So much inside Alice in Wonderland for Medical Humanities

Almost all of us are familiar with the Unbirthday or the Queen of Hearts, or the Cheshire Cat of Alice in Wonderland… since the given name is Wonderland, and since Lewis Carroll was a mathematician we might say that in this wonderland kingdom there are all possible degrees of freedom for the oddities to come true.

However… zooming at some topics of this novel, we come up to understand that Little Alice suffers from Hallucinations and Personality Disorders, the White Rabbit from General Anxiety Disorder “I’m late”, the Cheshire Cat is schizophrenic, as he disappears and reappears distorting reality around him and subsequently driving other characters in the story to madness. the Queen of Hearts is affected by egotism and narcissist syndrome “head off”, the hookah-smoking Caterpillar by drug addiction, and the Mad Hatter, simply by madness, repeating in an obsessive-compulsive way, for ten years at 6 p.m. the celebration of our beloved Unbirthday. But he is stuck there… no sense of time, while he is getting old.

What about the Cards? They are just servants, there to obey, with a vanished body and personality.

Let’s read a little portion “read me”- as well “eat me, or drink me”: Alice has just changed her size…This is her inner dialogue:

Alice took up the fan and gloves, and, as the hall was very hot, she kept fanning herself all the time she went on talking: ‘Dear, dear! How queer everything is to-day! And yesterday things went on just as usual. I wonder if I’ve been changed in the night? Let me think: was I the same when I got up this morning? I almost think I can remember feeling a little different. But if I’m not the same, the next question is, Who in the world am I? Ah, THAT’S the great puzzle!’ And she began thinking over all the children she knew that were of the same age as herself, to see if she could have been changed for any of them.

‘I’m sure I’m not Ada,’ she said, ‘for her hair goes in such long ringlets, and mine doesn’t go in ringlets at all; and I’m sure I can’t be Mabel, for I know all sorts of things, and she, oh! she knows such a very little! Besides, SHE’S she, and I’m I, and — oh dear, how puzzling it all is! I’ll try if I know all the things I used to know. Let me see: four times five is twelve, and four times six is thirteen, and four times seven is–oh dear! I shall never get to twenty at that rate! However, the Multiplication Table doesn’t signify: let’s try Geography. London is the capital of Paris, and Paris is the capital of Rome, and Rome — no, THAT’S all wrong, I’m certain! I must have been changed for Mabel! I’ll try and say “How doth the little — “‘ and she crossed her hands on her lap as if she were saying lessons, and began to repeat it, but her voice sounded hoarse and strange, and the words did not come the same as they used to do: —

‘How doth the little crocodile
Improve his shining tail,
And pour the waters of the Nile
On every golden scale!

‘I’m sure those are not the right words,’ said poor Alice, and her eyes filled with tears again as she went on, ‘I must be Mabel after all, and I shall have to go and live in that poky little house, and have next to no toys to play with, and oh! ever so many lessons to learn! No, I’ve made up my mind about it; if I’m Mabel, I’ll stay down here! It’ll be no use their putting their heads down and saying “Come up again, dear!” I shall only look up and say “Who am I then? Tell me that first, and then, if I like being that person, I’ll come up: if not, I’ll stay down here till I’m somebody else” — but, oh dear!’ cried Alice, with a sudden burst of tears, ‘I do wish they WOULD put their heads down! I am so VERY tired of being all alone here!’

As she said this she looked down at her hands and was surprised to see that she had put on one of the Rabbit’s little white kid gloves while she was talking. ‘How CAN I have done that?’ she thought. ‘I must be growing small again.’ She got up and went to the table to measure herself by it, and found that, as nearly as she could guess, she was now about two feet high, and was going on shrinking rapidly: she soon found out that the cause of this was the fan she was holding, and she dropped it hastily, just in time to avoid shrinking away altogether…..

It’s always teatime in Wonderland

 Six o’clock meaning tea-time, so they have been stuck in that tea-party for ages. Of course, time ran curiously in Wonderland because it was simply a dream. Another thing to remember is that when Alice wakes up from the dream, it’s tea-time, too. The Mad Hatter says that time is a living creature. Somebody holy to respect, not in the arrogant ways that Little Alice thinks to know.  However, they are imprisoned by the never-ending tea party, since time for them, is not passing… Is it true that time can by stopping? We don’t know, if they stay the same and they don’t get old, or if they – as Alice says- are just wasting time.

In the next book, “Through the Looking Glass” it’s also mentioned that in Wonderland, the days are sometimes merged together. According to the Red Queen:

“Nowhere, we mostly have days and nights two or three at a time, and sometimes in the winter we take as many as five nights together — for warmth, you know.”

Let’s go back to the Mad Hatter Tea Party and “read me”:

Alice sighed wearily. `I think you might do something better with the time,’ she said, `than waste it in asking riddles that have no answers.’

`If you knew Time as well as I do,’ said the Hatter, `you wouldn’t talk about wasting IT. It’s HIM.’

`I don’t know what you mean,’ said Alice.

`Of course, you don’t!’ the Hatter said, tossing his head contemptuously. `I dare say you never even spoke to Time!’

