Is There an Intrusive Thought OCD – Coprolalia (Tourettes) Hybrid?

I have “conventional” harm intrusive thought OCD towards my own family. (See what are Intrusive Thoughts? and postnatal OCD) To the outside world, I have something that an OCD psychotherapist has told me is Tourettes (as I generally know I will not act on the thought and it is the fear of vocalising it and being judged that keeps the syndrome going rather than the fear of acting on it). My unwanted thoughts, however, do not function in the same way as a simple Tourettes “verbal tic” – they have meaning (albeit they are definitel the OPPOSITE of my moral values) and they are kept alive by OCD Ruminations..

There is not a lot of information readily out there on this but I have managed to find an excellent article by Ken Shyminksky that explains a lot of what I have gone through:

Coprolalia can occur in Obsessive Compulsive Disorder as well as Tourette Syndrome.  People who have Obsessive Compulsive Disorder as well as Tourette Syndrome have a greater struggle as the two disorders may interact with and/or perpetuate coprolalia.   …

… the response to coprolalia and the lack of understanding and acceptance from other people amplifies the individual’s shame and embarrassment, leading to isolation.  Fear of performing the tic in public and being constantly scrutinized and judged … drives the individual to constantly think about their coprolalia symptoms, in turn making the coprolalia occur more often. …

racial slurs may be prompted by seeing a person of a particular race, sexual comments may be prompted by seeing a member of the opposite sex.  Seeing these people reminds the brain of forbidden/unacceptable words.  …  When faced with a person of the opposite sex, the sufferer may quickly think “I’d better not say “_______”.

By thinking this thought, the individual has put the offensive phrase into their own mind.  He/she will then be stuck with the phrase in their head.  … coprolalia has no relationship or meaning to the observed person and is not a personal attack.  There just happened to be something within the environment that prompted that particular urge. For the person with coprolalia, they struggle to prevent themselves from saying or doing the worst possible thing in the particular situation.

For me, my unwanted thoughts are very definitely the OPPOSITE of my moral vaules (just as conventional intrusive thoughts are the opposite of your moral values). As with conventional intrusive thoughts, these unwanted thoughts centre around my taboos (hurting innocent people, hurting children, inappropriate sexual thoughts, being attracted to someone other than my husband). Words and phrases are horrible, vile, something I am deeply, deeply ashamed of. Occasionally, lesser taboos get added into the mix – shoplifting (if in a shop), gay slurs (if I am with someone I know to be gay).

For me, these thoughts are built upon pre-existing social anxiety and physical anxiety problems – horrible digestive and hormonal problems that made my body smell whenever I got nervous, problems that became so acute that I ended up spending four years on Invalidity Benefit, living and feeling like a leper, too ashamed to venture much.

The more nervous I get, the worse the problems become – the more frequent the thoughts get (during bad spells, I was getting an unwanted thought every 30 seconds to a minute when outside my home), the stronger the urge to vocalise is and the louder I will vocalise if I do. In times gone by, when bullying and stigma sent my anxiety levels through the roof, I would say words or phrases loudly. Nowadays, if my anxiety levels are high-but-not-too-high, I may just whisper words/phrases; if my anxiety is under control, often this is “sub-vocal” – I can feel my vocal chords moving slightly but words do not get spoken. During good times (luckily these are increasing!), they may just be thoughts in my brain with no vocalisation at all.

The Process / Mechanism

For me, the “process” these thoughts take is very similar to OCD Intrusive Thoughts.

1 Feel Nervous with a Situation or Person (these thoughts rarely happen if I am just with my immediate family – although I had decades of harm OCD towards them).

2 Trigger (person or situation or just a realisation that I could be in a situation where I might feel nervous)

3 Unwanted thought. Sometimes this is an immediate thought – othertimes, my brain will realise I am feeling nervous and will search through a “stored list of unwanted thoughts” and select one – sometimes the one that I least want to say at that moment in time! Sometimes the thought selected will be one I have worried about saying recently; other times, it will be the “thought of the week”. (These sort of thoughts often go in cycles for me – I can spend a week, a few weeks, when one unwanted thought predominates; then a different one will take its place.) Sometimes there will be an immediate urge to vocalise this first thught – more often, my brain goes into the “thought checking and echo loop below”.

3b Thought Checking Loop – my brain realises I am nervous, and starts checking through all the thoughts I have had in the immediate past to try to ensure they have NOT been “forbidden thoughts”. (I suspect this may be an OCD thought-checking loop.)

3c Echo – on finding the “forbidden thought”, self-dusgust and self-loathing for having such a terrible thought will produce a strong urge to vocalise the “forbidden words / phrase”. (I suspect this is an element of Tourettes.)

