Tuesday, December 17, 2013


I’ve just returned from a very brief vacation with in-laws and young nephews, where the subject of tics did not come up.  As I am “the therapist” in an extended family with problems, I was struck by a distressing historical parallel which I helped create, but may now deconstruct, slightly, by this article.  In the late ’50’s and early ’60’s, I was a youngster with anxiety, tics and other nervous behaviors including a hideous blight of trichotillomania – hair-pulling.  I regularly chewed holes in my tee shirts, churned my neck, bit my lower lip bloody down to the nerve, sewed with thread patterns in my thumb, well callused by continual gnawing.  The bald was a massive, irregular continent shape.  No one said a single word to me, ever, nor was any therapy or other treatment ever provided.  My uncle, formerly an obstetrician and at the time a bona fide psychoanalyst who saw patients at his Park Heights Avenue condominium, never talked to me, and maybe not to my parents.  And they said nothing, but eventually took me to a hairpiece maker who fabricated a custom toupee.  A mediocre story writer couldn’t have come up with a more obviously condemning symbol for “cover up the problem.”

A psychotherapeutic throw-back or curmudgeon – take your pick – I pay indifferent homage to genetics’ likely implication in some psychological disorders, and generally consider the notion a cop-out that deserves to be laughed then kicked out of court.  Much more active than genetics are influences of powerful forces that are in the hands of parents or others.  Following is the abstract of an article, “Relationship of maternal and perinatal conditions to eventual adolescent suicide,” published in the March 16, 1985 edition of The Lancet:

“In an investigation of a possible relationship between falling perinatal mortality and rising rates of adolescent suicide, 46 risk factors from the prenatal, birth, and neonatal records of 52 adolescents who committed suicide before age 20 and 2 matched controls for each subject were analysed blind.  The results showed statistically significant differences between the suicide victims and each of the controls and no difference between the controls.  Three specific risk factors were shown to have a powerful capacity to differentiate the suicides from the controls: (i) respiratory distress for more than 1 h at birth; (ii) no antenatal care before 20 weeks of pregnancy; and (iii) chronic disease of the mother during pregnancy.”
Respiratory distress at birth along with an impaired mother, and mothering, leads to suicide thirteen to twenty years later.  Psychology is biology the younger we are, a fact that sublimates (I mean this more as the chemical definition of refine or purify, not the Freudian take) “blame” of parents to non-blame, but leaves “responsibility” undisturbed.  And the responsibility is: Don’t blame the goddamned genes.

I can tell you what happens when tics, and the person, are ignored.  At age 30, working as a typographer in Sarasota, Florida, I kept in my wallet a handwritten list of approximately twenty tics that I both cherished, perversely, as my identity neurosis and desperately determined to abolish.  Included were thumb-deforming squeezing and clicking; snapping upper and lower rows of teeth together; neck churning; brusque sniffing; finger stretching; foot churning; flicking back of teeth with tongue; sliding, in dreamy patterns, tongue over teeth; intensely compressing nostrils by muscular contraction; swallowing air; chewing skin off fingers and flicking it across the room.  Though the tip of the neurotic iceberg, these acts were essential to my identity, like skin, as they kept submerged the ghosts that, paradoxically, were the dreaded real self, the ungrown child.  In time, I mastered most of them by brute and depressingly vigilant force.  But right now, thirty-two years further on: The thumb is squeezed, and clicks.

Picture this truth: Tics are the compressed energy of impossible silence in the face of insane loss.  A father who does not talk to his son is the world gone wrong, essentially killed.  Say goodbye to that world, but without words, without sympathy.  Dull or divert your eyes from this grandest of all sights, because nobody cares.  And many years later, see the tic as the history of all the unsaid, un-had, ungiven.  How mute it is!  And because it should never have been mute but instead the language of meaning, color, life, it is awe-fully eloquent. 

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Comments are welcome, but I'd suggest you first read "Feeling-centered therapy" and "Ocean and boat" for a basic introduction to my kind of theory and therapy.