Precise clinical definition often presents an intractable problem in Tourette Syndrome. Attempting to analyse what causes what in TS and attach specific clinical labels to symptoms and behaviours is fraught with problems. Psychiatric theories and paradigms don't often lend themselves very well to describing neurological conditions such as TS. It's probably safe to say that dysinhibition (reduced selective filtering), compulsion and impulsiveness are all good descriptors for many aspects of behaviours such as vocal tics, motor tics and complex tics and are probably also part of difficulties experienced in filtering sensory input and in controlling emotional responses and intrusive/unwanted thoughts. Many people (but not all) are better able to exert conscious control as they get older and some find these problems reduce anyway with time. It's always good to keep in mind that TS is more than just the tics for which the disorder has become infamous.
For the individual with TS and those they share their lives with, it is frequently difficult to know where tics end and where the conscious thoughts, words and actions of the person's 'self' begin. Some would suggest one is always part of the other and that TS is so interwoven and so much a part of an individual's personality and behaviourisms that trying to sort this assumed duality into separate parts is futile. What are and are not tics might be considered really to be just an academic point. What does matter to those with TS is how to manage life with TS as an individual, or a parent, in the case of a child. This is something that comes with experience and lots of support and help from others. For children, a structured, secure family environment can help together with ample tolerance and understanding but rules and boundaries must still exist. A child still needs to be a 'normal kid' with their own sense of who they are as well at the end of the day, and TS should never be allowed to totally 'define' them. A person must be more than just their Tourette Syndrome even when others tend not to be able to see through the TS and see the person beyond the 'disorder.'
