Modern Australian
The Times

How Tourette’s causes involuntary outbursts – and what people with the condition want you to know

  • Written by Melissa Licari, Senior Research Fellow in Child Disability, The University of Western Australia; The Kids Research Institute

Tourette syndrome campaigner John Davidson has explained he left the British Film and Television Awards (BAFTAs) ceremony early on Monday night, aware his outbursts were causing distress.

Davidson was attending the ceremony to support the film I Swear, which tells the story of his life living with the syndrome. Tourette’s can cause involuntary movements and sounds, including words.

Davidson’s outbursts during the ceremony included a racial slur while actors Michael B. Jordan and Delroy Lindon, who are Black, were presenting an award.

In a statement, Davidson stressed the words were not intentional and did not “carry any meaning”. He said he was “deeply mortified” that people might have thought otherwise.

There are valid criticisms about how the BAFTAs and the broadcaster handled the situation and failed to properly acknowledge the hurt caused, whether or not it was intended.

But the syndrome Davidson has spent his life educating people about remains sadly misunderstood. So let’s take a look at Tourette’s and the tics it causes.

A neurological disorder

Tourette’s is a neurological disorder characterised by unintentional movements and vocalisations, known as tics.

While the exact cause of Tourette’s is not fully understood, it is likely to be complex and multifactorial.

Various genes have been linked to the condition, and we know it runs in families, so it likely has a strong genetic basis.

We also know that other environmental exposures during key periods of brain development contribute to the onset and course of the condition, such as complications during pregnancy and birth, illnesses and infections, and intense stress.

Tourette syndrome also rarely occurs in isolation, with many diagnosed with attention-deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD) and learning disorders.

What are tics?

Tics are thought to be caused by changes in brain circuits involved in impulse control and inhibition.

People with tics often experience uncomfortable physical sensations that build up in the body called premonitory urges. These urges are difficult and often impossible to suppress, and the only way to alleviate the urge is to tic.

It is a bit like when we experience itching on our skin or tingling in our nose, sensations we relieve by scratching or sneezing.

Tics vary between people and fluctuate in frequency, type and intensity, which can be challenging to manage.

Some tics are brief movements and sounds, such as forceful blinking, facial grimacing, head jerking, sniffing, throat clearing and grunting. These are referred to as “simple” tics and are very common, particularly in young children.

Other tics involve more elaborate patterns of movements and sounds – often involving several parts of the body.

These are “complex” tics. They include motor tics like hitting oneself, kicking or dropping to the floor, and vocal tics like repeating words or phrases. This can include socially inappropriate terms such as slurs or swearwords.

It is believed the Tourette’s brain sometimes struggles to control “forbidden” impulses. A person may experience urges to say taboo words and phrases, or make inappropriate actions, when they see or hear certain things within their environment.

How common are tics?

Tics are very common among children, with simple tics occurring in up to one in five children aged between five and six. These normally resolve in a short space of time, with many people unaware they are tics.

For one in 100 children, their tics will persist and become more severe. Having both motor and vocal tics for at least 12 months, meets the diagnostic criteria for Tourette syndrome.

While Tourette’s typically first appears in early childhood, onset can also occur during adolescence and adulthood.

For most children, tics will peak during early puberty, typically between 10–12 years of age, before reducing.

But for about one in four people with Tourette syndrome, their tics will be lifelong. Around 50,000 Australians currently live with a life-long tic disorder.

The use of obscene and socially inappropriate words and phrases, referred to as coprolalia, only occurs in about 15–20% of people with Tourette’s.

Unfortunately, coprolalia is often what gets portrayed in media and entertainment, impacting the public’s understanding of Tourette’s.

Is there a cure?

Tourette syndrome currently has no cure.

Ideally, treatment should include evidence-based behavioural interventions for tics. However these can be difficult to access, with few psychologists trained in these interventions.

Other psychological therapies aim to address the person’s stress and anxiety – which are factors known to increase tics – but not their tics.

Medications are also commonly prescribed if the tics are impacting the person, but these are not effective for everyone and often have side effects.

An exhausting and disabling condition

The frequent urge to tic disrupts attention and concentration, and the tics themselves can impact many aspects of daily living, such as dressing, eating, watching TV, and even relaxing.

Tics can also cause discomfort and injury, such as muscle soreness, cramping, whiplash, dislocations and broken bones. The research I’ve done with colleagues shows two-thirds of people sustain injuries from their tics.

I was involved in a national survey in 2025 involving more than 200 people with Tourette’s and their caregivers. They told us about the challenges they faced including:

  • long wait times for diagnosis
  • little understanding of tics and the condition from health workers and teachers
  • a lack of support and limited treatment options
  • a severe negative effect on mental health.

The social stigma, bullying, exclusion and exhaustion of living with this condition often leads to significant mental health struggles.

Our research shows around 70% of people living with Tourette’s struggle with anxiety disorders and one in three experience depression. One in four adults and one in ten children with this disorder have attempted suicide.

People with Tourette’s want to be understood and accepted

Tics are not something they are doing for attention. They increase when a person is stressed, anxious or excited, and trying to hold them in can make them worse.

Not everyone experiences coprolalia but, for those that do, the inability to inhibit taboo language can lead to public scrutiny and cause embarrassment and shame. This leads to many avoiding social situations and a life of isolation.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800.

Authors: Melissa Licari, Senior Research Fellow in Child Disability, The University of Western Australia; The Kids Research Institute

Read more https://theconversation.com/how-tourettes-causes-involuntary-outbursts-and-what-people-with-the-condition-want-you-to-know-276750

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