Motor tics are spasmodic contractions of muscles, which typically involve the face and are habitual. Examples include squinting of the eyes, grimacing, or even turning of the head. Sometimes motor tics involve muscles of the trunk, arms, and legs. Typically, tics begin between the ages of 5 and 10 years. Many tics are transient and improve with time, often during puberty. If motor tics persist for longer than a year and are also associated with vocal tics they can be diagnosed as Tourette’s Syndrome, which affects about 200,000 people in the United States. Vocal tics can cause throat clearing, grunting, repeated words, swearing, or even repeating what other people say (echolalia).
Tics can worsen with excitement or stress and tend to improve when patients are calm. Sometimes, tics are triggered by the environment such as when wearing a tight collar or hearing a certain sound such as nasal sniffing or throat clearing. Thus, teaching patients to avoid tic triggers can help reduce their occurrence.
Tics also can be treated with different kinds of medications such as those that block dopamine, lower blood pressure, or antidepressants.
Hypnotic stress reduction techniques can help reduce tic frequency significantly. Such techniques include imagining going to a relaxing place, relaxing from head to toe while in hypnosis, and deep, slow breathing that involves inhaling through the nose and exhaling through the mouth.
Positive talk can help calm tics. For example, “I would like my body to be peaceful,” or “It is comfortable when my eyes blink calmly.”
Specific imagery to help reduce tic frequency includes imagining turning a dial that controls the tics, flipping an imaginary switch to turn them off, imagining holding up a stop sign when the patient feels the tics are about to start, and locking the tics in a treasure chest and throwing the chest and its key into the ocean. Some people choose to place their tics in a filing cabinet during the days and to let them out at night, when they can tic in the privacy of their own home.
Hypnosis offers an attractive way of controlling tics rather than use of medications, which have the potential of causing undesirable side-effects.
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