good evening and welcome to the eighth installment of the adult webinar series my name is amethyst johnson creek and i am the manager of information and referral services here at the turret association of america for those of you that are tuning in for the first time allow me to give you a brief overview of the work that we do here at the taa our mission is to better the lives of eventual individuals affected by tourette syndrome and tick disorders the taa works to raise awareness advance research and to provide ongoing support through our centers of excellence chapters and support groups nationwide tonight i am joined by dr katie complete and eric mcgowan who will be discussing the details of navigating a romantic relationship when one or both of the partners is diagnosed with tourette's syndrome dr campolidi is the educational director of movement disorders as well as the director of movement disorders fellowship and centers of excellence on tourette syndrome and tick disorders at rush university medical center she is an accomplished author as well as an experienced principal investigator in research focus on therapeutic areas including studies to evaluate the safety and efficacy of new compounds to treat tourette syndrome parkinson's disease functional movement disorders and dystonia eric has a bachelor's degree as a bachelor of science in acoustics from columbia college in chicago and a master of arts in architecture from the university of kansas he first became involved with the tourette association the tourette association's southern california chapter in late 2016 and joined the board of directors in march of 2018. eric has a is passionate about helping about helping those living with tourette's syndrome through advocacy organization and attendance of the chapter events and as director of camp george a sleep away camp for youth with tourette syndrome and their families and before we kick off this webinar i just want to remind all of the viewers to please submit their questions to the questions section which is on the bottom right of the screen the presenters will be answering the questions during the q a session at the end of this presentation dr campolidi yes hello i'm katie campoliti and i'm a movement disorders neurologist at rush university medical center in chicago and a big part of what i do is seeing patients with threats and sick disorders both adults and children next one please so tonight we are going to spend the next hour or so discussing how to navigate uh romantic relations for patients with threats and take disorders so we start with some definitions and just uh feel free to ignore the difficult words on the left if you want and the only reason i can pronounce them is because i'm greek and a lot of them are greek but they are different types of love there are different ways we love in sick love one is eros which is the passion and madness which is most people confuse us the only kind of love with a in a romantic relationship in the greek myth it is the form of madness brought about by one of cupid's arrows the arrow british preaches the person and they fall in love as the paris with helen pelia is a friendship love that's based on friendships story is the love that that's based on fondness born out of familiarity or dependency it's the familiar love agape is selfless love it's like let's say the love of a mother for their child ludus is the playful uncommitted love that's the flirtations the flirtatious type of love pragma is the pragmatic love the love founded on reason and duty is the practical love and philote is the love for one's self which is something we should all practice to some degree because if you you do it in excess then you know you you approach what we call hubris next one please so what do people long for people we all long for intimacy we long for social connection and will long for sexual relations next one please and we try to find the person that's going to fulfill all this uh dreams if you will and what influences our partner selection has to do with our self-identity how do we perceive ourselves the similarities we see in other people and the proximity of their beliefs to ours and to some degree social class influences how people choose each other religious preferences ethnic identity and racial identity all this to different degrees for different people next one please so what happens with when we see somebody and you we feel that little thing that tells us that oh that could be a person i could be with that's the attraction that's uh at that point there's no interaction then we proceed to what we call invitational communication where we actually take a chance and we kind of reveal ourselves to the other side and then we start sharing information and that's called explorational communication and we're going to focus a lot on those two stages because i think a lot of times maybe the most uncomfortable for people with stress or at least they perceive they're the most uncomfortable and then as you figure it out and you hit it off you get into that point where we what where we call intensifying communication that's the happy stage the high the relation high and then things eventually always settle down and we start revising our communication we are starting to develop the realistic perspective of the relationship and then at some point people if you s if they stay together they start looking at the future together they start making joint decisions about the future and that's the stage of commitment and then you become that old couple where you change and you evolve and you grow together and grow apart and you start navigating the relationship reflecting on the changes of needs of each person that's part of the relationship and uh and that's the last part is the one that requires the most work as we those of us who have been married or in long-term relationships now so so what we said we're gonna deal with tonight is we're gonna try to dissect how