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Question 30: It is not uncommon for
TS children (even adults) to be sexually inappropriate, perhaps intrusive
and not complying with the cultural/societal norms. How does one address
this in an in-service since the question has popped up? More importantly,
how does one handle this behaviour to extinguish it? With some young
children it seems to extinguish fairly quickly with talking and substitution
training for in public. For others whom are at the age when this can
be viewed as deviant, criminal behaviour--Young Offenders 12+ and
age of sexual consent 14 years--what suggestions for working with
these young people. Some of them are hypersexual....so some management
issues need to be addressed. K.T., BC, Canada.
Hi
K.T.!
I
would approach 'sexual inappropriateness (in terms of tics, impulsive
acts/words, etc.) by first recognizing that the only difference between
this tic/compulsive behaviour/impulse and any other is the difference
it holds in cultural meaning/interpretation/importance to others. Teachers
and staff need to be assured that this behaviour is simply another,
albeit unfortunate, symptom -- not anyore indicative of sexual abuse
or sexual morals than any other tic is.
I
think it's also important to emphasize the 'rules' of tics again at
a time like this -- the bigger a deal that is made of a tic, the more
apt that tic will increase in frequency and/or intensity (i.e. attention,
concentration, and stress surrounding that behaviour will paradoxically
fuel that very behaviour). From this perspective, it is often the individual
who would be MOST mortified by engaging in these sorts of behaviours
(say, the son of a minister) who gets caught up in them. It is also
important to again emphasize how tics are a form of disinhibition --
a loss of censors. Everyone -- particularly in puberty -- thinks a lot
about sex and is devoting a disproportionate amount of energy to sexuality
(in terms of attention, curiousity, physical maturation, etc.) at this
point in life. It is of little surprise then that in a person without
good brakes might wear some of this interest 'on his sleeves' so to
speak. Framing it in this way helps increase empathy for the person's
'rape of privacy' -- most have the luxury (and dignity) of learning
to cope with this new facet of normal human development with more discretion.
In
terms of dealing with the symptoms, again because they are no different
(neurologically) than any other TS symptoms I don't have 'special' strategies
to offer. Habit-reversal training (symptom substitution) is an option,
as is symptom negotiation (touching oneself, for example, from inside
a pocket rather than more explicitly), education of the environment
(peers, teachers, etc.).
In terms
of hypersexuality, I agree that this is an often undiscussed issue that
needs to be brought out for discussion more. I have been working on
a hypersexuality article for an upcoming Disinhibited
Thoughts -- stayed tuned!! :-)
