Page:The International Journal of Psycho-Analysis II 1921 1.djvu/13

 PSYCHO-OBSERVATIONS ON TIC              5

ing the example of Gilles de la Tourette,¹ one usually designates as "maladie des tics".

These are progressive muscular convulsions affecting prac- tically the entire body which combine later with Echolalia and Co- prolalia and can result in dementia. The frequent complication^ of tics with a typically narcissistic psychosis certainly did not pro- nounce against the hypothesis that also the motor phenomena of less severecasesofillnessof convulsive movement that do not result in de- mentia owe their origin to narcissistic fixation. The last severe case of tic that I met with was that of a young man who was completely incapacitated in consequence of his psychic over- sensitiveness and shot himself as the result of an imagined injury to his honour.

In the majority of textbooks on Psychiatry Tic is scheduled as a "symptom of degeneration", as a sign — often the familiar first sign — of a psychopathic constitution. We are aware that, com- paritively speaking, a great number of paranoiacs and schizo- phrenics suffer from Tic. All this appeared to me to support the suggestion that these psychoses and Tic have the same root. The theory proved to stand on a yet firmer basis when I came to compare the principal symptoms of Tic with the knowledge gained of Catatonia from psychiatry and in particular from psycho-analysis.

The tendency to Echolalia and Echopraxias, to stereotypies, grimacing movements, and mannerisms, is common to both conditions. Psycho-analytical experience with catatonic patients led me some time ago to suspect that the extraordinary behaviour and attitudes were adopted in defence against local (organic) damming-up of libido. A very intelligent catatonic patient who possessed insight to a remarkable degree even told me he was obliged to carry out a certain gymnastic movement continously in order to break down "the erection of the intestine"². In the case of another catatonic patient I could also interpret the occasional rigidity of one or the other extremity, which was connected with a sensation of enormous extension, as a displaced erection i. e. as

¹Gilles de la Tourette, "Etudes sur une affection nerveuse, caractẻrisẻc par l'incoordination motrice, et accompagnẻe d'ẻcholalie et coprolalie", Arch, de Nsurologie, 1885.

²"Some clinical Observations on Paranoia and Paraphrenia", Contribu- tions to Psycho-Analysis, 1916, by the author.