Why does Tourette Syndrome manifest itself in swearing?

Tourette Syndrome is a very common reference in pop culture, especially the swearing (“coprolalia”?) which sometimes goes along with it.

I find the idea of involuntary muscular tics easier to deal with, or even the idea of random barks of sound (which I believe is another manifestation of the syndrome). So why should the syndrome manifest itself in words at all, especially swear-words? Is there an element of voluntariness, or conscious thought involved?

(Seems like we would have dealth with this before, but no luck on my searches…)

Well, less than 30% of TS sufferers have actual coprolalia (obscene utterances) and even fewer have copropraxia (obscene gestures). Most have involuntary tics, speech hesitations, and make spontaneous noises (verbal tics). Rarely, more severe sufferers do self-mutilation, usually involving the lips and tongue.

Coprolalia is not well understood. There seems to be an obsessive feature to it, of unbidden thoughts, for some sufferers. Others just frequently just find themselves blurting out the word with the barest warning that it’s about to be spoken. They are involuntary, obtrusive, and very distressing to the sufferer. Some hypothesize that it’s the (mainly) non-verbal right brain which is being driven to communicate in any way it can, but I’m not sure there’s any research to support that idea.

MRI scans have shown abnormal activity in the brains of TS sufferers with verbal tics. MRI in TS patients with verbal tics

Research has shown abnormality in the genes which regulate neurotransmitter metabolism in TS sufferers, and this gene abnormality may be passed on to offspring, making them higher risk for TS.

QtM’s covered the medical angle, so I’ll just address the media angle:

You cannot trust pop culture/Hollywood depictions of mental illnesses and disabilities. Even when they’re trying to be serious they’re not always that great at accuracy, and TS is commonly referenced just because of the (supposed) “comedic value”. It’s funny to have a character swearing inappropriately. It’s not so funny to realistically portray a typical TS sufferer.

Yep, dude, got it. That’s why I put all the disclaimers in my post. Thanks for the answers, guys.

I have TS but no coprolalia - when I swear it’s because I want to, just like anyone else :slight_smile:

I can’t directly address the spontaneous cussing but the physical tics aren’t completely involuntary - I’m aware of them and can stop them for a while if I so desire. It’s kind of like breathing, you know you’re doing it and you can hold your breath for a while but eventually something builds up and you can’t avoid it any longer. My tics are pretty much what Qadgop mentioned (although they have changed slowly over the years) - eye blinks, tensing of certain arm and leg muscles, nodding my head, clicking my tongue (people think I’m clearing my throat) and lately speech hesitations; those are strange, I just pause while speaking, it looks like I’m trying to think of what to say but I’m not, I just stop talking for a second or two.

If you’re interested there’s a very cool documentary called “Twitch And Shout” about people with Tourette’s. They take their cameras to the TS convention (yes there is one) and it’s fascinating to see a hotel full of people with varying degrees of TS. Some are relatively minor like mine and some are the major cases that Hollywood likes to portray - constantly screaming obscenities at the top of their lungs, etc.

One young lady keeps saying things like “Hey white boy” in the middle of whatever else she’s talking about. She tells the story of being in line at the bank behind a large black gentleman (she’s white). She could feel a very inappropriate word coming out but couldn’t stop it, the best she could do was alter the phrase a bit and she came out with “Purple nigger”. The guy looked at her and said “Lady, if you think niggers are purple you’ve got a lot of problems.”

I don’t think that anyone with coprolalia reallys wants to say something offensive, or that there’s a chain of thought starting with “Here’s some dirty words to use”, but once the sequence begins they are aware of what is happening and to some degree can control it, but if it’s like the physical tics you can only keep your guard up for so long.

Does that help at all?

That reminds me, I once saw a TV report on TS featuring a man who was training himself to say “ni…ckles, dimes, quarters” when he felt a certain nasty word beginning with “ni” starting to come out. He couldn’t always hold back the word altogether, but he could usually catch himself in time to transform the first sound into the beginning of an innocent phrase.

