It's a sunny, spring day in Boston. I'm out taking a lunchtime break from the hectic pace at work. The struggles of TS are spinning inside me, catching me in their web. I'm wound-up, edgy and out-of-breath. To get grounded and centered, I sit on a bench in the park with my head down between my knees. My head and neck are ticcing out the end of a storm. I just want to breathe and relax.

I'm beginning to let go when a woman comes up and asks, "Are you okay?"

I say, "Yes, I'm just resting," my usual response in this situation.

"Are you sure?" she says.

I say "Yes" again with a bit of fierceness in my voice, trying to protect my precious space. She walks away reluctantly, as if she doesn't really believe me.

Soon I start stretching and letting out big yawns. My body is finally able to take in more of the oxygen it cannot get when it is tense from holding in excess energy. I stand up, stretch my arms high in the air, open my eyes and mouth wide, and take a deep breath. Then I drop my arms and let my breath out with a big sigh.

Two men stop and look at me strangely. "Trying to wake yourself up?" says one, with a strong note of sarcasm. The other one snidely laughs and quips, "No, she's probably just one of those New Age worshippers." They continue walking.

My insides are churning. I know I should just let their comments blow over. But I am so sick of getting remarks every time I do something that doesn't look "normal," whether or not it's tics.

I want to yell out, "Can't you leave me alone? I just need space to recuperate from the battles going on inside me. I don't need your comments too." But to avoid fueling the fire, I just yell the words in my head and hold in this new round of wired energy. Then I sit down, ticcing head between my knees and wonder, "What is 'normal' anyway?"

People with TS get stared at, judged, criticized and taunted on a daily basis for how we move, sound, and act. Events like in this park vignette, although annoying, are by no means the worst. People with very pronounced TS symptoms may get beaten up by peers or picked up by police who think they are drunk or high on drugs. On-going criticism and outright harrassment from family, friends, bosses and teachers, as well as strangers, is a common experience for people with TS and can strongly damage self-esteem.

It is not just the tics that cause these reactions. As in my vignette, it can be the other ways we move and let out sounds to release and recuperate from the excess energy and tension that build up inside us. Sometimes I need to stretch and yawn. Other times I may need to vigorously shake out every part of my body in order to get centered. Or I may feel excited by emotion that's bursting to be let out by leaping and shouting down the street with joy.

Yes, I can control these impulses to move and make sound. They are different from the sensory urges preceding tics -- those physical sensations that must be satisfied so I do not feel like I will burst. The urges to carry out these impulses do not absolutely have to be satisfied, but they often feel very pressing. This urgency can make it difficult to hold in my energy and carry myself as a woman is generally expected to in our society.

Sometimes having TS makes me feel like I'm living in a different culture. Not only are the ways I move and sound different, but my rhythms and pace and the ways I experience the world feel different. Abrupt, jerky, repetitive movement is the norm for me. Every sensation inside and outside of me tries to pull me to it. Every detail stands out like a neon sign and demands my attention. My world is defined in gradations of tension. My vocabulary is rich in words for "anxiety" like an Eskimo's is in words for "snow." Letting go is a struggle. And that is a contradiction that is very stressful to live with.

Unfortunately, differences are not understood or accepted well in our society. When people do not understand why we are moving in certain ways they often feel threatened and scared. In an effort to make sense of the behavior, they may attach their own explanations to it. These explanations usually are subtly or outrightly negative. People use labels as a way to distance themselves from us.

In this societal context, getting even minor comments on a regular basis about looking and acting different can be intrusive. No matter what the person's intention -- whether genuine concern or harassment -- there is usually an implication that something is "wrong." If someone asks "Are you okay?," the implication is that I may not feel well. Constantly getting interrupted with such questions and comments when I am just trying to live comfortably in my body makes it hard to relax and just be myself.

So how can those of us with TS manage our energy and live in relative peace in a society that puts narrow limits on what is "acceptable" movement, sound, words and behavior? It's not easy. Holding back tics and excess energy is not only physically stressful and mentally distracting, it can also stifle our spontaneity and creativity.

The arts, especially dance and music, have been a part of my life since childhood. Music was the focus in my family and among my friends throughout school. I liked playing the violin, but dance gave me more freedom. With dance, my body was the instrument. Because I did not need to channel my impulses and energy through an object outside of myself, I could move in a larger variety of ways.

I tried different kinds of dance in different settings, including classes in modern dance and ballet, weekly folk dancing groups, dancing at parties, improvisational dance gatherings, and just putting on music alone at home and moving however my body felt like moving.

