Tic is a sign of degeneration, in the biological and evolutionary sense, a degenerative neuropathic and psychopathic basis, as mentioned previously, being present, although often latent.
The maladie des tics is but the extreme form.
The onset is as a rule insidious, with a tendency to spread.
Spontaneous cures may occur, while Gilles de la Tourette's disease is but the extreme form of a condition in which antagonistic gestures are frequently adopted by the patient to adapt himself and to get to a state of rest.
This, as I see the situation, is as far as the French students of this subject (including Brissaud, Meige and Feindel, and even Janet) have permitted themselves to go. And, in my opinion, their observations and conclusions seem to be quite accurate.
VIEWS OF THE FREUDIAN SCHOOL
Recently the Freudian school has endeavored to penetrate more deeply to the nucleus of the problem and to solve it. Freud has delimited what he calls obsessional or compulsion neurosis (Zwangsneurosis), which is classed under psychasthenia by the French and under neurasthenia by others. The Freudians regard this as a distinct neurosis, sometimes complicated by neurasthenic or hysterical symptoms. The characteristic symptom is a feeling of compulsion. The symptoms may be motor (obsessional acts, impulsions), sensory (obsessional hallucinations or sensations), ideational (obsessions), and affective (obsessive emotions, particularly doubt and fear). In this condition we find that there is an excessive psychical significance attached to certain thoughts. Obsessions are characterized by dissociations from the main personality. They thus exist in the unconsciousness. The original unconscious mental processes have brought about, by displacement, an excess of psychical significance to these thoughts. Ernest Jones[5] states that Freud found, by his work in psychoanalysis, that obsessions represented, symbolically, the return of self-reproaches of ancient, infantile and early childhood origin, which had been repressed and buried until the obsession made its appearance. "They always refer to active sexual performances or tendencies;" and, as Jones further explains, "there occurs early in life an exaggerated divorce between the instincts of hate and love, and the conflict and antagonism between the two dominate the most important reactions of the person. A fundamental state of doubt, an incapacity for decision, results from this paralyzing doubt. The patient oscillates between the two conditions of not being able to act (when he wants to), and of being obliged to act (when he doesn't want to). The symptom symbolizes the conflicting forces. These are not, as in hysteria, fused into a compromise-formation, but come to separate and alternating expression; one set of manifestations, therefore, symbolizes the repressed forces, another the repressing."
[5] See his article on "The Treatment of the Psychoneuroses," White and Jelliffe's Modern Treatment of Nervous and Mental Diseases, Vol I, pp. 408-409.
To put the matter plainly, the Freudians contend that obsessions are symbolical representations of the repressed sexual activities and tendencies of infantile and early childhood origin. It must be remembered that the Freudians employ the term sexual in a very broad sense, including under it the most indirect and distant physical, mental and moral reverbations. conscious or "unconscious," of the relations between the sexes. The sexual impulse is here conceived of as having incestuous, bisexual and polymorphous perverse sexual tendencies. The word sexual is not only used as synonymous with love, but practically all emotional surgings, all feelings, all affectivity, all sense-cravings and bodily heavings are classed by certain members of the Freudian school as sexual. This latter interpretation and extension of the connotation generally accorded by us to the term sexual we surely have no right to give it.
Clark, of New York City, is the author who has carried out the Freudian idea to its ultimate conclusion. I refer to his series of three papers[6] in the Medical Record, and call particular attention to his last (third) paper in which he has fully elaborated his theory of the meaning of tics.[*]