Vertiges (1989)
A short but clinically very dense work published by Éditions Ergo Press in 1989, in which Tomatis tackles head-on one of the most mysterious pathologies of otorhinolaryngology: Ménière’s syndrome. The thesis is striking: what is taken for an organic disorder of balance is in reality a disorder of communication. By teaching patients to listen, they are released from their vertigos. This discovery leads Tomatis to overhaul the physiology of the ear — which he describes as the “vibrating antenna of life”.
“Vertigo suppresses balance and provokes unbearable tinnitus. Brought on by a relational difficulty, by a lack of communication with the family or social environment, or by an internal suffering left unvoiced, such a malaise must be the object of a study that goes far beyond the framework of a simple functional disorder.”
— Back cover
Presentation
Ménière’s syndrome, described in 1861, is one of the most uncomfortable diagnoses in ENT: bouts of rotatory vertigo, tinnitus, hearing loss, nausea. Classical medicine relates it to an imbalance of the labyrinthine fluids (endolymphatic hydrops), without knowing precisely its origin nor possessing any satisfactory treatment. Tomatis, in the course of his practice, makes an unexpected observation: patients submitted to a protocol of auditory education (Electronic Ear, integration of filtered high frequencies) see their vertigos disappear.
Whence comes this effect? Tomatis traces his way back to the classical auditory physiology of Békésy — crowned by the Nobel around 1960 — which he judges incomplete. For him, sound does not attack the inner ear only by way of the ossicular chain; it attacks it through the whole bony system, the entire skull serving as a resonator. The academic distinction between balance (the vestibular ear) and audition (the cochlear ear) is, for Tomatis, partly artificial: it is the same ear that orchestrates both functions, and it is the global quality of listening that determines postural stability.
The work unfolds this thesis in seven precise chapters (contents below) that combine physiological reminders, clinical vignettes and therapeutic perspectives. Tomatis does not claim to cure every Ménière, but he opens a new therapeutic path, to be explored in complement to the classical treatments.
Contents
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Foreword (p. 3)
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Introduction (p. 6)
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How does Ménière’s present itself? (p. 10)
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What is the human ear? (p. 22)
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How does the human ear function? (p. 41)
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Vertigo and the psyche (p. 67)
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What to do in the face of vertigo? (p. 77)
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Conclusion (p. 85)
Place in the work
Within Tomatis’s production, Vertiges holds a particular place: it is the book in which Tomatis, almost in spite of himself, ventures onto the most contested terrain of academic ENT. He mobilises here the whole of his original medical expertise, but only to subordinate it to his audio-psycho-phonological perspective. The book thus functions as a manifesto: “he has stood man up on his ear”, says the back cover.
In brief
To be recommended to ENT specialists, to osteopaths, to specialised physiotherapists, and of course to every person suffering from recurrent vertigo — Ménière confirmed or not. The reading is dense but brief (87 pages); the clinical contribution is considerable. The work usefully recalls that the human ear is not only an organ of audition; it is the vibrating antenna of communication as a whole.
Available in libraries — BnF, Sudoc.