`Perhaps not,’ Alice cautiously replied: `but I know I have to beat time when I learn music.’

`Ah! that accounts for it,’ said the Hatter. `He won’t stand to beat. Now, if you only kept on good terms with him, he’d do almost anything you liked with the clock. For instance, suppose it was nine o’clock in the morning, just time to begin lessons: you’d only have to whisper a hint to Time, and round goes the clock in a twinkling! Half-past one, time for dinner!’

….And ever since that,’ the Hatter went on in a mournful tone, `he won’t do a thing I ask! It’s always six o’clock now.’

A bright idea came into Alice’s head. `Is that the reason so many tea-things are put out here?’ she asked.

`Yes, that’s it,’ said the Hatter with a sigh: `it’s always tea-time, and we’ve no time to wash the things between whiles.’

`Then you keep moving around, I suppose?’ said Alice.

`Exactly so,’ said the Hatter: `as the things get used up.’

….Take some more tea,’ the March Hare said to Alice, very earnestly.

`I’ve had nothing yet,’ Alice replied in an offended tone, `so I can’t take more.’

`You mean you can’t take LESS,’ said the Hatter: `it’s very easy to take MORE than nothing.’

Why did Lewis Carroll write about Madness?

In 1873 Skeffington Lutwidge, a Lunacy Commission inspector of asylums in England, was killed by an asylum patient. Lutwidge was the uncle and close friend of Charles Lutwidge Dodgson, also known as Lewis Carroll. One year later, Carroll began writing The Hunting of the Snark, a poem whose meaning has mystified Carroll enthusiasts. In fact, the poem is a description of the Lunacy Commission inspection team and reflects Carroll’s personal understanding of, and reaction to, the killing of his uncle by an individual with a severe mental illness. Carroll’s close relationship with his uncle also explains the prominence of psychotic thinking in Carroll’s work, including the Mad Hatter’s tea party, or even the more cruel, Queen of Hearts, who is as a matter of fact, a murderer.

Commenting on the Red Queen’s “constant orders for beheadings,” Gardner suggests that “violence with Freudian overtones” is quite harmless to children, but that the book “should not be allowed to circulate indiscriminately among adults who are undergoing analysis.”

“I see!’ said the Queen, who had meanwhile been examining the roses. `Off with their heads!’ and the procession moved on, three of the soldiers remaining behind to execute the unfortunate gardeners, who ran to Alice for protection.

`You shan’t be beheaded!’ said Alice, and she put them into a large flower-pot that stood near. The three soldiers wandered about for a minute or two, looking for them, and then quietly marched off after the others.

`Are their heads off?’ shouted the Queen.

`Their heads are gone, if it pleases your Majesty!’ the soldiers shouted in reply.


Bigger and smaller at the sight

In the story, Alice experiences numerous situations similar to those of micropsia and macropsia. Speculation has arisen that Carroll may have written the story using his own direct experience with episodes of micropsia resulting from the numerous migraines he was known to suffer from. It has also been suggested that Carroll may have suffered from temporal lobe epilepsy.

Lewis Carroll was said to have been inspired to write Alice in Wonderland after the onset of a bizarre neurological condition. Prey to “bilious headaches”, Carroll recorded in his diary his experience of “curious optical effects … seeing disordered ‘fortifications’.” Although the historical diagnosis is risky, scholars agree that these “disordered fortifications” were the likely product of Todd’s syndrome, a condition which distorts perceptions of size and induces the shrinking feeling Alice experiences. Only formally recognized 60 years ago, it affects just a tiny number of people per year.

Meanwhile, in the medical literature, the analysts were supplanted by neurologists and neuropsychiatrists with the introduction in the 1950s of the Alice in Wonderland Syndrome (AIWS).

In 1952 migraine investigator Caro W. Lippman reported in the Journal of Nervous and Mental Disease on patients experiencing transitory “hallucinations of the sense of body image, in which the patient has the feeling that the entire body, or certain parts of the body, have become distorted in size or shape” in connection with their migraines. One patient compared her sensation of being abnormally short and wide to a “Tweedle-Dum or Tweedle-Dee feeling” (referencing the rotund twins from Looking Glass) and Lippman remarked on the “migraine hallucinations” which Carroll himself described and recorded “in immortal fiction form.”

Todd expanded the list of diseases in which the symptoms occur to include “epilepsy, cerebral lesion, intoxication with hallucinogenic drugs, the deliria of fevers, hypnagogic states and schizophrenia.” He likewise expanded the list of possible symptoms to include “illusory changes in the size, distance, or position of stationary objects in the subject’s visual field; illusory feelings of levitation; and illusory alterations in the sense of the passage of time.”

Alice in Wonderland syndrome

It is a disorienting neuropsychological condition that affects perception. People experience size distortion such as micropsia, macropsia, pelopsia, or teleopsia. Size distortion may occur of other sensory modalities. Anecdotal reports suggest that the symptoms are common in childhood,  with many people growing out of them in their teens. It appears that AiWS is also a common experience at sleep onset, and has been known to commonly arise due to a lack of sleep.