dating and pursuing romantic relationships is different for adults with tourette syndrome what are the challenges and limitations we're going to focus quite a bit on disclosure and explanation of symptoms we are going to touch upon the fact that how not the fact of how socioeconomic social emotional experiences from the family and peers influence dating by influence influencing who we are and how we perceive ourselves and others and maybe we're going to point out some of the helpful factors for tourette's patients in navigating dating because there's always the other side of the story next one please so there is very very little of research on what are the specifics what are what are the differences on dating and romantic relationships interest syndrome and there is there are very few reports one of them dates back to the late 80s where as some person named doctor named champion interviewed 210 adults with tourettes and found that almost half of them reported problems with dating as a result of having tourette's but he didn't explore the nature of these problems you know on thinking about that most of us feel that the problems have have to do with the stigma and fear of rejection with the hesitation on exposing one's stakes and with the possible limited opportunities to develop the social skills involved in dating as as a consequence of growing up with threats next slide please so because of some people with tourette's growing up may have had to do with bullying or exclusion for from certain social circles which can lead to loss of opportunities to develop social skills and dating is just another social skill you have to practice it to learn it to feel comfortable within it and some of the things can result in impaired social and emotional learning as uh eric is gonna tell you transfer itself is not a social disability but some of the experiences that people experience people live growing up can lead into social or emotional problems next one please and then it's that big thing of lack of self-confidence is that is the fact that you know and people with threats are not the only ones we all have a problem with conquering self-doubt and that would go down the spiral of fear stress anxiety insecurity and conflict rather than going up that the the the ladder or the spiral of being real questioning things learning being self-aware curious and be brave enough to expose ourselves which is part of the foundation of every relationship next one please so thinks shape experiences perceptions and interactions with environment but the associated comorbidities may compound and alter this relationship and i'm not going to spend too much time talking about how depression can lead to social withdrawal and difficulty seeking relationships including romantic relationships or how anxiety can hinder these connections you can make with other people how add idiots they can make you unfocused and distract you from you know from bringing relationships to fulfillment but the point is that ticks and comorbid conditions sometimes may interact and result in a vicious cycle next one please and we always think at least the people i've talked to that uh thinking that they believe that it's all about the things it's the things that create the emotional dysregulation impact emotional regulation and social functioning but as a matter of fact emotional regulation can impact both fixability and social functioning and that's something we can learn to have control on and that's a thought i want people to take with them tonight you know how we can achieve that mindfulness that non-judgmental awareness of the environment that can help us you know see other people around us for what they are and be able to approach them easier next one please so i said i'm not gonna deal with depression or anxiety or adhd but i'm gonna just spend a few minutes on ocd and obsessiveness sometimes the obsessions can be uh people can be really um embarrassed by their obsessions and they it has been shown that the severity of obsessions negatively correlates with emotional social sexual intellectual and recreational intimacy next one please so obsessions can be difficult to share that create sometimes shame because they are so hidden and deep and deeply embedded or in our thoughts and on what we are it can create embarrassment and fear of rejection and this can be difficult to share because this a lot of times is perceived as disturbing uh by the individual who is having the obsessive thoughts so that can be a big problem in you know exposing yourself to others and starting relationships with others next one please but that you know this brings us to the biggest point of tonight's talk and that's disclosure and uh we are sitting there with somebody across from us in the table sipping on wine and we have the elephants sitting on the table too there is an elephant in the room and whether we prefer to talk about it the elephant or not the elephant is there and we have to address the elephant in the room and next one please so the different uh aspects of disclosure is uh first of all is whether do we really have to disclose why when how or what next one please so weather depends on the question that is it worth it and is it worth it it depends on whether there is a potential for long-term relationship if you feel that the other side is worth your time and you see that going far then you start thinking more about this closing and also depends on tick severity if your ticks are easy to hide at least temporarily during a dinner date then it makes it less worth it at least at the poor at that time where you're facing the other person and you can postpone it i guess at least you think you can postpone it but then if if the relationship becomes more serious then you start seeing your life together then you start thinking about things like the genetic risk of offspring and things like that and starting a family and that's that's a big factor that determines the