When the lips are the seat of involuntary muscular action, have the
patient show his teeth, open and shut his mouth, purse his lips; make
him speak and conform his expression to his speech; let him read aloud
slowly, and fix his attention on his subject.
As a specimen of treatment for a facial tic, we may cite the subjoined
programme:
Every day, and three times a day, at the same hours--nine, one, and
six--the patient is to look at himself for two minutes in a mirror,
preserving absolute immobility the while; to read aloud for two
minutes, to speak in front of the glass for two minutes, to walk
backwards and forwards in front of the mirror for two minutes.
During the ten minutes of these exercises he will endeavour to keep
his facial musculature under control. If the tic assert itself in
the course of one of the exercises, he will recommence the latter,
if necessary twice; the third time he will leave it till the next
séance.
For tics of the head and neck, such as tossing tics and mental
torticollis, inclination and rotation movements are indicated, of which
an instance may be quoted:
Mademoiselle R. is quick in learning how to correct her muscular
faults. Her actions are gradually becoming more complete and ample,
and if she performs her allotted task with little animation, at the
least there is no question of her indefatigable willingness. In
less than a month she has been able to fix her regard, open her
eyes widely, turn her head, uninterrupted either by halts or
twitches; she can remain motionless in front of a looking-glass for
as long as a minute. Equally satisfactory progress hat been made
in the art of reading aloud; she breathes more regularly, and
articulates more distinctly.
Thus the patient has come to realise that she need but give her
attention to the involuntary movements for them to cease, and there
has been a synchronous advance in her mental activity and power of
concentration. Her nonchalance and timidity have diminished; she is
no longer indifferent to her surroundings, nor furtive in her
glances; she enters into conversation with zest, and her movements
are characterised by decision.
Take another example of treatment, for a case of mental torticollis:
Stand or sit in front of a mirror and endeavour to maintain an
absolutely correct position of trunk and shoulders.
Lift the arms vertically and turn the head to the right, then lower
the arms while the head remains as it is.
Bend the body forward, and stretch the arms out till they touch the
ground, the head meantime being rotated to the right. Then rise up
again with the head in the same attitude. After two or three
efforts it will be found that the head can be kept straight for a
few seconds.
Public-domain text, read in full here on John Shaqi.
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