Aside from their diminutive size, the behavior of these Lilliputian figures in a hallucination adheres to the laws of physics as they somersault, parade, and play instruments.
History and Description
In a scientific paper published in 1909, French psychiatrist Raoul Leroy described a peculiar psychiatric disorder. It's characterized by hallucinations he termed "Lilliputians," wherein patients see miniature men or women cavorting around the room.
Remarkably, these hallucinations still follow the real-world laws of physics. Despite their small size, the Lilliputians use tiny tools (bicycles, horse-riding), their trumpets or drums making correspondingly small sounds. The Lilliputians are not ethereal beings, but rather resemble a life-sized augmented reality.
Leroy himself experienced the hallucination in 1909. He described the Lilliputians as multicolored and cartoonish-looking, but amiable.
Prevalence and Characteristics
Neurologist Jan Dirk Blom at Leiden University recently compiled 226 cases of Lilliputian hallucinations, shedding light on this rare psychological phenomenon.
Blom's records show only approximately 145 people worldwide have experienced it. He estimates the rate of occurrence at 30–80/10,000 within the population of clinical psychiatric patients. This includes all variations of the hallucination, "involving figures of men, women, children, giants, dwarves, or midgets, often in colorful and elaborate attire as hunters, clowns, dancers, soldiers, peasants, noblemen...," writes Dirk Blom.
In the majority of cases, the hallucinatory beings appear in great numbers, sometimes thousands or even several million (in two instances). Most Lilliputian hallucinations are described as animated, jumping on chairs, tables, and furniture, marching in processions, or performing acrobats.
Blom classifies Lilliputian hallucinations as "object-based, realistic hallucinations" as they are set in a real-world environment and appear to obey three-dimensional space and physical laws.
The figures range in height from 1mm to 1m (average height being 23 cm) and are occasionally accompanied by gigantic hallucinatory beings (Brobdingnagian Hallucination). The episodes can last from a few seconds to decades.
Impact and Treatment
About 46% of patients report the Lilliputian figures as distressing, threatening to attack or causing discomfort, exhaustion. Only 36% described the hallucination as positive, enjoying the amusing and flashy performance of the Lilliputians.
This contradicts Leroy's original theory that Lilliputians were a benign hallucination. A 63-year-old Indian male patient reported the Lilliputians appearing twice a day, each episode lasting 5 minutes and continuing for 6 months.
"Around 200 such small men were attacking me, which were very small in size. My family members mentioned that I used to scream and panic due to their attacks," he said, and had to be admitted to a psychiatric hospital for treatment.
One of the most alarming experiences of a Lilliputian hallucination was recorded by Leroy:
"A 50-year-old chronic alcoholic woman, who stated she had seen two men 'finger-sized,' dressed in blue and smoking pipes, perched on a telegraph wire.
While watching them, the patient allegedly heard the voices of the little men threatening to kill her. At that, the vision disappeared, and the patient ran away."
"Nevertheless, Lilliputian hallucinations have generally been considered as benign and are reputed to have a pleasant nature," writes Professor Blom.
Interestingly, the Lilliputians often appear around twilight hours, a time when vision is most susceptible to illusions.
Additionally, a phenomenon Blom refers to as "dream intrusion" can cause patients to perceive the Lilliputian figures as external when they are actually part of their dreams that intermix with reality in a half-awake state.
"It is a very rare condition, only one in a million may develop such a disorder. This Lilliputian hallucination is a misperception of things without any stimulant. This may occur during the intake of drugs like cocaine, marijuana," said Dr. Dharmendra Kendre, a physician at Noble Hospital who treated the Indian patient. "Electrolyte or metabolic imbalances may also lead to such hallucinations. Also, we can see such cases in those patients who have lesions in the temporal lobe of the brain, dementia, or schizophrenia."
Treatment for Lilliputian hallucinations can vary depending on the underlying cause. In the case of the Indian man, Dr. Kendre suggested it could be due to some post-traumatic stress.
"He is being treated for the last three months, and we have put him on some antipsychotic medications, plus counseling. In old age, even post-traumatic stress or prolonged sleep deprivation can trigger Lilliputian hallucinations. In such cases, patients should consult a psychiatrist for early recovery," advised Dr. Kendre.
Fortunately, for the Indian man, the treatment has been successful. Dr. Kendre says his hallucinations have subsided and are now completely gone.
"I am a retired person, and I used to sit at home all the time. Earlier, at least for two days, I used to feel that small men were attacking me. Now, I am able to sleep comfortably, and I do not get any such thoughts," remarked the patient.
However, not all Lilliputian hallucinations have such a successful outcome. Dirk Bloom's statistics show that only 62% of treated patients recover from the hallucination. Around 18% will experience the hallucinations for life, and 8% die from them.