weather whether you should disclose or not next one then why why should you disclose there is this sense of obligation or duty to be honest that's most of us have and that has the foundation of every relationship that can flourish and last there is also the why depends again on the degree of ability to conceal you know how severe the ticks are and how good you are in concealing them and but most of the time i think what prevails in most people is the negative impact you perceive that the non-disclosure may have on the relationship further down the road then some people argue why not you know why why there is the implicit fear of rejection or humiliation or the mental draining or emotional energy involved in disclosing and the anticipation of discomfort you see across from you on the at the table on the other person that sit in the air and maybe it's not real discomfort but it's something that a lot of people have learned to anticipate when they disclose or disclose something like the ticks for example next one please so when do you disclose and i've said that many times already that you disclose when the relationship has a potential for the future you do disclose easier when there is a certain degree of trust and closeness in the relationship then when the tick severity is you know severe enough that doesn't allow you to ignore the elephant in the room and then there is always a personality variability you know you just don't not everybody handles these things the same way and you know that's what's wonderful about human beings that we are all different in the way we handle things and that's okay next one please so how do you disclose the best way is probably to use natural openings in the conversation or you know you you cough and somebody asks oh what's wrong with you and then you just take grab that opportunity to elaborate on it uh the right way you know the torch just grab it and run with it or some people prefer to rely on a third party so they don't see the impact of the disclosure having a friend talk to the other person and all is okay you know there's no right or wrong you know whatever works is fine and then next one please and then it's the what how much do you say you don't need to say the whole story or maybe people won't understand the whole story and you know it's maybe it's too much for other people to grasp so maybe you can give them a little bit at the time so that's that's also something that depends on the circumstances depends on who you are who the other person is and what stage you are in the relationship but grab that opportunity and just say a little bit and that's an opening you can use to elaborate later on next one please and you know the a lot of problems with disclosure one is that threats can be a poorly understood disorder and if you look at the social media and the popular media there is a an exotic uh presentation of what tourette's is and that's not true but you know it's up to you to explain that and that things draw attention sometimes that can make people uncomfortable and they increase self-awareness but uh again you know we would have to do what we have to do there's this shame and embarrassment embarrassment and uh there is also this thing that it takes a lot of times are perceived as voluntary you know remember this your second grade teacher who kept saying why can't you stop doing that even though you know a lot of people you know your parents have told her maybe you know an advocate had told you this is not voluntary mrs smith but you know she keeps people have a tendency to perceive things a lot of times at least part of them is voluntary but then there's always the perceived strengthening of a relationship after disclosure and you never forget that next one please then so then at that point and usually that's in in the beginning that during the explorational communication you have to weigh what's what's what's harder for you is the emotional energy required for disclosure or the emotional draining involved in concealing your tics in front of the other person that doesn't allow you a lot of times to be yourself next one please and as i said before there is a relationship between the experiences with important others in childhood and other lessons the our family and the people who loved us and the expectations we have from others when we grow up and how we believe other people view us you know if we've grown up with the notion that we are wonderful and people should love us ex you know even though we have our little corks then we grow up and go out there and expect people to love us but not everybody has that you know it's this is you can't change your family don't don't choose your family so we have if you have it you'll like it but if you don't you have to create that you know you have to find those friends uh through whose reflection you can start appreciate yourself more next one but people with tourette's can do well in romantic relationships and now i've seen it in my clinic time and time again i've seen people coming in with significant others and they bring them to meet me before they after they get engaged and then they come with them later periodically through their married life and those people who do well is the ones who use creativity or humor to their advantage and those who can focus on things they're good things they enjoy doing and that never reduce yourself to a single story there's a danger of reducing ourselves every one of us to a single story we're much more you're much more than your tourette's or your tics and we're much more than a single attribute of our story there is no single story for everyone anyone next one please i don't know what the composition of the audience is but then there is some advice for people who date those who threats try to keep things light ignore the stuff that can be ignored know that ticks are involuntary there is a top layer of voluntary control and that's what we capitalize for behavioral