Davidson has been a familiar figure to British audiences since his teenage years, when he first appeared in a BBC documentary about Tourette syndrome. He has since devoted decades to public education about the condition, earning him a distinguished honor from Queen Elizabeth II in 2019.

The reactions to Davidson’s tics at the BAFTA awards make clear that Tourette syndrome remains a deeply misunderstood condition, especially when it comes to obscene language tics, called coprolalia.

I am a sociologist who studies the social dimensions of Tourette syndrome, including the stigma of coprolalia. I also live with Tourette syndrome. Most people with Tourette’s will never experience these taboo tics, but those who do bear the weight of society’s judgment.

What is Tourette syndrome?

Tourette syndrome is a neurodevelopmental condition that affects about 0.5% to 0.7% of the population. It is characterized by involuntary movements and sounds called tics that usually begin in childhood and, for some people, continue into adulthood.

Tics consist of movements, such as eye blinking or shoulder shrugging, or vocalizations, such as throat clearing or brief sounds. Some involve a single movement or sound, while others combine several movements or involve longer verbalizations – for example, finger snapping followed by a head jerk, or repeated words or phrases.

Coprolalia, or involuntary obscene or offensive speech, is one of the most widely misunderstood features of Tourette’s. About 10% to 20% of people with Tourette syndrome experience this type of tic. https://www.youtube.com/embed/CgbCQ88RxYk?wmode=transparent&start=0 Fewer than 1 in 5 people with Tourette’s experience taboo tics, such as coprolalia, but they can have an outsized effect on people’s lives.

Tics often change over time in intensity, frequency and form, with relatively quiet periods followed by phases when symptoms are more severe. Many people feel an unpleasant building sensation before a tic, called a premonitory urge, describing it like an itch that needs to be scratched. Others experience tics more suddenly, like an unexpected sneeze. Some can temporarily suppress their tics, often at the cost of greater discomfort later, while others are unable to suppress them.

Tics can be physically taxing, leading to acute and chronic pain and injury. People with Tourette syndrome also frequently face stigma, discrimination and the pressure to monitor or hide their tics, which can take a serious psychological toll. People with Tourette syndrome are at increased risk of self-harm and suicide.

The causes of Tourette syndrome aren’t fully understood, but it has a strong genetic component. Although it often runs in families, it can also be caused by birth complications or infections.

Understanding taboo tics like coprolalia

Even though a minority of people with Tourette syndrome experience coprolalia, media portrayals of Tourette’s disproportionately focus on outbursts of profanity. This “swearing disease” stereotype misrepresents how most people with the condition experience it. But because taboo tics are shocking and unexpected, they loom larger in the public imagination than more common, less dramatic tics.

Coprolalia is only one form of taboo tic. Others include copropraxia, or obscene gestures, and non-obscene but socially inappropriate tics, such as making kissing sounds, spitting or touching others.

One of the most confusing aspects of taboo tics is that they can be contextually relevant while also being involuntary. Consider, for example, the person who tics “I have a gun!” when stopped by law enforcement. Cues in the social environment can trigger tics, especially in moments of heightened stress.

Why profanity in particular? Tics arise from dysfunction in neural circuits involved in movement and impulse control. Taboo words are emotionally charged and socially significant, so they tend to be more strongly encoded in the brain’s language and emotional networks than neutral words. This helps explain why coprolalia can also occur, albeit rarely, in people with brain lesions, neurodegenerative conditions and seizure disorders.

The challenges of living with coprolalia

The social world can be precarious for people with Tourette syndrome who experience taboo tics like coprolalia. These tics are often associated with more severe symptoms overall, more co-occurring conditions and greater social difficulty.

My research on coprolalia stigma reveals the depths of distress public misconceptions can cause.

A common misconception is that tics reveal what people “really” think and feel. In reality, tics often compel people to say or do precisely what they most wish to avoid. The stakes are especially high when tics involve slurs or insults. As one interview participant told me, “It’s like my brain weaponizes my most polite intentions and turns them into the cruelest things. And it’s scary to go outside … to have this sudden confrontation mechanism inside of me that I absolutely do not want.”

These socially inappropriate tics can draw unwanted attention and lead to exclusion, bullying, hostile encounters and barriers to employment. As another participant put it, “There’s no jobs I can work where I can get the accommodation that it’s okay for me to cuss at my boss.”

Anticipating these reactions, many people with prominent coprolalia withdraw from public life or carry the burden of constant disclosure and education.

A second misconception is that coprolalia always looks like someone shouting obscenities in public. While that does happen for some people, like Davidson at the BAFTA awards, others can suppress, mask or carefully manage their tics in social settings. Both experiences of coprolalia are stressful. Like other tics, coprolalia can come and go over time.

The stress of taboo tics extends beyond the individual. Families frequently describe feeling helpless in the face of their child’s distress, unsupported by schools and judged by others when these tics occur.

People with Tourette syndrome, and especially those with taboo tics, need understanding and support to participate fully and safely in public life.

Rena Zito, Associate Professor of Sociology, Elon University

This article is republished from The Conversation under a Creative Commons license. Read the original article.