People who suffer from Tourette’s syndrome (TS) have good cause to be sensitive about the public’s misperceptions about their condition: the media tends to focus on the 10% of people with TS who suffer from coprolalia, the most mysterious and socially stigmatizing manifestation of the disorder, to the exclusion of more common manifestations of the condition. Coprolalia is the medical term for a type of tic characterized by the excessive and uncontrollable use of foul or obscene language. An inherited neuropsychiatric disorder, TS falls within a spectrum of tic disorders, and is that is characterized by the presence of multiple physical (motor) tics and at least one vocal (phonic) tic. These symptoms vary widely in severity and typically wax and wane.

Coprolalia is a typical symptom of TS, and is characterized by compulsive arm movements, facial tics, grunting, groaning and the shouting of culturally taboo or socially unacceptable words and phrases (such as compulsive cursing and repeated references to genitals, feces and lewd sexual acts). For people with coprolalia, these outbursts are truly involuntary in nature; they are not expressed out of anger or frustration. Outbursts of derogatory racial and ethnic slurs are not uncommon, but do not generally reflect the opinions of those with the disorder. Unsurprisingly, people with coprolalia often experience intense psychological upset as a result of their condition, and many sufferers isolate themselves in order to avoid social embarrassment.

The exact causes of TS and coprolalia are unknown, but scientists believe that both genetic and environmental factors play a role in the development of the disorder. Interestingly, coprolalia has been observed in deaf patients, where swearing in sign language has been described. Currently, there is no ‘magical’ medication that relieves all of the tics experienced by a person with TS. Thus, people with TS usually treat their condition with a combination of psychotherapy and certain medications that can relieve the manifestation of certain tics. Recently, a number of patients with coprolalia have managed their symptoms with some success by getting botox injections near their vocal cords. While these injections do not prevent the vocalizations, they help to reduce their volume; for unknown reasons, coprolalia outbursts tend to be loud and spoken in a different pitch than normal conversation.

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