I had no idea there was a convention, Valgard! Thanks for your info.

What set this off was a terrific book, a memoir by a South African surgeon, Jonathan Kaplan, The Dressing Station (a terrific read, by the way). In it, there’s a story about a senior surgeon with whom Kaplan worked who had TS. In the middle of an interview before surgery, this guy would sometimes start twitching and swearing, and would have to leave the room. Not suprisingly, this stressed out some of his future patients.

I used to joke that the only think TS kept me from doing was being a nude figure model or a brain surgeon.

Dated an artist for a while who had me pose so there went #1. Then I saw a heart surgeon being interviewed on TV. His tics look exactly like a baseball coach giving signs to his players. He’s very upfront about it with his patients, and yes it does happen while he’s up to his elbows in somebody’s torso. He can feel it coming and “covers” it by stepping away for a second and adjusting his watch; it’s hard to explain but it’s like scratching an itch, you have to do something.

Anyhow there goes #2. I can do anything now :slight_smile:

This is totally second-hand, but my biology-studying roommate read something about this recently, and it was claimed that it was so often swearing that came out because the urge to curse comes from a more primitive part of the brain, and this is what Tourettes is stimulating.

I saw this a LONG time ago.

He would just shout out “niggers” when he saw a black guy, so he did this training you’re talking about.

Sometimes it would just basically come out “niggers, dimes, quarters”, IIRC. I think it would have been easier just to move to Idaho.

Strange disease.

One summer when I was in HS I worked as an aide in a nursing home where the chief cook had Tourette’s Syndrome, of the shouting obscenities type. Before I started work I was warned about this, and how he didn’t mean the cursing and no one should take it seriously.

However…the cursing was specific and fitted to the target most of the time, which surely means it was ‘meant’ at least to some decree. I mean, there were about a dozen of us aides. I never once heard Rafe call any of the whites ones ‘nigger’, but the black girls got that all the time. Most of the aides were girls, but there were three guys – and they never got called ‘slut’ or ‘whore’ or ‘cunt’ like the rest of us, and we never got called ‘prick.’ There was one seriously overweight girl, and whenever he shouted at her it always included ‘fat’ or ‘pig’ or ‘cow’ or some such weight reference.

It looked to me like the impulse was to shout something that would hurt or offend the target, and then the insult selected to suit – which feels rather different (on the receiving end) than if he’d just randomly shouted the same words and sometimes they didn’t match the target.

I don’t doubt that the insults were specific but I doubt very much that there was any conscious choice by the cook to insult anyone. The physical tics certainly aren’t intentional even though I know exactly what I’m doing. I think it much more likely that there’s some part of the brain that recognizes what would be inappropriate to say to a given person and bang, something fires and out come the words, but the person doesn’t go though the process of “Hm, there’s a woman, ‘cunt’ is very offensive, let me yell that out.” The brain is involved and something (like appearance) is a trigger, but it’s not intentional.

Just found this if anyone is interested, it’s a list of films about TS:


“It’s bitchin’ to be twitchin!”

This almost perfectly describes me. In fact, I used the exact same breathing analogy when I was describing my condition to my doc a few weeks ago.

I’ve been aware that something was wrong for about 15 years, and I’ve known it was tourettes for about 5, but I never came out and asked a doctor about it directly until about a month ago because it’s so embarassing. He gave me a [very] small dose of catapres and it worked the first time I took it but it does nothing now. I’m scared to take a larger dose because 1) it’s addictive and 2) it lowers your blood pressure and mine is already slightly low.

My case is mild but it is still a load I have to carry on my shoulders every day and it sucks. I’ve been having the pauses in my speech lately too and I think my girlfriend is starting to think I’m losing my memory.

The sad thing I learned from my neurologist is that there is NO cure for tourettes and in fact it usually gets worse as you get older. He said even if I found an effective medication I could take it every day for 10 years and then miss one day and I would start ticking again.


