I involuntarily repeat words and phrases. They forcefully crawl their way out of my throat. I hear my voice talking, but I didn’t chose for it to talk.

I don’t mean the things I say. They just pop out.

I’ll try to keep my jaw clenched tight to prevent them, but I can’t hold my mouth like that all day.

Lately the most common word is “Dead“. Others include “I’m gonna kill myself” and “Fucking hate you“. Sensing a pattern? There’re many more than just those few. A lot are minor variations on the same phrases.

Often they come out in the third person. In the phrase “I’m gonna kill you” the “you” refers to me. This is a little confusing, because I don’t mean these words when I say them. Why would I be able to explain the intended meaning of the words? I can’t explain why, but I with 100% certainty know that the “you” is me. In a way it makes some sense for them to come out in the 3rd person. While my mouth is involved in the process of producing the sounds my consciousness is not involved in the decision to make them.

When I was in a french immersion program they switched into french “Je veux me tuer“. If only they could have stayed in french after the program ended. That would have been nice.

I do have some levels of control over the words. Not to much with the decision to make them, but more with minimizing the way they come out.  For example: I can reduce a phrase to a shorter nonsense sound. Suppose “I’m gonna kill you” starts to come out. I can compress it into “mmmgn“.  It takes a level of concentration, but is worth it since a nonsense sound is much less socially damaging than what would otherwise happen. Unfortunately for me psychologically I know what was supposed to come out.

I also have some control over volume. Well, not consiously. The volume when I am alone at home is a normal speaking level. In public it is generally only whisper.  It happens all the time to me in public, but it’s quiet enough that no one has ever commented on it. I’m just the crazy person walking down the street muttering to herself. Problems can occur when I forget I am not alone and the words come out too loudly. Then I feel anxious worrying that I might have been heard.

It’s pretty impressive how little I have been overheard. Or at least how few times I’ve been called out on it. My brother hears me all the time, I don’t hold it back as much around him. He thinks I just get really angry at my computer and talk to it.

Being overheard is a major worry. There are times I’ll be walking somewhere with my headphones on and be struck with panic. I’ll be convinced that it might happen and I wouldn’t know it had because of the headphones blocking the sound. This has not to my knowledge ever happened. I’ll keep my jaw clenched shut preventing sounds from escaping until the fear passes.

So what triggers it? It only happens when I’m being spacey. It would never happen while in conversation with someone or while in deep focus. My mind will be off doing something and then suddenly I hear words coming out of my mouth pulling me back down to earth. If immediately after it happens I scan my brain for what I was thinking about I can locate a specific thought that triggered it. If I don’t do that the thought is gone. The thought is always something anxiety provoking. Saying the words serves the function of forcing an unpleasant thought out of my mind.

I imagine it works by taking advantage of the limited capacity of working memory. By throwing a distraction at me older items get pushed out of working memory and forgotten.

The thoughts are always more minor anxieties. It doesn’t happen for bigger stressors.

Around a month ago I decided to keep count how often it happened. Therapists kept asking the number and I had difficulty answering. Unfortunately the act of counting manipulated how it presented. Knowing I was counting made it happen less so I didn’t get an accurate number. I became better able to stop it while I was keeping count. I noticed my body often tenses in specific ways right before it happens. With that warning I could hold my jaw shut to stop the words.

My body is tricky and wouldn’t accept that. The ways my muscles tensed before the words broke free from the speech. They started happening independent of words and became more exaggerated.

One day I noticed that everything was uncomfortably quiet. And realized it was because I wasn’t talking to myself as much. I realized that the words also served an additional function. I spend most of my time alone and they break up the quietness.

I decided to stop counting and things went mostly back to normal. The muscles tensing are still happening independent of the words sometimes, but I guess this isn’t so bad. Less crazy looking than talking to myself.

Whether this is OCD or a Tic disorder all depends on who the therapist I’m talking to is. Tic disorders run in my family. Some think OCD because I can, with effort, identify a specific trigger. The words are “undoing” the thought. I don’t know. It doesn’t matter too much to me though it would be nice if for a change I could have a diagnosis that could be agreed upon. Both are obsessive compulsive spectrum disorders so combined with my trichotillomania someone should invent the diagnosis “Obsessive Compulsive Spectrum Disorder NOS” for me. It’s probably already been invented I bet. Nope. I just googled it no one has. DSM-V committee members, get on that, will you?

I wonder about the relationship this has with my ADHD. It happens at times when I’m spacey. Tic disorders have high co-morbidity with ADHD. Do other people with similar problems find attention is a factor?

If anyone can recommend a good memoir about tic disorders I’d be interested in reading it. I want to read about subjective experience. I’ve read about the outward presentation in technical literature, but I’ve been unable to find much on the experience.