modification treatments but threats is a neurobiological disorder and most of what you see is involuntary have a sense of humor make it clear that it's safe to communicate take note of triggers so you don't waste your good time responding to triggers that can make the ticks worse and do not try to fix the other person maybe you won't like them if you fix them there is a reason that you're there with them right next one please and since i've gone down the you know road of advice even more advice this time for the people who with tourette's take the opportunity offered to you the next time you take that's an opening for disclosure provide as much or as little information as the person's reaction seems to require don't overwhelm them a joker too can come in handy talk about it sometimes the role playing before you go out on a date may help lower your stress level play your strengths again none of us is a single story remember you're a person first and you're much more than your tourette's next one and then when you go out there and you're confused lost unsure perplexed and disoriented next one just remember if they are the right person for you they will accept you no matter what and if they don't they're not the right person for you next one please and it always takes two to do the tango next one and do in every relationship one side reveals and the other side listens in the understanding in somewhere in the middle and those roles change we swap those roles throughout any throughout building every relationship next one please and you know what's the rolling stones said you know was when what did they say when when the heart is on fire smoke gets in the eyes and uh then you know when you get to that point i don't maybe the ticks don't matter as much and next one please that's all i have to say and i'm gonna pass the back on to eric hey everyone my name is eric mcgowan i'm on the board of directors for the southern california chapter of the tread association and um i am a 30 year old man with tourette's you'll hear some ticks like that and maybe some other things can you go to the next slide please maybe click one more time um so yeah just a few thoughts before we start um so just like our daily lives all of us living with tourette's syndrome um relationships are tough uh you know relationships with anyone's friends family are tough but you know romantic relationships can be especially tough for some of us um successful relationships take effort and practice um for everyone it's not just us with tourette's or those of us with ocd or depression it's it's everyone neurotypical um or otherwise and it can be hard you don't want to let failures discourage you i've talked about this in my social and family relationships talk everything takes practice when it comes to developing relationships and i just want to let you know that my focus today is going to be more on um on ticks and less on co-occurring conditions because i think ticks are the one thing that most of us can't hide and it's on display you know pretty much from the beginning so we're going to focus on that mostly next slide please so what are the challenges for everybody um general insecurities mental and physical it can be anything height weight but also um you know tourette's ocd anything mental and physical everybody has insecurities most people are pretty good at imagining the worst case scenario for us um a lot of us the number one thing is you know we won't be accepted because of our our tourette's something we can't control and then that leads into the the obvious uh fear of rejection uh next slide please so what makes us different than everyone else as i was kind of just saying our thing our insecurity or one of them is something that's on display most of the time um suppressing can only go so far if you're like me you're not going to have the luxury of you know waiting until a relationship is ready to move to the next level when i disclose because it's something they're gonna see within you know the first five or ten seconds of meeting with me um and just as dr coppoliti said you know ticks aren't mainstream they're not often um understood threats in general really isn't and a lot of other mental health issues um so they often just won't know what they're looking at you know um why is his face twitching why is nor all these things happening um it's just it's a lesser known condition compared to a lot of those out there um but we also we have thick skin but i i'd like to say we have a unique type of thick skin um we have to uh you know like i was saying it our thing is on display all the time especially growing up you're more prone to comments rude comments um and then you know it could be awkward encounters or bad encounters even as you go into adulthood when you kind of but you have to develop this kind of thick outer layer yeah we all do it's just something we live with next slide please so if it were in person i'd ask you all you know who's had an awkward interaction because of something they can't control um and this i mean this would go out to anyone it's like um everyone in the world who's pursued a romantic relationship um pretty much everyone has or they will um everybody's had this it could be you know anything can make a situation awkward it doesn't just have to be tourette's there's tons of things you know you drop something on you during a dinner date uh it could be any trip while you're taking a long walk it could be anything um but for us so who has friends and loved ones who can look past uts i think most of us do and you'll realize um when you get into dating and romantic relationships that this applies to romantic partners as well it can often be surprisingly easy and almost weird to see how quickly tourette's you know your ticks are no longer um any sort of issue at all uh next slide please so our biggest hurdle and what i really want to focus on um how do i tell someone i'm interested in dating that i have tourette