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Oh What A Tangled (Neural) Web We Weave: A first-person account of Tourette Syndrome (part 3, symptoms)

EDITOR’S NOTE: This multipart series first appeared in the March 2010 edition of the Journal of Clinical Psychology Practice and also can be found on Life’s A Twitch, a website run by Canadian psychologist Dr. B. Duncan McKinlay.

Symptoms feel opportunistic, too. Whenever I’m ill-equipped to bear the load — I’m late, tired or hurt, there they are, right on cue. Tics are also not above taking advantage of a situation – knowing I mustn’t do a particular tic at a particular time virtually guarantees its expression.

Growing up this was interpreted as “obvious” game-playing on my part. To me it was blatant persecution – first from a malevolent inside, and then from an uninformed outside. No wonder I was anxious and paranoid. A malicious demon resided within, reading my thoughts (particularly ones concerning what not to do) and using them against me. And no wonder I reacted so viscerally when confronted with my behaviour – it was a suggestive buffet for this demon, a sadistic “set-up” I would surely also be held responsible for later.

The vast majority of my tics are comprised of routine and simple things – blinking, head movements, throat-clearing. Things which occur in a stereotyped fashion countless times per day in everybody – often it is only the lack of context for the thing that I do, and not the thing itself, which defines its abnormality.

I can distinguish between “older” and “younger” tics in my repertoire. The former appear embedded in all that I do and are more difficult to suppress, whereas the latter seem more constrained to specific situations (e.g. standing in the garden whilst holding a water hose) and are easier to “nip in the bud” than their less selective elders.

Each emergence of a particular tic emboldens it and increases the sense of inexorability; left unchecked in a day it builds to a frenzied fever, urge and tic melding into one. Yet each morning I awake peaceful, as if a “reset” button has been pushed. It makes me not want to rise. Each urge-tic dyad lies in wait for some unknown flag to drop; the first pair out the starting gate “wins” dominance for the day.

Doing so increases their odds each time for the next day, in a cumulative fashion. One day a different dyad somehow jostles position, establishing their temporary front-runner status and increasing the chances they will reign supreme in the days to follow. In this way symptoms change over time.

Tic-free periods occur, too. It’ s not distraction that produces them: I can be wholly aware of the absence of my tics (even explicitly present on that very topic), yet their absence persists. I’ve noted these moments occur during highly complex tasks requiring considerable investiture from me – presenting, assessing, juggling or drumming.

It’ s almost as if my tics serve as pressure valves: with all energy channelled to constructive pursuits, their function is momentarily unnecessary. However, even a fleeting pause (e.g. to listen to an audience member’s question) creates enough discrepancy between energy and activity for tics to fill the void.

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