Setting the stage with our new specialist for Tourette Syndrome

Posted: July 27, 2011 in Tourette Syndrome
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This a continuation of the post A new specialist for Tourette Syndrome…   In this previous post I described my son’s new doctor who specializes working with kids with Tourette Syndrome. He is not a typical doctor, but an expert in self-hypnosis, and my son enjoys talking with him. Our first appointment focused on the doctor getting to know my son and for my son to get comfortable talking to him. Dr Dan is a pretty funny guy and is fairly easy to talk with him.

This week we had another appointment with Dr. Dan. He began our second appointment by asking my son, “What did you think about our last meeting.”  My son said, “It was all good.  I also talked to my mom about what it meant when you asked me what types of tics I had.  I didn’t understand by what you meant by ‘types of tics.  We also talked about hypnosis.”

Description of a tic

The doctor asked my son, “What is your worst tic?”  My son said, “It is a yelling tic.” The doctor asked, “What happens when a tic starts?”   At first my son had a hard time describing it. I jumped into the discussion to help, and said to my son, “Think about where you are at when these tics start.” My son explained, I usually gets movement tics at the grocery store.”  The doctor then asked him what kinds of movements and my son showed him his jerking head tics.

My son explained to the doctor that there are so many people at the store and he felt like they were watching him. The doctor asked if the tics stop and if they do, how do they stop?   My son responded saying they just stop. The doctor asked if he was sure. He added, “Tell me what do you do when they start? What if you are not done shopping?” My son explained that sometimes he sits down on a bench at the store or he goes to the car. Then he does deep breathing to try to relax. The doctor exclaimed, “Well there is a lot that you are doing to make them stop.  You are removing yourself from the location, and your are doing deep breathing and trying to relax.”

He then said to my son that he knew that my son could not control the tics but did my son know what caused his tics.  My son couldn’t really answer.  The doctor turned to me and asked the same question.  I explained that when this first started I thought my son was doing it on purpose.  Later I realized it was tics, and it appears the tics are caused by stress.  The doctor responded that stress is a big word and has a big effect on many people.

The doctor went on to tell my son about one of his patients that had the same type of tic my son had except his yelling tic was so loud that when the boy had an appointment with the doctor other people in the building would come to his office to see if everything was all right. The doctor explained to my son that he ran into this boy’s mother at a local mall. The mother approached Dr. Dan and told him she wanted to update him on her son David. The woman said, “David is now 26 years old, has graduated from college and is married. He hasn’t had a yelling tic for over ten years.” The doctor then said to my son that we can make that happen with him too.

Visualization

The doctor asked my son if he can go some place without physically moving. My son laughed and said no. The doctor said that he could, and he asked us to watch him do it. He closed his eyes and explained to us he was on the beach and his dog was sitting beside him.  He even reached out to pet the dog.  My son then understood that by imagining the beach the doctor could go there in his mind.

The doctor asked my son to participate in an experiment. He brought out a pad of paper and a pen. He asked my son to close his eyes and then write his name on the paper. After my son did this the doctor said keep your eyes closed and now write your name in cursive. Then he said my son could open his eyes. Looking at the piece of paper, my son had perfectly printed and wrote in cursive his first name.  The doctor asked how did you do that?  He continued, “Did you tell your hand that it should write the letters of your name, making them nicely spaced, and beginning your name with a capital letter?”  My son said, “No, I just imagined my name and then I wrote it.”  The doctor then said, “That is exactly what I am going to teach you to do which will help you with your tics, or taking shots or falling asleep at night.  He also asked my son how did he learn how to write his name so well.  My son said it was with practice.  The doctor explained that my son will need to practice in order to get the benefit from self-hypnosis.  The topic of practice came up several times during the discussion.

What is hypnosis

As I mentioned earlier my son and I had talked about this doctor being a specialist in hypnosis. Since my son brought up this discussion in the appointment Dr. Dan began talking about that topic.   A good portion of the appointment consisted of  talking about what hypnosis was. Dr. Dan first quizzed my son and asked him to describe what he knew about hypnosis. My son gave the typical Scooby Doo television description of hypnosis:

It’s like a trance.  A man takes a watch and swings it in front of the person, telling the person they are getting sleepy. The man then makes a suggestion that the hypnotized person do something, like squawk like a chicken. Soon the hypnotist snaps his fingers to wake up the guy. Everyone is laughing and the guy doesn’t understand what has just happened.