A prominent and often disturbing symptom are experiences of altered body image. The person may find that they are confused as to the size and shape of parts of (or all of) their body. They may feel as though their body is expanding or getting smaller. Alice in Wonderland syndrome also involves perceptual distortions of the size or shape of objects. Other possible causes and signs of the syndrome include migraines, use of hallucinogenic drugs, and infectious mononucleosis.

Patients with certain neurological diseases have experienced similar visual hallucinations. These hallucinations are called “Lilliputian”, which means that objects appear either smaller or larger than they actually are.

Patients may experience either micropsia or macropsia. Micropsia is an abnormal visual condition, usually occurring in the context of visual hallucination, in which affected persons see objects as being smaller than those objects actually are. Macropsia is a condition where the individual sees everything larger than it actually is.

The eyes themselves are normal, but the person will often ‘see’ objects as the incorrect size, shape or perspective angle. Therefore, people, cars, buildings, houses, animals, trees, environments, etc., look smaller or larger than they should be, or that distances look incorrect; for example, a corridor may appear to be very long, or the ground may appear too close.

The person affected by Alice in Wonderland Syndrome may also lose the sense of time, a problem similar to the lack of spatial perspective. In other words, time seems to pass very slowly, akin to an LSD experience. The lack of time, and space, perspective leads to a distorted sense of velocity. For example, one could be inching along ever so slowly in reality, yet it would seem as if one were sprinting uncontrollably along a moving walkway, leading to severe, overwhelming disorientation. This can then cause the person to feel as if the movement, even within his or her own home, is futile.

In addition, some people may, in conjunction with a high fever, experience more intense and overt hallucinations, seeing things that are not there and misinterpreting events and situations.

The social dreaming at the end

Wake up, Alice dear!’ said her sister; `Why, what a long sleep you’ve had!’

`Oh, I’ve had such a curious dream!’ said Alice, and she told her sister, as well as she could remember them, all these strange Adventures of hers that you have just been reading about; and when she had finished, her sister kissed her, and said, `It WAS a curious dream, dear, certainly: but now run in to your tea; it’s getting late.’ So Alice got up and ran off, thinking while she ran, as well she might, what a wonderful dream it had been.

But her sister sat still just as she left her, leaning her head on her hand, watching the setting sun, and thinking of little Alice and all her wonderful Adventures, till she too began dreaming after a fashion, and this was her dream. First, she dreamed of little Alice herself, and once again the tiny hands were clasped upon her knee, and the bright eager eyes were looking up into her–she could hear the very tones of her voice, and see that queer little toss of her head to keep back the wandering hair that would always get into her eyes–and still as she listened, or seemed to listen, the whole place around her became alive the strange creatures of her little sister’s dream.

Social dreaming, we could call it today: after Alice told the beautiful and somehow exciting dream she had, this was embodied in her sister phantasy. She starts to dream the same creatures of the Wonderland. Social Dreaming is a way of working with dreams where the focus is on the dream and not the dreamer, where dreams are shared amongst people who come together solely for this purpose. With Social Dreaming, the meaning of a dream is about the broader world in which one lives. In a Social Dreaming event, participants are invited to offer their dreams and, through association, explore the possible social meanings contained within them.

Participants at a Social Dreaming event, known as a “matrix”, access a potential to create new thoughts that arise from what has been described as the “associative unconscious” (Long). These new thoughts are often an expression of ideas, thoughts, and feelings that are deeply held or known but yet to be expressed or thought (the “unthought known”, Bollas). This key feature differentiates Social Dreaming from other forms of debate, discussion, and dream work.

Dreaming has long been used by communities around the world, including Native Americans, Africans, and Australians, to capture thinking about the past and learning about the present, while guiding them towards the future. Social Dreaming builds on this legacy to bring new thinking and meaning to the communities in which we live and work.

Social Dreaming was discovered by Gordon Lawrence of the Tavistock Center in London, in the ’80s.

Here, the Alice in Wonderland book for free, in pdf.


Maria Giulia Marini

Epidemiologist and counselor in transactional analysis, thirty years of professional life in health care. I have a classic humanistic background, including the knowledge of Ancient Greek and Latin, which opened me to study languages and arts, becoming an Art Coach. I followed afterward scientific academic studies, in clinical pharmacology with an academic specialization in Epidemiology (University of Milan and Pavia). Past international experiences at the Harvard Medical School and in a pharma company at Mainz in Germany. Currently Director of Innovation in the Health Care Area of Fondazione ISTUD a center for educational and social and health care research. I'm serving as president of EUNAMES- European Narrative Medicine Society, on the board of Italian Society of Narrative Medicine, a tenured professor of Narrative Medicine at La Sapienza, Roma, and teaching narrative medicine in other universities and institutions at a national and international level. In 2016 I was a referee for the World Health Organization- Europen for “Narrative Method of Research in Public Health.” Writer of the books; “Narrative medicine: Bridging the gap between Evidence-Based care and Medical Humanities,” and "Languages of care in Narrative Medicine" edited with Springer, and since 2021 main editor for Springer of the new series "New Paradigms in Health Care."

This Post Has 5 Comments

  1. Belle

    i love this

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