The Advantages of Tourette's

John Updike, in his memoir Self-Consciousness, devotes an entire chapter to his lifelong struggle with stuttering. He memorably describes the act of stuttering as the process of "trying, with the machete of the face, to hack my way through a jungle of other minds' thrusting vines and tendrils." According to Updike, however, his stuttering wasn't just an aggravating mental hiccup which got him teased in school. Instead, the affliction was responsible for his lifelong interest in words. He was hurt into writing:

Stuttering is kind of -- I suppose it shows basic fright. Like in the comic strips, when people begin to stutter it's because they're afraid. And also, a feeling that -- my father thought that I had too many words to get out all at once. So, I didn't speak very pleasingly, but I never stopped speaking or trying to communicate this way, and I think the stuttering has gotten better over the years. I have found having a microphone is a great help, because you don't have to force your voice out of your throat, just a little noise will work. But, it was real enough, and one of the things -- you know, you write because you don't talk very well, and maybe one of the reasons that I was determined to write was that I wasn't an orator, unlike my mother and my grandfather, who both spoke beautifully and spoke all the time. Maybe I grew up with too many voices around me, as a matter of fact.

The larger lesson is that obstacles can also be advantages - who we become is deeply influenced by what we cannot do. (Or, to quote the sage words of Kanye, "Everything I'm not/made me everything I am.")

Consider the growing literature on Tourette's Syndrome and cognitive control. Tourette's is a developmental disorder defined by a set of involuntary motor and verbal tics. The most common tics are eye blinking and throat clearing, although some people can also suffer from the "spontaneous utterance of taboo words or phrases." Previous research has demonstrated that the constant attempt to suppress these tics relies on the activation of the dorsolateral prefrontal cortex, a brain area closely associated with self-control and motor regulation. Interestingly, the chronic struggle of people with Tourette's leads to enhanced cognitive control, at least on certain tasks. Consider a 2006 study led researchers at the University of Nottingham. The experiment involved a challenging eye-movement task, in which subjects were forced to actively inhibit automatic eye movements. Here's where the results get strange: individuals with Tourette's made significantly fewer error responses than their "neurologically normal" peers, without a decrease in speed. The scientists speculate that this result "likely reflects a compensatory change in Tourette individuals whereby the chronic suppression of tics results in a generalized suppression of reflexive behavior in favor of increased cognitive control." In other words, the struggle makes us stronger.

A brand new paper by the Nottingham researchers, published this week in Current Biology, expands on this concept. Once again, young patients with Tourette's were given a motor task that requires high levels of cognitive control. (Think of the game "Simon says" - you might want to touch your nose, but you are only allowed to touch your nose if Simon said to. This skill requires the regulation of impulses, which is why kids are often so bad at it.) As expected, kids with Tourette's did a much better job of regulating their motor impulses. The scientists then compared the brains of those with and without Tourette's using diffusion MRI. Interestingly, kids with the most severe tics had denser connections between the prefrontal cortex (which regulates our impulses) and the brain areas that generate them. (They also showed more activity in the corpus callosum, which connects the two hemispheres.) As the scientists note, "These results provide evidence for compensatory brain reorganization that may underlie the increased self-regulation mechanisms that have been hypothesized to bring about the control of tics during adolescence."

The relevance of this study extends far beyond Tourette's. I think these results are yet another reminder that we can dramatically improve our self-control and impulse regulation, if only we practice. (These character traits are much more malleable than we typically assume, especially if we start working on them at a young age.) Consider a1999 study by the psychologists Mark Muraven, Roy Baumeister and Diane Tice. The researchers asked a group of students to improve their posture for two weeks. Instead of slouching, they were told to focus on sitting up straight. Interestingly, these students showed a marked improvement on subsequent measures of self-control, at least when compared to a group that didn't work on their posture. Why? Because they practiced a little self-control, just like those kids trying not to display their tics. And practice makes perfect.