What I want to know is, why is it given such a nicety-nice, French-sounding name? It should be something like “Butch’s Syndrome” or better yet, “Cartman’s Syndrome”. :wally

How old are you? It sounds like you’re in your late teens/early twenties which is not generally the time of your life to feel different…

My advice to you is the same that I gave my uncle (his son started displaying symptoms when he was about 6) - most people aren’t mean but they are curious and don’t understand what TS is. Find out a bit yourself and explain it to them. Start with your girlfriend, your other friends and your family. They’re easy to talk to and supportive (if not they suck, but that’s their issue not yours), it’s good practice and you’ll feel more at ease talking to somebody new about it later.

When I meet somebody new I’m sure they are wondering “What the hell is up with this guy?” If they ask, or if they have that look in their eye, I let 'em know the story. My friends don’t even notice it anymore, and have told me that if they introduce me to somebody who later asks “What’s up with your friend?” they have to think about it for a second. Frankly it’s background noise to them now.

Now I have no problem talking about it; once people hear “Tourette’s” and I tell them that I won’t start swearing like a sailor (unless the situation calls for it) they stop wondering and I guess they think of it like meeting somebody who is dyslexic or has six fingers or whatever, it’s just something about the person and that’s it. Everyone from little kids to adults understands it.

If somebody gives you crap about it after you explain, that’s their problem, not yours. That’s the kind of jerk who’d tease somebody in a wheelchair and maybe they think they’re being cool but trust me, everybody recognizes that they’re an idiot. You’ll probably meet one of those folks some day, blow 'em off.

What do you think it interferes with in your life? When I was a teenager I thought it’d get in the way of all sorts of stuff but it hasn’t, quite the opposite in some cases - for example I have no problem getting up and speaking to a crowd which most folks can’t do to save their own life. Dunno that my symptoms have gotten worse over the years, they’ve just changed - some different tics now (34) compared to when I was say 12.

From your description it sounds like the side effects of the medicine are much worse than the mild symptoms you’ve got. I’ll take “eye blinks” over “messed up blood pressure” any day, the former is at worst a minor annoyance, the latter can be serious.

Thanks Valgard. I’ll be turning 23 in about two weeks so you nailed it on the age.

It’s really hard for me to talk about it in person to friends or family. I’ve spoken it outloud a total of only 4 times in my entire life: once to two different doctors and twice to my brother (who also has symptoms but is afraid to see a doctor for it.)

It does affect my life even outside the embarassment. Sometimes I feel like I can’t breathe, and the tics are just generally uncomfortable.

They do tend to rotate around every few months or so. The earliest tics I can remember in elementary school were purely physical; mostly torquing my neck around and stuff. I’ve gone through lots of various physical and vocal tics through the years but I’ve found the vocal ones to be more embarassing and harder to hide. The physical ones can be very subtle; curling my toes, tensing my elbow…etc., but there’s no disguising the vocal ones. Sometimes I’ll have whole conversations without being able to complete a sentence because as soon as I start to talk I have a tic that sounds like a laugh. Best case scenario that makes me sound like an idiot that thinks EVERYTHING is funny, worst case it makes me sound like an insensetive asshole. Either way I don’t come off looking very good and I can’t take the time to explain what’s going on to every single person I come in contact with, even if I was comfortable enough to do that.

I general I can’t really complain. I have a good life with awesome friends and family that love me, a good job, nice car, nice apartment, etc. The tics really are hell though. I’m glad they don’t seem to bother you so maybe one day I’ll reach that stage. As for now though they are tormenting. There’s not a minute that goes by that I’m not constantly reminded of them and how much they bother me physically, psychologically, and emotionally. At times they can really drop bombs on my self-esteem.

Thanks for talking about it though, it feels good to type this stuff out, even though I’m not saying it outloud.

I don’t mean to hijack this eye-opening thread, but I do have a somewhat related question.

Can Tourette’s-like symptoms be the result of food allergies?

