mind & bodyanalysisThe Conversation
People with Tourette syndrome, like Billie Eilish, use everything in their power to suppress tics – this exhausting process is key to treatment
Tourette syndrome causes tics, which are sudden movements or sounds a person cannot fully control. Many people can hold tics back for a while, using intense concentration, but the urge keeps building and is usually released later, often at home. Suppression is a hallmark of the condition, not evidence that tics are voluntary or that someone is faking. It is also now a basis for treatment: comprehensive behavioral intervention teaches people to notice the warning sensation before a tic and to respond with a competing action, such as slow nasal breathing, that makes the tic harder to complete. Large clinical trials show this reduces tic severity for many children and adults, and the American Academy of Neurology recommends it as an evidence-based treatment. Anxiety, obsessive-compulsive symptoms and attention problems often affect quality of life more than the tics themselves.
Tics are thought to be preceded by a premonitory urge, an uncomfortable sensation that builds until movement or sound relieves it. Behavioral therapy works on that sequence: a person learns to recognise the sensation early and performs a competing response that uses different muscles, so the urge is met without the tic. Over weeks, this strengthens the brain's self-regulation and reduces how often tics occur.
Tics often come and go with stress, sleep loss and illness, and many are invisible in public, which fuels doubts about whether the diagnosis is real. Understanding suppression helps explain why a person can look fine at school or on stage and struggle at home. It also shows that the same ability to hold tics back can be trained into a treatment that works.
Tourette syndrome is named after the French neurologist Georges Gilles de la Tourette, who described it in 1885.
Illustrative photo · Paul Legendre, Public domain, via Wikimedia Commons
