Tourette's Syndrome and the Baftas Controversy: Understanding Involuntary Tics

A racial slur shouted during the awards show has raised questions about how Tourette’s outbursts should be understood. Controversy has erupted over the Baftas after the BBC initially failed to edit out a racial slur shouted by John Davidson, who has Tourette syndrome (TS). Here we explore what vocal tics are, and how they should be understood.

One of the films up for awards was I Swear – a movie inspired by the real-life story of the TS campaigner Davidson, who was present at the event on Sunday. Davidson shouted several times during the ceremony. In one case, he used the N-word while the actors Delroy Lindo and Michael B Jordan were presenting a prize on stage. While the host Alan Cumming explained later to the audience that the incident was a result of Davidson living with TS, it was not initially edited out of the programme before broadcast – despite the awards being shown with a two-hour delay. The show has now been removed from the iPlayer platform, pending editing.

The Oscar winner Jamie Foxx posted a comment on Instagram that use of the N-word had been “unacceptable”, while Wendell Pierce, who stared alongside Jordan in The Wire, wrote on X: “It’s infuriating that the first reaction wasn’t complete and full throated apologies to Delroy Lindo and Michael B Jordan. The insult to them takes priority. It doesn’t matter the reasoning for the racist slur.”

A spokesperson for the charity Tourette’s Action stressed vocal tics were not intentional. “We deeply understand that these words can cause hurt but at the same time, it is vital that the public understands a fundamental truth about Tourette syndrome: tics are involuntary. They are not a reflection of a person’s beliefs, intentions, or character,” they said.

TS, often called Tourette’s, is a condition that has tics as its main symptom. These are involuntary sounds or movements. Maddie Groom, a professor of neurodevelopmental conditions at the University of Nottingham, said it was thought TS affected approximately 1% of the population, while about 3% of the population were affected by less severe forms of tic disorder – although these can develop into TS. However, these are only estimates. “Clinics do not accurately or routinely record tic disorder referrals and diagnoses so we don’t know the true prevalence,” said Groom.

No, in fact swearing tics – known as “coprolalia” – are rare. “Most vocal tics are not swear words. It’s far more common for people to have vocal tics like throat clearing, whistling, clicking, or saying words that are not offensive,” said Groom.

Dr Valerie Brandt, an associate professor at the University of Southampton, said it was not clear why some people with TS ticced swear words. “We can only speculate that the mechanism is similar to OCD [obsessive-compulsive disorder]. When you ask someone not to think of a pink elephant, that is all they can think about,” she said. “It is possible that coprolalia happens especially because someone is very aware of how inappropriate it would be to say a taboo word out loud. Combined with a difficulty to suppress verbal output, this could result in coprolalia.”

Groom stressed tics were not deliberate or intentional. “Some people can manage to suppress tics for short periods of time but then they often experience a phase of extreme tics – like a rebound effect – which can be even stronger because they’ve been suppressed,” she said.

Groom added there were psychological therapies designed to reduce the severity and frequency of tics, but they did not work for everyone and required a lot of practice and support, while medications could have unpleasant side effects and did not always have a large effect. What is more, access to healthcare for people with tics is limited. “In most parts of the country there are no services willing to assess, diagnose and treat tics, and a lack of experts trained in the assessment and treatment of tic disorders,” said Groom.

Groom added that public stigma was one of the most challenging aspects of living with tics. “It’s a balancing act for people with Tourette syndrome – not all want to control their tics, particularly if the only way to do this is via treatments that don’t suit them. With more acceptance and understanding in society, many would be able to cope with their tics,” she said.