Guest Blog: Mindfulness Practices for people with tics or Tourettes Syndrome (TS)

Here at the Mindfulness Centre of Excellence we are interested to hear about theory-driven innovations in the delivery of mindfulness. Part of this work is supporting those who might struggle to connect with “standard” practices. How can we thoughtfully innovate to improve access to the benefits of mindfulness? How can we use co-design to ensure that what we deliver is accessible, helpful and optimised?

Using a clinical psychology formulation model, guest blogger Dr Seonaid Anderson, a Psychologist and research manager for Tourettes Action, explains the thinking behind the creation of the first guided mindful relaxation available which is designed specifically for people with tics or Tourettes Syndrome (TS).

See this recent BABCP publication CBT Today about Behavioural therapy for tics (pg 6) by Seonaid and Dr Tara Murphy from the Tourette’s Action Team.

Mindfulness and meditation is a real challenge for people with movement disorders but can be beneficial. Tourettes Action wanted to help people with TS overcome barriers to practicing mindfulness. This is why we have created the first guided mindful relaxation available which is designed specifically for tics.

Overview

This is the first guided relaxation available designed specifically for people with tics or TS.
Mindfulness is a real challenge for people with movement disorders.
It is hoped that the guided relaxation may decrease the intensity and frequency of tics, during or after practice.
If you use the recording, let Tourettes Action know how you got on with this short survey.

Some Background on Tourettes Syndrome

TS is an inherited, neurological condition, the key features of which are tics, involuntary and uncontrollable sounds and movements. Over 85% of people with TS will also experience co-occurring conditions which might include Attention Deficit Hyperactivity Disorder (ADHD), Obsessive Compulsive Disorder (OCD), and Anxiety. TS is often misunderstood as a condition which makes people swear, or say socially inappropriate things. 90% of people with TS do not have involuntary swearing (coprolalia).

It is estimated that more than 300,000 children and adults in the UK live with TS. For some people, living with TS will continue throughout their life, but symptoms are likely to wax and wane. There is no one treatment that can permanently stop tics; but medication and psychological therapies can help to manage symptoms. From anecdotal evidence we often hear that people with TS like and engage in relaxation techniques and these are often suggested by their clinical practitioners.

Designing the Recording

Liz Murray, a British Psychological Society (BPS) Chartered Psychologist, was inspired to create a recorded guided relaxation for people with tics and TS. Liz delivers behavioural therapy for people who have a diagnosis of tics or TS, via telemedicine. Liz also has TS herself.

Liz was influenced to create some kind of audio recording that people with tics could use after taking part in a mindfulness course. While generally beneficial, Liz found it difficult to stay still in sessions and that the mindfulness practices had little or no effect on her tic activity. Liz began to think that there needed to be a relaxation specifically designed for someone with tics. Influenced by the work of Dr Tamara Russell, a clinical psychologist and neuroscientist, two concepts described in her book Mindfulness in Motion were incorporated into the script: setting ‘intention’ and exploring neural pathways from within the body during meditation.

A group of psychologists; Dr Seonaid Anderson, Dr Tara Murphy, Jolande van de Griendt and Dr Cara Verdellen; offered specific knowledge and expertise on TS. The script follows current research in the treatment of tics of tolerating the urge to tic and stress reduction. Our team decided that the recorded script should be called ‘A Guided Relaxation’ as it engages the thought process while a meditation is more about giving attention to one thing such as the breath.

Elizabeth Craig also brought multiple layers of expertise. Elizabeth is a retired nurse and meditation teacher who has experience teaching meditations to individuals with complex conditions who find it difficult to relax. She set the syntax and pace, advised on meditation theory and narrated the recording. Psychology input (see Credits) then helped to edit the piece and gave advice on the concepts and tic related neuro psychological theory. These are woven into the script and are aligned with third wave treatments for tics and Tourettes for both relaxation and tolerating the urges to tic.

Accessing the Recording

If you wish to download the MP3 of the guided relaxation this can be bought for a small fee at the Tourettes Action shop.

Please don’t forget to also complete the feedback form about the guided relaxation.

Credits

Liz Murray; Elizabeth Craig; Attic Studio, Glentrool, Scotland; Antony Gouldsbrough, Riverside Studios, Belgium; Dr Seonaid Anderson; Dr Tara Murphy; Dr Tamara Russell; Jolande van de Griendt; and Dr Cara Verdellen.