Tics

Short Description

The "cure" for tics and stuttering is the same -- practice doing it right after you stutter or have a tic. (one person's experience)

Will This Work?

Probably. Dr. Levine has treated approximately 12 people for tics. The treatment failed on only two. These were both elderly ladies, at least one of whom for which the tics were presumably brought on by medications she were taking.

Otherwise, you get either (1) an immediate cure; (2) an immediate reduction followed by a quick cure; or (3) a slower process of curing all of the tics.

Will This Completely Eliminate the Tics?

Yes. In all 10 patients for which this worked, the tics were eliminated. One patient went from 600 tics an hour to 0 tics, in one week.

Examples

For Dr. Levine's first patient, there was a marked reduction in the boy's tics during the first session. Dr. Levine sent the boy home with instructions to continue the treatment. There was supposed to be a second session, but the mother cancelled it because the tics were gone.

An example of a relatively slow cure: One girl had whole body tics that completely disrupted her social life. After these were cured, she still had a smaller facial tic. It could be that this smaller facial tic spontaneously appeared, but Dr. Levine suspects it was always present but it was masked by the larger whole body tic. Anyway, this smaller tic was cured with the same treament. The girl was then tic-free, she had a normal social life, and feedback years later found she was still tic-free.

The Actual Treatment

Dr. Levine's treatment is this: When a tic occurs, repeat the tic 10 times. Don't do this "practice" in public; just doing this at home is fine (and the recommended treatment).

It is important to do the practice right after the tic occurs. The idea of just practicing the tic, without waiting for it to occur, is called "massed negative practice" (see ref., or ref.). Dr. Levine calls his technique "contingent negative practice". Simple "massed practice" can help, but apparently takes a lot longer and is not as effective: "Patients have shown some decrease in tic frequency, but the long-term benefits of massed negative practice are unclear." (ref)

There is nothing magical about the number 10. Perhaps more would be better; perhaps less would be sufficient. But in the absence of any reason to the contrary, you should probably do 10.

An "accepting" attitude probably helps. If practicing the tic makes it go away, it follows somewhat logically that a contributing factor to the tic occurring in the first place was that the person was fighting against the tic. Hence, accepting the tic might be useful. Along similar lines, there are suggestions that tics are increased by anxiety, and that the fear of having a tic might increase anxiety. So it is useful to disrupt this feedback loop by taking the anxiety out of the tic.

Do It!

It's a no-brainer that you should try this treatment. It's free. It's simple and easy. There are no known risks and no expected risks. If it doesn't work, you can simply stop. The alternatives are not that attractive. Drugs have undesirable side-effects which can be worse than the tics; other behavioral treatments promise only a reduction in tics.

This treatment might sound backwards or crazy. According to the current theories of our culture, you should practice the behaviors you want to perform. While this is true, it is a shallow understanding of skills, practice, and attention; in particular, it ignores the value of practicing behaviors you do not want to perform.

So, you should try this even if it does sound crazy. When the treatment works, you won't care why it works. But if you care, Dr. Levine suspects that practicing the tic also makes it aversive, and click here for a discussion of why practicing undesirable behaviors can help.