What makes you tic?

Are you a nail-biter? A hair twirler? A rapid pen-clicker? Do you tap your fingers, or drum your hands off almost any flat surface? Fidgety is one way to describe you, then; you just can’t seem to sit still without doing something. It’s just a thing, right? Just something you do naturally, for as long as you can remember, for no particular reason. Some of you may think you don’t have one of these little habits, but chances are you probably do, you just haven’t noticed.Have you ever thought that there could be more to it than just that? Most can be pinned down to being caused by general nervousness, a certain level of anxiety or even be caused by stress. These nervous habits or tics range on a spectrum from being barely noticeable and relatively harmless, to extremely annoying and potentially injurious. Research has found an undeniable connection between one’s peace of mind and these habitual rituals; the degree to which people engage in repetitive, non-functional motor behaviours such as nail biting, finger tapping, leg bobbing is a barometer of one’s peace of mind and how at ease, comfortable or relaxed they feel in particular situations. The stressful society that we live in in today’s world has a lot to do with bringing out these tics, according to Dr. Alon Mogilner, a neurosurgeon at New York University Langone Medical Centre: “It’s a delicate balance within the circuitry of the brain so you are able to tamp down on things you don’t want to do.” According to the experts, although there are arguments for and against this, there are three main categories of these repetitive, non-functional motor behaviours. Classic Tics are those that typically involve sudden, quick, and jerky movements of the head, neck or arms; these rapid movements can feel or even look like a shudder or shiver from the cold, even when no cold is present. Included under the category of Classic Tics are the impulsive behaviours that are audible, called phonic tics, like grunting, coughing, throat-clearing or sniffing.The next category is called stereotypies (pronounced steer-ee-AH-ta-peez), which include body rocking, finger tapping and leg bobbing. They are different to Classic Tics in that they don’t usually have a premonitory feeling; they are more fluid and rhythmic, less sudden, and short lasting. John Hopkins Medicine, an $8 billion integrated global health enterprise, headquartered in Baltimore, Maryland, and one of the leading health care systems in the United States, defines primary motor stereotypies as “rhythmic, repetitive, fixed, predictable, purposeful, but purposeless movements that occur in children who are otherwise developing normally”. They give further examples that include flapping and waving of the arms, hand flapping, head nodding and rocking back and forth.Do you bounce your leg up and down rapidly when sitting? Tap your toes or shake your feet? You could have RLS, Restless Leg Syndrome. John Hopkins Medicine defines RLS as a neurological condition that causes a person to feel like they must continuously move their body. Basically, they just cannot sit still, or find it extremely difficult to do so. If you describe an uncontrollable desire to move your legs when sitting and lying down, often even occurring in sleep, then you most probably have RLS. There is no exact cause of RLS, it can begin at any age, and it is more often than not passed down from generation to generation through families (The National Institute for Neurological Disorders and Stroke (NINDS)). Although it is stereotypically associated with men, it has been discovered that women are twice as likely to suffer from symptoms as men are. Causes include agitation, anxiety and more often just general boredom. Body-focused behaviours make up the last of the three categories. These include habits such as nail-biting, hair twirling and/or pulling, and skin-picking. People who engage in these habits compulsively can be known as "pathological groomers" — people for whom normal grooming behaviours, like skin picking or hair pulling, have become virtually uncontrollable. The medical name for excessive nail biting is 'onychophagia', which psychiatrists now classify as a fully-fledged impulse control disorder, meaning that those who suffer from it cannot control their urge to bite their nails. This places nail-biting, or onychophagia, on the spectrum of the more commonly known OCD (obsessive compulsive disorder). So you see, nail biting is more than merely a bad habit. Nail-biting rarely develops before the age of about 3, but about 30% of children between the ages of 7 and 10 bite their nails, while almost half of teenagers (45%) do. There is much speculation within the medical and psychological world about the causes of nail-biting. Some argue that it stems from a form of anxiety and nervousness, and for these people nail-biting becomes a means of coping in stressful or uncomfortable situations; nail-biting becomes an outlet for or way to relieve nervous-energy. This connection between nail-biting and anxiety makes sense and can be seen to explain the results of studies carried out to investigate nail-biting and it’s relationship with psychosocial reasons; A study investigating the relationship of nail-biting with mental health among children found that prosocial behavior scores were lower among nail-biters compared to non-nail-biters whereas emotional and behavior problem scores were higher (Ghanizadeh & Shekoohi, 2011). In another study, the nail-biting habit was also observed less among children with high prosocial behavior scores (Ghanizadeh, 2011). As well as this, nail-biting has been found to be heavily associated with psychiatric conditions among children. “A study examining the association between nail-biting and psychiatric disorders in 5- to 18-year-old children reported that more than two-thirds of nail-biters had at least one psychiatric disorder accompanying nail-biting.” (The effect of psychological state and social support on nail-biting in adolescents: An exploratory study - Fatma Nevin Sisman, Ozlem Tok, Ayse Ergun, School Psychology International) It is also interesting to note that boys with nail-biting had more psychiatric disorders compared to girls.Even as far back as Sigmund Freud’s time there were theories being developed as to the possible causes. Freud’s own theory is somewhat controversial; he believed that nail biting was a result of what he called oral fixation, an oral condition that involves a person having an unconscious obsession with his or her mouth and feeling that they need to be sucking or chewing on something all the time. Freud explained it as something relating to an experience in one’s childhood, resulting in particular from a traumatic experience, and often related to breastfeeding. Freud believed that a child whose nursing period (breastfeeding) was cut short or restricted in any way or were not nursed at all was orally frustrated, thus these babies later become envious, suspicious, and pessimistic, and exhibit the symptoms of oral fixation that include nail-biting. There is more recent research that reflects a similar view to Freud’s, characterising nail-biting as possibly being due to an impaired mother-child relationship.Other theories suggest that nail-biting stems from internal hostility towards oneself. It is, after-all, a mild form of self-mutilation, and thus it isn’t unreasonable to consider the possibility of it being a form of unconscious self-punishment.There are many methods of treating and dealing with nail-biting, including a variety of medical and therapy treatments. Many are simple fixes that one can do on their own:

