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Tics
Using Medical Hypnosis to Treat Tics And Habits (without Tourette Syndrome)
Many children experience tics that last for a few weeks or a few months and often go away on their own. These patients do not have Tourette syndrome, which is characterized by multiple motor tics and vocalizations that last more than one year.
(In a rare condition called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections), tics are precipitated by a streptococcal infection such as a strep throat. You need not worry about your child getting PANDAS after a typical strep throat. It is mentioned here only for the sake of completeness.)
Cough tic, or habit cough, is not uncommon in children. Typically, the patient develops throat-clearing behavior as a result of post-nasal drip associated with the common cold. Because the throat-clearing is comforting, the patient continues the behavior after the cold is gone. The patient forces a dry (unproductive) cough during the day, but the cough is absent while the child is asleep. Some parents report that the cough keeps the patient up at night, but on closer questioning, they realize that the cough is gone while the patient is actually asleep.
Often these patients have unsuccessfully tried medications. They have undergone tests such as chest x-ray or CT scan. They have seen subspecialists including ear, nose and throat (ENT) doctors and pulmonary (lung) specialists, and they have been told that there is nothing wrong.
Treatment
Usually, Dr. Lazarus first meets alone with the parents. Then, he sends an introductory letter to the patient; the letter sets the tone and expectation for a positive outcome with the patient.
At the first visit, Dr. Lazarus gets to know the child, emphasizes that he will help the patient help him/herself, and assigns homework. The homework is designed for the patient to think about the tic in a different way.
At subsequent visits, the child watches a video of a boy who overcomes his cough tic through self-hypnosis; he is clearly empowered and happy during and after the treatment. The video offers the reassurance of knowing that other kids have this problem, too, and gives patients the motivation and hope that if this boy can take control over his body and life challenge, then they can, too.
Results: 79% percent of the patients trained in this technique experienced short-term clinical response, defined as control over the average 6-week follow-up period. Of the responders, 46% achieved tic control with self-hypnosis (SH) after only 2 sessions and 96% after 3 visits. One patient required 4 visits.
When self-hypnosis is used, it is generally successful in treating patients with tics. It can be used as a primary treatment, without the use of medication, or as an adjunctive therapy, in addition to medication. When used as an adjunct, medication can often be decreased or even discontinued.
Michael's Story
“I can't tell you the impact that Dr. Lazarus has had on our family. Our son, Michael , has always been a straight-A student, and he got kicked out of school for disturbing other people with a cough tic. It really bothered him that he was disturbing others.
Dr. Lazarus had such an impact. Our son doesn't have any tics anymore. We are in the process of relocating to another city, but Dr. Lazarus is still our pediatrician regardless of where we live. If he asked me to come to the west coast on a red-eye to help support him, I'd do it. That's how much he means to us.” --Father of 8-year-old Michael
To Learn More
Read the JDBP Abstract (PDF): Nonpharmacological Treatment of Tics in Tourette Syndrome Adding
Read Los Angeles Times Article (PDF)
Watch Channel 5 KPIX/CBS news story
View Tourette Syndrome Case Study: how one child was able to control his cough tic
To contact Dr. Lazarus, you may phone him at: 650-322-5333. Or, email him a brief form.
