TS and ADHD, Page 7

Duke Behavioral Therapy

The announcement by the Duke University Medical Center Clinic that therapists there have had significant success treating a nine-year old boy with a severe case of Tourette’s Syndrome, using behavioral therapy aimed at habit reversal, has generated reactions among some involved with TS ranging from skepticism to sarcasm and derision.

Rick Shocket has suffered so grievously with TS symptoms that his case might be referred to as debilitating. Among a host of other TS tics, the boy felt compelled to do deep knee bends between almost every walking step. The impetus of the therapy he was treated with at Duke was to have him become aware of the warning signs that precede his tics and then resist the urge to perform them.

Here is a quote from an Associated Press article:

“It's a controversial development. For decades, Tourette's patients have been told that tics are involuntary and that they should do their best to ignore them. Habit-reversal training, the type of behavioral therapy Rick does, preaches the exact opposite. It instructs patients to be hyper-aware of tics so they can learn to anticipate and suppress them.

"Duke has been a leader in establishing behavioral therapy as a treatment for children who have neurocognitive conditions such as obsessive-compulsive disorder.”

Patients with TS like this youngster are taught to “surf the urge,” which sounds much like the advice my older character in my story gives to the boy with a mild case of TS. He advises him to learn to “float” through repetitive thought patterns that precede the onset of his tics.

This development at Duke is of great interest to me. I have never understood why Tourette’s Syndrome was ever reclassified from a mental health issue to a “neurological disorder,” which seems to give the distinct impression that TS has some physical cause. If there was ever an affliction less likely to be attributed to some physical abnormality, I would think it would be TS; which, in my opinion, is nothing other than a variation of obsessive-compulsive disorder.

Although I might be able to be made to understand how some errant neuronal impulses within my brain were responsible for the head twitches and facial grimaces I had been afflicted with as a boy, for the life of me I do not see how anyone could attribute any physical cause to verbal tics (shouting inappropriate words at aberrant times) and tics along the lines that have afflicted this boy, such as his feeling compelled to perform deep knee bends for no discernable reason. Click to continue:

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