I shiver when I recall the day, I took my eldest to the Alberta Children’s Hospital ER, wholly convinced that, like my mother had a few years prior, he was dying from a brain tumour. The previous week, his teacher had emailed me to advise that my son had “completely lost motor control” during an activity in class. The pediatrician at the ACH ER sensed my urgency (panic) and made a referral to the Child Development Centre – bless her beautiful, empathetic soul. After evaluating my son, and confirming a diagnosis of Tourette’s Syndrome, the CDC developmental pediatrician looked at me with the kindest, biggest, most beautiful brown eyes I’d ever seen, and gently inquired, “Your kiddo is fine for OCD…but have you ever been tested?” She nailed it! Apples and trees, you know…
I am so grateful for the bumps (mountains?) along my journey – I believe I am much more effective and empathetic in my day job (well, let’s be honest, also my, and every parent’s, home job!) as a Psychologist because of them, and much like the iceberg metaphor associated with TS and Tic Disorders depicts, I love working with families with all of the moving parts (pun intended) that can come along with this type of a journey. These other considerations can include: Attention-Deficit/Hyperactivity Disorder (ADHD), Obsessive-Compulsive Disorder (OCD), obsessive-compulsive behaviours (OCBs), anxiety, depression, social challenges, sleep issues, sensory-processing deficits, executive-function (EF) challenges, and learning disabilities (LDs). Very little occurs in a silo, and it is the strength inherent in each family/community system that ultimately helps us to triumph over whatever challenges arise.
When clients are referred to me (often by pediatricians and/or neurologists), or self-refer (no referral needed!), I enjoy wholeheartedly inquiring as to what each of their moving parts entails. It is a real privilege to join a family and try to understand how the puzzle/iceberg pieces fit together, as well as what disarray and dismay they can cause. By the time families arrive at my office (virtual or actual), they are often frustrated, disillusioned, exasperated, and hopeless. It can be a real sense of defeat to navigate these considerations with very little direction or understanding. It is very rewarding for me, and relieving for families, to come up with a plan to tackle some of the iceberg – it can generate some synergy and momentum once pieces start to be chiseled into something more skillful and beneficial.
Tic work is often not just tic work – we can absolutely explore ways to manage and reduce tics and their impact, within the Comprehensive Behavioural Intervention for Tics (CBIT) framework (which incorporates self-awareness, functional behaviour assessment, habit-reversal components, etc.). We are also looking for strategies to help engender more skillful living, whether that be anxiety management, trigger management, family dynamics, and so on. What emerges is often a much more resilient, tenacious, and functional human being (and family)! Who wouldn’t want that? Let’s begin.