November 2009

When we find ourselves perplexed by behavior that seems incomprehensible, or irrational, we turn to psychology for insight. Alas, the days of Freud, Jung, existential psychology, and all else of any depth are long gone. Instead of insights, we are offered either behavioral or biologistic explanations.

In regard to the latter, a psychiatrist might, for example, explain that a person displaying abnormal behavior is suffering from a chemical imbalance, causing the neurotransmitters in his brain to misfire. Not surprisingly, the psychiatrist’s remedy will be a drug.

This is not to deny that there exists a physiological concomitant to psychological problems — for mind and body are inseparable — and that the medicines that result from this research are of value. But a concomitant is not the thing itself. Consequently, biologistic explanations that seek to reduce psychological events — whether they be normal or abnormal — to chemical processes are unsatisfying. They leave us still wondering if there might actually be some real meaning to the abnormal behavior. As we shall see, there is.

A psychological malady is written in a symbolic language, or code. Were we to decipher this code, such behavior would become intelligible. We would discern its strange logic. Furthermore, we would realize that what a person is attempting to accomplish, by his odd behavior, is not that far afield from the activities and pursuits considered to be well within the province of normalcy.

A case in point is Tourette’s Syndrome (also called Tourette Syndrome and Turrets). Those who suffer from it are beset with bodily ticks, twitches, facial grimaces and sometimes strange sounds, such as grunts. Most cases are relatively mild, but some are rather violent. The afflicted person might, for example, suddenly burst out with a flood of obscenities. It almost seems as if he were possessed by demons. What sense, then, can we make of this syndrome? Might there be a way of interpreting ticks, twitches, grunts and all else? There is, indeed, a language of Tourette’s and a rather intriguing one at that.

Before proceeding further, a caveat is in order. The analysis that follows is neither based on my having engaged in clinical work with patients suffering from Tourette nor from an extensive knowledge of the clinical literature. It is, rather, a first person account. In other words, I myself had been afflicted with this malady, from adolescence till recent years. It has abated almost completely, although there still exist a danger that it can flare-up during times of stress.

What follows, then, is what I’ve determined to be the deeper meaning of this malady and its cure, based on my own introspections. As to whether my interpretations of various symptoms are universal — and not merely specific to me alone — will be up to other Tourette’s sufferers to decide. There are many possible symptoms; I shall explore only a few.

In the Blink of an Eye

There exists a class of mental and physical disorders, in which the sufferer is at war with his own body. Autoimmune diseases are an example. Various organs become enflamed, without the presence of an offending antigen. According to one theory, the body is actually at war with itself. There are a number of diseases of that type, from rheumatoid arthritis to inflammatory bowel disease. (See Hans Selye’s The Stress of Life, McGraw Hill, 1978, for his discussion of autoimmune disorders.)

There is a different kind of internecine war going on in Tourette’s, for it is taking place not on a cellular level, but on a psychological level. Every war has its casus belli. What, though, can be the justification for declaring war on one’s own body? The war is a fight for freedom and liberty, albeit this fight is for a lost cause. Bodily existence impedes the freedom of our will. No matter what we decide to do, our body gets tired, hungry, sexually desirous, suffers aches and pains and all else, when it sees fit to do so, apart from any plans that we may have to the contrary.

Having a body is intrinsically problematic and can invite a nostalgia for a mythic time before the fall. Here we have a somatic expression of what Paul Ricoeur, in The Symbolism of Evil (1969), refers to as “the myth of the exiled soul,” from Orphic mythology. The sense of the body as the prison house of the soul receives philosophical expression in Plato and then religious expression in Christianity. Might Turrets have its roots in this same tradition, but on an unconscious and psychopathological level?

Let us consider whether this may be so. The finitude of having a body is localized for the Tourette’s sufferer. He focuses on certain parts of the body that belie the freedom of his will. That is where skirmishes are fought. Consider, for example, a common manifestation of this disorder, the compulsive desire to blink one or both eyes. There is actually something other than the usual sort of blinking that occurs here. The eye lids hang there, drooping just a bit, which is how they are supposed to be. But the Tourette sufferer experiences this as having a quasi-moral dimension to it. The lids droopiness symbolically a certain moral flabbiness. The eyelids would seem to be particularly important, psychologically speaking, for they are the windows or doorways with which we apprehend the world.

The Tourette sufferer tenses and tightens the muscles in his eyes in an effort to assert his control over that muscle and thus to regain his freedom. He loses each battle, for the eyelid continues to droop, but there is too much at stake to admit defeat. It would mean having to confess to being an embodied being. Rather than accepting the fallen or tragic aspect of the human condition — that the soul is subject to the limits and corruption and mortality of the body — he keeps trying to gain mastery and control. Thus the compulsive nature of Tourette Syndrome.

