Tourette’s and obsessions: it’s not just about tics
We often think of Tourette’s as a series of visible outbursts, but the storm can also rage within the mind. Obsessions are thoughts, images or impulses that arise insistently and involuntarily. They are not mere worries, but actual ‘mental tics’ that take up precious space in the brain. It is like having a browser tab that won’t close and keeps replaying the same content.
This internal aspect of the syndrome is often the most difficult to explain to others. Whilst a motor tic lasts a second, an obsession can last for hours, consuming an enormous amount of mental energy. Understanding the nature of these thoughts is the first step towards no longer feeling trapped by one’s own mind. Let’s examine how these loops arise and how science explains this deep link between action and thought.
What obsessions really are
Obsessions are intrusive cognitive phenomena that the brain perceives as foreign yet impossible to ignore. Scientifically, they arise from hyperactivity in the orbitofrontal cortex, the area that assesses risks and errors. When this area is overactive, it sends constant alarm signals even when there is no real danger. For those with Tourette’s, these obsessions often concern the need for symmetry, order, or the fear that something bad will happen.
Why the mind gets stuck on a thought
The blockage occurs due to a malfunction in the brain’s ‘switch’ mechanism. Normally, once a problem is solved, the brain moves on to the next thought. In Tourette’s, the ‘task complete’ signal does not reach the deep circuits correctly. The thought gets stuck in a biochemical loop, continuing to spin its wheels like a scratched record. This phenomenon is linked to difficulty with inhibition, the same mechanism that causes motor tics.
The difference between obsessions and mental tics
It is essential to distinguish between an obsession and a mental tic, even though they may seem similar. A mental tic is a rapid, involuntary thought, such as repeating a word or a number in one’s head for no particular reason. An obsession, on the other hand, carries with it a burden of anxiety and the feeling that one ‘must’ think about that thing to avoid distress. A mental tic is a motor ‘short circuit’ in the mind, whereas an obsession is a more complex and structured cognitive process.
When they become difficult to manage
Obsessions become a major obstacle when they start dictating the rules of your day. If you are unable to study, work or sleep because your mind is preoccupied with resolving endless doubts, the situation requires attention. Physical fatigue drastically impairs the brain’s ability to filter these thoughts. At such times, the intensity of the obsessions increases, making it difficult to distinguish reality from the projections of an anxious mind.
The impact on daily life
Living with obsessions means making a constant, invisible effort to appear calm on the outside. Many people develop small mental rituals to try to ‘neutralise’ the intrusive thought. This mental effort reduces the ability to concentrate and can lead to significant social isolation. Often, there is a fear of being judged ‘crazy’ or strange, when in reality it is simply a matter of highly reactive brain biology.
Strategies to reduce the intensity
Science suggests that the best strategy is not to try to suppress the thought, but to learn to observe it without reacting. Cognitive techniques help to label the thought as ‘background noise’ generated by the brain. Reducing general stress and improving sleep quality helps to stabilise neurotransmitter chemistry.
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The information contained in this article is for informational purposes only. For medical advice or a diagnosis, always consult a professional.
