Transcript: Tourette’s syndrome

Introduction

Today, we’re going to talk about a specific neurotype that you have probably heard of, but might not fully understand: Tourette’s Syndrome.

When I say “Tourette’s”, I know exactly where a lot of minds automatically go. You picture a character in a film or on the TV, who’s shouting out inappropriate things or swearing at the worst possible moments. So, let’s address the elephant in the room right away. That specific symptom, of swearing randomly, is called coprolalia, and while it is very real for the people who experience it, it only affects about 10% of people with Tourette’s. The media just loves to focus on it because it makes for dramatic television.

The reality for the other 90% is much less sensational, but incredibly interesting. From a neurodiversity perspective, having Tourette’s just means your brain handles movement and sound a bit differently. It’s a neurological condition, meaning it’s all about how the brain is wired and how it sends signals to the body. It isn’t a behavioural issue, it isn’t a sign of lower intelligence, and it certainly isn’t someone just trying to get attention. It’s simply a different kind of brain.

Tics

So, what does this different brain wiring actually look like day-to-day? It manifests as “tics”. Tics are sudden, rapid, recurrent movements or sounds that a person does involuntarily. We generally split them into two camps: motor tics and vocal tics.

Motor tics are movements. This could be blinking really hard, twitching a nose, shrugging shoulders, or even more complex movements like tapping a desk a specific number of times. Vocal tics are sounds. This could be clearing the throat constantly, sniffing, humming, clicking the tongue, or repeating words. To get a diagnosis of Tourette’s, a person has to have experienced both motor and vocal tics for over a year.

The premonitory urge

But the most fascinating part about tics isn’t the movement itself; it’s what happens right before it. Most people with Tourette’s experience something called a “premonitory urge”.

Imagine you feel a sneeze coming on. You get that weird tickle at the back of your nose, right? The longer you try to hold that sneeze in, the more intense and uncomfortable that tickle gets. Eventually, your body just has to sneeze to get rid of the feeling. Once you sneeze, there is a sense of relief. That is exactly what a premonitory urge feels like. It’s an uncomfortable physical sensation, like a tightness, an itch, or an energy build-up in a specific part of the body, that can only be relieved by doing the tic. So, while the tic itself might look random to us, to the person doing it, it’s a necessary response to an overwhelming physical feeling.

The Tourette’s iceberg

Now, let’s talk about the “Tourette’s Iceberg”. Tics are just the tip of the iceberg. They are the part that sits above the water, the part that everyone else can see and hear. But below the surface, there is usually a lot more going on.

Tourette’s rarely travels alone. It is highly linked with other neurodivergent traits. Many people with Tourette’s also have ADHD, obsessive-compulsive traits or OCD, anxiety, and sensory processing differences.

For a lot of people with Tourette’s, the tics aren’t actually the hardest part of their day. The hardest part is the invisible stuff beneath the water. It’s the exhaustion of trying to focus on a spreadsheet while your brain is fighting off an urge to tic. It’s the sensory overload of a loud office making the tics worse. It’s the anxiety of worrying if a tic is going to disrupt a meeting. When we look at Tourette’s through the lens of neurodiversity, we have to look at the whole person, not just the visible movements.

Suppression

This brings me to a really important concept: masking, or in the case of Tourette’s, “suppression”.

Going back to that sneeze analogy, you can hold a sneeze in for a little while if you really try, right? But it takes concentration, and eventually, it’s coming out. People with Tourette’s can often suppress their tics for short periods. A lot of neurodivergent folks do this at work or in public because they don’t want to draw attention to themselves or make others uncomfortable.

But suppressing tics takes a monumental amount of mental and physical energy. It is exhausting. Imagine spending an entire hour-long meeting using half your brainpower just to physically stop your shoulder from twitching or your throat from humming. By the end of the day, you’d be absolutely shattered. And usually, once that person gets home to a safe, private environment, all those suppressed tics come rushing out, often much stronger than before. This is called a “tic attack”.

When we talk about creating an inclusive environment, our ultimate goal is to build a culture where people feel safe enough that they don’t have to suppress their tics. Because when someone isn’t wasting all their energy trying to sit perfectly still, they can put all that brilliant energy into their actual work.

How to be supportive

So, how can we be supportive colleagues and friends to someone with Tourette’s? It is actually beautifully simple.

The best thing you can do when someone tics is to simply ignore it. Don’t stare, don’t point it out, and definitely don’t tell them to stop. Remember that they can’t, and pointing it out usually just makes the tics worse because it causes anxiety. Just carry on with the conversation as normal. Treat a tic the same way you would treat a colleague coughing or shifting in their chair. It’s just a thing their body does.

If they bring it up with you, listen openly. Ask them if there’s anything you can do to make the environment more comfortable for them, like reducing harsh lighting or moving to a quieter space, as sensory stress often triggers tics.

Embracing neurodiversity means accepting that there is no one “correct” way for a human body or brain to function. Some brains are quiet and still; some brains are wonderfully active and vocal. When we make space for all of them, without judgement, we all get to do our best work.

Thank you so much for listening. I really appreciate you taking the time to learn about this with me today!

In the discussion, we talked about the film I Swear, Lewis Capaldi’s Glastonbury set, and the 2026 BAFTAs.