Of course, this negative sense of one’s body — as an impediment to one’s free willing — need not be localized in the eyelid. One might, for example, experience it in one’s foot or leg, while driving. At a traffic light, one’s right foot is holding down the break pedal. One’s body has, in a curious way, become an extension of the car, which is rather ironic since the automobile was intended to be an extension of one’s body.

A person with Tourette’s might then experience a desire to tense up his leg, or press down on the pedal — even though there is no practical need to do so — or something else along these lines. The ultimate irony, though, that to a an observer the person with Tourette’s has a body that is out of control, when in point of fact Tourette’s stems from an effort to be in control of one’s body.

As with any habit, Tourette’s consists of attempting to do what we already know cannot be done — but in lieu of a better answer or of a confession of defeat — we simply do it again and again.

Back to the Old Joint

Another aspect of Tourette’s involves a struggle, not for freedom, as in our previous example, but for identity. This can find expression as a number of tics, one of the most common of which is the desire to crack one’s joints. Certainly not all people who do so have Tourette’s, but they may very well be sharing in the same threat to self-identity that prompts the Tourette’s sufferer to crack his joints.

The cracking sound that a joint makes when it is fully extended only confirms that it has been extended to its limit. Extending it to the limits distinguishes the two bones that comprise the joint. Prior to that, the identity of each bone was not clear and distinct, nor should they be, for they work in tandem.

The separating of the bones symbolizes the emergence of one’s own identity as no longer submerged in a larger process, but as clear and distinct. At the root of this compulsion is an anxiety over losing one’s identity. Apropos is R.D. Laing’s notion of the fear of engulfment as a type of ontological anxiety.

An interesting example of this compulsion involves the jaws. The Tourette’s sufferer might feel compelled to open his jaw to the maximum. The urge to do so might be compounded by another anxiety. There is a sense, that many people have, that they will never have the opportunity to express themselves, to let the world know who they are. This might be all the more a concern for more creative type. There is, thus, an anxiety that their jaw will lock before they have a chance to express themselves. They wish to open their mouth fully, to confirm that their jaw is not locked. Unless the threat to identity is overcome on a deeper level, there will still be an urge to establish one’s identity through the separating of the joints.

Reversing the Spin

I shall now speak, in the first person, regarding a certain manifestation of Tourette’s. It was one from which I daily suffered in my last years of high school and my early years of college. Basically, I had a compulsion to jerk my head upward and to the right. It actually consisted of a single jerking motion, at a 45 degree diagonal. What I was seeking, by this compulsion, was neither freedom nor identity, but rather orientation. I shall explain the connection in a moment.

My high school and college years were a time when I was feeling threatened by a terrible sense of disorientation. One might say that I had “ontological vertigo,” for it concerned what was real and who I was. In a very deep sense, I didn’t know if down was up and up was down. I mean that both metaphorically and literally. I remember once, for example, browsing in a bookstore in NY City. When I came upon Einstein’s General Theory of Relativity. I began thinking that up and down were merely relative notions. That dreadful thought started the world spinning. I ran for a chair, for fear that I would faint. Looking back on those years, my life was an endless series of panic attack. Anything could make the world start spinning chaotically.

Much of my disorientation was due to suddenly being exposed to a great variety of new ideas, resulting in an overdose of relativity. In other words, having read and thought a good deal, I soon no longer knew what to believe. I needed a foundation, or ground, but the more I read and thought the more the ground disintegrated beneath me. My interest in philosophy was an effort to find an orientation, a center, one that was non-relative.

What, then, does this have to do with the compulsion to jerk my head to the right? It was, to my mind, a way of orienting my world. Odd though it may sound, I experienced chaos as having a direction. The world was, indeed, spinning in a circle, like the hands of a clock. It was being pulled that way by Father Chronos, creating a dangerous vortex. In order to prevent the world and myself from spinning out of control and into chaos, I would jerk my head, in the opposite direction, counterclockwise. This desperate movement only seemed to allow me to halt the chaotic clockwise flow of the world, for but a moment. Hence I would have to repeat the jerking of my head, again and again.

This nervous habit began to abate when I began to find the inner-orientation, for which I had been searching, and I became centered. I.E., I found meaning and purpose, which functions as a center. The world did start spinning again for me, in latter years, for deeper reasons, but then my response was not Tourette’s, but the sword of philosophical discrimination and awareness.

