In the case of children, the efforts of the medical man may often be
seconded by parent or teacher, who has assisted at the first lessons and
is in a position to superintend their repetition. On the other hand,
treatment may be nullified by deplorable weakness on the part of father
or mother. One of the reasons for the existence or at least the
persistence of tics in children is that there has been no attempt at
their correction when they were still "bad habits." Neglect or
indulgence is an etiological factor of the first importance, as we have
already seen. Many a time we have had occasion to note this,
notwithstanding the protestations of the family. Fear of aggravating the
mischief is sometimes advanced as a reason for non-interference. Nothing
could be more misleading.
The method which seeks to check the youthful _tiqueur_ by the
multiplication of threats and penalties is not to be countenanced; it
produces the opposite effect to what is intended. Clearly the
educational therapeutic measures we have been advocating demand a
patience and an ingenuity on the part of both doctor and patient which
we have no desire to minimise, but it is along these lines that success
is to be reached.
A noteworthy adjunct to treatment is to sketch out a daily routine for
the patient to follow regularly and punctually. His mental disarray is
patent not merely from his disorders of motility, but in the
unmethodical and changeable habits of his everyday life. To introduce
discipline into his manner of living is a most wholesome step. To find
something with which to employ his leisure time, to direct his energies
into suitable channels, will prove to be eminently beneficial, not
merely for the child but also for the adult. Those who tic ought to be
able to contract good habits as readily as bad, provided their
instructor be sufficiently persevering and inventive.
There is an infinity of occupations for the patient to put his hands to,
and this variety suits his unsettled mood and his wavering attention;
but longer efforts will be secured from him if his interest in his task
can be engaged and stimulated as well. It is a good plan to make him
write down each day what he does and how it is done, and to have him
rehearse from time to time. Such pedagogical details are far from being
superfluous; adults, moreover, are quick to gather their significance
and to demonstrate their advantages in practice. That their fickle will
must be reinforced they know well; how to achieve this end they are
unaware. This fact explains their eager acceptance of the support
furnished by these "moral crutches."
Public-domain text, read in full here on John Shaqi.
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