Volition in the Ticcing Brain

Abstract

AbstractThis chapter traces how dominant philosophical views of volition and ‘free will’ have shaped the study of tic disorders and Tourette Syndrome (TS). Are primary tics voluntary or involuntary? And is voluntary action affected more broadly by the presence of tics? While responses to these questions vary in the scholarship, most contributions draw on a classic experimental paradigm: That pioneered by Benjamin Libet in the 1980s. I show how Libet’s notion of volition as a conscious ‘veto power’ commonly expressed through motor control has led to the view that tic suppression is paradigmatic of free will in Tourette’s. Alternative views proposed by some authors suggest that actions are voluntary when they are consciously intended, not necessarily inhibited. I show how this latter emphasis on consciousness has re-focused the debate on subjective experience, and particularly on the contested role of premonitory urges and sensory phenomena in TS. By drawing on insights from philosophical phenomenology, I propose that we should reconsider what it means to be conscious of an experience such as an urge to tic, and that doing so promises to advance our understanding of the elusive link between the experience and inhibition of tic disorder symptoms.KeywordsVolitionFree willTic disorderTourette SyndromePremonitory urgePre-reflective consciousnessReflective consciousnessIntentionActionMotor controlSuppressibilitySubjective experience