Coprolalia: Description
The word coprolalia comes from the Greek kopros “dung, feces” and lalia “speech.” Sufferers compulsively spout obscene, vulgar, foul, offensive, insulting, and sometimes even hateful words. In some cases, it is also sexually tinged expletives that coprolalia patients throw around. The short, abrupt swear words are interspersed without context during normal speech, usually between two sentences. It is thus to be understood as a kind of interjection. The voice pitch and tone also usually change.
Sometimes there is an urge for foul language, especially in the presence of certain people. Not infrequently it is family members, such as the mother.
Doctors count coprolalia among the neuropsychiatric symptoms – both the brain and the psyche play a role. The use of fecal language cannot be consciously controlled, but functions compulsively. Affected persons feel an inner urge to “fire off” regular salvos of words. This is associated with a feeling of powerlessness. The time at which coprolalia occurs cannot be influenced by the will either. Coprolalia is therefore not a conscious reaction to other people.
Coprolalia is also not a phenomenon of modern times, but was described as early as 1825 by the French neurologist George Gilles de la Tourette. Five of the nine patients he described used such fecal language.
Coprolalia can also occur exclusively in the brain. Obscene thoughts and fantasies are typical, but they are not uttered as words, only flash through the mind.
In another variant, copropraxia, patients show involuntary and inappropriate obscene gestures, for example, they show the “stinky finger” or pretend to masturbate. This is also extremely distressing for the patients, and no less so for those around them.
In coprography, sufferers draw, paint or write obscene pictures or words.
Coprolalia – social problems
Coprolalia is extremely unpleasant and embarrassing for tic patients, and it marginalizes them socially. That is why many try to stop saying the obscenities and only press out the first letter. But tics can only be suppressed to a limited extent and eventually find their way out.
Coprolalia usually occurs for the first time in adolescence, which can lead to social isolation at school or with friends. Especially in adolescent boys, such verbal outbursts are often a reason to give the rude counterpart a good thrashing. And teachers at school also sanction foul-mouthed behavior – especially if they see themselves as the target of the verbal attack. In some cases, this can lead to expulsion from school.
This usually puts a great deal of stress on those affected by tics, because the use of vulgar language is in no way socially acceptable and is considered an insult, abuse and violation of the other person. People with verbal tics are rejected and quickly become socially marginalized. No one wants to have anything to do with them, let alone be seen with them in public. Even the parents themselves are sometimes startled by their children’s peculiar behavior. The symptoms can be so pronounced that children are perceived as bizarre, disturbing and frightening.
Coprolalia: Causes and possible disorders
It is known, however, that the exclamation of foul terms and swearing are also found in other neurological diseases. Examples are dementia (especially frontotemporal dementia), encephalitis, brain tumors, aphasia, or severe traumatic brain injury. Increased sexual activity is known from various brain damage, such as in the right frontal brain, limbic system, or temporal lobe. Drugs such as dopamine agonists also sometimes trigger hypersexual behavior – they are used for Parkinson’s disease.
Researchers have put forward a hypothesis that could explain the phenomenon of coprolalia. According to this, there are two separate systems for language in the brain: one for content-rich speech formed into sentences, located in the right cortex. The second is thought to be responsible for emotional vocalizations and is thought to be located in the limbic system. Tourette’s patients would have motor and verbal tics that originate in the limbic system.
However, coprolalia or motor tics are not the sole diagnostic criteria for Tourette syndrome. Most often, these patients have other conditions, such as ADHD syndrome.
Coprolalia: When should you see a doctor?
Coprolalia: What does the doctor do?
If coprolalia is pronounced and disrupts social life, it can also be treated with medication.
Medication
There are several medications that can be used to treat motor and vocal tics. They should be used when the tics are particularly distressing to sufferers and families. The substances are neuroleptics and act in the broadest sense on the central nervous system. In Germany, the active ingredient tiapride is primarily used. However, risperidone, pimozide and haloperidol are also effective – the latter works well but has considerable side effects. The dose necessary to control symptoms varies greatly from individual to individual and must be tailored to needs. To date, there is no therapy for Tourette syndrome that leads to a complete cure.
If other neurological diseases are the cause of coprolalia, such as dementia or damage to the brain, the underlying disease must be treated – if possible.
Other therapy options
Coprolalia: What you can do yourself
The most important thing is to inform and educate your family, neighborhood, school, circle of friends and workplace. Because: People with tic are not dangerous, malicious, rude, badly behaved and also not mentally inferior. Coprolalia is just one of those people.
Since the tics occur more frequently under stress, affected persons should organize their lives with as little stress as possible. Learning a relaxation technique can also be helpful. Above all, it is crucial that the disorder does not lead to social withdrawal. For this, humor, a healthy self-esteem and acceptance of the disorder are important. Psychotherapy can help people with coprolalia to strengthen these.