A new study of children and adolescents with Tourette Syndrome finds that self-hypnosis taught with the aid of videotape training reduced their symptoms and improved their quality of life.

Seventy-nine percent of the 33 research participants achieved enough improvement in tic control to report personal satisfaction with the technique, according to the study published online in the July issue of the Journal of Development and Behavioral Pediatrics. This is the largest case series of patients with Tourette Syndrome treated with self-hypnosis. The authors, Jeffrey Lazarus, M.D., and Susan K. Klein, M.D., Ph.D., were with University Hospitals Rainbow Babies & Children's Hospital and the Case Western Reserve University School of Medicine at the time of the study.

Subjects were shown video clips of a young boy with Tourette Syndrome before, during, and after his self-hypnosis training. Following that, each child or teen in the study was taught self-hypnosis in individual sessions. The participants ranged in age from 6 to 19 years, with an average of 13 years.

The research subjects also were assigned to practice the self-hypnosis technique three times a day and homework to answer questions designed to increase their awareness of tics and how they felt about experiencing them. All of the research participants had motor tics and three had verbal tics in their initial evaluations.

According to Dr. Lazarus, self-hypnosis helps the patient experience a state of mind that combines relaxation with concentration on a desired point of focus while other thoughts or feelings fade into the background.

"Once the patient is in his or her highly focused 'special place,' work is then done on controlling the tic," said Dr. Lazarus. "We ask the patient to imagine the feeling right before that tic occurs and to put up a stop sign in front of it, or to imagine a tic switch that can be turned on and off like a light switch. Further suggestions are made, including encouraging the patient to invent his or her own images."

Almost all of the participants experienced a dramatic increase in tic control after only a few sessions: 12 after two sessions, 13 after only three visits, and one after four visits.

Dr. Lazarus says that this non-pharmacological therapy for tics is attractive because the medications that are used to treat tics can be associated with undesirable side effects. Also, physicians are reluctant to prescribe medications for mild or moderate tic disorders, which many children often outgrow as they get older.

"This case series suggests that self-hypnosis might be able to be taught effectively in fewer sessions than another technique known as habit reversal, but we'll need to study this further. However, the use of videotape as a teaching aid presents several advantages: It can help standardize the technique of teaching the method, it may shorten the length of time needed to teach the technique, and it makes the technique more accessible to younger children. Viewing a series of videotapes of another patient gives patients the reassurance that they are not the only ones in the world with this problem, and it gives them hope and the motivation that they can take control of their bodies and life challenges," said Dr. Lazarus.