Habit Reversal Therapy for Tics , FND, and BFRB
CBIT Therapy is a leader in the management of a Functional Neurological Disorder (FND) called TikTok Tics. This condition includes a very sudden onset of alarming and unusual behaviors in response to anxiety, depression, isolation, and misleading social media related to Tourette Syndrome.
TikTok Tics presents with multiple tic-like behaviors accompanied by disabling symptoms such as hand tremors and paralysis of the legs. This disorder is thought to be a physical response to extreme emotional distress brought on by the pandemic and binge-watching social media influencers with erroneous content related to tics and Tourette Syndrome. In the United States, this serious condition occurs almost exclusively in middle to upper-class white girls and non-binary youth. Many of the children and teens have a documented history of anxiety, ADHD, OCD, and / or "Asperger's." Most are highly empathetic, high achievers, creative and articulate, but immature in relation to their peers. Many recently also came out to their parents in regards to sexual identity.
People who develop TikTok Tics often report having viewed a massive number of "tic" videos prior to becoming ill. Oftentimes this social media use is kept hidden from parents, although there is tremendous outreach to others online with similar symptoms and who follow the same influencer. Some of these girls and non-binary youth will decorate their rooms somewhat similarly and have tic-like behaviors much like those viewed in the videos. Common behaviors include head jerks, Iip popping, tongue clicking, whistles, hitting their head or chest, saying words that are out of context (such as Beans or Biscuits) dropping items, throwing objects, touching others inappropriately, excessive blinking and more. These behaviors can go on for months or even years.
TikTok Tics are a Functional Motor Disorder, which is a form of a Functional Neurological Disorder, also known as FND. This means that the symptoms are real but tend to be much more closely related to a mental health concern than a neurological cause. So, even though the videos may not be truthfully portraying what tics are, those with TikTok Tics are not faking. These behaviors are sometimes more prevalent when parents and peers pay attention to them and during times of heightened stress or a desire to escape a situation. Patients benefit from finding ways to decrease anxiety and isolation and need help reducing time on social media. It is especially important to unsubscribe from all social media with tic related content. It is also very helpful to address concerns related to the pandemic and the many stresses and losses it has caused.
Comprehensive Behavioral Intervention for Tics (CBIT) has been found to be the most effective therapeutic treatment for TikTok Tics. CBIT Therapy is an occupational therapy practice that utilizes video calls to treat patients in their homes, where most of the social media is consumed and stressors and supports can be identified. We train patients how to stop disruptive motor and vocal activity by doing a blocking technique called a Competing Response, which is successful with traditional forms of tics.
Teenager using a CBIT strategy called a competing response to prevent an arm tic.
Patients with sudden onset tic-like behaviors related to social media often believe they have Tourette Syndrome. This is because their movements and vocalizations are extremely similar to misleading social media influencers on TikTok, YouTube, and other platforms. These influencers push out multitudes of videos and claim the behaviors are due toTourette's and other disorders. Algorithms then feed these videos over and over to vulnerable people with similar profiles. Without personally knowing anyone who actually has Tourette's, the influencers' bizarre motor and vocal tic-like actions are believed to be legit. Empathy for the creators develops and they are seen as heroic for how they handle a once unimaginative diability. People with TikTok Tics tend to become highly attached to the influencers and feel that they have a strong connection, and sense of belonging with the other followers. Although the relationship is completely one-sided, the influencer brings both comfort and a sense of awe. Upon the realization that the videos are mostly inaccurate and insincere, instead of a mission to advocate for the disability community, some people with TikTok Tics feel duped. They wonder how they have been misled so easily and become angry that they were hurt in the process.
If you or your child seems to have TikTok Tics, know that there is help and this condition is treatable. A good place to begin is a pediatrician, neurologist, mental health specialist, nurse, social worker, or occupational therapist specializing in CBIT. Below are articles guiding the way to understand and treat this disorder.
On 10/17/21 The Wall Street Journal published an article on sudden onset tics related to social media.
The Verge followed up with an important article called TikTokTics Are A Symptom of A much Bigger Problem.
Also of interest is The Guardian's article 'The unknown is scary': why young women on social media are developing Tourette's - like tics.
Another important read is How TikTok has become a dangerous breeding ground for mental disorders.
Sudden onset tic-like behaviors related to social media has also been explored by the Tourette Association of America in the article Rising Incidence of Functional Tic-Like Behaviors. What's happening? Why now?
Please also view the research articles below and be on the lookout for our upcoming report in collaboration with specialists from across Massachusetts.
According to Statista Digital Economy Compass, the 2021 global average daily time spent on social media per internet user is 142 minutes. Algorithms control much of what is being seen and causes users to be flooded with messages that normalize serious health concerns. Take charge by deleting social media accounts, cancelling alerts, setting screen time limits, and finding something more hands on and productive to do with your time. Social media has some benefits, but over use and misuse is associated with greater isolation, depression, jealousy, anger, anxiety, and other emotional and physical concerns.
In 2020 the Calgary Tic Disorders Clinical Registry referred to TikTok Tics as Functional Tic-Like Behaviors (FTLBs) and is tracking the trend closely. The condition, which is related to both extreme anxiety and exposure to erroneous tic content is extremely disabling and even life threatening. Misdiagnosis leads to further complications related to medications and recovery.
TikTok Tics is possibly associated with a psychological condition called a parasocial relationship
Binge-watching videos created by an engaging social media influencer can lead to a false sense of knowing them and the belief that they are your friend. This fascination with the influencer may be due to social isolation and loneliness. The bond occurs even though the relationship is entirely one-sided and will always be that way. The influencer does not watch videos made by you or know anything at all about you, even though she may share intimate and sometimes embarrassing details about her life. You may also feel like part of the influencer's family or friendship group if they are also introduced in some of the videos.
Some people in parasocial relationships may adopt their influencers fashion, hairstyle, beliefs, room decorations, and even what seems like a disabling condition. Others may be tempted to support their influencer financially by donating money to help them continue turning out more videos.
Learn more about parasocial relationships here.
TikTok Tics are an outward expression of inward distress. Patients with this disorder benefit from a neurological evaluation, mental health support, and Comprehensive Behavioral Intervention for Tics.
On 10/03/07, South Park released Le Petit Tourette, shaming those who fake tics and Tourette Syndrome. You can watch the full episode here. The writers touched on many important (and sometime adult-oriented) topics related to Tourette Syndrome. People with TikTok Tics are thought to be not faking it, even though they may be following people on social media who are. It is important for parents to take the responsibility to help their children discontinue watching all videos related to tics. It is also important to understand that TikTok tics is a serious disorder that involves tic-like behaviors (such as a neck jerk) but also much more dramatic behaviors such as throwing things, tremors, feelings of numbness, paralysis, and fainting. These conditions are often also viewed in popular TikTok and YouTube videos related to tics.
CBIT Therapy is a telehealth occupational therapy practice that collaborates with clinicians at UMass, MGB, Boston Children's Hospital, and many practices throughout NY, MA, NH, ME, and VT. A HIPPA compliant Google Suite platform is used for video calls. Parents are required to participate in all therapy sessions along with their child.
Please FAX referrals and authorization numbers to 857-202-5085. Thank you!
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