The doctor then told my son he was going to ask me what I knew about hypnosis, which he did.  I explained that of course I had seen hypnosis in cartoons, but I also participated in a hypnosis group in my college group.  Though I didn’t achieve what I wanted to achieve, I still used the relaxation techniques to this day.  During this description the doctor interrupted me at one point when I said that I did not accomplish what I wanted to with hypnosis.  He smiled and said, “Not yet.”

The doctor then turned to my son and asked if I had taught him those relaxing techniques.  My son said no, which really wasn’t true.  I had taught him visualization to get rid of hiccups.  When he was little we also used to breath and count when he had some of his seizures.  My son had also worked with a specialist who taught him biofeedback which used the deep breathing relaxing technique.  In fact my son tries to use that technique when we have to change his insulin inset, which is administered with a shot.  During this description the doctor interrupted me at one point when I said that I did not accomplish what I wanted to with hypnosis.  He smiled and said, “Not yet.”

The doctor explained that none of the TV depiction of hypnosis is true and that only you, yourself, can control your mind. He then went on a small tirade about the lack of ethics with these people who offer programs to stop smoking, losing weight, etc. or even worse, using the topic of hypnosis as a means of entertainment. He explained, hypnosis is a medical treatment and these people are practicing medicine without a license, which is against the law. He explained, that is why these people have a show for one day in a city and then they quickly leave town.  I could tell that this topic of giving the wrong impression about hypnosis really bothered this doctor.

As he was having this little tirade he was trying to get a TV ready to watch a VHS recording.  Soon his tirade of false impressions of hypnosis moved to a tirade about how the university doesn’t provide better equipment.  The TV was ancient.  The doctor wiggled all of the cords, and still the TV would not work.  He also said, “They won’t even pay to convert my videos to disc.  This is just another example of poor budgeting by our state government.”  As he continued to fiddle with the TV he mentioned that recently he got a phone call from a department in Washington D.C. asking him if the shut down of the state government, was impacting his access to his grant funds, which it wasn’t.

Demonstration by a previous patient

Soon the doctor came back to the task at hand and said that he was not going to waste our appointment time to deal with faulty equipment.  He said we will look at a different recording that he had on disc and could watch on his huge computer screen.  The DVD was a recording of a ten-year old girl explaining how hypnosis has affected her and how she does it.  She called it meditation rather than self-hypnosis.  She also explained what type of tics that she had, which ranged from a head turn to as extreme as coprolalia, which are swearing tics.  She called them bad word tics.  She demonstrated that as she relaxed, envisioning a nice place, she would then see a stop sign.  She said it was really “cool” because when she saw the stop sign her tics would stop.

Just three words:  3 and 6

At this point our appointment was getting close to the end.  The doctor wanted to give my son a tip for starting the process of self-hypnosis.  He said all you have to do is remember three words which are:  three and six.  He went on to explain that he wanted my son to practice breathing in deeply, through the nose, for at least three seconds, and then exhaling through the mouth for six seconds.  He demonstrated this and then asked my son what happens to the doctor’s shoulder when he does this.  My son said they go up when you breathed in and then they went down when you breathed out.  The doctor explained that as you continue doing the breathing exercise slowly the whole body would relax, all the way from the head to the toes.  Then to end our appointment he asked my son to practice this and he will see us at our next appointment.

A talent for children

Looking back at this appointment I realized why this doctor appeared to be good.  My son and I have been to many doctors, including pediatricians, neurologists and psychologist.  But none of them had the gift of talking to a child.  Yes, some of them changed their language and tone, but this doctor was different.  It was not just the style of the language but it was the progression of the topic.  He clearly lead my son through topics without my son realizing he was learning new things.  This doctor was really an expert at this.  He knew how to start down a topic, ease into it, get my son’s impression of it, and then provide the details of it, along with reinforcement.  As a result of this, the appointment was actually enjoyable.  The doctor even mentioned that my son was a very good listener, and remembered things that many people would not remember such as not using the words “trying” or “can’t.”  The way this doctor was working with my son was actually boosting my son’s self-esteem.  It was absolutely wonderful to watch.  I am looking forward to our next appointment in a couple of weeks.

To Be Continued . . .

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