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How to Define Tourettes Disorder?

The definition of Tourette Syndrome has changed over time and is not fixed from one person or clinician to another. A definition is intended for clarity among clinicians and researchers. One patients or clinicians definition may not not represent a "thing" that you have.

Tourette Syndrome as defined close to diagnostic criteria (DSM-IV-TR) for Tourette's Disorder could be “Tourette Syndrome is a neurobiological condition resulting in motor and vocal tics.” - tsnowwhat

Some recognize Tourette's as a spectrum disorder, “…with some people having a few tics and others having tics plus features of other (comorbid) conditions such as obsessions, compulsions, inattention, impulsivity, mood variability.” - Leslie Packer PhD

There are those that feel “…Tourette Syndrome rarely exists in isolation and is part of a global neurological dysfunction, which includes but is not limited to tics, and dysinhibition. Where does one draw line? Is “this” a symptom of “Tourette Syndrome” or is it part of “ADHD” or “OCD” or, as does it really matter? Tourette Syndrome is… something more akin to “cross wiring” and reality being that daily function requires one deal with what is thrown at one regardless as to what it is called." - Colleen Wang, Tourette Spectrum Association Inc.

Here again is also a great perception and explination of Tourette Syndrome. "Tourete Syndrome is not a disease, it is a syndrome, a cluster of recognizable patterns. There are no tests for it. The diagnosis is by history and observation only, and boundary is fuzzy. No one has decided how many tics a day are necessary to call it a tic disorder. (Spitting 3 times in school, for example, will probably result in a phone call, whereas 10,000 eye-blinks won't!) Although tics are often described as "rapid" or "sudden," not all are; some tics are "held" or "tonic" movements involving freezing in a position for a few seconds. "Purposeless" is another descriptor, but because many tics are preceded by an uncomfortable feeling to which tic is a response, this word also isn't very satisfactory. The definition is simply a multiple, changing pattern of tics (not necessarily at same time) for at least 12 months, including at least one noise-making tic. (There is no requirement for severity or impairment.) You can have TS and function normally." - Roger D. Freeman, M.D

Reflecting more than 25 years of research; two of leading international authorities on Tourette’s Syndrome and tic-related, obsessive-compulsive disorders narrarate Tourettes this way. "Tourette Syndrome was considered rare and exotic at one time (however now,) Tourette's syndrome is a relatively common childhood-onset disorder defined by persistent motor and vocal tics and frequently associated with obsessions, compulsions, and attentional difficulties." - James F. Leckman, Donald J. Cohen of Yale Child Study Center.

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As you can read all above oppinions and descriptions vary in definition. Regardless, they will all have similar goals for a Tourette patient. They want a Tourette patient to have support and information they will need to deal with Tourette Syndrome and or any other disorder they experience. The ultimate goal would be for patients and families to live happy and productive lives with joy to best of their abilities.

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Finally a very important subject to understand is; many people diagnosed with Tourette’s Disorder may have a variety of other conditions that they deal with. Nonetheless, Tourette’s Disorder is by DSM-IV-TR definition listed under Childhood / Adolescent,Tic Disorders and characterized by involuntary body movements and vocal, outbursts. Though DSM categorization is under Childhood / Adolescent, Tic Disorders, don't misunderstand this categorization, as it is based on age of onset and diagnosis.

Continue to an in depth Diagnostic Criteria here or jump to our Tourette Information pages here.

Paul Marshall editor@tourettes-disorder.com

http://www.tourettes-disorder.com

Meditative Approach

The first technique I would like to share is first one I discovered as a child with osteomyelitis. And that was to simply focus all my attention on pain, in as relaxed way as possible. The pain became a focus for a form of meditation, whereby it is observed dispassionately for what it is.

Synesthesia

An extension of this technique (and best carried out in a light trance in my experience) is to observe pain as a sensation, and then observe it as one would see it if it had a physical existence. What shape is it, what colour, what texture, what movements does it make? Where is it, does it move quickly or slowly? Don't worry if this seems difficult, don't put too much effort into it – make it up! The important thing is that image you are working with is a metaphor for your pain, and as such, it makes sense to your unconscious mind.

The next stage is to move representation of pain outside your body, where it is easier to observe. Continue to examine it from, say, two meters in front of you. Now become aware of any sound it might make. What pitch is it, how loud is it and so on?

Now we can start to change some of qualities of representation. We can make it smaller or darker for example, or change colour(s). Alter way it moves, change it's position. Change sound; turn whole thing up side down. As you experiment with this, notice which changes cause changes in pain. Finally, when you are satisfied with changes you have made you can either send whole thing off into distance over horizon, or you can put it back in your body in a different location where any discomfort might be more manageable or simply turn it upside down and put it back so it cancels out original pain.

Increasing Energy

The debilitation caused by pain leaves us depleted of energy. Very simple visualisation exercise can help combat this. Put yourself into a very relaxed state and focus on breathing. Imagine a golden ball of light around your body, that you can both hear and feel vibrating. Spend some time experiencing this, sensation of vibration on and through your body, sound of vibration as a gentle mixture of harmonies weaving together.

Now, simply become aware that as you breathe in, you take in energy. The golden light gets brighter, harmonies louder and richer and vibrations stronger. As you breathe out, waste and tension are expelled, so light gets clearer, harmonies more harmonious and vibration serves to further relax and massage your body.

These techniques are simply presented as an introduction to idea of taking control of your experience of pain. They are not "NLP" or "hypnosis" techniques, and they are not necessarily sorts of work I would do on a consultation. I don't know how successful you have been with techniques discussed in this article, but I do know that you have embarked on a quest to explore nature of your own relationship with experience. And that is key. Successful pain management is less about a practitioner intervening and taking away your pain, and more about you understanding and gaining control over factors that influence your pain.

Adam is an NLP practitioner and Hypnotherapist, as well as a mental health nurse with over a decades experience. He is passionate about the use of language to effect change, and about the ability of people to maximise their own potential.