Understanding Tourettes: Tourette Syndrome Beyond the Stereotypes
Promotional image from the film I Swear. Used under fair use for commentary and educational purposes.David Webb (Founder and Editor of All-About-Psychology.com)
This article was inspired by a film I watched the other day called I Swear. I went into it thinking I had a decent grasp of Tourette syndrome. I came out of it realizing I didn’t.
I Swear isn’t a film that tries to explain Tourette’s in a tidy or instructional way. Instead, it stays close to lived experience. It shows what it’s like to move through the world with a condition that is highly visible, widely misunderstood, and too often reduced to a stereotype. The focus isn’t just on tics or symptoms, but on the social friction that surrounds them: the staring, the assumptions, the discomfort of other people not knowing where to place what they’re seeing.
What makes the film so effective is its restraint. It doesn’t ask for sympathy. It simply shows how exhausting it can be to exist in a body that constantly draws attention, and how much of that exhaustion comes not from the condition itself, but from other people’s reactions to it.
The line in the trailer that stayed with me long after the film ended was: “I don’t think Tourette’s is the problem, people not knowing about Tourette’s is the problem.”
That sentence neatly captures why I wanted to write this piece. Watching I Swear forced me to confront the gap between what I thought I knew about Tourette syndrome and what I actually understood. The film made it clear that much of the difficulty associated with Tourette’s doesn’t stem from the neurological condition alone, but from ignorance, simplification, and the discomfort of those observing it.
As the film states at the end as the credits are about to roll:
New technology, medication and therapies can help many living with Tourette syndrome. But the most powerful support is education, understanding and acceptance.
What follows is offered in that same spirit, in the hope that better understanding can be part of that support.
What Is Tourette Syndrome?
Tourette syndrome (often shortened to TS) is a neurological condition that involves differences in how the brain controls movement and sound. It was first formally described in the late 19th century by the French neurologist Georges Gilles de la Tourette, but our understanding of the condition has continued to evolve since then.
Tourette syndrome is more common than many people realise. Current estimates suggest that around one in every hundred people is born with TS. However, a significant number are never formally diagnosed. In many cases, tics are mild, intermittent, or so familiar to the person experiencing them that they don’t stand out as symptoms of a condition at all.
The defining feature of Tourette syndrome is the presence of tics. Tics are sudden, involuntary movements or sounds that a person does not consciously choose to make. These can be motor tics, such as blinking, head movements, or shoulder shrugs, or vocal tics, which may include throat clearing, noises, words, or phrases.
One of the most important points to understand is what tics are not. They are not expressions of a person’s thoughts, beliefs, emotions, or intentions. They do not offer insight into someone’s inner world, personality, or character. Tics are neurological events, not meaningful messages. Confusing the two is one of the most common sources of misunderstanding about Tourette syndrome, and one that can have real social consequences for the people who live with it.
Understanding Tourette syndrome starts with recognising this distinction: what you see or hear is not who the person is.
Diagnosis
Receiving a diagnosis of Tourette syndrome can be an important turning point. Not because it changes who someone is, but because it provides a framework for understanding what’s been happening, and opens the door to appropriate support, healthcare, and specialist services.
Tourette syndrome is diagnosed based on a person’s history and observed symptoms. There isn’t a single test that can confirm it. Instead, clinicians look for a specific pattern over time. For a diagnosis to be made, a person must have experienced multiple motor tics alongside at least one vocal tic, with tics present for more than a year. These symptoms typically begin in childhood, although they may change in form and intensity as someone gets older.
Assessment usually involves careful observation and detailed discussion rather than invasive testing. Clinicians may use structured rating scales to help gauge the frequency and impact of tics, particularly when deciding whether treatment or additional support is needed.
In some cases, further investigations such as brain scans or blood tests are used, not to diagnose Tourette syndrome itself, but to rule out other neurological or medical conditions that can look similar. This might include conditions such as epilepsy, certain movement disorders, or other neurodevelopmental differences. These tests are about clarity and exclusion, not because Tourette syndrome shows up on scans or lab results.
Because tics can wax and wane, and because many people with Tourette syndrome have mild or manageable symptoms, diagnosis is sometimes delayed or missed altogether. That can be frustrating, but it also explains why many people only come to understand their condition later in life. For those who do receive a diagnosis, the real value often lies not in the label itself, but in the understanding and access to support that comes with it.
