Ava came to see me because she had been suffering with extreme vertigo for the past three years. Uncompensated labyrintis occurs when the inner ear becomes damaged and does not heal after eight weeks. Basically, the brain must then relearn how to correct the faulty signals that are coming from the sufferer’s damaged inner ear. Until then, you can experience dizziness, imbalance, and fatigue.
Ava’s brain was taking a long time to learn how to reinterpret the signals coming from her inner ear. Hence her continual bouts of vertigo which were unpredictable and could last for days. The strange part is that dizziness is actually part of the healing process as it shows that your brain is trying to correct the faulty signals.
Despite all this, Ava kept insisting that her life, in general, was happy and that she was happy. But still there were things she missed doing like skiing and dancing. Ava (30) was married and also wanted to start having children, but she was constantly afraid of falling down and didn’t dare have a baby for fear of falling while carrying the child.
Underneath her presenting issue of vertigo, however, was another story. When Ava was 18 and just beginning university, 200 km away from home, one morning, she spoke to her mother on the phone. Later that day she received a call that her mother had died in a car accident. This tragedy was particular difficult for her for many reasons, not to mention, the accident being so unexpected and her mother’s death so sudden. Ava was an only child. And finding herself far from home, without any real friends at the new school, she had no one to go to for immediate comfort.
There were also many difficult consequences as a result of her mother’s death. Ava’s father sold or got rid of everything belonging to her mother without telling her or letting her take anything for herself. He remarried after two years, and upon hearing the news of his engagement, Ava experienced for the first time her heart palpitating and loss of breath.
It felt to me that the vertigo seemed to mirror her “losing her ground” as if the “world was pulled out from under her and left her spinning.” Most of our time together would be spent around acceptance – of her mother’s death, of her father’s remarriage, of her physical limitations. However, we also needed to immediately address Ava’s constant fear of falling, which was stopping her some days from leaving the house.

Assagioli drew from the work Viktor Frankl, the founder of logotherapy, and the two men were acquaintances.Photo by Prof. Dr. Franz Vesely.
For this, I drew on one of Viktor Frankl’s (1905-1997) major insights which he observed during his time as a prisoner, but also as a psychoanalyst, in four different concentration camps during World War II. He noticed that anxiety can build up undesirable pressure and affect the outcome of a person’s actions. By changing one’s attitude in completely the opposite direction, the person can often overcome his or her internal struggle. He called this technique “paradoxical intention,” based on the twofold fact that “fear brings about that which one is afraid of, and that hypertension makes impossible what one wishes.”
In other words, the client is invited, even for a moment, to intend precisely what he or she fears. This reverse in attitude “takes the wind out of the anxiety.” For example, Frankl once advised a bookkeeper who was suffering from writer’s cramp to practice writing as badly as possible, which cured him in 48 hours. Another one of Frankl’s clients was a woman who was obsessed with cleanliness to the point of suicide. Frankl advised her to actively seek bacteria – to clean out toilets in a hospital ward. Within weeks, her neurosis was manageable and not long afterwards she was cured.
So when Ava told me she was afraid of falling, I first asked her if she had ever fallen. In fact, during her three years of living with vertigo, Ava had never once fallen. “Put a mattress down in your living room floor,” I said, “and try to feel unstable. Try to fall.”
This seemed to work. The next time I saw Ava she looked brighter and more peaceful despite feeling slightly dizzy. After spending one afternoon “trying to fall,” she managed to find the inner courage later in the week to walk to the Saturday market on her own. “Later that afternoon and Sunday as well, I actually felt well,” Ava said with a soft smile. “A feeling that was so familiar and yet odd. I became very happy and hopeful.”
By the time we ended our meetings, Ava was much more accepting of her reality – her past and present, and more hopeful about her future. She was no longer afraid of falling, and was even planning to travel on a plane and go skiing again! During our last time together, Ava’s was shining when she said, “You helped me move from the wrong path to the right one. Now I listen to my inner voice.” Instead of her brain trying to listen to her damaged inner ear, Ava was sending it messages from her inner heart.
Next time you can’t sleep, try not to sleep. Try to stay awake as long as possible. Get up, read, do the dishes, practice some yoga or meditation. See how sleepy you become. Can’t stop shaking/perspiring/(whatever) when you are nervous? Try showing people just how much you can shake or perspire! In all cases, humor helps along with identifying and then dis-identifying from the fear. As Frankl stated, as soon as you stop fighting your obsessions and instead “try to ridicule them by dealing with them in an ironical way – the vicious circle is cut.”
Start today to lovingly and humorously cut your vicious circle of fear and move towards Joy!
Special thanks for Ava (not her real name) for giving me permission to share her story.
References
Frankl, Viktor E. (1984). Man’s Search for Meaning. New York: Pocket Books.