While the stereotyped act has all the appearance of a normal movement,
the tic, on the contrary, is a "corrupt" muscular contraction; its
subject is irresistibly impelled to its performance, and any attempt at
repression is painful, sometimes even agonising. Victory is perhaps not
entirely impossible, but any arrest is, as a rule, only temporary, and
entails suffering which well deserves to be considered pathological.
On the other hand, the thousand illogical and absurd mannerisms of which
we have been speaking betray no irresistible imperiousness in their
execution, and require no agonising struggle for their repression. They
are not tics. The crucial point in the differential diagnosis is the
presence or absence of mental suffering.
The distinction may be further elaborated. Concentration of the
attention may diminish the intensity or even inhibit the occurrence of a
tic; inversely, a simple bad habit is manifested preferably during this
very concentration. In the heat of physical or intellectual labour, we
have all our favourite and characteristic tricks: we curl our moustache,
we twist our beard, we scratch our forehead, we rub our chin, we nod our
head, we fidget with our fingers in reading, speaking, reciting--in any
mental or physical exercise requiring our attention we reveal
innumerable little oddities of movement; but let our thoughts be
directed for an instant to these gestures of distraction, and they
disappear forthwith, to reappear afresh when we are absorbed in our work
again. Charcot used to twist his hair round his index finger so
intricately that to disentangle the finger one day a lock of hair had
actually to be cut off. It was a trick of his, not a tic.
In the case of the latter, leisure of mind and body is the signal for
the apparition of the inopportune movements. Any form of effort
demanding the attention will, as a general rule, lessen their frequency
or abolish them altogether.
Trousseau quotes the case of a young girl afflicted with severe tic who
could play through any piece on the piano without the slightest
interruption. Guinon similarly has known cases, one of whom could juggle
accurately with knives, and another whose infirmity did not prevent her
from taking a successful part in operatic ballet. Young L. is
passionately fond of dancing, but he never tics in the ballroom. O. is
an excellent amateur billiard player and never handicapped by his tic
when playing, or, for that matter, when fishing or fencing; but if his
attention be not thus absorbed, it is only with the utmost difficulty
that he can master his tic.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account