Your child is sitting in a quiet classroom and feels a vocal tic coming. They know other kids might hear it, so they try as hard as they can to hold it in. Or maybe you’re at a restaurant and their motor tics suddenly increase. Without thinking, you say, “Can you try to control that for a little bit?”

And sometimes…they can.

That’s one of the confusing things about tics. Many kids can temporarily suppress them.

So if your child can hold in their tics, should they? In most situations, no.

As a CBIT therapist, I don’t want kids spending their day using all of their mental energy trying not to tic. Suppression may temporarily make a tic less visible, but it doesn’t teach the child an effective strategy for managing it.

And there’s a much better way to use that motivation for control.

What Is Tic Suppression?

Tic suppression is exactly what it sounds like: your child feels the need to tic but intentionally tries to prevent the movement or sound from happening.

For many people with tics, there’s a sensation that happens before the tic called a premonitory urge. A child might describe it as pressure, tension, tingling, an itch, a “weird feeling,” or simply the sense that they need to complete the movement or sound.

Some kids discover on their own that they can resist that feeling temporarily.

You might notice this at school, church, during sports, around friends, or anywhere your child is especially aware of other people noticing their tics.

The problem is that being able to temporarily suppress a tic isn’t the same thing as having an effective strategy for managing it.

Suppressing Tics Takes A LOT of Mental Energy

Imagine sitting in math class while simultaneously thinking:

Listen to the teacher.

Don’t move your neck.

Finish the worksheet.

Don’t tic.

What did she just say?

Don’t tic.

That’s a lot for one brain to manage.

Suppressing tics can require significant attention and effort. So while a child may look like they’re doing “better” because you aren’t seeing as many tics, internally they may be working incredibly hard.

And that mental energy has to come from somewhere.

Instead of focusing fully on reading, math, conversations, sports, or playing with friends, part of their attention is constantly monitoring their body and trying to prevent the next tic.

That’s a lot of effort for very little long-term payoff.

The child hasn’t actually learned how to manage the tic. They’ve learned how to fight against it temporarily.

Then Comes What I Call the “Tic Explosion”

Parents tell me about this all the time.

“He barely tics at school, but the second he gets in the car, it’s nonstop.”

Or:

“She holds it together all day and then comes home and the tics are SO much worse.”

In my practice, I often call this the “tic explosion.”

After spending hours trying to hold tics in, a child finally gets somewhere they feel comfortable letting them happen.

And suddenly…

BOOM.

The tics come out.

There is some nuance here: research doesn’t show that everyone who suppresses will experience a dramatic rebound above their usual tic level. But many children describe increasing discomfort or urge while suppressing and may tic more freely once they stop.

So I don’t want a child spending seven hours at school thinking their job is to keep their body perfectly still or quiet.

Home should especially be a place where kids know they don’t have to hide their tics.

Does Suppression Make Tics Worse or Cause New Tics?

Tics naturally wax and wane, and they can change over time. One tic may disappear, another may show up, and old tics can return. So we can’t assume that every new or changing tic is caused by suppression.

That said, in my clinical work—and from my own personal observations—I have seen some people experience an increase or change in their tics during periods of frequent suppression. A tic may become more intense, shift into a different movement or sound, or a new tic may appear. This doesn’t happen to everyone, but it’s a pattern I would pay attention to.

When a child is constantly resisting the urge to tic, they’re putting a tremendous amount of attention and effort toward controlling something their body is repeatedly signaling them to do. For some kids, that seems to create more tension around the tic rather than giving them meaningful, lasting control.

That’s another reason I don’t want “just hold it in” to be a child’s primary tic-management strategy.

If a child wants more control over their tics, I want to take that motivation and teach them a more intentional, structured strategy through CBIT rather than having them rely on suppression alone.

“But My Child Wants to Control Their Tics”

Good. If your child is already trying to suppress their tics, I don’t automatically see that desire for control as a negative.

I see motivation. Your child is telling us:

This tic bothers me.

I can recognize that it’s happening.

I want more control over it.

Those can be really useful insights for Comprehensive Behavioral Intervention for Tics (CBIT). The problem isn’t necessarily that your child wants to control the tic. They just don’t have an effective way to do it yet.

Suppression and CBIT Are NOT the Same Thing

This distinction is incredibly important. Suppression is essentially: “I feel like I need to tic, so I’m going to try really hard not to do it.”

CBIT gives the child a much more specific process. First, we identify the exact tic we’re working on. Then we build awareness of the premonitory urge that comes before the tic. Next, we develop a competing response—or what I often call a tic blocker—that is specifically designed around that individual tic. Then we practice using that response intentionally and consistently.

So instead of:

Urge → TRY NOT TO TIC

We’re doing:

Urge → tic blocker → urge goes away on its own → No tic

That’s a very different skill. CBIT gives the child something to do, rather than simply asking them not to do something.

The Goal Doesn’t Have to Be: Stop Every Tic

This is another really important piece of CBIT. We don’t need to target every tic simply because it’s there. If your child has a little eye-blinking tic that doesn’t hurt, distract them, embarrass them, or interfere with anything… Why make it a problem?

Instead, I want to know which tics matter to your child. Maybe a neck tic is becoming painful. Maybe a vocal tic is making them uncomfortable at school. Those are the tics we can prioritize.

If Your Child Is Already Suppressing, CBIT May Be a Great Next Step

When I hear that a child is spending significant amounts of time trying to hold in their tics, that’s something I want to explore. They’re already putting in the effort. They’re already motivated. And in many cases, they’re already aware that something is happening in their body. Now we need to give that effort some direction.

At Three23 Therapy, I provide virtual 1:1 CBIT therapy for children and teens with tics and Tourette Syndrome. We identify the tics that are actually interfering with their life, build awareness, develop individualized tic blockers, and practice using those skills in everyday situations.

CBIT isn’t about teaching your child to hide their tics better.

It’s about giving them an evidence-based strategy so they aren’t relying on brute-force suppression every time they want more control.

Learn more about 1:1 CBIT Therapy at Three23 Therapy →

The Bottom Line on Tic Suppression

If your child can suppress their tics, I wouldn’t make “just hold it in” the strategy.

Let them tic freely when they want to tic.

Create environments—especially at home—where they don’t feel like their movements or sounds need to be hidden for everyone else’s comfort.

And if your child is telling you, “But I WANT to be able to control this,” listen to that too. They just need a better way to get there. That’s where CBIT can take all of the awareness, effort, and motivation they’re already using and turn it into an actual skill.

Peace + Blessing,

Emily Reid, OTR/L