A twitch, a bark, a swear, a jerk, a hum. Unprompted. Sounds like crazy behavior, doesn’t it? I used to be disturbed, as a young, reactive child, by such bodily functions. Why are these big, scary people humming, muttering, distorting their faces for no perceptible reason? The unknown was looming and terrifying. I stuck to my mom and twin.
My twin actually developed a tic before I ever did. We went away to an Appalachian girls’ summer camp for a few weeks as preteens and were placed in different cabins. I’d slept in the same bedroom as my sister since birth; I knew well what it was like. I was aware that she hummed inadvertently when stressed. A quick, soft, spurting hum, like a mouse clearing its throat. It could happen in clusters or just once, softly in the night. I overhead, one mid-afternoon, a group of girls gossiping about my sister’s humming, how “annoying” it was. I burst onto the scene, arms crossed. “She can’t help it guys, it’s a vocal tic!”
I was right, even if I was just verbatim repeating something my mom had said. Tic disorder, most commonly comorbid with Tourette’s Syndrome, is defined by repetitive, spasmodic motions or sounds that sufferers unwittingly and/or helplessly engage in to relieve stress. They’re most common, overwhelmingly so, in children and teens. Most adults kick the habit (can’t wait!). There is a distinction between OCD and Tourette’s Syndrome, but the overlap is considerable and there is a diagnosis in the new DSM-5 titled tic-related OCD.
I have a lifelong set of tics that have come and gone, swapped between themselves, and varied in severity. When my PTSD symptoms were most acute, I developed a twitch and need to flex my muscles in my thighs, shoulders and neck. I’d do this several times an hour; it was as if an egg cracked down my body in the way the flexing would travel through my muscles, mildly disturbing to anyone who happened to be watching in those brief moments. Eventually, those muscles would become so sore I’d hardly be able to move them, and I’d move onto my wrists and hands, flexing and writhing them. Once those were too sore, I’d switch back to my more central muscles. Back and forth, always something.
More lifelong tics of mine, and ones that overlap most with OCD, are my facial tics. A common element of OCD is performing a compulsion that needs to be done “just right” in order for it to cease. My picking disorder and symmetry related symptoms are like this, most acutely. Physical tics are like this, too: performed to satisfaction. My facial tics are definitely the most perturbing and sometimes grotesque, and they aren’t commonly activated but when they are (once every few days, or so) they’re hard to stop.
My nose. I crinkle my nose as hard as I can, over and over. It appears as if I’m attempting to pinpoint all of my facial features down to just my nose, squeezing them all towards the central point of my face. My ankle. I twist and turn my ankles until they’ve been twisted and turned just so. My eyes. I slam my eyes shut harder, harder, harder still, until I release them, tearful and sore. My brow. When it occurs to me that I need to crinkle my brow, I do so dozens of times in a matter of minutes, each time more forcefully until I’m finally so desperate to most forcefully and satisfactorily crinkle it that I press the palms of my hands, hard, into my eyebrows to stop them from moving and to apply the pressure I hope will alleviate the desire. It usually does, but not without the accompanying distress of feeling out of control of one’s own facial features. It’s a scary, helpless sensation, and when you add the embarrassment when it’s performed in public, having facial tics, or any tic, is a destructive ordeal.
I actually know an abundance of people with tics (I naturally would; it affects around 1% of the population). A guy I know barks at unexpected, stressful moments. A girl I met in treatment hummed, like my sister. A close friend of mine has Tourette’s, and she bounces and kicks, among a plentiful list of things. Recently, this friend and I were seated at an event behind an older man and his son. My friend, try as she might, could not stop herself from bouncing in her seat. The man apparently detected this movement, turned in his seat, grabbed her ankle, and exclaimed “stop kicking my seat!”
If I’d been there (I was off getting drinks), I would have vehemently launched into a tirade about accepting those with Tourette’s at this man, but as it was, she apologized profusely and she and I swapped seats when I returned. What this occurrence, and the youth camp incident, exemplify to me is that watching others in distress, unable to control their own movements, is inherently scary to most. As a result, “most” lash out or are repulsed by those who can’t control their bodily functions. This extends even further into the very concept of the perception of mental illness at large; seeing folks helpless induces secondhand fear and disgust in others, naturally, others who don’t or can’t understand what it’s like to be the sufferer.
As is the case with most of my explanations of more obscure mental disorders, I would encourage you to try to imagine what your life might be like if you, with all else being equal, sometimes couldn’t control your facial movements when you got a bit stressed. Imagine the humiliation and helplessness that comes with that. Next time you see someone going through what you suspect may be tics, keep such a projection in mind.