Life's a Twitch - Dr. B. Duncan McKinlay (Archives

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Life's A Twitch! ®

Question 104: Dear Dr. Duncan, I am a mental health professional. I read your story in the Reader's Digest of July 2004 and immediately went to your website. It is a wonderful website and provides extremely useful information. In am writing from Calcutta, India, and very little information on TS is available here. The reason for my sending this mail to you is the following:

About two months ago, a 29 year old female was referred to me for psychotherapy. She was reportedly suffering from OCD. The symptom was that she has an irresistible urge to insert her finger in her right eye. She has this symptom from age 12 and has been treated by the best psychiatrists both in America and India. Nothing has helped her beyond temporary relief. She also is on drugs for epileptic seizures which are controlled now. The girl has lost sight in her right eye and has also damaged her left eye. The symptoms decrease or increase in intensity from time to time. She does this mostly in bathrooms or places where she cannot be observed. She also has an urge to scream loudly and when she does that her mouth becomes distorted. Somehow I became a bit skeptical about the diagnosis of OCD. Her personality does not have any perfectionist trend, the anxiety-reduction after completion of the compulsive act is also not present. I am aware that it may not be present in all cases.

My questions are:
a. Is it possible that the symptom this girl is suffering from is TS and not OCD?
b. Could it in any way be related to her epileptic seizures?

Even before reading your story, in last week's session, I advised her to be aware of her urge and immediately to do something which will make her hands inactive, like putting her hands in a pair of gloves etc. I would like to help. Any suggestion will be hightly appreciated. With thanks in advance, PM.

Response

Question 99: Just wanted to ask for a little assistance with a young fellow...we're looking for some advice to help him transition into a new school. We want to be as helpful as we can and give them some suggestions....I thought of you and if you might have some good ideas. [He] has a real problem with transitions and new things so the move will have some impact on his behavior but we want to be as pro-active as possible. Anything you can send or direct me toward would be good. Cheers, C.M., NS, Canada.

Response

Question 96: My son was diagnosed with full blown TS and symptoms of ADHD and OCD when he was 6 yrs old (now 7). He also experiences bouts of rage and when he is emotionally "hurt" he will verbalize the desire to do violent things. I don't really believe he would ever do what he comes up with but...he is currently on Luvox and with the more recent light shed on the possible conection with odd behaviors and SSRI's I'm seriously reconsidering giving him the med. His rages have greatly decreased since his diagnosis but I think that has more to do with our acceptance of him and his natural developement than any med (in the last 11 months he has been on Clonidine, Respiradol, Serequel (2 wks), and now Luvox (in that order). We fired the first psychiatrist we were with as we by this point had more knowledge of TS than he did and now find ourselves on at least 3 different waiting list to get our son some help. In the mean time I can no longer tell if the medication he is on is doing anything or if it simply the wax and wanning of the disorder and seriously the more I read about the medications he is/has been on the more confused and frightened I get. The next suggested med (via the pediatrition) is concerta in combination with luvox. But not one physician has ever talked to my son about what he feels/experiences so how do they know what is the disorder and what is his lack of understanding and frustration with the disorder?

Please send me some feedback on the direction I should take now...I feel like I'm drowning in confusion. Meds or no meds? that is the question. Sincerely, D.R.

Question 95: Dear Dr. Dunc, My 10 yr old son....has just been diagnosed with TS +associated disorders. Anyway, have you ever heard of a TS patient who stutters to have improved stuttering by using a speech easy device? This device is similar to a hearing aid and new to Canada. Of course the company thinks it would be worth the $200+ assessment but we would have to also cover expenses to get there etc. I would pay any amount if it actually would help aleviate [our son's] stuttering since this is the "tic" which gives him the most "attention". Have you heard of this? Since TS is caused inside the brain and believed to be chemical, could a device work? Just wondering.... Thank you, M.M, ON, Canada.

Response

Question 93: Hello: My daughter was recently diagnosed with OCD and high anxiety... The problem I have is that there is very little help out there for her or me and how to cope. She has obessive sexual thoughts that have caused her much distress and discomfort. she is receiving therapy but there is little out there on how to approach this. In most cases the therapist told me exposure is used but in this case it is hard to do. Exposure to masturabation is not an option my daughter wants to take. She is taking [medication] but her Doctor wishes to stop this medication in early 2004. I guess what I want to know is there any approaches oout there that could help her. i just feel at times to be at the end of my rope. The medication to me has made her more demanding and outspoken. G.L., NS, Canada.

Response

Question 85: I was one of the fortunate 500 that sat in the audience at Horton High School in Greenwich and witnessed the magic that is you!! I am a....college prof and grief therapist. I have a question regarding one of the techniques I was taught as a graduate student re: behaviors that needed to be performed in access of 30 times a day. The technique involved the paradox of asking the client to increase the behaviors and hence they would be unable to perform, say handwashing, at all. Can you share your understanding of how this works? Or possibly you don't support this approach. It was lovely to be in your presence. Regards, S.S., NS, Canada.

Question 84: I have searched your archives but couldn't fine an answer to my specific question. My grandson has very negative reactions to positive reinforcement. Tell him he's done a good job and he gets all bent out of shape. My daughter, who attended your presentation in Kentville, Nova Scotia mentioned this was because it increased his internal pressure by making him believe he now has to live up to that standard he's just set. I can appreciate that and don't want to cause him any more pain. Would it be reasonable to encourage him by making it incident specific? IE..you handled that one really well, for example and let it go at that? Are there other strategies for providing encouragement and positive feedback that would not be as threatening to him? He is 8. By the way, my family came home saying your presentation was great and they will be going to every one within reach. They will be bringing family members and friends to the one you are having in Halifax in October. I believe you are doing a lot of good for a lot of people and I thank you for it. P.D., NS, Canada.

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Last updated on March 25, 2022

All activities related to Life's A Twitch!® are conducted by B. Duncan McKinlay, Ph.D., C.Psych. (Retired) in a private capacity and do not represent the Ministry of Children and Youth Services or the Government of Ontario.

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