Imagine trying not to blink, resisting the urge to sneeze or refusing to scratch an intense itch. For a short time, you can probably succeed, but the effort becomes increasingly untenable until the urge eventually wins.

People with Tourette syndrome describe tic suppression in a similar manner. Tourette syndrome causes tics, or repeated movements and sounds, that a person cannot always control. These tics often come and go, change over time and may occur along with attention problems, anxiety or obsessive-compulsive behaviors.

Some people with Tourette’s can temporarily control tics, such as during a public interview, but that does not mean tics are voluntary. Nor does it mean the person is faking their diagnosis. Rather, suppression can be a hallmark of the disorder and, ironically, has become one of the foundations of modern treatment.

Yet suppression can come at a cost.

I have seen this firsthand as a neurologist who has been treating people with Tourette syndrome for over 20 years. Many of my patients have told me that while they can temporarily hold back tics through intense concentration, they later need to release them. They say it’s an exhausting process.

Understanding the neuroscience behind tic suppression and people’s experiences with it can help those without the disorder better recognize – and have compassion for – the dynamic and sometimes demanding symptoms of Tourette syndrome.

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