About five years ago, I started noticing a weirdness about me: dancing hands. I have a suite of “dances” that my hands do. There’s “piano fingers”, “crazy hand flapping”, and “twirly hand”. And then there’s “snappy fingers”. Snappy fingers, while the most fun, is also the most annoying.

When I force my hands not to dance, the “tic” (if that’s what it is) will move to my head and shoulders. (I will do a “head banging” thing that’s not exactly painless). When it’s really bad, I begin to grimace and vocalize nonsensically.

Only recently have I noticed that these behaviors (which come and go every month or so) often follow after I eat pizza or doritos. But not always, which makes the matter all the more frustrating. The “tics” last for a couple of days and then, thankfully, go away. For the most part, I can control them when I’m around others, but not always. I’ve embarrassed myself a few times when people have asked “What’s wrong with your hands?” And of course, I hate when I go home and I start jerking around, literally. It makes me tired and depressed.

I know it’s all very weird and crazy. I saw a doctor about it but she didn’t have a clue. This is the first time I’ve told anyone about it besides that doctor. Searches on the internet have been fruitless. I don’t think I have TS since I didn’t have tics when I was little (and like I said, they come and go). But at least once a month, I surely feels like I have Tourette’s .

Somebody please help me. :frowning:

See, TS also gives you psychic powers! :slight_smile:

Well other people won’t initiate the conversation so it’s up to you to do it. They are probably worried about seeming insensitive or ignorant by bringing it up first, so until you do they’ll tiptoe around. Start with your girlfriend and keep it light-hearted, when she knows that you can smile while you’re talking about it she’ll relax (she may already be relaxed but just nervous that you aren’t) and it’ll be cool. A plus is that women really like emotional intimacy and talking about it with her will deepen that. Get a copy of “Twitch and Shout” (see that link I provided) and watch it with her and talk about it.

OK, so now you are both psychic and closer to your GF. Gimme a few minutes and we’ll get to the x-ray vision and flying through the air with the greatest of ease.

Ditto. Same tics, the head jerks, tensing toes/knees/elbows. Yeah the vocal tics are harder to deal with because you feel like it interferes with your ability to communicate.

Well most of your conversations are with friends, family and coworkers and those are the folks who need a little educating. They aren’t blind and deaf, as long as they’ve known you you’ve had the physical and verbal tics, they don’t think you are an idiot or an insensitive asshole but unless they’ve been doing outside research they don’t know what the deal is. If you’re like me the tics tend to get worse when you are feeling stressed, and if what you’re stressing about is the tics then it kinda snowballs. So you gotta school 'em a bit, then they know and stop wondering, and you know that they aren’t thinking there’s something wrong with you and voila everybody’s stress level drops dramatically. You will really feel like a 100 pound weight came off.

You’ve got to remember that you are talking about minor physical tics, nothing more. It’s not Ebola.

Sounds like you’re doing great! You’ve got a girlfriend, you’re one up on me. Seriously, name ONE THING that TS prevents you from doing?

It’s not that the tics don’t bother me, I wouldn’t mind waking up tomorrow and finding them gone, but I’ve gotten over being self-conscious about it and that’s pretty much all of the mental issues right there. Dunno that it’s all due to confronting TS but I have the self confidence to do all kinds of things that 99% of humanity will never, ever do.

I’m not a doctor or an expert on the causes of TS but my understanding of TS is that it’s genetic, not the result of a food allergy. There are also some very characteristic physical tics (eye blinks, head nods, etc) so it doesn’t sound like TS.

However there are lots of other things that could cause physical tics, one of the resident doctors here may be able to enlighten us. Maybe your doctor can refer you to a specialist. If you put yourself on a very strict no pizza/doritos diet (I hope you’re out of college) do the tics go away completely?

My brother, who has TS, avoids nitrates (like in hot dogs) and sucrose whenever possible, because they exacerbate his tics. He has tics anyway, but they become much more severe when he’s eaten something containing nitrates or sucrose.