Exposure and Response Prevention in the Treatment of Gilles de la Tourette's Syndrome: Four Case Studies

The present article describes a new treatment method for Gilles de la Tourette's Syndrome, consisting of 10 2-hour sessions of exposure and response prevention. This method is based on the notion expounded by Bliss (1980) that patients with this syndrome often produce the tics voluntarily in order to rid themselves of unpleasant sensations. The hypothesis was that, if the patient was aware of premonitory sensations, it should be possible to intervene at the level of these sensations; by preventing the tics, the patient might habituate to the sensations. As a result, it was hypothesized, the urge to produce the movements and sounds would eventually diminish, leading to an extinction of the motor and vocal tics. This article discusses four Gilles de la Tourette patients for whom this method of exposure and response prevention was reasonably effective. Within-session habituation to the premonitory sensations took place in three of the four patients.