The hardest part is not the tics. I know. I have them too.

I have Tourette syndrome. I know what it's like to hold everything in during a meeting and then let it all out alone in the car. The knot in your stomach when you're suppressing. The arithmetic before every social situation: where to sit, when to leave, who to tell, how much to explain. I know the loneliness of a condition that most people think they understand because they saw something on TV once.

I'm also a therapist. And the thing I keep seeing, in my own life and in the lives of other adults who have this, is that the tics are usually not the hardest part. The hardest part is everything that built up around them. The hiding. The shame. Anger you've never had a place for. The exhaustion of holding it together all day and then falling apart the moment you walk through your front door. You learned to retreat into yourself because it was easier than being seen. And the scars formed whether or not anyone was technically cruel to you, because hurt and humiliation don't need a bully. Sometimes all it takes is someone looking at you a beat too long.

What this therapy is for

You've probably become your own expert by now. You know which tics are active today, how bad it's going to be, what makes it worse. You've developed hiding strategies. Redirecting a head jerk into a stretch. Turning a vocal tic into a cough. Clicking your tongue softly under the table instead of making the sound your body actually wants. You've gotten good at blending in.

And you pay for it. Your whole life gets organized around concealment. You calculate constantly. You monitor your body like it's a threat. You come home from work and collapse, not because of the work, but because you spent eight hours suppressing. The pressure builds all day like something that has to come out, and then it does, the moment you're alone. People around you see someone who's competent. Maybe a little intense. They don't see the rest of it.

This therapy is for the rest of it.

The shame that formed before you could name it. You knew something was wrong with you before anyone gave you a diagnosis. Other kids asked why you did that thing. Adults said "just stop." You learned, not as a thought but more like something you absorbed through your skin, that your body made you unsafe in social situations. That feeling didn't go away when you finally learned what Tourette syndrome was. It doesn't go away because you can explain it fluently at a dinner party. Shame isn't an information problem. It only shifts when someone actually sees you, tics and all, and doesn't flinch.

The anger nobody makes room for. The frustration at a body that won't cooperate. The fury at "just relax" and "have you tried not thinking about it." Having to explain yourself, again, to someone who doesn't get it. And the deeper anger, the kind that's harder to say out loud: at what this condition has cost you. Things you didn't try. People you pulled back from. The clinical literature calls it "anger dysregulation," which is a polite way of saying you've had legitimate rage building for twenty or thirty years with nowhere to put it.

OCD, rigidity, perfectionism. Tourette syndrome rarely shows up alone. The need for things to be even, or symmetrical, or "just so." The checking. The difficulty with transitions. The way something has to be exactly right or it becomes unbearable. These don't come from the tics. They come from the same wiring. They're comorbid, part of the same neurological package. But they create their own suffering. The loop of not being able to let something go. The inability to call something good enough. I work with all of this.

Your relationship to your body. When your body has been a source of social danger for most of your life, you learn to treat it as something to manage. Suppress. Override. You become exquisitely aware of every sensation, every new tic that shows up or fades. Always scanning. That pattern gets so automatic you stop noticing it. Therapy can help you find out that your body isn't only a problem.

What this isn't

I don't do CBIT, ERP, or behavioral tic management. Those are specific protocols, and specialists trained in them can be effective at reducing tic frequency. If that's what you need, I can help you find someone.

What I do is work with the whole person. The emotional life. The relationships. Who you've become after decades of living with this. You don't have to be in crisis. You just have to be carrying something you haven't had space to put down.

A lot of people I talk to describe it this way: apart from the tics, they have what looks like a good life. Job, relationship, functioning fine. But there's a private version of themselves that nobody sees. The one who is always aware of the pressure to tic. Who has gotten very good at concealment. Who has pulled inward in ways that keep them safe but also keep them alone. That's who I work with.

How I work

My approach comes out of character-analytic and psychodynamic traditions. Not the old psychoanalysis that claimed tics were repressed sexuality (that was wrong, and it's over), but a way of working that takes seriously how a person's early experiences shape who they become and how they move through the world.

For someone with Tourette syndrome, that means looking at what a lifetime of ticcing, hiding, suppressing, and explaining has done to you as a person. Not what you do with your body, but who you became in response to it. How you learned to scan every room before you can relax. The intensity that makes you excellent at work and exhausted by evening. The way you pull back in relationships right when things start getting real, because being truly known has always felt risky. Those are the patterns I work with.

I also understand, from living with this myself, something that people without Tourette syndrome don't really get: how much cognitive energy goes into managing tics all day long. It fragments your attention. It drains you. It leaves you with less capacity for everything else. That's not a clinical observation for me. It's Tuesday.

One thing I'll mention, because people ask: in my own therapy, doing this same kind of work with my own therapist, my tics have gotten significantly less severe over time. The constant tension and pain I used to carry in my shoulders and neck has mostly gone. I'm not making a promise that the same will happen for you, and reducing tics is not the goal of what we do together. This is talk therapy, not medical treatment. But I do think that when the emotional weight gets lighter, when the shame and the anger and the rigidity start to loosen, the body sometimes follows. That's been my experience. I can't guarantee it'll be yours.

To be clear about what this is and isn't: I'm a therapist, not a doctor. This is not medical treatment for Tourette syndrome. I don't diagnose, I don't prescribe, and I don't offer behavioral tic interventions. What I offer is a space to talk, with someone who understands, about the emotional and psychological side of living with this condition and the comorbidities that tend to come with it. The goal is to help you feel better in your life. That's it. Sometimes that also means the tics get quieter. Sometimes it doesn't. Either way, the work is worth doing.

Sessions are 60 minutes over secure video. Before your first session, we have a brief 15-minute call to see if this feels like the right fit for you. Before your first session, we have a brief 15-minute call to see if this feels like the right fit for you. We can see if it's the right fit.

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