syndrome and i say this is the biggest hurdle because like i was saying before i can't hide my ticks for more than a few seconds um and so that either is you know i've just now met this person and they're gonna see it or you know i've met them and been talking with them um through text or online which we'll get to and they're going to see it as soon as they do meet me so how do we go about this uh next slide please so i borrowed from dr campolidi's uh section let's see i think there might be one more on there um i want to focus almost entirely on disclosure um because i think for us once we get into a relationship uh you know the extent of our our tourette's can is either has they've already witnessed it they already know what's going on they know what to expect or they've at least got some dose of it and for me the hardest thing was always disclosing um you know and we'll go over yeah the why the how the when and the what next slide please so why disclose so with a lot of us i put most of us but probably most of us there's no avoiding somebody noticing the ticks they're gonna see it and also apologies in advance if if you see some repeating points um it's because it's it's uh it's quite important i think to remember um so why else dread syndrome is a big part of our life physically and mentally whether we like it or not and if you're looking for a partner and somebody you're going to spend you know your time with they're going to need to understand that and they're going to need to understand how to support you assuming that they're going to be a good partner and then opposite i think they deserve to know about anything that may affect your relationship just as the opposite is is also true that doesn't mean you have to lay out every single thing you know that you've got on your mind or in your life right away but uh something like this that you know we can't just turn off i think it's uh it's important that a partner understand exactly you know what they're getting into and what to expect and like i said how to support you uh next slide please so how we have a lot of options and i'll elaborate on this um so i tend to break down the how of disclosure kind of into an offensive approach or a defensive approach and what i mean by that is offensive just get out ahead of it so yeah bring your tourette's up early so you're on the same page you know it's not you sit down you just boo my threats but um try to work it in you know sooner rather than later because you know they're gonna notice something's going on um and so an offensive strategy is just to go ahead and just get it out of the way um but you can also wait to address your ts especially if you have much more mild ticks than some of us have um once the other person comments um for a lot of you know a lot of uh people with tourette's and tick disorders you know they might just have a tiny little eye blink or a nose twitch or something like that and it might even be you know someone may never even notice it um but that being said um i i've had friends or i have friends right now who i just you know i never brought it up and eventually it came up and you know that was fine as well um and then this is something that if you're comfortable doing so making light of your ts through humor can be a great way um to disclose that's that's just kind of how i uh grew up getting it out there um i was lucky enough to have support you know and a fair amount of friends growing up and you know you lean into it and all of a sudden things in my experience weren't really nobody's you know laughing at you it's just we're all kind of just enjoying if something funny happens or if i can make a joke out of it but once again that's something that you need to be comfortable doing and there's no way something that you need to do to disclose see next please oh yeah and i think this is very important um try not to go into more detail about your tourette's at least towards the beginning than what the situation is calling for i so i'm always personally an open book i say you can ask me anything you want about it i i'm happy to talk about it answer questions but you know some people it's like oh why do you do that or you just say oh i have threat syndrome like oh okay and they don't ask more questions and you know that's so you don't really need to just start you know really diving in and going into detail if they ask questions and you're comfortable answering them then that's i think the the situation where you would go deeper and deeper however deep they want to know or that you're comfortable going um but most importantly do what's best for you based on your experience with your tics and your relationship with your own ticks and your tourette's don't be afraid to put yourself out there but don't you know go too far out of your comfort zone if it's really going to stress you out or give you anxiety but one point i want to hammer home most people are not going to be concerned with your ts just like lots of people aren't going to be concerned with other mental and physical um traits their partners or their friends um have you know they want to be there to get you not just uh something you live with next slide please so whoop yeah disclosure when so the two most common scenarios i think this day and age are what i call in the wild meaning you just meet somebody while you're out and about or in a group of friends or whatever it may be and then also online dating which is extremely popular and i i feel like especially you know in cities it just goes up a notch so let's look at uh if you go to the next slide please let's start with the in the wild quote unquote so this is meeting someone in person without pre-arranging it while you're just out and about um if you're going to be spending some time right then and there i'd say go back to the house slide it's like this is all the different ways you can work it in now you didn't have any time to prepare you weren't talking