures tend to share further curious but consistent qualities: a tendency to appear in groups, for example, or arrayed in phalanxes (‘numerosity’), to wear headgear or exotic dress, and to go about their business autonomously, paying no attention to the subject’s attempts to interact with them.
From the perspective of the neurosciences, these are privileged, if cryptic, glimpses into the deep structure of the brain: the fact that they can be generated by so many unrelated conditions suggests hardwired perceptual structures that reliably manufacture them. But they also have a cultural life – and, for quintessentially private mental events, a remarkably well-defined social history. They are assigned distinct meanings in different cultures: in many, their familiar appearance is taken as evidence not of their neurological basis but of their independent existence in a transpersonal or spirit world. Their cultural and literary resonances are immediately familiar, and indeed adopted as clinical labels. One of the many terms for seeing miniature people is ‘Lilliput sight’, another is ‘Alice in Wonderland syndrome’; naturally it has been suggested that Jonathan Swift may have experienced it during his demented final years, while Charles Dodgson may have based Alice’s distortions of scale on an account of mushroom-eating Siberian shamans in Mordecai Cooke’s drug compendium, Seven Sisters of Sleep (1860). The phenomenon appears to be consistent through history – the oldest example typically cited in the literature is the ‘little strangers’ who appeared to St Macarius the Elder in his desert solitude around 350 CE – but susceptible to varied cultural interpretations: in Ireland such figures might be described as leprechauns, in Norway as trolls and so on. Do these archetypes draw on a private but universal mental landscape? If so, we might square the circle of nature and culture with the suggestion that they have a basis in neurology but their interpretation shifts with the times: the fairies of old now manifesting more commonly as aliens.
This famous case introduces Oliver Sacks’s survey of hallucinations, and sets his terms of engagement with the subject in distinctive ways. First, it predates the adoption of ‘hallucination’ as a medical term, and in that way escapes some of the ideological pressure the word would exert on the phenomenon from the 19th century onwards. Second, and crucially, it severs the link with mental illness: Lullin’s eyesight may have dimmed but his cognitive faculties were perfectly sharp, and he had no difficulty recognising his hallucinations as unreal. Sacks’s boldest move is to exclude hallucinations associated with schizophrenia, on the grounds that they demand ‘separate consideration, a book of their own’ that would approach them as one symptom among many of a radically altered mental world. He is still left with an extensive – even overextended and at times incoherent – field of inquiry, but one solidly directed at organic conditions such as neurological disorders and drug effects: the 19th-century category, paradoxical to modern ears, of ‘hallucinations in the sane’.
Much has been learned in the intervening century, but the old question remains: what, if anything, do such hallucinations have to tell us? Whatever it is, they announce it quite regularly and consistently, and for a wide variety of reasons. Miniature people, for example, are commonly seen by those with Charles Bonnet syndrome: Sacks recalls one patient who was accompanied for a couple of weeks by ‘little people a few inches high, like elves or fairies, with little green caps, climbing up the sides of her wheelchair’. Similar characters are just as commonly witnessed by sufferers from migraine, epilepsy or Parkinson’s disease, those on mind-altering drugs such as DMT (dimethyltryptamine) or magic mushrooms, or in withdrawal from alcohol or sedatives. In all these cases the hallucinated figures tend to share further curious but consistent qualities: a tendency to appear in groups, for example, or arrayed in phalanxes (‘numerosity’), to wear headgear or exotic dress, and to go about their business autonomously, paying no attention to the subject’s attempts to interact with them.
From the perspective of the neurosciences, these are privileged, if cryptic, glimpses into the deep structure of the brain: the fact that they can be generated by so many unrelated conditions suggests hardwired perceptual structures that reliably manufacture them. But they also have a cultural life – and, for quintessentially private mental events, a remarkably well-defined social history. They are assigned distinct meanings in different cultures: in many, their familiar appearance is taken as evidence not of their neurological basis but of their independent existence in a transpersonal or spirit world. Their cultural and literary resonances are immediately familiar, and indeed adopted as clinical labels. One of the many terms for seeing miniature people is ‘Lilliput sight’, another is ‘Alice in Wonderland syndrome’; naturally it has been suggested that Jonathan Swift may have experienced it during his demented final years, while Charles Dodgson may have based Alice’s distortions of scale on an account of mushroom-eating Siberian shamans in Mordecai Cooke’s drug compendium, Seven Sisters of Sleep (1860). The phenomenon appears to be consistent through history – the oldest example typically cited in the literature is the ‘little strangers’ who appeared to St Macarius the Elder in his desert solitude around 350 CE – but susceptible to varied cultural interpretations: in Ireland such figures might be described as leprechauns, in Norway as trolls and so on. Do these archetypes draw on a private but universal mental landscape? If so, we might square the circle of nature and culture with the suggestion that they have a basis in neurology but their interpretation shifts with the times: the fairies of old now manifesting more commonly as aliens.
Fascinating piece
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