Tourettic OCD and Just Right OCD

The line between Tourette Syndrome and OCD can be a little hazy for some people.

Sometimes, tics are carried out to reverse an intrusive thought. On other occasions an OCD-style compulsion may feel ‘just right‘ or help to scratch a ‘mental itch’.

Tourettic OCD -or Just Right OCD– may more accurately define someones experiences and help to improve quality of life.

Having a bridge between the two will no doubt help some to better understand their mind.

A much needed link

This relatively recent term is much welcomed. Many sufferers have longed for a more accurate label for an experience that isn’t fulfilled by a Tourette or OCD diagnosis alone. 

The International OCD Foundation provides a useful article on the relationship between Tourette and OCD, as well as the following paragraph on TOCD:

...boundaries between symptoms of OCD and T/TS can be blurry, especially with regard to differentiating complex tics from compulsions in cases where actions are repeated specific numbers of times according to prescribed rules or until a “just right” feeling is achieved.

‘Blurry’ is the key word here.

Understanding when TS and/or OCD is taking hold can be difficult enough on their own. Even more so when they occur concurrently. 

The following list provides examples of how TOCD may occur, with the hallmarks of both Tourette and OCD present.

  • Switching a light on and off repeatedly, until a sensation in the finger goes away
  • Having three head nodding tics in a row, and needing to do a fourth because even numbers ‘feel right’
  • Saying a ‘good’ word out loud after saying or thinking a ‘bad’ word. Saying the ‘good’ word provides relief or a feeling of ‘evening things out’

OCD-style compulsions due to a sensory feeling

Sometimes behaviours typically linked with OCD are caused by a feeling and not a thought or fear.

Repeating an action (such as locking a door or pressing a switch) may be carried out because of a need to hear the sound of the lock, or feel the finger press against the switch. 

These may be considered complex tics, but can also fall under the category of Tourettic-OCD.

Tourettic OCD example, with person pressing a switch

Tourette closely followed by OCD, and vice versa

On occasions, symptoms of Tourette and OCD may occur separately, but in quick succession.

For example, someone with a dislike of odd numbers may feel anxiety if a tic is carried out three times.

In this case, a fourth ‘phantom’ tic would be carried out. This action would not be to alleviate the pressure built from a tic, but to satisfy the need to do things an even number of times.

'Phantom' tics reversing intrusive thoughts

Compulsions may appear identical to tics in Tourette, and very difficult to distinguish without context.

For example, someone struggling with intrusive thoughts on a religious theme may say ‘Heaven’ out loud when thinking of Hell, or apologise to God after an intrusive thought.

These differ from vocal tics as the words are said to reverse a thought, and not due to a sensory urge.

TOCD example, with person saying phrase

How common is Tourettic-OCD?

Tourette’s affects roughly 1% of the population, and OCD 2.3%. 

Tourettic OCD will no doubt be a number within these figures, although there isn’t much information on this.

In the same article at International OCD Foundation linked above, it states that 60% of Tourette’s sufferers experience OCD symptoms. It goes on to say that 50% of children with OCD have tics, and 15% meet the criteria for Tourette’s Syndrome.

It seems that if you have one of these conditions, there is a chance you have both.

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