about it before but hey it might come up it might be a good opportunity to but uh yeah what are you most comfortable with if you want to stay connected say you meet briefly you you exchange numbers or social media or something like that and it hasn't come up yet uh i wouldn't worry about it tell them later why you're chatting or when you meet up next or if they ask a question about it um which leads me to my next point depending on the length of your encounter at the you know quote in the wild there's a good chance they've already noticed your tics even if it doesn't come up um if you keep talking and make arrangements to uh to meet again then i think that's a pretty that's a good sign but that can be a great opportunity to disclose something i've said several times it's like hey while we were talking earlier you might have noticed you know that's my my face twitching or my shoulder jerking um i usually don't have as many vocal tics as i have right now when i'm um out in public but there's all sorts of things you know your ticks you know your tourette's so that that's an op that's an opportunity to kind of work it in there and just close i really think that um it's obviously not something you can just plan to work out but meeting people when you're in a group setting with friends can be very advantageous because they get to observe you being you presumably um interacting with friends and people you know and a lot of times they'll also see you ticking so that's like you're almost you're disclosing without actually explicitly disclosing but you're showing off you as a person your personality and all of that and so a lot of times that can really just it's like two birds with one stone it's all just it's out there and they they understand what you're about uh next slide please so online this is something that um i've been asked about a lot and i've talked with people a lot and it's just because it's just more and more common um people meeting online these days and for serious relationships um so getting to know each other over the you know the integrated tech system and whatever dating app you're using or you're texting messaging that's kind of usually the first step when you you know meet or match with somebody online so now what do you do do you just do you tell them about it right off the bat you know over text before you ever meet or do you want to wait till you meet or maybe do like a facetime or a video chat uh you know do i want to put that threat syndrome in my dating profile this it can become kind of a stressful thing before anything really even happens and um i've i've kind of myself learned i've tried all these different approaches and um and i i think i can offer some insight so i i find it easiest if you're gonna meet up with somebody online that you met online um it's easiest to bring it up for me before meeting them in person but after a little bit of conversation and getting to know each other so i mean it's almost kind of like that group setting it's like they're kind of getting to know you but before you know they're just taken by surprise it's like okay yeah i also i have threats and this is kind of what it is um and i say that not just doing it right off the bat which is a perfectly fine approach um i actually dated someone for quite a long time that i had it just i had it in my profile and they just okay acknowledged and moved on um and we yeah so tourette's might play a large role in your life but it doesn't need to be your defining characteristic so it doesn't need to be like i'm looking at a profile eric tourette's okay that's it i think it's it's advantageous to kind of see if you guys click or have similar interests or you know take the first step before diving into the disclosure portion but once again i'll say it again there's no wrong way to disclose your tourettes proceed in the manner you're comfortable with based on your understanding and your relationship of with your own tics uh next slide please so what um how do i go about telling them about my ts when the time comes um and this is i've already said this but i i i think it's important um and this is where what i most commonly see myself it's like so i personally i like to get out in front of it if i'm meeting someone for the first time and i haven't told them that threats i really just look for that first kind of smooth time to to bring it up like oh yeah and if you notice my you know face twitching it's just because i i have threat center um or sometimes it'll be a noticeable dick i once my knees shot up and hit a table and i almost spilled uh my drink and so i just kind of like oh yeah so i have this that's why that happened um and for me that's a great time to introduce some humor i think into the situation but those are kind of just for me i usually wait i usually yeah i get right out in front of it or i just really i just wait for a good time but i don't like to wait too long because i think um i think as dr uh kaplani mentioned suppression can really take a lot out of you and just waiting to disclose and wondering what's to happen builds up stress and anxiety and i just i feel better and i think a lot of people feel better when they just get just get it out of the way next slide please oh oh yeah and this is kind of what i've uh already talked about this second to last point go into the the degree of detail that the situation calls for um no need to go into lots of detail if they're not asking more questions or if on the other side if you feel uncomfortable you know really diving into it and one thing i love to stress and i really believe in it is don't apologize for having ticks or tourettes it's not your fault and um i mean obviously i you know i've had a tick that maybe yeah knocked something over i ran into someone or something like that and i'll apologize for that but i think it is very important um socially to not apologize for uh for having tourette's and and really just show you know it's