How to Help Player with Tourette's

Question

I have a friend who has Tourette's syndrome. He's a great guy, I've been friends with him for over a decade. We both love RPGs, and we've played many games together. However, his condition occasionally disrupts play, and a few times has even ended a session. Sometimes, when he's talking, the conversation suddenly ends. You can almost feel it, it's like the life in the conversation just drains away and you're listening to a recording. He isn't talking to anyone any more, he's just talking. Loudly. There's no communication getting in or out. It's like a trance, or a highly verbose seizure. One of these went on so long, I had to shake him out of it. Usually, when he snaps out of it, he barely remembers what he was even talking about. I understand this is hard for my friend, but this is also hard for me as well, because it is very difficult to organize a group game when one of the players could randomly and spontaneously shut down all socialization at the table. It makes other people not want to play, just because he's there. (I know that hurts his feelings too)

I've learned a few of his trigger topics, (Greek myth, the name of any anime he likes, Mormonism, a few others) but sometimes he isn't triggered by a topic, and it's impossible to eliminate everything and still be able to talk to him. He's been a lot better since he swore off caffeine, but it can still be problematic at times.

He has a lot of other little tics, like saying "um" a lot even when he knows what he's going to say, or "yeah, but" even when he isn't in an argument, or doesn't make sense in the context. It's all verbal. None of it is as disruptive as when he "disengages" though. The trigger topics aren't really direct triggers. The trigger seems to be somewhere in when he gets a long stretch of time to speak. The trigger topics are just things he has a lot to say about. It's like he falls apart mid-stream and everything after that is the verbal equivalent of nervous rocking. It tends to come up most during table chatter, when communication takes on a more standard conversation form.

I'm not sure if even he knows how he gets out of it. Usually, forcibly interrupting him and getting his attention works. Usually, he seems pretty embarrassed when he realizes what happened though.

What can I do to help my friend and the rest of my group work around this situation, so we can focus on having fun and playing a game?

I am not looking for a cure. Tourette's syndrome is just part of who he is. But finding a way to get the game to work around or through it would be beneficial to everyone at the table.

UPDATE: The comments here and my struggles to explain have made me recognize my own ignorance about the subject. So, I talked to him about it some more. The Tourette's syndrome and the ranting are different things, but they're related. He wouldn't have one without the other. The ranting is actually a nervous compulsion. It happens when he is...

1. Talking about something he is very comfortable or familiar with.
2. The subject has no logical conclusion.
3. He talks long enough for his ADHD to make him loose track of why he was talking in the first place.

Basically, he feels compelled to try and finish talking about the subject- everything there is to say about it. Because he can't remember why he started talking, he's afraid to stop. Giving up or being embarrassed is usually how he gets out of it. He is aware of the people around him, it just doesn't seem like it, because he's panicking. Right away I have some solutions.

1. Put a premium on table chatter. I'd been considering this, but now I have a good reason for it. I'm not eliminating it entirely, but I'm limiting non-game-related chatter to 1 comment and 1 reply between 2 people. That's enough to crack a joke and laugh.
2. Part of the problem is his social anxiety. The only reason he's anxious is because of his tics. I'm going to talk to the other players with him present at the next game I organize. We need to find ways to make him comfortable with us. Since the group may include strangers, that could be hard.
3. Obviously, talk to my friend more.

If anyone has any further experience-based information on how to help people with Tourette's syndrome in the setting of an RPG, it would be greatly appreciated.

Answer 1

I'm sorry to tell you this but I don't think the RPG stackexchange is going to be able to help you a lot with this. The issue is really specific and requires the solution to be tailored just for him. If you need help on the matter I suggest you ask a psychologist for tips.

I can make a few suggestions on how to deal with the situation but please note that I have zero experience with dealing with this kind of issue, opposed by your 10 years. You'll have to decide for yourself, using your own experience and wishes if these suggestions are worth considering. And on a sidenote, thumbs up for being a good friend to him.

Play with his friends

If playing with strangers makes him uncomfortable then try and play with friendly faces. These people will (hopefully) know his issues and will be less mad at him for causes disruptions. You've learned to deal with your friend and learned to be around him. Strangers have not and might not be willing to do so.

Of course you can only play with friends if you have enough of friends that are interested in tabletop gaming.

Play solo campaigns, for now.

It is very much possible and enjoyable to play games with just one player. This might seem weird at first but it might be worth something considering. The main purpose of this is to keep him in his comfort zone. If it's just you he will have no reason to be nervous. If you do this for a while you might consider bringing in more players, one at a time. Just try to keep him in his comfort zone.

The problem with this solution is that your friend might consider this 'giving up'. My guess is that he knows rejection by now and will just consider this giving in to the rejection from other players. The point of this idea is to build up slowly and to work around his social anxiety that way, not to isolate him. So if you are going to take this route make sure to try and tell it him in a positive way. You'll have to use your knowledge about your friend to decide how to do this for yourself.

Also, solo campaigns take a lot of time to prepare.

Online gaming

This solution isn't great, but's it there. You and your friend could try and play in text based RPGs. Of course this is something that you need to enjoy and isn't a solve-all solution, it's more of a workaround. But if you both enjoy it them it might be something to consider.

Ask him for suggestions and feedback.

If anyone knows what the problems are, it's probably your friend. You've said this yourself in your post, but it's important enough that I'll repeat it here. If you find any possible solutions or workarounds for said problems, talk them with through your friend. I know I'm just stating the obvious here but really is that important.

You might also want to ask him if he has any solutions for the problem if you haven't already (But I'm kind of assuming you already have.).

In short.

The gist of these suggestions is to work around his social anxiety as he obviously (and understandably giving his condition) has a lot of issues with it. Try to get him in a comfortable spot and hopefully his ticks will he less frequent. Make sure that you pick other players who are okay with playing with him.

Answer 2

One possible solution, based on the one for a slightly different Tourette's issue from Spider Robinson's story, "Involuntary Man's Laughter", is for your friend to play by chat or post on an online venue. Play by post is very slow (typically one or two posts per day), but play by chat (typed) can proceed at a reasonable pace -- and when your friend disengages, he'll just seem to have gone quiet. Run-on typing is much less likely than run-on speech (because of the nature of Tourette's tics, which are motor-nerve oriented, it's very unlikely he'll tic in a way that shows in text), and even ADHD responses are much more susceptible to being caught by your friend before they dominate the chat channel.

There is a valid concern about the distancing effect of electronic communication -- the flame war phenomenon, trolling, etc. all stem from the anonymity of web communication. This is a hazard, of course, but in the case where face-to-face interaction is unavoidably disruptive, this amount of distancing is likely to be preferable over the much greater exclusion of simply having group after group come apart because one player can't control certain behaviors that, at a minimum, destroy the immersion for everyone else. Playing by chat is better, in my opinion (as one who's been playing by post for more than a year due to lack of local groups who can match my schedule) than not playing at all.

Answer 3

Possibly he would be open to agreeing to a contract for the group. At appropriate points the table can break playtime for general chatter but have a timer (or mini hour glass, 2 minutes worth) and set it off. The time will end and at that point play is to resume again. Poke him if he's the one who keeps going but poke others if they do too. The thing being, you have to be very consistent about all this. A behavioral contract is all about consistency and even application.

If you're the DM, just institute a rule about table chatter, and if you're not I'd rather expect the DM would be willing to go along with this, as the games are getting disrupted. And who wants that? Not even your friend.