Cognitive-Behavioral Management of Tic Disorders (2005) by Kieron O'Connor

Author:Kieron O'Connor [O'Connor, Kieron]
Language: eng
Format: epub
Published: 0101-01-01T00:00:00+00:00

Tic

tension

Low level

No tic- - - - - - - - - - -

threshold for tic onset

- - - - - - - - - - - - - -

(b) Treatment program addresses processes preceding the apparently isolated tic onset

Ticcing maintains tension

Beliefs about Activation High-risk Tension way to act level situation/ level

activity

Figure 7.4 Model of processes preceding tic onset

than in others. (3) They form part of a tension–release cycle and so serve a function like all habits, and you feel better temporarily if you tic. (4) Tics are linked to background muscle tension and activity which, in turn, is linked to the habitual way you behave. Typically, after you have ticced or performed your habit, you feel temporarily relieved; but not for long, because unfortunately in ticcing you have maintained your already high tension level. You are caught in a perpetual tension–release cycle whereby high tension produces the urge to tic and the tic itself maintains the tension (see Figure 7.4[a]). Other strategies you use to keep in or hide the tic or habit (see Appendix 1h) also produce tension, and so maintain the vicious cycle. Obviously, we need to break the tension–release habit cycle by learning a less tension-producing way of acting.

! OVERVIEW OF TIC MANAGEMENT MODEL

! Learning a New Habit

The model we adopt on this program is a learning model. Essentially, this means that you can learn to control your tic by learning strategies to control your behavior. A learning method is different from taking a pill or having a surgical intervention. Learning is a process you are actively involved in and, of course, learning takes time, step by step practice, and you can have good days and bad days. Each step is

TIC onset

CLIENT MANUAL 169

important and, as you go along the steps, your learning will accumulate until you feel more confident and in control. In order for learning to take place, you must be an active collaborator. In effect, you are the most important element in the process. If you are not motivated, not practicing or otherwise impeded from following the program, it will not succeed. This doesn’t mean that you need to bring anything extraordinary to your participation. All that is necessary at the beginning is that you have an open and willing attitude and that you follow the exercises. The exercises will always be fitted to your ability and we progress at your rhythm, so you will always be able to follow the exercises.

! Our Treatment Approach

You will notice that our model puts a lot of emphasis on controlling the tic by preventing its occurrence. We see the tic as an end result of a series of behaviors that have become habitual ways of acting, and our studies suggest that it is by changing these ways of acting that we can best control the tic onset. This is different to the strategies you currently employ to control your tic. The strategies you use currently consist of trying to resist or hide the appearance of the tic once it has recurred and lead to more stress and tension.

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