• Keeping hands clean and tidy. (Not only important for trying to stop nail-biting, but if nail-biting is to occur then one would want to keep dirt or any other potentially harmful substances away from their mouths.)
• Getting a manicure! Treat yourself to a really lovely, proper gel manicure to prevent yourself from gnawing your lovely nails away. This will also cover your nails, protecting them and encouraging them to grow.
• There are special polishes that you can get that are specially formulated to deter nail-biters from biting their nails with its poignant nasty, bitter taste.

The most common therapeutic treatments are usually focused on pinpointing the causes; pinpointing the situations in which the person finds themselves biting their nails and from then, developing alternative strategies as a means to cope in these situations that don’t include nail-biting. As nail-biting is commonly a release of nervous-energy and means of coping in stressful or anxiety-inducing situations, other forms of stress relief and anxiety management may be prescribed. The psychoanalytic view describes tics as “erratic and aggressive instinctual impulses” which are continually being expressed through repetitive physical movements, and the treatment derived from this view is counselling within which the patient is convinced that the impulses themselves are the cause of the problem, and then teaching the patient to channel these impulses elsewhere.  As you can see, there is a lot more to those little nervous habits and quirks that people have than you would have thought. Next time you find yourself biting your nails or fiddling with your hair or bouncing your leg, ask yourself; why? It could be that you’re in a somewhat uncomfortable situation and are feeling anxious, you could be really nervous waiting outside the room to where you’ll be going for an interview, or you might find that you’re simply bored. Whatever the case may be, it’s cool to know and be aware of the reasons and causes behind these habits, and as far as treatments go, it might be a good idea to try tackle them and see if we can eliminate the more harmful habits that we have.