In Stories We Tell Ourselves, Seeing Things, Part 1, Michelle Herman recounts that her daughter’s perception of her Getting-Smaller-and-Getting-Bigger was idiopathic, meaning the doctors had no explanation for it, but that did not make her feel any better. Time went on, and Michelle kept notes about Grace’s experiences, sensing she would write an essay about them at some point. Then at a writer’s conference in Vancouver, she shared this with a friend, Joe who said: “You’re not serious!”, and confessed that this odd perception occurred to him quite often as a child, but he never told anyone and hadn’t thought about it many years. “Why didn’t you tell anyone?” Michelle asked. Joe replied: “Are you joking? I was eight or nine when it started. I figured that either a) this was the way everyone saw the world, and they would think I was crazy for bothering to mention it, or b) I was the only one who saw things this way – in which case I was crazy. Either way, I was crazy.” Michelle decided to run all this by Steven Katz, a neuro-ophthalmologist at OSU with whom she was friendly. They met at a small table at Cup O’Joe, a Columbus Institution, surrounded by college kids immersed in their laptops.
Here is Dr. Steven Katz’s self-introductory YouTube video on the OSU website, and at the 2:13 mark he says something quite pertinent.
“There is a tendency for some people to think that there is a paradigm that fits everybody. But everyone has different genetics, and everyone has different environmental influences, and nobody responds the same way to a disease, and diseases don’t read textbooks and don’t always present classically so there is not a one size fits all approach to Medicine.”
Michelle had done what most parents would do when faced with a diagnosis of idiopathic origin. She went to the Internet where she came upon terms such as micropsia and macropsia related to size illusions of known objects appearing larger or smaller. Dr. Katz listened, and reasoned that whatever Grace had it wasn’t likely she had a macular problem because that wouldn’t create the zooming out and looming in effects – it would be one or the other. The next step would have been an MRI, but a CT scan was at least a step in the right direction, seeking the origin of Grace’s illusions in her brain more so than in her eyes. There was some suggestion that the subjective reports such as what Grace offered could be related to migraines. The zooming out and looming in often occurs in a similar time frame that an aura builds and then subsides — a 15 to 20 minute interlude of scaling in the effects of visual field and intensity
In her own research, searching the Internet, Michelle had come across a constellation of symptoms that seemed to best describe what Grace was experiencing.
Alice in Wonderland Syndrome. Although neither Grace’s pediatrician nor psychiatrist had encountered it before, it may be less uncommon than they thought, perhaps signified by self-help discussion groups for it. Through her writer’s network Michelle made inquiries, and 24 people responded that they experienced exactly what Grace was reporting when they were a child. And most of them were considered to be “weird” children, though many learned to wear that title as a badge of distinction. None of them reported experiencing migraines. Michelle realized she was paddling her way into very deep waters, and felt the need to go further. She found her way to Paul Grobstein, a neurobiologist whose ideas led her to the title of her book, and who describes his expertise and interests this way:
“I’m a neurobiologist, biologist, philospher, and educator with a life-long interest in understanding why people behave the way they do, and how they can continually expand their capabilities. I am interested as well in the nature of biological, cultural, and intellectual change, complex systems and general information processing principles, and the character of human understanding and the relationships among its different forms.”
But, Michelle declares, experts on the way our minds work are in short supply, if there are any. It turns out that your guess is really as good as mine, or as a neurobiologist’s. Grace is now 18, and away at College, and her Alice in Wonderland experiences have considerably subsided. There’s nothing that happens in life that Michelle finds unworthy of looking into for possible meaning. Getting-smaller-and-getting-bigger warrants trying to make sense of, for it seems that what we call “symptoms” results from emotions so extreme and insistent that they have to make their way into consciousness. Dreams simply aren’t a large enough canvas for the artist that is the unconscious, and the scriptwriter of those dreams.
Helen Stapinski wrote a nice article about Alice In Wonderland Syndrome in the New York Times two months ago, which contains a link to Grant Liu’s neuro-ophthalmology presentation on the Syndrome. This is welcome, because it takes these transient distortions or illusions of body image and space out of the realm of Jefferson Airplane and more into the arena of natural neuroscientific phenomena vividly encountered in childhood.
Michelle finishes her essay with a flair:
“To make sense of everything we do, or feel, or see, or are is a hopeless undertaking. But just as art is meant to be contemplated, engaged with, speculated about, felt – and inevitably, interpreted – we are surely meant to contemplate the ‘work’ of the unconscious as it reveals itself in each of our lives, and to appreciate its artistry. We can only look – and see what we shall see.”
Although Alice in Wonderland Syndrome may be relatively rare, there is another syndrome we encounter with children whose eyes are apparently fine, and whose visual abnormalities likely reside in the realm of the unconscious. Rather than size and distance changes, their zooming effects thwart clarity and create a tunnel vision illusion. I’ll bet Dr. Streff would have had some interesting thoughts about Alice in Wonderland Syndrome.