Page:The International Journal of Psycho-Analysis II 1921 1.djvu/16

 8 S. FERENCZI

the work with those of the latest discoveries of Psycho-Analysis is in itself a criterion of an objective argument.

I will quote Trousseau's short but classic description of Tic: "Painless tic consists of momentary twitching of lightning rapidity confined as a rule to a small group of muscles, usually those of the face, though the muscles of the neck, the trunk, the limbs can also be affected . . . . . . With one patient there may occur blinking of the lids, a twitch of the cheeks, the nostrils, or the lips, that makes one think he is pulling faces; with another the head nods or there is a sudden and repeated twist of the neck, with a third a shrug of the shoulders, a spasmodic movement of the stomach muscles or of the diaphragm in short it is an unceasing series of bizarre movements that defy description. In some cases the tic is accompanied by a cry or by a more or less loud vocal sound. The tic may consist entirely of this very characteristic larynx- or diaphragm-chorea. There also occurs a very strange propensity to reiterate a cry or a word, the patient will even utter words in a loud voice which he would rather keep back".¹ ' Grasset gives the following account of a patient, a characteristic picture of the manner in which tic can get displaced from one part of the body to another. "A young girl had tics of the mouth and eyes as a child, at fifteeti for several months she stuck her right leg out iri front, later this leg became lame, then for several months a whistle took the place of the motor disturbances, l-'or a ' year she would litter a loud cry from time to time : 'Ah'. At eighteen years appeared nodding movements, backward jerks of the head, shrugs of the right shoulder, etc."²

These tic displacements often come about in the same manner as compulsive actions which displace the actual and original on to the most distant, only to return in the end to the repressed by a byway. A patient of Meige and Feindel³ named these secondary tics "Paratics" and recognised clearly that they were in character defence-mechanisms against the primary tics, converted in their turn into tics.

The starting point of a tic may be a hypochondrical self observation. "One day I felt ... a crack in the neck" recounted a patient of Meige and Feindel, "at first I thought something had

¹ Quoted from Meige and Feindel, Op. cit., pp. 29 and 30. ² Idem., Op. cit., p. 143. ³ Idem., Op. cit., p. 8.