A tic is a sudden, repeated movement or sound: blinking, shoulder shrugging, throat clearing, sniffing. Tics are common in childhood and usually fade. When several motor tics and at least one vocal tic persist for more than a year, the diagnosis is Tourette syndrome.
Tics are not deliberate and not a sign of bad behaviour. They are neurological. But they are not entirely beyond influence either, and that opens the door to behavioural methods, including self-hypnosis.
How tics work
Most people with tics describe a premonitory urge: a build-up of tension or an uncomfortable sensation, relieved for a moment by the tic. It has been compared to the feeling before a sneeze.
Tics also change with circumstances.
- They get worse with stress, excitement, tiredness and being talked about.
- They ease during absorbing activity: playing music, sport, a favourite game.
- They can be held back for a short time, at a cost in effort.
Those two facts, the urge and the effect of absorption, are what behavioural treatments use.
The recommended treatment
The best-evidenced non-drug treatment is Comprehensive Behavioral Intervention for Tics (CBIT), built on habit reversal training. It has three parts:
- Awareness training: learning to notice the urge and the earliest sign of a tic.
- A competing response: a small, discreet movement that makes the tic impossible, held until the urge fades.
- Managing triggers: changing situations that make tics worse.
Two large randomised trials, involving 248 people aged 8 to 69, supported it, and American, European and Canadian guidelines list it as a first-line treatment where available.
Many mild tics need no treatment beyond understanding and reassurance.
Where self-hypnosis comes in
Access to CBIT is limited, and it takes several sessions. Researchers have asked whether self-hypnosis could offer a quicker tool.
In a 2010 study, two American paediatricians taught self-hypnosis to 33 children and teenagers with Tourette syndrome, aged 6 to 19. Each first watched video clips of a boy with Tourette before, during and after his own training. They were then taught individually.
79 per cent achieved enough improvement in tic control to report being satisfied with the technique. Most needed only a few sessions.
This was a case series with no comparison group, and the outcome was the participants’ own satisfaction. It cannot show that self-hypnosis works as well as CBIT, or better than nothing. It does suggest it is worth proper testing, and that children take to it readily.
Why it might help
- Relaxation. Tension and stress make tics worse.
- Absorption. Tics ease when attention is fully taken up, and hypnosis is absorption on purpose.
- Awareness. Noticing the urge early, the first step of habit reversal.
- Imagery of control. A dial, a switch, a “stop sign.”
- Confidence. Finding there is something you can do.
What it looks like for a child
- A favourite place or activity, imagined in detail.
- Noticing the urge as a signal.
- An image for control: turning down a dial, pressing a pause button, a traffic light changing to red.
- Letting the urge pass like a wave.
- Short daily practice, a few minutes at a time.
Realistic expectations
- Self-hypnosis does not cure Tourette syndrome.
- The aim is fewer or less disruptive tics, and less distress about them.
- Tics come and go naturally, so a good spell is not proof of anything, and a bad one is not failure.
- Suppressing tics all day is exhausting and not the goal.
What helps most at home and school
- Do not tell a child to stop. It increases tension and usually makes tics worse.
- Do not punish or tease.
- Ignore tics where you can.
- Tell teachers, so the child is not disciplined for them.
- Reduce stress and tiredness.
- Explain it to the child in simple terms: “Your brain sends extra messages to your muscles.”
When to see a doctor
- Tics that are painful, cause injury, or interfere with school or daily life
- Tics that distress the child
- Sudden onset of severe tics
- Difficulties with attention, obsessions or compulsions, anxiety or mood, which often come with Tourette and may matter more than the tics
Ask about CBIT. If you want to try self-hypnosis, look for a health professional trained in hypnosis with children.
For adults
Tics often improve after the teenage years but can continue. The same principles apply, and CBIT has been tested in adults.
The bottom line
The recommended behavioural treatment for tics is CBIT. Self-hypnosis is a promising, quick-to-learn addition that uses the same ideas, with early evidence that many children find it helpful.
Next in the series: Hypnosis for Asthma, Habit Cough and Breathing Problems
This article is for general information and is not medical advice.