TIC TIC TIC - All About Tourette Syndrome
Tourette Syndrome (TS) is a neurological condition which results in uncontrollable repetitive movements or unwanted sounds - we call these behaviours tics. Tics can be simple (single movements like a shoulder roll or a grunt) or complex (eye raising with a head nod and a leg kick, full sentence vocalisations). TS is typically first noticed in children from the age of 6-8 years and can increase in intensity during adolescence. Many people believe TS to be an anxiety disorder – however whilst symptoms can become worse during times of stress, it is actually classified as an impulse control disorder. People with TS describe the disorder as debilitating, embarrassing and often struggle to engage in everyday, regular activities as a result of their tics. It can be very distressing for kids and parents alike when the individual becomes overcome by the uncontrollable movements associated with their disorder, sometimes for hours on end.
What does TS (and its related disorder Tic Disorder) look like? TS and Tic Disorder might be difficult to detect, but the types of behaviours you would tend to see include behaviours that parents and kids describe as repetitive, annoying, ritualistic, and uncontrollable. They may look like OCD or Autism related behaviours (stimming), with many non-sufferers believing that the person with the tics has some kind of conscious control over them. It’s really important for parents and carers to understand that tics are completely uncontrollable – they begin with an overwhelming urge to perform the motor (or vocal) movement, and result in the action taking place, and relief being experienced. This is different to stimming (as in ASD), which results in pleasure/comforting, and OCD compulsions – which feel purposeful and feel safety related.
Let’s do a little exercise – just to see what it is like to experience an uncontrollable urge that HAS TO HAPPEN. I want you to stare straight ahead, for as long as you can, resisting the urge to blink for as long as you can. When you finally do blink, what do you notice? Did you feel like you had control over the movement? Did you feel a sense of comfort or relief? Was the first blink quite pronounced followed by a flurry of blinks? What were you thinking during the exercise? This experience is very similar to what someone with TS or Tic Disorder experiences – a strong urge followed by uncontrollable movements AND relief now that the urge has resulted in a completed action.
Whilst TS and Tic Disorder can have a big impact on people's lives, there is definitely hope!!! - So how do you get help for TS or Tic Disorder? The first port of call for help is through your GP, who can make a referral to access psychological intervention. In Australia your GP should be able to provide you with a Mental Health Care Plan, which can be used to subsidise sessions with a Psychologist. Psychological therapies are proven to be very successful in treating both Tourette Syndrome and Tic Disorder and are the first line of treatment before we try medication intervention. The Gold Standard treatment is known as Comprehensive Behavioural Intervention for Tics (CBIT) and has proven to be effective in many cases in just 6-8 sessions. The therapy is a combination of behavioural and some cognitive strategies designed to give the person control over their tic behaviours. Clients report the treatment to be validating, collaborative and effective, with many describing it as a “miracle cure”.
Successful application of CBIT requires the therapist to have participated in some form of training in this specialised treatment frame-work so it is very important that you make sure the therapist you are referred to is appropriately trained. If you are seeking support for your child I encourage you to ask specifically if the therapist has attended or is formally trained in CBIT and whether they have access to a Supervisor familiar with TS and Tic Disorder.
With help people with TS or Tic Disorder can gain control of their bodies and feel like they can live normal lives.
Yours in good health,