Where Tics and Compulsions Meet: TS Plus OCD

Now lets throw more uncertainty into the simple blowing on the back of the right hand.  Perhaps this tic or compulsion is linked with another behaviour.


For example, the person has established that the blowing on the back of the right hand is a tic but immediately after performing the tic they are compelled to do it over until it feels just right.  Now the behaviour may be motivated by anxiety and the following act is a compulsion.  So the person blows on the back of the hand twice, once performing a tic, the second time due to a compulsion but both times in the exact same way. Alternatively, it may be the opposite, where the initial act is a compulsion which then triggers the tic.

And to make it more confusing, it may not be the exact same behaviour, it may be any other tic or compulsion. For example, the person may be compelled to jiggle the door handle to make sure it is locked and then perform a tic by knocking on the door. The combinations may be endless and the compulsions and tics may interact in very intricate ways.

So why may it important to distinguish a tic from a compulsion?

Sometimes it may not be. If the tic or compulsion is not intrusive, disruptive or bothersome to the person performing it, knowing the motivation for the behaviour may not be important to them.  If the person is bothered by the act, motivation is important in terms of modifying or extinguishing the behaviour.

Obsessive compulsive disorder may be treated using Exposure and Response Prevention, (ERP) and Cognitive Behavioural Therapy, (CBT).
Tics may be treated or modified using Cognitive Behavioural Intervention for Tics, (CBIT).
Both of these therapies require gaining insight about the motivation that drives the behaviour and thus determining whether it is a tic or a compulsion.  The insight lays the groundwork for the appropriate behavioural intervention. But, not only is knowledge and understanding  important for therapy, it helps us to better understand who we are, how our brains work and why we do what we do which will contribute to our overall self awareness and emotional well being.

Here is a short example of tics and compulsions interacting….

For information how Tics and Compulsions manifest in Coprolalia see:  Coprolalia Part 1:  The Nature of Coprolalia

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2 thoughts on “Where Tics and Compulsions Meet: TS Plus OCD”

  1. Dear Sir,
    I suffer from an early age of obsession with involuntary movements (moving the chest muscles, shortness of breath,shoulders, eyes , neck …) with other movements since the age of 10 or less and it reached the maximum at the age of 15 years till now , I am now 45 years do not use any current treatment because I am tired of medicines for several years ago, I have a girl in the tenth and son in the eighth began to show the same symptoms, even less frequently in the boy more than a girl, I am afraid that they are same case like me and they will suffer the same as what I suffered.. Does the second generation same like parents I hope to get an answer from you if allowed and possible detail Perhaps there is hope that they are not as complex as I am ..thank you very much respect ..

    1. Abbas

      Since TS and the associated disorders are hereditary traits, I’m not surprised to hear your children also show signs of them. Don’t fear that they will have the same experiences as you. You, their parent are already knowledgeable and understanding of the disorders and are more equipped and willing to offer support to your children. As well, you can model coping strategies for them. With your support behind them, they will be stronger and better prepared to face their challenges. Best of luck, and sorry for the late reply.

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