something you live with but you're good we can move on it's just my tourette's uh next slide please so this is the big one like i said at the beginning it's what everyone's afraid of whether you have tourette's or anything else um but for a lot of us i know me personally what took me a while to get over um and in some ways it'll always be there is if you get rejected you automatically think it's because of your tourette's um could be a hundred other things but you know our minds often just go right there so yeah everybody that dates unless you ask out one person and then you know you get married they're gonna they're gonna either be rejected or they're gonna fear being rejected by a potential partner um he said we're really quick to chalk it up to our uh our tourette's but like i said people without threats are rejected all the time it's just yeah personality your manners your appearance your job if you smell bad it could be a million things um so try not to dwell in that just thinking it's because you're tourette um yes pick yourself up dust yourself off get back out there be yourself just like your friends and your family who accept you who you are for your tourette's there's partners out there that will too and to quote one more thing from dr complete's uh portion i i in my experience um you know who you do date you're usually going to get a i don't want to say higher quality but somebody that really is into you for you because they're just going to cast away this funny thing that we do that we can't hide that's going to go everywhere that they go and they see you for yourself next slide please and then conclusions yeah most people struggle with insecurities that reflect that affect their romantic life you can just close your tourette's in a bunch of different ways but do it how you're comfortable and what the situation calls for and don't let yes get in the way of you being the person you want to be or you being the person you are it's uh it can seem scary but um having romantic life even with tourette's mild moderate severe it's completely possible and um you just gotta just gotta go after it so uh i believe that's all i had and you can turn it over for questions oh yeah keep trying if you fail okay okay thank you youtube so now we're going to move into the question and answer section of the webinar um the first question comes from a lay andy do you plan dates where ticks aren't as noticeable i.e a concert or a loud venue versus a movie i guess the answer is um kind of but it's really well so i'll i'll say that i i i did used to do that but or i have done it in the past but um like i said i i really like to just get that disclosure out there sooner because i i just it's going to come up at least for me there's no way i can completely hide it um and i don't want to be thinking throughout this whole loud event like oh god and then you know dreading when we're back in the car or something like that and then it's you know the potential or the next time we're gonna go out that you know i'm getting a tick like you can't hide it forever um at least most of us uh and i really like to get out of the way but very specifically about that one i do not plan movie theater dates because i don't think there's anywhere i'm less comfortable besides maybe a crowded airplane than in a movie theater with my tics okay the next question comes from roxanna b my husband has tourette and he thinks that i am too sensitive to his tics and he does not take any f he does not make any effort to see a psychologist or do medication medication meditation excuse me or any mildness my mindfulness he is not open to talking about his tics i am interested to know your suggestion for someone like me who is getting anxious or maybe annoyed by his tics thank you doctor yeah can i say something about that please i maybe eric is the right person to talk about it but um i've seen a lot of couples come into my office like this and um usually a lot of people with tourette's they go through the work day suppressing and then they go home at night and home is a sanctuary and should be a sanctuary and that's when a lot of people release so the the severity of the ticks at night when you hit that couch and unwind for the days is not necessarily a depiction of the severity of the ticks during the day so i i think you know it's just uh people have the right to unwind and treat home as a sanctuary but on the other hand i understand your point you know you're human too and you need you need a break as well but just make sure you you understand that this is not that how the takes are the whole day most likely eric yeah it's it's kind of a difficult one um i know for from experience at least when it comes to getting help when i was younger i probably cycled through a dozen different medications none of which worked and all of which the side effects were way worse than having ticks i did eventually find something that i use to kind of take the edge off um right take a dose that only you know takes the edge off because it it affects me you know mentally it makes me very anxious if i take too much but on the other hand uh it is you know it's something that you you have to live with as well um and i mean i guess i don't have the best uh advice there it's just uh everybody's sort of different with how they want to approach it and their past with um you know being treated you see it a lot with um with people that have depression too um i have friends and family that you know they're they're not having a good time it's hurting them but at the same time um they may not be ready or they may not be wanting to to go get help for a multitude of reasons i mean it's interesting because a lot of the adults are like you and they've been through tons of different medications as children and psychologists and behavioral modification and all this and then i've seen that when people have a word of their own and they can be they can decide from this for themselves