Casting Out the Devils

I once knew a fellow sufferer, from Tourette’s, whose primary symptom was a series of violent grunting sounds, sometimes low pitched and sometimes high. To my ears it sounded like he was trying to expel something. What, though, was being expelled? Psychologically speaking, what was being expelled was the moral defilements that Tourette’s suffer felt that he had absorbed during the course of the day or in previous days. Particularly the human realm can seem defiling.

If our hypothesis is correct then this type of grunting is related to a number of other compulsions, not endemic to Tourette’s, including the compulsive clearing of one’s throat (which is rather common), compulsive spitting, bulimia, and compulsive showering (for an example, see the film Carnal Knowledge).

The relatively rare case of Tourette’s suffers, who feel compelled to release a flood of imprecations, might be related to this desire to rid oneself of the defiling aspect of human existence. Cursing is, of course, an expression of anger. But it also is intended as a kind of emotional catharsis. One is spitting out all of the inner poisons. Alas, other people have to hear it, which means that they can become defiled. Cursing might, therefore, be an effort to cast the negative on to other people, just as the ancients would cast the negative upon a goat and then drive away the goat.

The Remedy

Is there a cure for Tourette’s Syndrome? Psychiatrists claim that there is no cure, but recommend various drugs to alleviate its symptoms. Drug therapy does not interest us here, for it only eradicates the symptoms of a malady. It does not cure the underlying malady itself. Here, then, are some thoughts regarding a cure:

1. Yoga, breathing exercises and meditation, which are calming in general, can quell the types of anxieties that express themselves as Tourette’s. Such healthful practices are certainly a good deal safer than drugs and without the side effects.

There is, though, a problem with alleviating Tourette’s in this fashion. Yoga, breathing exercises and meditation can become a crutch. Furthermore, they are essentially behavioral solutions. Similarly, it is true that getting a back massage can alleviate one’s anger, at least for a time, but it does not get to the source of the anger. Nor do these practices uncover the meaning of Tourette’s. Unless the meaning of this malady is deeply understood, it will recur or it will result in what Freud called a symptom substitution.

2. A sobering experience can cause a complete remission of symptoms, at least for a time. The most sobering of experiences come from a brush with the grim reaper. As Dr. Samuel Johnson famously put it: “Depend upon it, sir, when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully.”

It has been confirmed by a number of neurologists, including Oliver Sacks, that Dr. Johnson had Tourette’s Syndrome. I suspect that the above quotation is the fruit of serendipity. Dr. Johnson must have discovered that upon thinking honestly about death his symptoms suddenly disappeared.

How is this possible? Acknowledging one’s mortality ends the hopeless inner warfare against the body, that lies at the heart of Tourette’s. Realizing that the war cannot be won prevents it from resuming. (This sobriety of mind has a salutary effect, not just on Tourette’s, but on other maladies problems as well.)

Alas, it is all to easy to forget this truth and so return to one’s folly. That is why practice is necessary. Christian monks used to pray in graveyards and keep various memento mori, such as skulls, by their bedsides. The Buddhists speak of cultivating mindfulness; a number of their meditation involve focusing on the transiency of one’s existence. In Carlos Castaneda’s books, we have Don Juan Matus recommending that we make death our advisor.

3. Ultimately, it is not enough to remember one’s mortality. Greater insight is needed into the deeper meaning of the various symptoms of Tourette’s. That has been the purpose of this essay, but more is needed. Like all maladies, Tourette’s is an answer to a question. The question, most generally, involves how to be in the world. Tourette’s is, more specifically, a symbolic way of satisfying the various demands of selfhood, such as freedom, identity, and orientation.

Mystics assert that the effort to attain selfhood is ultimately the narrative of the cosmic dream. When the comic dreamer awakens, he sees that what he was attempting to do was to see himself. The empirical ego is the road he takes in search of himself. When self and the world are seen as illusory, one is no longer subject to the same sort of anxieties. Ah, but this sort of realization is easier said than done.

I have presented here just the bare bones of a remedy for Tourette’s Syndrome and many other maladies as well. I’ve pointed out in a new direction, rather than laying out a precise map. Tourette’s is a habit. Here is the good news: Even a small amount of insight into a habit can be powerful enough to interrupt it, for at least a couple of seconds. That is just enough, such that it is no longer automatic.

In other words, here is what happens: a person experiences the usual anxieties that we all experience. He then seeks for his familiar answer, or solution, to those anxieties endemic to the human condition. Such answers might, for example, include twitching, grabbing a drink or a cigarette, feeling sorry for himself, starting an argument, grabbing a donut, or placing a bet with his bookie.