What Causes Tourette Syndrome?
Tourette syndrome doesn’t have a single, simple cause. Instead, it’s understood as the result of a combination of genetic vulnerability and differences in how certain brain systems develop and function.
There’s strong evidence that Tourette syndrome runs in families. It’s considered a hereditary condition, but not in a straightforward, one-gene way. A parent may not have Tourette syndrome themselves, yet still pass on a genetic susceptibility. This helps explain why the condition can appear to “skip” generations or show up in different forms across family members.
Importantly, the inherited risk isn’t limited to Tourette syndrome alone. Research suggests that Tourette syndrome often shares a broader genetic vulnerability with other neurodevelopmental conditions, such as ADHD and obsessive–compulsive symptoms. In this sense, what’s inherited is not a single diagnosis, but a general neurological predisposition that can express itself in different ways.
At the level of the brain, Tourette syndrome is linked to differences in circuits involved in movement control, habit formation, and inhibition, particularly those connecting the basal ganglia, frontal cortex, and related networks. One neurotransmitter that has received a great deal of attention in this research is dopamine.
Dopamine plays a key role in regulating movement and signaling which actions should be initiated or suppressed. In Tourette syndrome, dopamine activity appears to be atypical, especially in pathways involved in motor control. This doesn’t mean there is simply “too much dopamine” everywhere in the brain, but rather that dopamine signaling may be imbalanced in specific circuits, making it harder to inhibit unwanted movements or sounds.
This understanding also helps explain why many medications used to reduce tics work by altering dopamine activity. They don’t cure Tourette syndrome, but they can reduce tic severity in some people by dampening the neural signals that drive tics.
What’s important to emphasize is that Tourette syndrome is not caused by parenting, stress, trauma, or psychological weakness. Tourette syndrome is fundamentally a neurodevelopmental condition, shaped by biology, with wide variation in how it shows up from one person to another.
Is There a Cure for Tourette Syndrome?
There’s currently no cure for Tourette syndrome. That said, many people find that symptoms can be managed effectively, and for a significant number, tics lessen naturally over time.
Tourette syndrome rarely occurs in isolation.
Treatment for Tourette syndrome isn’t one-size-fits-all, and it isn’t always necessary. Some people experience tics that are mild enough not to interfere with daily life, in which case formal intervention may offer little benefit. For others, particularly when tics are painful, disruptive, or socially disabling, treatment can make a meaningful difference.
One of the most well-supported psychological approaches is Comprehensive Behavioral Intervention for Tics (CBIT), which includes habit reversal training. Rather than trying to suppress tics through willpower, CBIT helps individuals become more aware of pre-tic urges and develop alternative responses that reduce tic frequency or intensity over time. It’s an evidence-based approach recommended in clinical guidelines, but it does require sustained effort, practice, and access to trained therapists.
Medication is another option, particularly when tics are severe or when co-occurring conditions are present. Drugs that affect dopamine signaling are commonly prescribed, as dopamine plays a role in the neural circuits involved in tic generation. However, medications don’t work for everyone, and side effects can be significant. This is why medication decisions are usually made cautiously, weighing potential benefits against costs to quality of life.
An important and sometimes overlooked point is the role of coexisting conditions. Many people with Tourette syndrome also experience ADHD, obsessive–compulsive symptoms, anxiety, or mood difficulties. Treating these conditions can sometimes lead to a noticeable reduction in tics, even when the tics themselves aren’t targeted directly. In practice, this can be more effective than focusing on tics alone.
It’s also worth noting the developmental course of Tourette syndrome. For many individuals, tics peak in late childhood or early adolescence and then reduce substantially in late teens or early adulthood. Some people continue to have tics into adulthood, but often at a lower intensity than earlier in life.
Taken together, this reframes the question away from “Is there a cure?” and toward something more useful: What level of support helps this person live well, right now? For many, that support comes not only from therapy or medication, but from understanding, accommodation, and realistic expectations.
Does Everyone With Tourette Syndrome Swear?
No. And this is one of the most persistent misunderstandings about Tourette syndrome.
