Dizziness and depersonalisation

Abstract

Complaints of dizziness and depersonalisation are frequently associated with anxiety and/or medical problems. However, neither experience can be tied exclusively to one medical or psychosomatic disorder. Although both experiences have been reported during anxiety, neither can be related directly to anxiety level and it seems probable that both arise in the wake of psychological concomitants to change in arousal rather than to high arousal itself. The importance of cognitive processes is a neglected element in both dizziness and depersonalisation. Both experiences are amenable to cognitive intervention as a therapeutic measure. Cognitive and in particular cognitive-perceptual conflict can provoke both experiences. Cognitive attributions about the meaning of an attack form major distress-defining constituents of each experience Two models are discussed: one, that dizziness and depersonalisation are the same experience described differently; the other, a bipolar hypothesis, proposes that the two experiences form opposite ends of a dimension describing disturbed self-world relations. This type of disturbance is not easily described in everyday vocabulary and attention to the precise phenomenology of both complaints would help further psychological understanding.