VESTIBULAR DISORDERS

Vestibular disorders can have a profound impact on daily life, work, and relationships. Common symptoms include spinning or rocking sensations, head pressure, visual disturbances, nausea, fatigue, and brain fog -often worsening in certain environments or positions.

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Many individuals seek extensive medical evaluation yet continue to suffer despite being told that tests are normal or that no clear structural cause can be found. Diagnoses such as Persistent Postural-Perceptual Dizziness (PPPD), vestibular migraine, Mal de Débarquement Syndrome, idiopathic dizziness, or no diagnosis at all are common in these circumstances.

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“Am I going crazy?”

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No. These symptoms are real and deeply distressing. While they are not caused by structural disease, they are generated by the brain and nervous system. Your brain is not broken - but it may be caught in maladaptive patterns that continue to signal danger or imbalance.

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My work with vestibular disorders is influenced by Dr. John Sarno, who emphasized that chronic physical symptoms often arise in the context of unacknowledged or repressed emotional states, particularly in individuals who are conscientious, self-controlled, or under chronic internal pressure. From this perspective, vestibular symptoms are not imagined - they are meaningful expressions of a dysregulated mind-body system.

An integrated, psychotherapeutic approach

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Psychotherapy focuses on identifying both conscious and unconscious emotional, relational, and psychological factors that may be maintaining symptoms, while supporting nervous system regulation and emotional awareness.

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In line with Sarno’s work, I support a very specific type of therapeutic journaling as a process for accessing and articulating emotional experience. This type of journaling gradually brings awareness to emotional experiences that have often been kept out of conscious awareness. When used thoughtfully and in conjunction with therapy, this reflective writing can help loosen entrenched patterns within the nervous system and deepen the therapeutic work. 

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I often recommend combining individual psychotherapy with a reputable neuroplasticity-based program designed for chronic vestibular symptoms. These programs provide education, somatic skill-building, and peer support, while therapy offers a deeper, individualized exploration of the patterns that sustain symptoms.

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When is psychotherapy helpful?

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Psychotherapy may be especially indicated when:

• Symptoms persist despite adequate medical care

• Recovery feels stalled after six months to a year

• Anxiety, depression, isolation, or fear accompany symptoms

• There is a history of trauma, loss, or significant life stress

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There are no quick fixes in this work. It is most helpful for individuals who are willing to approach symptoms with curiosity, patience, and emotional honesty. Those seeking immediate symptom elimination or a formulaic solution may find this approach frustrating.

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In therapy, symptoms are approached not as enemies to eliminate, but as signals pointing toward areas of emotional or psychological strain that require attention. While symptom relief often follows, it is usually a byproduct rather than the goal, emerging as emotional awareness and nervous system regulation deepen over time.