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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