The involuntary swearing that many people associate with Tourette’s is known as coprolalia, and it affects only a minority of those with the condition. Most estimates suggest that somewhere between 10 and 30 percent of people with Tourette syndrome experience coprolalia at any point. That means the majority do not.
Despite this, coprolalia has become the dominant public image of Tourette’s, largely because it is dramatic, easily sensationalised, and frequently exaggerated in film, television, and comedy. As a result, many people come to believe that involuntary swearing is central to the condition, when in reality it is neither typical nor defining.
This narrow focus has consequences. When Tourette syndrome is reduced to swearing alone, the broader and often more challenging aspects of the condition are overlooked. These can include frequent motor tics, vocal sounds, exhaustion from suppressing tics in public, social anxiety, difficulties with attention, and the emotional toll of being misunderstood or mocked. For many people, these less visible features have a far greater impact on daily life than coprolalia ever would.
There’s also an added layer of stigma. Because coprolalia involves socially taboo language, people who experience it are often judged as rude, aggressive, or intentionally disruptive. In reality, these vocal tics are no more voluntary or meaningful than any other tic. They don’t reflect a person’s beliefs, personality, or intentions.
Understanding this distinction matters. When awareness focuses narrowly on swearing, it distorts public perception and makes it harder for people with Tourette syndrome to be seen accurately. Education shifts the conversation away from shock value and toward what actually helps: recognition of the condition’s diversity, respect for individual experience, and a willingness to look beyond stereotypes.
Is Tourette Syndrome a Mental Health Disorder?
Tourette syndrome is not a mental health disorder. It is a neurological condition, rooted in differences in how certain brain circuits develop and function, particularly those involved in movement control, inhibition, and regulation.
That distinction matters, but it doesn’t tell the whole story.
While Tourette syndrome itself is neurological, mental health difficulties are extremely common alongside it. Anxiety disorders, depression, obsessive-compulsive disorder (OCD), and attention-deficit hyperactivity disorder (ADHD) frequently co-occur. In fact, for many people, these coexisting conditions have a greater impact on day-to-day wellbeing than the tics themselves.
Anxiety is especially important to understand. It doesn’t cause Tourette syndrome, but it can significantly influence how tics are experienced. Periods of heightened stress, worry, or social pressure often lead to an increase in tic frequency or intensity. This is not because the tics are psychological in origin, but because anxiety affects the same regulatory systems involved in tic expression.
Crucially, this means that addressing mental health can reduce tic severity, even though Tourette syndrome is not a mental health condition. Psychological support for anxiety, such as cognitive behavioural approaches, stress management, or environmental adjustments, often leads to noticeable improvements. Not because the tics are “in the mind,” but because the brain functions more smoothly when anxiety is better regulated.
This is where misunderstandings can arise. When people see tics fluctuate with emotional state, they may assume Tourette syndrome is psychological or under conscious control. It isn’t. What’s changing is the nervous system’s level of strain, not the nature of the condition itself.
Understanding Tourette syndrome as neurological with significant psychological overlap allows for more effective and compassionate support. It shifts the focus away from false debates about whether the condition is “mental” or “physical,” and toward what actually helps: recognising the whole person, not just the tics.
Learn More About Tourette Syndrome
If you’d like to build on what’s been covered here, Tourettes Action, the leading UK charity supporting people with Tourette syndrome, offers a free online course titled Understanding Tourette Syndrome.
The course is designed to move beyond media stereotypes and provide a grounded, real-world understanding of what Tourette syndrome actually looks like. It covers the nature of TS, how it presents across individuals, and the broader impact it can have on daily life.
Across a series of short lessons, the course explores:
- What Tourette syndrome is, how common it is, and common misconceptions
- The different types of motor and vocal tics, including less visible and often misunderstood features
- Co-occurring conditions and differences that frequently accompany TS
- The physical, emotional, and social impact of living with Tourette syndrome
- Practical guidance on support, understanding, and accommodation
The full course takes around 45 minutes to an hour to complete and is suitable for anyone wanting a clearer, more accurate understanding of Tourette syndrome, whether for personal, professional, or educational reasons.
You can access the course via the following link:
👉 https://www.tourettes-action.org.uk/learningplatform/#/
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