Psychological treatment of Tourette syndrome in Children, a treatment success!


Several months ago a Chinese mother form North China found me thru my Chinese weibo (Chinese Twitter) and brought his young son to me for treatment. Several years ago he was diagnosed with tic disorder, taking several kinds of medication to control his symptoms. He often at home and in few occasions in my room made loud meaningless loud sound, jerked and kicked with his feet involuntarily. 

His father initially was quiet and did not talk much but after few sessions told his side of story. His parents often quarreled in front of child, but interestingly when parents calmed down, child’s symptoms subsided. Child at times asked parents stop fighting or just get divorced! 

I begun with treating mom for depression, conducted couple, family and marriage therapy for few months and suggested that child to live in school dormitory for few months in which at end his therapy, child made a tremendous improvement in his symptoms in which only required very small dosage of only one medicine among many medicine he was on. I had phone call from parent’s year later stating child has no more symptoms and he was quite involved in school and having fun.

Tourette syndrome is a neurological problem with symptoms including involuntary movements (sudden brief or multiple movements in different parts of body including shoulder, hands, feet, face, head, etc.) and tics (a kind of low or high tone vocalization, sudden shouting or making sound, sniffing, rapid eye blinking, coughing and more).
Some of the symptoms of this syndrome such as involuntary movements could sometimes endanger patient’s life and might even result in physical injury or accident. 

Researchers indicate that cause of Tourette syndrome is due to partial changes in gene or it can occur during the development of fetus. It generally begins at age 6 to 10 and lasts for remaining patient’s life. In some patients the symptoms might subside in adulthood.

At this time there is not any medical cure for this syndrome and some of the medications that these patients end up taking are mostly to reduce the intensity of abnormal body movement and tic to some degree. The neurological causes of this syndrome include changes in brain structure and or abnormalities in brain chemistry. 

The psychological problems, which are often associated with this syndrome, are different in every child. They can include depression, anxiety, impulsivity, learning problem, OCD, ADHD, and more. Therefore, apart from medical evaluation, a psychological & neuropsychological evaluation of such patient by psychologist is very important to rule out any emotional or developmental difficulties associated with this syndrome as earlier as possible in order to start the treatment. Besides other disorders such as psychotic disorders and bipolar disorder also need to be ruled out.

Development of symptoms in this disorder and the intensity of movements and tics are very closely related to different forms of psychological problems mentioned above. These children may be quite sensitive, lonely, have low self-confidence, socially feel inferior and easily affected by their unique psychological problems and end up having more severe physical symptoms. Different degrees of anxiety, stress, depression, hyperactivity can trigger more severe physical symptoms. 

Symptoms associated with Tourette syndrome may also interfere in child’s education by affecting his attention, concentration, memory and occasional physical discomfort or medical emergency.

Children with this disorder can put tremendous stress on their parent’s life. If parents themselves are not psychologically well equipped; they end up of having emotional & marital difficulties, which will exacerbate these children’s problem with more and severe physical symptoms. Therefore, family and sometimes marital therapy should be part of holistic psychological treatment package for their parents. 

Dr. Mike Mehrvarz, Ph.D.
Child and Adult Psychologist