But those two or three seconds — which are the gift of insight — allows us just enough time to make a decision: Should I engage in my habit or should I not? Every time the answer is yes, the habit is reinforced. And every time we say “no,” our personal power increases. Here is the amazing thing, that one may come to discover: true freedom, contrary to popular opinion, does not consist in doing one’s thing. It consists in resisting the lure to do one’s thing!

If one resists any habit — be it smoking or twitching or reaching for the switch to turn on the TV set — the original anxiety, that had prompted the false remedy to the anxiety, will return. This anxiety is the perception of our non-being, our unreality, measured by the criteria that we need to satisfy in order to attain selfhood. Paradoxical though it may sound, this anxiety can sometimes be accompanied by a certain sense of inner-calmness and clarity.

Contained in this anxiety is a wealth of big questions about who one is and what life is all about. These anxiety infused questions, this unsettling perplexity, from which we sought to flee, are of great value. They are the spur, the force that drives us to our self-realization.

Summary

We have explored only a few of the many symptoms of Tourette’s and have sought to uncover their deeper meaning. (The reader may notice that Tourette’s bears a certain resemblance to obsessive-compulsive disorder.) What is at issue, in each case, is universal, for everyone seeks freedom, self-identity, orientation and seeks to expel the negative. What makes Tourette’s a neurosis is the level on seeks to fulfill psychological needs. Freud was correct in viewing a neurosis as a private religion, for a neurosis is seeking to fulfill on a symbolic level — and in the case of Tourette’s, on a somatic level — what philosophy and religion seek to fulfill on a “higher” level.

There is a great value to illuminating psychological maladies. They can offer us clues about the human condition itself. This is because a malady is an answer to the same questions that life calls upon each of us to answer. Most generally, the question is: How can I, as a person, attain happiness and fulfillment? Of course, a malady is not a very satisfying answer to that questi0n, but that is another matter. The important thing is to derive, from our investigation, clarity about the puzzle that life requires that we solve.

Afterthought: Primitive or Postmodern? And What About the Kids?

In the popular book The Man Who Mistook His Wife for a Hat (1970), the neurologist Oliver Sacks has an intriguing essay about a young man suffering from this disorder. Sacks contends that those with Tourette’s have an excess of nervous energy.

Like those in the psychoanalytic tradition, Sacks suggests that Tourette’s involves a surging forth of primitive impulses. Sacks does not specify what sort of primitive impulses are involved here, but perhaps he is referring to aggression or sexuality. The general sense is that Tourette’s Syndrome is due, to use Freudian terminology, to an ego structure inadequate to handle powerful libidinous forces, which all but threaten to drown it. In any case, his interests are neurological, and so he does not offer insight into the meaning of the various manifestations of this syndrome.

Louis Sass, in his book Madness and Modernism (1998), suggests that certain psychological maladies that psychoanalysists deem to be primitive aren’t so at all. On the contrary, they are reflections of the types of stresses, strains and threats to selfhood, endemic to those living in the modern and postmodern age. Although Sass doesn’t explore Tourette’s, I shall suggest that the person suffering from this syndrome is not simply suffering from primitive impulses, but to very modern and postmodern anxieties. But, most likely, Tourette’s has always been around. After all, Samuel Johnson, whom we earlier discussed, lived over three hundred years ago. These modern and postmodern anxieties, although coming to fruition in the Twentieth Century, were still there though, although far less prevalent.

This leads to another question: what about the kids? Tourette’s is a malady that often effects young children. But we have been suggesting that this malady is due to the type of anxieties that requires the sophisticated levels of self-awareness found in adults. After all, are young children really concerned with the question of life’s meaning and the relativity of values? They aren’t, in any conscious way, but such questions and concerns are in the air, such that everyone experiences them far more than we usually realize. Despite having a happy childhood and a secure home life, I remember how, at the age of seven, I was beginning to experience such anxieties.

In regard to a cure, should young children begin walking the path of philosophical inquiry? They already are walking it, but in some cases they have advanced further along on it than other children. Not all children, but for those who are showing signs of being perplexed by the big questions, philosophical counseling can prove valuable. Quite often children whose parents are divorced are more prone to such perplexities, for untoward life events has already undermined the foundations of their world.

But many a disadvantage has its corresponding advantage. In his case study of a Tourette’s sufferer, Oliver Sacks lays out certain cognitive advantages of this syndrome, such as a quick and creative wit. More essentially, though, there are advantages to all maladies. Moses, as a baby, had been cast adrift and floated down the Nile, a long way from home. So it is that those who have felt lost, at an early age, may be headed for a greater glory. They are more likely, than most other people, to one day find themselves and to gain insight into what this amazing journey is all about.