CBT for Persistent Dizziness: Why Your Brain Might Be the Key
If you have ever felt like your world is constantly tilting or spinning with no clear cause, and your doctors keep telling you everything looks normal, you might be living with Persistent Postural Perceptual Dizziness (PPPD). This condition can feel confusing and overwhelming, especially when it lingers despite rest or medication.
For many high-functioning professionals and BIPOC women, PPPD is more than a physical sensation. It is wrapped up in stress, performance pressure, and being in constant survival mode. That is where Cognitive Behavioral Therapy (CBT) comes in.
CBT is not just about talking. It is about learning how your thoughts, behaviors, and body sensations interact. For PPPD, CBT helps you challenge anxious thinking, reduce fear around dizziness, and slowly reintroduce movement and situations that have started to feel unsafe (Waterston et al.; Edelman et al.).
Research shows CBT significantly reduces dizziness severity and the impact it has on daily life. Studies have found improvements even after just a few sessions and even greater results when CBT is combined with medication or group vestibular rehab (Yu et al.; Magnussen et al.; Toshishige et al.).
CBT strategies for PPPD include:
Psychoeducation to understand the condition
Graded exposure to dizziness-inducing movements
Attentional refocusing to shift your mind from symptom scanning
Behavioral experiments to test out feared movements
This approach not only improves physical symptoms but also boosts confidence and restores a sense of control. The best part is that CBT can be tailored to your lifestyle and delivered virtually.
At Balens Therapy, we offer culturally aware CBT for PPPD that respects the layered experiences of BIPOC women. You deserve care that sees the whole picture.
You are not stuck. You are not imagining it. There is a path forward.
Book your free consultation with Balens Therapy today.
Works Cited
Edelman, Sarah, et al. “Cognitive Behavior Therapy for Chronic Subjective Dizziness: A Randomized, Controlled Trial.” American Journal of Otolaryngology, vol. 33, no. 4, 2012, pp. 395–401. doi:10.1016/j.amjoto.2011.10.009.
Magnussen, Liv H., et al. “Patient Experiences of a Group Intervention Integrating Vestibular Rehabilitation, Body Awareness, and Cognitive Behavioral Therapy for Long-Lasting Dizziness.” Physical Therapy, 2025, pzaf062. doi:10.1093/ptj/pzaf062.
Suica, Zrinka, et al. “Comparative Effectiveness of Non-Pharmacological Treatments in Patients With Persistent Postural-Perceptual Dizziness.” Frontiers in Neurology, vol. 15, 2024, 1426566. doi:10.3389/fneur.2024.1426566.
Toshishige, Yu, et al. “Cognitive-Behavioural Therapy for Chronic Subjective Dizziness.” Acta Oto-Laryngologica, vol. 140, no. 10, 2020, pp. 827–832. doi:10.1080/00016489.2020.1772994.
Waterston, John, et al. “Persistent Postural-Perceptual Dizziness: Precipitating Conditions, Co-Morbidities and Treatment With Cognitive Behavioral Therapy.” Frontiers in Neurology, vol. 12, 2021, 795516. doi:10.3389/fneur.2021.795516.
Yu, Yuchao, et al. “Cognitive Behavior Therapy as Augmentation for Sertraline in Treating Patients With Persistent Postural-Perceptual Dizziness.” BioMed Research International, 2018, 8518631. doi:10.1155/2018/8518631.
