Aside from their small size, the actions of these tiny individuals follow all the laws of physics as they tumble, parade, or play musical instruments.
In a scientific paper published in 1909, French psychiatrist Raoul Leroy described a particular mental disorder. It is characterized by hallucinations he referred to as Lilliputians, in which patients see little people or tiny beings dancing chaotically in the room.
Interestingly, all these hallucinated figures still adhere to the physical laws of the real world. With their small size, these tiny beings use small tools (bicycles, horses), and when they blow horns or hit drums, they make small sounds. The tiny beings do not morph, but they can appear similar to an augmented reality version.
Leroy himself experienced this hallucination once in 1909. He reported seeing colorful little people that resembled cartoon characters and appeared very friendly.
All these hallucinated figures still adhere to the physical laws of the real world.
Recently, Dutch neurologist Jan Dirk Blom at Leiden University collected written records of 226 cases of Lilliputian hallucinations to shed light on this rare psychological phenomenon.
According to Dirk Blom’s documentation, only about 145 people in the world have ever encountered them. He estimates this rate to be 30–80 per 10,000 individuals within the clinical psychiatric population. This estimate accounts for all forms of these hallucinations, “involving men, women, children, giants, tiny people, or dwarfs, often dressed in flamboyant and elaborate costumes as hunters, clowns, dancers, soldiers, farmers, officials…”, wrote Dirk Blom.
In most cases, the hallucinated creatures appear in large numbers, sometimes reaching thousands or even millions (in two cases). Most individuals who experience Lilliputian hallucinations report these tiny beings as very lively, jumping on chairs, tables, climbing on furniture, marching in groups, or performing acrobatics.
Dirk Blom states that Lilliputian hallucinations belong to the “reality-based optical illusion“ category because they are set in a real environment and seem to follow the laws of physics and three-dimensional space.
The tiny creatures range in height from 1mm to 1m (with an average height of 23 cm) and, in some instances, are accompanied by giant hallucinated creatures (Brobdingnagian Hallucinations). Hallucination episodes can last from a few seconds to several decades.
Lilliputian hallucinations belong to the “reality-based optical illusion” category.
About 46% of patients report that these tiny creatures disturb them, threatening to attack, causing discomfort, or fatigue. Only 36% say that the hallucination is quite positive, describing the little people as amusing dancers that bring delight.
This contradicts Leroy’s initial hypothesis that Lilliputians are benign hallucinations. A 63-year-old male patient from India reported that he sees these little figures appear twice a day, consistently for 5 minutes each session and lasting for 6 months.
“About 200 such beings have attacked me. They are very small. My family members say that I often scream in panic whenever I am attacked“, he said. They had to take him to a psychiatrist for treatment.
One of the most frightening experiences with Lilliputian hallucinations noted by Leroy involved:
“A 50-year-old woman with chronic alcoholism claimed to have seen two men ‘the height of a finger’, dressed in blue, smoking pipes, perched high on the telephone wires.
While observing them, the patient reported hearing the tiny voices threatening to kill her. At that moment, her vision vanished, and she ran away.”
“Nevertheless, Lilliputian hallucinations are traditionally regarded as benign and are known to be pleasant,” Professor Blom wrote.
Another interesting point is that the little beings often appear at dusk, a time when the light is dim and vision can be easily deceived.
Additionally, a phenomenon referred to by Professor Blom as “dream intrusion” may cause patients to mistakenly believe they see little people in real life, but in reality, it is just a part of their dream mixed with reality during a semi-conscious state.
Dharmendra Kendre, a doctor at Noble Hospital who treated the Indian patient, stated: “This is a very rare case, affecting about one in a million people with such disorders. Lilliputian hallucinations are merely a misperception of everything without any stimulating agent.
This can occur when using drugs such as cocaine and marijuana. Metabolic or electrolyte imbalances can also cause these hallucinations. We may also encounter such cases in patients with temporal lobe tumors, dementia, and schizophrenia.”
Metabolic or electrolyte imbalances can also cause these hallucinations.
Depending on the identified cause, the treatment for Lilliputian hallucinations may vary. In the case of the Indian man, Dr. Kendre noted it could be caused by some post-traumatic stress.
“He has been treated for three months. We prescribed him some antipsychotic medications along with psychological counseling sessions. In elderly patients, even post-traumatic stress or prolonged insomnia can lead to Lilliputian hallucinations. In such cases, patients need to see a psychologist immediately for early recovery“, Dr. Kendre said.
Fortunately for this Indian man, the treatment has been effective. Dr. Kendre mentioned that his hallucinations have gradually diminished and he is now fully recovered.
“I am a retired person, and I stay home all the time. Previously, at least twice a day, I would see myself being attacked by little people. Now, I can sleep peacefully and have no such thoughts anymore“, the patient said.
However, not all patients with Lilliputian hallucinations are fortunate enough to recover. According to Dirk Blom’s statistics, only 62% of treated patients can recover from this hallucination. About 18% of them will experience the hallucinations for a lifetime, and 8% may die from them.
