The Town That Caught Tourettes

Last night Channel 4 televised a fascinating 1 hour documentary called The Town That Caught Tourettes. It concerned a small rural community in New York State where a dozen or so teenage girls had all suddenly within a short space of time come down with a Tourettes-like condition of uncontrollable physical and verbal tics. In a very measured presentation, it considered all the possible causes that could underlie such an outbreak, given that you can't transmit Tourettes Syndrome and that this particular set of symptoms were like Tourettes but not actually the disease itself (so the programme's title itself wasn't quite so measured). It might have been interesting to see clinicians present the reasons why their ailment wasn't considered to be Tourettes itself.



Essentially, because all the girls went to the same school, their parents wanted answers as to whether there was something environmental that had precipitated the spate of symptoms in their daughters. The school was rigourously tested but nothing detrimental was found. Erin Brockovich also became involved when it emrged there had been a train crash some years before 5 miles away and that the danegerous chemicals it was carrying might have reached the environs of the school's subsoil by this time. Brockovich's own investigative team cleared the train crash as a possible cause, but said there were other environmental issues that were of a concern, although the programme didn't detail these.

If there was an environmental cause, then I would ask why only girls were affected. Why not boys, or women teachers if it were to be gender specific? There was one adult woman who suffered the symptoms, but she wasn't involved in the school, though she lived in the community. A Doctor diagnosed the strep-related Pandas Disease and started treating some of the girls with anti-biotics to deal with their strep-throats. The girls started improving, but other doctors with a radically different diagnosis (see below) claiumed this was just as likely to be due to a Placebo effect for the girls and their parents having their view of an external cause of the condition finally being listened to and backed up. These doctors claimed that Pandas Disease is too rare for it to have suddenly burst out in such profusion.

Instead these doctors offered a diagnosis that reminded me of the Arthur Miller play The Crucible which was about a case of mass hysteria among teenage girls in 16th Century Salem as they accused their elders of witchcraft. (Incidently my son is studying this for his GCSE English, so I'm going to sit down with him to watch it). The doctors prognosticate that patient zero, (which again frustratingly perhaps we were not shown, or if we were we didn't realise she was patient zero), probably broke out into the ticcing symptoms as a response to her own internal collapse under stress and that within her small community of school and town, it triggered a mirroring response in other teenagers who had stresses of their own. This was not a conscious response, anymore than the kids were faking the symptoms for attention. But like The Crucible, it became a case of being passed on through mass hysteria, though the doctors don't call it this any more; now it is known as Conversion Disorder. There are no physical prompts or causes for the psychological/neurological effects that lead to ticcing. It's merely the power of suggestion, even when the suggestion is ultimately a negative one, but the girls were so vulnerable that it possessed them. The girls at the school who remained unaffected, were they genetically immune, or merely had less stress to cope with driving down their immunity?

All the girls and their parents insisted the girls were not under any particular stress when they fell ill. They were all 'normal' teenagers. Yet the doctors treating them for Conversion Disorder also reported an improvement in their patients through treating the causes as internal rather than external. The programme also showed a journalist who started digging into the upbringing of the girls and reported that some had indeed had troubled unbringings, leaving them vulnerable to this sort of response when the critical breaking point is reached. However, only two girls' backgrounds were portrayed on the programme and the adult women too, who reported that she'd been the victim of abuse as a child.

So there seem to be two nwidely divergent theories as to the cause, both of which claim success in the consequent treatment stemming from their respective diagnoses. I find it fascinating that we could be witnessing an outbreak of suggestive mass hysteria. In the UK there has been the incidence of 7 teenagers committing suicide within the same town of Bridgend as a version of mass hysteria or at least a collective influence. And although that is more people falling under the influence of others whispering in their ear, it shows how susceptible we can be to influences on our behaviour.

The abiding image I have was from the beginning of the show, when a teen from a completely different town in New York State was being interviewed with her mother, and her mother who later complained that her daughter's verbal tics drove her to distraction in a most unsympathetic way, was explaining her feelings with hand gestures that resembled nothing less than lower energy tics thermselves. The ticcing symptoms of Tourettes are described as pressure from the inside demanding release, so that the motor impulse of the tic is a response to the nervous system's drive and charge. The motor-neuro is intimately bound up with the emotions and while it seems it could be to do with the brain's wiring, it can also be absolutely about emotions and stresses and dealing with that kind of build up. I did feel particularly sorry for this lone girl in the town of Corinth with her condition and with her family situation. If the others in the town of LeRoy showed signs of improvement, she alas was as bad as ever.