a lot of times they choose not medications and you know there is a a wrong perception that they're not adults with sicks but and that's wrong and i remember once we had the study for adults with tourettes and there was an ad on the radio and everybody came out of the woods so people are out there they're just i think sometimes disillusioned with the you know what the medical profession has to offer and uh you know it's um maybe you know it's a and i i i think people when you get to be an adult you've tried in so many different ways for so many years it's just that you have to discuss that more with the other side with other person you know it's maybe it's you know they can have their safe place they go away do the ticks and then understand that you're a person too you want to have some quiet time in the couch but uh i think this is something that has to do with communication more than anything between the two people who have to share like the evening together and the night together after a hard day's work and this is doable you just have to be able to articulate your your your emotions you know let the other side know that that's how you feel because that's another elephant in the room you know if you don't do it then you know you you're not gonna get rid of it it's there okay and the next question comes from okay the next question okay comes from lindsay g do you have any tips for newlyweds moving forward one with tourette's and one without um michael morbid conditions get more in the way than the ticks which affect the relationship more i feel like it might be a lot of overlapping with the comments that you just gave katie um do you want to take uh you know unfortunately i i have not been married um so i can talk about that i've been married and divorced i feel like it's a lot of the same comments that um yeah i mean but yeah go ahead it's hard it's not so hard it can be a wonderful thing it's a it's just it's something that requires a lot of work once you get away from the you know the you know the the the honeymoon period so to speak then you need work you need to start accepting each other and allowing and growing together but allowing each other space to grow and you know some of the comorbidities as you said they can be you know very difficult to deal with but you know it's it's not that you didn't know you know you know we were not in the air of arraigned marriages that's why people date that's why people take their time and you go into eat and you have to take the other person with everything with all the whole baggage and their family together so it's a it it's in it's a constant negotiation and that i i would i heard that i mean that's not my line but i just heard the ted talk the other day and it was the danger of the single story you know none of us is a single story we're not only our depression we're not only our teeks we're not only our ocd we're many more things we just have to put it all in the table and if you get to the point of getting married you've already put it on the table but then marriage brings a whole new set of problems and you just have to face them honestly i think you know it's uh honestly and with respect for each other and allowing each other space but trying to grow together and even i know this sounds like generalities and this is true for everybody whether you have anxiety or you have threats or have ticks or whatever we have because we all kind of have something and you bring it to the table and you have to learn how to deal with it and we have one last question um any questions that we don't get to tonight i will be emailing you with the answers from the presenter so please don't think we're going to ignore you the last question comes from dansy how do you deal with a date that has an insensitive reaction to your disclosure of your tourette's syndrome and this one is barrack yes so i mean yeah that's that's really unfortunate um i guess it would it would it might um it might depend on to the degree of insensitivity and whether it comes truly from a place of ignorance or i should say like not understanding um and then you know but if it's if it's that and you can explain it and then it's still a problem or it was insensitive in a way that was truly meant to be you know hurtful or put you down um i i think it's it's kind of the same um with any insensitive comment you might get on a first date i think that's uh it's that's probably not the person for you or a person that you want to be um investing your time with because like i said if they're not open to learning and uh you know accepting what you have to say is what's going on then it's it's just not um it's not the right person it's just like a friend if you have a friend that well a quote friend that's you know making fun of you or putting you down or you know poking at your insecurities that's that's not a friend that's not someone you want to be around so um i know it can sometimes be hard to uh let go of this this idea that you have especially before a first date about how well it can go and maybe you really like this person you've liked them for a while or whatever but um if it's an incense if it's insensitive from a place that was meant to be insensitive and not a just an errant comment that you know you can educate them on and and they can apologize you can move on then it's probably time to move on from that person yeah all right well thank you so much eric and dr completely for speaking on this topic tonight and thank you to our viewers for tuning in for those of you that are joining us currently you will receive a survey in about one hour we encourage you to fill it out we always like to know how we can improve on our web-based presentations and um we look forward to seeing you at our virtual conference and that will be may 14th through the 16th and again it will be held virtually and to our supporters it is free of charge have a good night everyone thanks for coming bye-bye thank you bye