3d Thought Spiral – one unwanted thought will trigger another, and another, and another … I will often find myself thinking these thoughts using words and phrases that suggest I really intend to act on them (even though I know I won’t!!).

3e Worry about other people’s reactions – I start worryig whether other people have noticed, what they will think of me if they have; this keeps the unwanted thought in my mind. I also start assessing whether I could logically have carried out the action (even though I know I don’t want to!) – I couldn’t have abused that child because there are other people in the room. I believe this is my mind trying to assure me that I’m not a bad person, that I wouldn’t really have done this terrible thing anyway.

4 OCD Ruminations – I worry during the situation, then go home and worry – and worry – and worry! These ruminations (especially active during the night!) feed back into the unwanted thought cycle in the same way as ruminations feed into conventional intrusive thoughts.

What Has Helped Me

For me, the turning point came when I found out about Intrusive Thought OCD, had an OCD psychotherapist explain to me that intrusive thoughts build up by worrying (OCD ruminations create neural pathways in the brain between trigger and unwanted thought – see what are intrusive thoughts). Her advice was to never “go into a thought”, never worry about it, never analyse it – just label it as an OCD intrusive thought and immediately distract yourself (use Mindfulness to count the number of circles/lights/flowers in a picture or watch a good film etc). I have definitely found that the less I ruminate on thoughts, the less they happen.

I also joined OCD support groups and plucked up courage to speak to others in the groups about (at least some of) my unwanted thoughts. Interestingly, the thoughts I have repeatedly shared with the groups (my postnatal OCD hell) have now lost their power over me and I rarely worry about them anymore!

I am also lucky enough to have the support of an understanding, caring husband, someone who realises that my horrible thoughts are just due to anxiety and doesn’t judge or condemn me for them.

For me, positive affirmations (see Louise Haye) have helped rebuild shattered self-esteem. On bad spells in the past, I would often listen to positive affirmations on YouTube over and over; I did not in those days have the strength to think positive thoughts myself, but my mind absorbed some of the positivity from those tapes and, whilst I was listening to them, I was not ruminating. I also use some affirmations as a “preventative, BEFORE the first unwanted thought” – if I feel myself becoming nervous in a situation and I am not too tired, I will think good affirmations such as “I am a good person, good wife, good mother” – or, more frequently, “other people can think what they want to think, but …”. For me, this can often stop the first unwanted thought – and therefore stop all the other thought spirals and thought ruminations that follow. For several years, I used these thoughts as a sort of “firewall” before going to check on my children – with the “I’m a good mother” thought, up would pop an imaginary screen between the horrible thoughts on one side of the screen and my precious children on the other.

  • Note: This goes against the general advice from OCD psychotherapists to “not try to stop intrusive thoughts but just to let them happen and move on as if they had not happened” but it helped me in the past as, for each unwanted thought that was stopped, an endless cycle of other thoughts and ruminations and fears of what others think of me was saved. Now that I have had OCD counselling and have joined support groups and am following the “do not ruminate about intrusive thoughts” advice, I do this less. My OCD psychotherapist told me that, whilst she doesn’t generally recommend this, it was working for me so continue with it.

I have also (recently) found that chewing gum, and placing the gum over my tongue and behind my teeth, gives me some sort of control over my vocal chords; the thoughts still happen, but the outside world doesn’t need to know about it.

Please Share So Others Need Not Suffer Alone

Whatever mix of syndromes I have, it has been MASSIVELY traumatising. I spent 30 years of my life thinking I was going through a breakdown, thinking I must be a terrible person for having such thoughts, blaming myself and beating myself up mentally over and over. My mind, and my life spiralled out of control. Bullying made this massively worse.

My experience has been that many authorities have little understanding of either Intrusive Thought OCD or Coprolalia. Without understanding, authorities – and the public – treat sufferers as criminals or potential criminals.

  • Note: If I had known about these syndromes years ago, I might have had the courage to go to my GP and request help; had I been conventionally diagnosed and “in the system”, then maybe the authorities would have been nicer to me. Many people within my support groups have had positive experiences with authorities after diagnosis. As it is, I have had a MASSIVE fear of Social Services since we first started going though IVF and so have relied upon private counselling and support groups.

Without knowledge that these syndromes exist, sufferers are reluctant to seek help. On average, it takes 11+ years for someone with Intrusive Thought OCD to get the help they need due to lack of information, shame, fear and stigma. (For me, it toook 30 years!) This is completely unacceptable and needs changing. 11 years is a looooong time to suffer traumatising mental health problems with little or no idea why your mind creates such terrible thoughts.

Intrusive Thought OCD - where Thoguhts are the OPPOSITE of your moral values