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Tourette’s Syndrome: Shedding fresh light on our everyday Organisation Development Practice

Tony Nicholls researches Tourette's syndrome and shares his insight on how studying it can shed light on Organisational Development Practice
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Since a Tourette’s related one-liner won the funniest joke of the 2019 Edinburgh fringe, the neurological condition has received a lot of media attention. Mayvin Principal Consultant Tony Nicholls has been investigating more about Tourette’s. He writes about his reflections on one of Oliver Sacks’ stories about patients with this syndrome. In addition, Tony shares his insight on how studying Tourette’s can shed light on Organisational Development Practice.

I have long been a fan of Oliver Sacks’ writings. With eloquence, humility and deep empathy for his patients, he shares stories of neurological conditions. These stories shine a light on the very essence of what it is to be human. Often, scientists learn more about the human condition when things are not working as they should.

In his recently published collection of writings, Everything in its Place1, a story about patients with Tourette’s syndrome caught my attention. Specifically, in his ‘Travels with Lowell’, Sacks travels with a photojournalist with Tourette’s. Sacks observed how

“many of the tics and compulsions of Tourette’s seem to be aimed at testing the boundaries of what is socially acceptable...”

He also noted how

“a person with Tourette’s has a certain degree of voluntary control of an otherwise involuntary or compulsive behaviour”.

To some extent, this degree of control is connected with whether people were within earshot or touching distance of the person with Tourette’s.

Tourette’s is a relational condition and has an element of agency

As an example, when Lowell discussed a possible walk with Sacks in the desert where they would be alone. Lowell stated he would not Tourette much, remarking

“What would be the point?”

One of Lowell’s compulsions was to touch people he was near. Sacks likened it to

“an animal urge, the way a horse butts it’s head against a person and nuzzles them.”

Linking back to the observation that the tics and compulsions were somehow testing the boundaries of social acceptability, the reaction of the touched person,

“whether positive, negative, or neutral...[would]...complete the circuit.”

The compulsion to create life-affirming circuits dampens when no one is around. Therefore, Tourette’s is not a condition centred purely on the individual, with completely uncontrollable tics and compulsions. It is, in fact, relational and has an element of agency to it.

Sack’s summarises his findings by stating that

“Tourette’s, in its effects, is never confined to the person but spreads out and involves others and their reactions; and they, in turn, exert pressure - often disapproving, sometimes violent - on those with Tourette’s. Tourette’s cannot be studied or understood in isolation, as a ‘syndrome’ confined to the person who has it; it invariably has social consequences and comes to include or incorporate these as well. What one sees, therefore, is a complex negotiation between the affected individual and his world, a form of adaptation sometimes humorous and benign, at other times charged with conflict, pain, anxiety, and rage.”

Similar to Tourette’s Syndrome, Organisational Development is not a wholly individual endeavour; it requires us to create disturbance in the status quo.

For me, Sacks’ study of people with Tourette’s syndrome has shone fresh light on how our agency as Organisational Development practitioners is not a wholly individual endeavour. It needs others around us to fully emerge, otherwise

“What would be the point?”

Our work also requires us to create a disturbance in the status quo, where we can see fresh perspectives. It often requires us to

“test the boundaries of what is socially acceptable.”

We do this through our less extreme versions of compulsions and tics.

One such compulsion is to scan ourselves and our surroundings for data, to ‘notice’. Our most pronounced tic, perhaps, is to reach out metaphorically and ‘touch’ in the form of articulating our noticings and thereby hoping to ‘complete the circuit’ through the emerging inquiry.

I wonder whether a more in-depth study of Tourette’s and experimentation with metaphorical and actual tics and compulsions might result in an array of effective Organisational Development interventions.

To conclude, I also reflect on the nature of healthy human relationships. Including how much these depend on us being able to find our place through testing social boundaries and reaching out to metaphorically or actually making physical contact with others.

Tweet us @MayvinLtd and @TheTonyNicholls or contact us here. We would love to hear your thoughts on Tourette’s relation to the practice of Organisational Development.


1. Sacks, O. (2019) Everything in its Place: First Loves and Last Tales. Picador, London.

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