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George sat in the principal's office, scowling and flicking his middle finger continuously, blurting out an occasional “fuck” to no one in particular. As I went through the file cabinets, he asked me in a very engaging fashion if I were a teacher. I explained that I was a kind of a teacher, and that children talked with me. He asked me if he could talk with me. I saw him quite frequently in the principal's office, and I was intrigued with the prospect of treating a case of Tourette's, which the literature indicates to be prognostically unfavorable.
Gilles de la Tourette's syndrome is a disease which afflicts mostly males. Its onset is usually during latency years and can be gradual or precipitous. Symptoms include facial, bodily and vocal tics, especially coprolalia and obscene gestures. There is generally considered to be no cure, although various treatment methods are followed. Drug therapy is often prescribed. Also family and individual supportive therapy to help the family and Tourette's sufferer deal with the symptoms have often proved useful. Symptom outbreak seems to be positively correlated to stress, and there are recorded cases of both spontaneous remission and drug induced Tourette's. It is notable that drug therapy often moderates the symptoms, but in no way attends to the underlying cause of the symptoms.
I approached the school psychologist and told him I would like to treat George. He arranged with the parents, whom he was seeing in family therapy once a month, for me to start treating