Recalibration™
“Where?”
— Another perspective, Part 1 — Using PPPD as a reference —
Considering sensory weighting and postural control
So that dizziness is not dismissed as “nothing”
From many years of clinical experience, I hold deep respect for these medical advances.
At the same time, even when imaging reveals no clear structural abnormality, dizziness and unsteadiness can make walking, eating, or going out difficult, significantly impairing a person’s daily life.
A clinical starting point
Applying today’s diagnostic criteria retrospectively, it is not possible to diagnose that patient with PPPD.
Nor is this experience used as evidence of the medical effectiveness of PPPD or Recalibration™.
However:
• Never treating a patient’s dizziness lightly
• Never judging their suffering solely by the presence or absence of imaging findings
• Never closing a patient’s experience with a diagnostic label alone
These attitudes remain one of the clinical foundations that continue to this day.
A new shared language introduced in 2017
Symptoms such as floating sensations, unsteadiness, and non-spinning dizziness persist for more than three months on many days, and typically worsen with:
• Standing
• Moving the body or being moved (e.g., in vehicles)
• Viewing moving or complex visual stimuli
The name PPPD and its international diagnostic criteria were published in 2017.
However, these symptoms did not begin in 2017.
Before that, overlapping conditions were described under different names—phobic postural vertigo, visual vertigo, chronic subjective dizziness, and others.
The name is new, but the symptoms patients have long experienced are not.
This shared language has great significance:
It opened a path for recognizing and studying unsteadiness that cannot be fully explained by imaging alone—without dismissing it as “nothing.”
A diagnostic name is progress.
But having a diagnostic name does not mean the person’s problem has been solved.
The significance of diagnostic criteria—and the questions that remain
At present, there are no physical findings, test values, or imaging results that are uniquely specific to PPPD.
At the same time, PPPD is not a diagnosis made by exclusion such as:
“Nothing abnormal was found on tests, therefore it must be PPPD.”
Examinations are necessary to identify other diseases, triggering conditions, or coexisting disorders.
But this boundary does not mean that a clear line existed within human bodily sensation from the beginning.
A person who slightly falls short of the criteria may still have significant problems.
Conversely, meeting the criteria does not fully explain the mechanisms by which symptoms arise and persist.
• Being able to classify
• Being able to explain a pathophysiology
• Being able to determine appropriate support
These are separate stages.
Whether PPPD represents a single unified mechanism or includes multiple states that lead to similar symptoms remains an unresolved question in the original diagnostic publication.
The question of sensory weighting
The degree to which each is used changes depending on lighting, ground conditions, body movement, and visual environments.
Research on PPPD examines whether functional changes in postural control, multisensory processing, spatial perception, attention, and threat evaluation may contribute to symptom development and persistence.
However, the mechanism is not singular.
“Sensory weighting” here is not a single answer that explains all patients.
It is one question for considering how visual, vestibular, and somatosensory inputs relate to a person’s posture and sense of stability.
Between being able to diagnose and being able to determine support
Some individuals experience reduced symptoms or improved daily functioning.
However, research continues regarding:
• Which individuals benefit from which methods
• In what order
• And in what combinations
A 2023 Cochrane review found that, when strict PPPD criteria and adequate follow-up periods were required,
no eligible comparative trials existed for medication, and only very limited trials existed for non-pharmacological treatments.
A 2026 network meta-analysis included more studies, but also incorporated related conditions considered PPPD-like;
across 11 trials with 518 participants, many studies had high risk of bias, and evidence quality was rated low to moderate.
• It is not that there are no treatments.
• But it is not the case that diagnosis automatically determines a single optimal treatment for all individuals.
Understanding and support after diagnosis remain in development.
Relationship with Recalibration™
It is not a method for diagnosing or treating PPPD.
It does not claim that PPPD proves the medical effectiveness of Recalibration™.
Nor does Recalibration™ attempt to fill unresolved medical areas with new definitive assertions.
Recalibration™ brings this question closer to everyday bodily sensation:
• Not assuming that what you feel is abnormal
• Not dismissing what you feel simply because no structural abnormality is found
• Revisiting how you feel your body now, without rushing to judgment, while receiving necessary medical evaluation
• Not closing the problem with a diagnostic name, but keeping open the questions that the diagnosis reveals
PPPD is one important reference point for this.
The next page introduces the evolution of MUS (Medically Unexplained Symptoms)—a perspective that values both your “mind” and your “sensations,” offering a contemporary view of neurological conditions.