Severe vertigo is a vastly distressing symptom, and understandably may give rise to acute anxiety. But such anxiety is secondary to the disease and is based on the reality of disturbed equilibrium. This paper deals with a different sort of anxiety, anxiety which precedes and is the cause of the symptom of vertigo instead of being its result. It is based on neurotic conflicts which are unrecognized by the patient. For the physician to be aware that such a condition exists and to be able to recognize it is of great importance, for not only can it be seriously, even totally, disabling, but it will obviously not respond to the usual medical or surgical procedures. In fact, prolonged and unsuccessful otological treatment may even result in fixation of the neurotic symptom.
Though fairly common, it seems to us that vertigo of purely psychic origin has not received sufficient attention from