Anyone 
          who has met me in the last few years probably knows that I am pretty 
          positive about my TS.  My belief that I am JUST FINE the way I 
          was "built", thank you very much, is integral to my entire 
          approach as an individual with TS and as a speaker.  Quite honestly, 
          I don't ever want to lose my disinhibition, never mind purposely 
          get rid of it.  That's why it surprised me some weeks ago when 
          a friend suggested I try a new, much more effective medication that 
          is now on the market.  This person of course had only my best interests 
          in mind, but nevertheless the experience helped to remind me that, for 
          many people, not being on medications is synonymous with not being treated.  
          Medications absolutely are a valid and popular choice.  But they 
          are not the only available one.  Other responsible, purposeful 
          and legitimate choices do exist.
          
          I'll explain: on a very basic level, TS and its associated problems 
          involve disinhibitions in various parts of the brain.  TS "amplifies" 
          you.  It takes all of your thoughts, feelings, actions, and impulses 
          and brings them closer to the surface.  Everything comes out quicker, 
          more often, and BIGGER than it would if your censors were working like 
          everyone else's.  Think of yourself as a stereo, and TS is 
          the thing that turned you up to full volume.  
          
          Now think about the choices that you have in dealing with a stereo blaring 
          on full.  One is to turn yourself down.  Suppress your amplification.  
          When a person inhibits a symptom, in essence they are trying to turn 
          down their volume.  However, conscious suppression, no matter how 
          determined a person is, doesn't work well, and only serves to frustrate 
          and instill the belief that you cannot control your symptoms yourself.  
          Hence the suppression method of choice is medication.  For those 
          that prefer to turn their stereo down, medications can be a godsend, 
          and by far the best choice to make.  There may be side-effects, 
          yes; maybe some good stuff is turned down too.  But to these people 
          the costs are more than worth the gains.
          
          On the other hand, some people like loud music.  These people 
          don't have a problem with the volume at all.  They just want 
          to change their music to a better tune.  People who make this choice 
          realize that TS is not necessarily about "bad" disinhibitions, 
          and not necessarily about "good" disinhibitions.  Like 
          any quality of oneself, disinhibition can be bad OR good depending on 
          what you and others focus on.  These people may have learned ways 
          of using their volume to their advantage, and are likewise responsible 
          for learning methods for changing any of their songs which are unacceptable.  
          Albert Einstein, Mahmoud Abdul-Rauf, Howard Stern, Mozart, Robin Williams…….these 
          guys all roar with intensity, and were in fact heard above others BECAUSE 
          of that.  There may be side-effects, yes; maybe some things that 
          aren't turned down should be.  But to these people the costs 
          are more than worth the gains.
          
          Basically it comes down to a choice between what I call Suppression 
          or Expression.  Whether you turn the music down, or put on a CD 
          that everyone enjoys, you've solved the disruption.  Neither 
          route is better than the other - soft music is nice, but a great song 
          deserves to be heard at full-blast.  It would be a boring world 
          if everyone's music was low, but it would be an annoying one if 
          everyone spoke through 200-watt speakers.  
          
          Both methods of dealing with the problem have benefits - in some situations 
          medications might be of much more help.  A person who is very young, 
          or who is intellectually challenged, or who has insufficient supports 
          and resources for learning coping strategies, or who needs some easy 
          and consistent positives in his/her life to build back some esteem, 
          or who needs a stable foundation on which to start building some strategies 
          might fit this category.  On the other hand, an individual who 
          is capable of developing a deep knowledge of and positive attitude toward 
          TS, or who can learn techniques like tic and rage modification, or who 
          can learn to tap into their energy and capacity for hyper-focussing, 
          might find that the long and difficult years these things take to perfect 
          wind up being the grains of sand that form the oyster pearl.    
          
          
          Having a hard time choosing?  Then don't!  There is no 
          reason why one might not find the most comfort in only turning down 
          the volume a little after slightly changing the music, 
          or deciding to leave some of the same music on now that it is not so 
          deafening.  In fact, some studies suggest that while medications 
          result in some improvement and therapies result in similar improvement, 
          combinations of both medications AND therapy might result in more improvement 
          than either alone.  Of course, that all depends on whether you 
          define improvement as "less symptoms" or "more happiness" 
          though, doesn't it…?
          
          In the end, the direction you choose is, and should be, your own individual 
          choice.  A person who cannot stand the fracas of their personal 
          stereo should not be forced to endure it, nor should a person who thrives 
          on the beat be forced to hit "mute".  My own personal 
          preference is to keep the volume high, and to continue learning the 
          best melody that I can.  I recognize that unacceptable behaviours 
          are unacceptable behaviours, and require change: whether that change 
          be through therapy or Respiridone, behaviour management or Ritalin, 
          disorder-specific strategies or Orap, the change itself is not negotiable.  
          As long as I can continue improving my tune, I have bought the 
          right to keep it cranked.  Then it isn't a matter of whether 
          the medication really works or not -- the undeniably perfect medication 
          could exist yet still I would not take it.  After all, all that 
          medication is trying to do is turn a piece of me down.  And why 
          would I do that? I love me!
          
          Cheers!
        Duncan