Is this more than just a tic?

[Betty04]

Hi,

 

Just wanted some feedback on this... my 6 year old son has a history of motor (e.g., blinking, wiping, neck movements) and vocal tics but we have never identified any OCD behaviors. However in the car yesterday he was blinking extremely rapidly, to the point where it seemed voluntarily done. This is not the first time we have questioned the tics being voluntary but his age makes it a tough call. Anyway, when I asked him if he was doing that fast on purpose he told me "my brain says blink faster."At first I thought it was just his way of describing the urge/need to rapidly blink but then he offered, "sometimes if I don't do it, my brains says it louder." This was the first time I have ever had him acknowledge or state any thoughts associated with tics. And as you would imagine I have been assessing this for years with him. But I have never used terms like his brain talking or anything leading so that he can just be repeating what I have said. Mostly I have been observing. I did not question him further because the blinking was so out of control and he told me he needs to think of something else to stop.

 

Have others had their children describe their tics in this manner? Thanks for any thoughts on this

[LNN]

I think distinguishing between a tic and OCD can be like looking at a puddle of gray paint - is it white with a little black in it or is it black with a little white in it? Somewhere there's a crossing point, where it's more obviously a tic or OCD. But where that line is can be really hard to tell.

 

I think of movements in three categories -

involuntary - such as myoclonic jerks, seizure movements and choriform movements (finger movements that look like piano playing, or search some youtube videos).

 

voluntary but "have to" do them - the majority of tics are like this - I think of it like having an itch on your nose - you "chose" to scratch it, but it will drive you mad with distraction if you resist and eventually, you only get relief once you scratch the itch. It may be a choice, but it's a choice you "have to" make. However, there's no "reason" that you do it.

 

OCD movements - these are things you "have to do" but are driven by a thought. For example, my son has a "punching" compulsion where he punches his bladder, but it's purpose is to "check" if he needs to use the bathroom (it's connected to urinary urgency). So the OCD is a checking obsession and the compulsion is the punching behavior. In the past, he had to touch things 4 times - again an OCD "evening up" or symmetry obsession with a touching movement as a compulsion. The difference, in my mind, between a tic and a compulsion, is that OCD usually has some sort of "reason" for the movement, a pre-meditation (a purpose), not just a premonition (meaning you feel it coming but there's no reasoning behind the action, nothing bad will happen if you don't do - like feeling a sneeze coming on).

 

OCD generally brings fear and anxiety, like something bad will happen, if you don't comply with the compulsion. There are some general categories - contamination fears, checking/symmetry, scrupulosity, hoarding, and intrusive thoughts. A tic just brings physical discomfort if you don't comply. Your brain may be telling you to do both, but only OCD brings fear of not complying.

 

It's a gray area and not clear cut. When my son jerks his head back, I think it's a tic. When he punches his gut, I think it's OCD. In his mind, the punch has a purpose to it.

 

In our case, there were also obvious OCD behaviors beyond movements. DS was obsessed with clocks and time and had to stop playing in order to watch his favorite numbers appear on the digital clock, he had to walk into a room a certain way or else he'd have to go back and do it again, he had to ask a lot of questions over and over for reassurance... I'd recommend reading a few OCD books or reviewing a list of OCD behaviors posted under the helpful threads section of the forum for examples.

 

From your description, you could argue either way, but without a "reason" other than "I have to", I'd say the eye blinking is a tic. Just my opinion.

[Betty04]

Wow! You did the impossible and separated the grey into black and white

 

Thank you so much for writing so clearly and taking the time to help me understand.

 

I think distinguishing between a tic and OCD can be like looking at a puddle of gray paint - is it white with a little black in it or is it black with a little white in it? Somewhere there's a crossing point, where it's more obviously a tic or OCD. But where that line is can be really hard to tell.

 

I think of movements in three categories -

involuntary - such as myoclonic jerks, seizure movements and choriform movements (finger movements that look like piano playing, or search some youtube videos).

 

voluntary but "have to" do them - the majority of tics are like this - I think of it like having an itch on your nose - you "chose" to scratch it, but it will drive you mad with distraction if you resist and eventually, you only get relief once you scratch the itch. It may be a choice, but it's a choice you "have to" make. However, there's no "reason" that you do it.

 

OCD movements - these are things you "have to do" but are driven by a thought. For example, my son has a "punching" compulsion where he punches his bladder, but it's purpose is to "check" if he needs to use the bathroom (it's connected to urinary urgency). So the OCD is a checking obsession and the compulsion is the punching behavior. In the past, he had to touch things 4 times - again an OCD "evening up" or symmetry obsession with a touching movement as a compulsion. The difference, in my mind, between a tic and a compulsion, is that OCD usually has some sort of "reason" for the movement, a pre-meditation (a purpose), not just a premonition (meaning you feel it coming but there's no reasoning behind the action, nothing bad will happen if you don't do - like feeling a sneeze coming on).

 

OCD generally brings fear and anxiety, like something bad will happen, if you don't comply with the compulsion. There are some general categories - contamination fears, checking/symmetry, scrupulosity, hoarding, and intrusive thoughts. A tic just brings physical discomfort if you don't comply. Your brain may be telling you to do both, but only OCD brings fear of not complying.

 

It's a gray area and not clear cut. When my son jerks his head back, I think it's a tic. When he punches his gut, I think it's OCD. In his mind, the punch has a purpose to it.

 

In our case, there were also obvious OCD behaviors beyond movements. DS was obsessed with clocks and time and had to stop playing in order to watch his favorite numbers appear on the digital clock, he had to walk into a room a certain way or else he'd have to go back and do it again, he had to ask a lot of questions over and over for reassurance... I'd recommend reading a few OCD books or reviewing a list of OCD behaviors posted under the helpful threads section of the forum for examples.

 

From your description, you could argue either way, but without a "reason" other than "I have to", I'd say the eye blinking is a tic. Just my opinion.

[thenmama]

xx

Edited March 26, 2013 by thenmama