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Talk Therapy Can Help Control Tourette’s Tics

May 18, 2023

The outbursts and involuntary movements of Tourette’s syndrome are often embarrassing, but a tailored type of talk therapy can help patients control their tics.

Tourette’s, a neurologic condition affecting about 450,000 children and adults in the U.S., is believed to stem from chemical imbalances in the brain and/or disfunction of brain circuits that control movement, according to Benjamin Dorfman, MD, a movement disorders specialist with the Chase Family Movement Disorders Center, part of the Hartford Healthcare Ayer Neuroscience Institute.

“Genetics can also play a role in Tourette’s, which can be inherited as a dominant gene. We see it more in children because about half of patients may go into remission by early adulthood,” he adds.

Telling symptoms

The most common sign of Tourette’s syndrome, he continues, is motor and phonic tics.

“These are brief, sudden-onset, repetitive movements or vocalizations,” Dr. Dorfman says.

To meet the criteria for diagnosis, patients must have at least two motor tics and one phonic tic, although not necessarily at the same time. These must start before age 18 and cannot be linked to other conditions.

Tics, he says, are thought to be “semi-voluntary” as patients have some control over when they occur and can sometimes suppress them. Some common tics may include:

• Blinking or eye rolling
• Grimacing
• Shrugging the shoulders
• Jerking head or limbs
• Jumping
• Clearing the throat
• Grunting

Life-altering

Movement disorders specialists monitor each patient with Tourette’s for:

• The number of different tics they have
• How often tics occur
• How disabling or bothersome tics are
• Whether the patient can suppress the symptoms at will for a period of time

“Many tics can be subtle and not immediately obvious to others, whereas others may be more embarrassing or difficult to hide,” Dr. Dorfman says.

Treating Tourette’s

Various medications can be prescribed to control the symptoms of Tourette’s, including alpha-2 antagonists, dopamine blockers and other medications that block the excessive brain signals causing unwanted movement, he explains. Other treatments include anti-seizure medications, botulinum toxin injections or, in severe cases, deep brain stimulation surgery.

However, one of his favorite options for patients is a form of talk therapy called cognitive behavioral intervention for tics (CBIT).

“CBIT allows patients to capitalize on their ability to use their mind to reduce the frequency and intensity of their tics,” he explains.

Specially-trained behavioral health providers conduct CBIT with solid success. It can also help with other behavioral health conditions commonly found in people with Tourette’s, like obsessive-compulsive disorder and attention deficit hyperactivity disorder.