Hello
again S.H.:
You are of course very welcome!
Concerning
b-mod, while I was not talking about behavioural techniques for the
TS persay (I was more addressing the sleep disorder component), there
are actually a number of cognitive-behavioural techniques for dealing
with symptoms of TS, OCD, ADHD, and resulting behavioural and emotional
problems (which can often be of greater concern and impact than the
disorder symptoms themselves). Many studies exist to demonstrate that
these proven techniques can be at least as effective, and in some cases
more effective, than drug treatment.
Medical
doctors (psychiatrists, neurologists, general practitioners) are not
routinely trained in these, and certainly do not receive the nine years
of training that psychologists receive, and so it is important when
curious about alternative methods to discuss them with someone who is
informed in them (a psychologist).
Concerning
your acquarium idea, I have heard of others using this technique with
success. Having training both in neurology and psychology my mindframe
is more of a balanced "whatever works" one -- I don't think
it is fair for your neurologist to deter you from possible avenues of
assistance, and I encourage you to try different creative solutions
like this. As with medications there is no "perfect" strategy,
but every little bit can potentially help. You don't know until you
try.
Concerning
sleep clinics and their familiarity with TS, I'm sure it would depend
upon the clinic, but seeing as sleep disorders are not unusual with
TS many have doubtless come across the combination.
Concerning
the organic nature of TS, your neurolist is absolutely correct about
this, however he is demonstrating a fundamental misperception of psychology
when he sees the two as mutually exclusive. Psychology and neurology
are about level of explanation and not organic versus environment. To
put it another way, the study of psychology is more macro than the study
of neurology -- psychology is simply what we see happen on the surface
when countless billions of neurological events occur. Talking about
Tourette Syndrome neurologically or psychologically doesn't assume a
different cause for each. Unfortunately the view that psychology is
in contrast to neurology is rather prevalent in the medical community.
This blinds the profession to some very viable and successful strategies
for neurological disorders. Studies exist to demonstrate that ON THE
NEUROLOGICAL level 'our' techniques effect the same changes as 'theirs'.
Finally,
I think your neurologist is showing some very sound judgement regarding
his conservatism with meds -- even most experts in the medical community
these days (JF. Leckman and J. Walkup are two giants in the field) agree
that the "neuroleptic era" is ending and that medications
are not necessarily the best, or first, solution anymore.
I'm
glad I could help, and please excuse my tirade -- I understandably feel
very passionate about the dilution that my field often is subject to.
Psychological treatments are not a less powerful route for less severe
cases, nor are we are all about mothers, penises, and repressed emotional
trauma (Freud, incidentally, was a neurologist! :-)
cheers S.H.!
Dr. Dunc.
