Psychological treatments for Tourette Syndrome

There are several approaches that can help reduce tics. A few of the main approaches are presented in the sections below:

This is the best-known behavioural approach and is usually learnt with a psychologist. It involves increasing your awareness of when your tic is about to happen and practising a behaviour to stop the tic until the urge to tic reduces. This behaviour is called a ‘tic blocker’ or ‘competing response’. For example, sucking a sweet for a spitting tic, or pressing your hands against your side if you have a hand-waving tic. For sound tics, the most common tic blocker involves breathing slowly through the nose or mouth.

You will need to practise the competing response until your tic is better under control. It is sometimes difficult to find a competing response or tic blocker. However, the best approach will be the one that suits you and the tic you are working on.

You may need to make a different competing response or tic blocker for each tic.

ERP helps people learn to control their tics, and recognise that they can resist the urge to tic, until they get better at doing this. When they tolerate the urge to tic (known as a ‘tic signal’) they can find that the urge reduces or that they don’t mind it anymore.

This is a behavioural approach in which you and a therapist work out which places tics tend to occur most, and what happens after they occur. The psychologist will then work with you to try to find different ways to change this pattern. The triggers and responses to tics are sometimes surprising and unexpected.

For some people with TS, relaxation can make their tics increase, and for others it seems to help them decrease. You will only know whether it works for you if you try. Relaxation means different things to different people. For some, it may be listening to music and for others it might be lying on their bed. As stress is known to increase tics, relaxing might decrease stress and have a positive effect on tics.

Some tics only happen in certain places and seem to be triggered by specific things to do with that situation. For instance, some people find they only have a sniffing tic at the dinner table. It may be helpful to pay careful attention to what situations trigger your tics so that you can focus on changing this. Thinking certain thoughts might also increase the possibility of a tic and it can be useful to work out which thoughts might be doing this too.

For a long time, people did not know much about TS and did not understand the difficulties that are common in young people with TS. We now know a lot about TS, which makes it easier to describe to other people. There are many good books and organisations to help people with TS. Tourettes Action is a great organisation that has regular meetings, a website and a telephone line you can call to find out more information. Learning about your TS and sharing information with teachers, family members and friends can help to develop their understanding

If you would like a referral for behavioural therapy with a qualified health professional, it would be best to discuss this with your doctor or local child and adolescent mental health service (CAMHS) team. While psychological treatments are helpful for many people, there is no particular strategy that works all of the time, in all places and for every tic. It is also important to understand that tics are a special part of you and try to accept them as part of your life.