Graded Motor Imagery Level 1 For Chronic Dizziness & PPPD

Graded motor imagery is a powerful technique used by many people, including world-class athletes, to improve how their brains and bodies communicate with one another. For people with chronic dizziness, graded motor imagery helps rewire the brain's responses to physical positions, movements or activities that normally trigger dizziness. Using just the power of the mind, graded motor imagery can significantly reduce symptoms in response to these triggers.

Transcript

Welcome.

This is Dr.

Yoneet Arthur.

Thank you for joining me for this graded motor imagery for chronic dizziness level 1 exercise.

This exercise will help change neurochemical responses in your brain to movement,

Positional,

And activity-related triggers for your dizziness.

Research shows that motor imagery can significantly change how our brains and bodies respond to movement,

Positions,

And activities.

In fact,

This technique is often used by world-class athletes to improve their performance.

Even though all we will be doing is using our minds for this exercise,

It can lead to a reduction in your symptoms.

As a warm-up,

I want you to think of one movement,

Position,

Or simple activity that tends to trigger your symptoms.

There might be different ones,

And that's okay.

Just pick one.

Pick something simple like bending over,

Rolling over in bed,

Or turning quickly.

Spend a few moments right now just imagining someone else doing this activity.

Let's create a good internal video of this activity in your mind.

Ready?

All right,

Let's get settled in.

Get yourself into a comfortable position.

You can be lying down,

Sitting,

Or reclining,

Whatever is comfortable for you.

Allow your eyes to close or you can keep them open with a soft gaze.

Let's take a few long,

Deep breaths through your nose if you can.

Breathe in and exhale fully.

As you inhale,

Imagine your belly,

Back,

And sides as a big,

Big bowl.

When you inhale,

I want you to inhale down and fill that bowl,

Expanding your belly,

Back,

And sides.

Then exhale even more slowly,

Letting the bowl empty of air.

Let's try another breath just like that.

Breathe in,

Filling the bowl of your abdomen,

Sides,

Back,

And pelvis.

Slowly breathe out,

Trying to prolong that exhale.

Let's take one more breath like this.

Inhale to fill your belly back and sides.

Now slow exhale,

Long breath out.

Now let your breathing settle into its natural rhythm.

Take a moment to notice your breath and then let your attention take inventory of how your body is feeling.

What sensations do you notice in your body right now?

If you notice anything,

Pleasant or unpleasant,

Just look at it.

Just watch it.

You're not trying to do anything to it.

You're not trying to get rid of it.

You're not trying to change it.

You're just noticing your baseline.

Once you have your baseline,

Take note and let's move on.

Take note and let's move on.

Now still breathing and keeping your body relaxed,

Bring your attention back to the task you selected before we began our exercise.

Imagine again someone else is completing the task you imagined.

Watch that imaginary person simply go through that position,

Movement,

Or activity.

Go ahead and do this right now for a few moments.

Now while you are doing this,

I want you to pay close attention to the sensations in your body.

While you imagine this task,

Do you notice anything changing from your baseline?

Keep picturing the task you selected.

If you feel like you did at your baseline,

Just keep on imagining that other person completing your task.

And if you notice changes in the sensations in your body,

Take a moment to locate them.

Where are they and what do they feel like?

There's no need to interpret what they mean,

Just notice where they are and how they feel.

Some people feel sensations in their chest or throat,

Others feel them in their legs,

Still others feel them in their shoulders,

Neck,

Or head.

How would you describe these sensations?

Is there floating,

Rocking,

Or heaviness?

Is there tingling or pressure?

Is there warmth or coolness?

See if you can watch the sensations that you feel with a sense of curiosity without judging them as good or bad.

They're just there.

As you keep imagining your activity,

Breathe and soften into any of those sensations without judgment.

Remember,

These sensations are your nervous system's automatic responses to the task you picked.

They will not harm you and they do not mean you are in danger.

You are safe and just imagining someone else engaging in that task.

By imagining your task in a safe,

Comfortable environment,

You are using the power of your imagination to make the task easier.

By imagining your task in a safe,

Comfortable environment,

You are using the power of your mind to change your nervous system.

You are teaching your nervous system that it can engage in this task.

You are changing the neural patterns in your brain and deactivating your fear response.

This will decrease your symptoms.

Now,

You can gently let that mental image go.

Take a moment to breathe in and take inventory of your body.

Let's take three grounding breaths together to a two count in and a six count out,

Constricting your breath on the exhale so you can draw it out.

Ready?

Inhale,

Two.

Now exhale,

Two,

Three,

Four,

Five,

Six.

Don't worry if you don't make it to six.

You can inhale sooner if you need to.

Now take the next two at your own pace.

Now that you've done this,

Where are you at in relation to your baseline?

If you are at your baseline,

Fine.

If not,

That is also fine.

Take inventory of the sensations in your body at your new baseline for this next part of the exercise and let's continue.

Now,

Going back to the task we started with,

I'd like you to imagine it's you who is completing it.

Keep your body relaxed and your breathing even and natural.

Imagine there is a video camera recording you.

Watch yourself simply go through that position,

Movement,

Or activity.

Go ahead and do this now for a few moments.

While you are doing so,

I want you to pay close attention to the sensations in your body.

Has anything changed from your new baseline?

As you imagine your task,

If you are maintaining your baseline level of sensation,

Keep imagining your task and keep observing how you feel.

If you are noticing changes in the sensations in your body,

Take a moment to locate them.

Are they similar to how they felt a few minutes ago when you imagined someone else completing the task?

Are they weaker?

Are they stronger?

Are they completely different?

Whatever they are,

It's okay.

You're just noticing them for right now.

You can locate them in your body,

Whether they are in your torso,

Upper body,

Or lower body,

But it doesn't matter what the sensation is.

Just notice it without judgment.

You're just observing that sensation like you're watching a leaf fall from a tree.

Keep on imagining yourself completing your task and observe the sensations that come up in your body.

Remember to soften into whatever sensations you feel without trying to stop them.

You are safe and the feelings that come up,

If any,

Are your nervous system's automatic responses to the task you picked.

Isn't it interesting how our brain and body store these kinds of responses and release them even when we are not physically moving?

Notice if your mind starts to wander and bring it back to imagining your task.

Right now,

You are safe and comfortable.

By imagining this task this way,

You are changing those automatic brain responses and teaching your brain a new way of responding when you do your task.

Know that even though you are not physically moving,

There are parts of your brain that do think you are actually doing the task.

This work you are doing right now is re-wiring your brain with safe,

Healthy responses to the task you picked.

When you are ready,

Gently let go of your mental images.

You did very powerful work today with this graded motor imagery for dizziness exercise.

When you are ready,

You can open your eyes if they were closed and stop the exercise for now.

Reviews

Does this work for MDDS too? The symptoms don’t seem to change with the visualization the way they used to when I met the diagnostic criteria for POTS (which I don’t anymore). The sensations mirror MDDS even though it wasn’t motion induced.

Thank you. This helped reduce my symptons by about 85-90%. WOW... I will definatley keep this exercise handy. Thank you for sharing this for our benifit. 🥰

Dr Yonit Arthur, you are truly amazing! ❤️ Thank you!

This is powerful. I have long covid and therefore various associated neurological symptoms, including dizziness. During this exercise, I experienced similar sensations
to what I have with EMDR techniques (my abdomen and pelvic floor relax). I assume this exercise could help my other neurological symptoms and I’ll continue to practice it for them as well.

I am so excited to find these therapies. I have struggled with 3PD for many years and have recently had a terrible flare up. Thank you for adding to my arsenal of vestibular therapies!

Helpful!