Over time two things became clear to me. First, if I hadn't danced for awhile, when I started again I found myself becoming much more alive -- more energetic, open, joyful and creative.

Second, I preferred not to have to fit into preset movement patterns, as is expected in folk dancing, ballet and modern dance technique classes. Nor did I like being constrained by the limits of what were considered "in" ways of dancing at most parties. My body experienced a lot and just wanted to be free to express what it had to say. After all, it was enough work every day to have to control my body to fit into society's accepted ways of moving.

In my early 30's I began to realize that when I improvised alone and in groups where a freer range of movement was accepted and encouraged, I discovered positive parts of myself that I had not known before. Out came more self-confidence, strength and joy. I was learning about myself from my body and enjoying more of the experience of moving in it. I didn't have to struggle as much to control my wild energy in order to keep myself in balance and satisfy other people. Improvisational dance became a means of personal growth for me as well as a physical energy outlet, an art form and a social event.

In exploring ways to further integrate dance with my personal growth, I discovered improvisational movement theater. Improvisation means creating a piece in the moment as it evolves. Movement theater combines movement, sound and words. I experience movement theater as a kind of integration of modern dance and acting. Pieces can range from real-life scenes to very abstract.

With improvisational movement theater I have been able to explore a larger range of ways to express myself than with other art forms. Using spoken language along with movement and sound has increased my possibilities beyond those of dance.

Compared to the acting I did in junior high and high school (in improvisations, as well as scripted plays), I have much more freedom to make movement the focus, and move in different ways. In movement theater, I can use body and energy awareness as well as thoughts, language and emotions, to help me decide what to say and do and how to move.

Improvising with language is also helping my writing. I have been writing for years in an expository style in my personal journal and professional work as a health educator and medical writer. But until recently I did not think of myself as a writer in the artistic sense. I am now beginning to experiment with writing in other styles, including poetry, and to use my writing and movement theater explorations to enhance each other in my creative process. The images in the poem "Caught in a World of Detail" developed from an interweaving of my writing and movement theater improvisations.

Most of the improvisational movement theater I have done has been in a weekly class. To warm up at the beginning of class, we work with our voice and various muscle groups and experiment with different kinds of movement and vocal expression. During this process we clear our mind of the day's events and get in touch with how we are feeling in the moment. We have time to move, let out sound and speak in whatever ways we feel like. We often explore specific images and experiences we have brought from a variety of sources, including our own lives, our dreams, things we have read or events in the media.

We usually start warming up individually, each person in his or her own explorations. The movement and sound may include anything from slow stretching and sighing to running around the room shouting to fragments of dance pieces or acting out specific characters. Gradually we begin to improvise with other people in various ways, such as joining or contrasting movement or engaging in dialogue as characters.

Although I am the only person in the class with TS, I am usually no more self-conscious than anyone else because we are all moving in different and unusual ways. This kind of opening up and letting go can be hard for everyone. For me it is especially meaningful because of the constant pressure to manage my TS energy so that my movement and sounds stay within society's limits. When I am allowed to move and make sound as my body wants to, I feel increased freedom on all levels -- physical, mental, emotional and spiritual. This freedom allows me to get to know much more of myself and my potential.

Improvisation becomes "art" when we work with our impulses in ways that we consciously choose and create pieces that communicate a message to other people. This is a form of channeling energy, but with much greater freedom of movement, sound and words than in everyday life. In our class we create an open, supportive environment where being unique is valued and where we can express much more fully who we are.

While improvisational movement theater allows greater freedom, it also requires a great deal of concentration and focus. When you are creating a theater piece moment by moment with other actors you have to listen carefully, process a lot of information and then make quick decisions about how to respond. If you do not speak or take action, whether out of indecision or intention, you still affect the scene.

The concentration and focus required can be especially challenging for people with TS who have difficulties with obsessive thoughts, attention deficits and impulse control. On the other hand, when we concentrate on an activity we enjoy, tics often decrease. I have found the supportive environment of my class to be a great laboratory to experiment with staying focused, listening and interacting on the spot with other people. It is much more positive for me to work on these skills as part of creating something from myself and with others rather than as an attempt to fit into someone else's mold.

Not only is improvisational movement theater a useful tool for coping with TS, but certain aspects of TS can be advantageous in this art form. Some characteristics of TS that may be problematic in everyday life can become valuable.

One of these characteristics is a heightened sensitivity to stimuli both inside and outside ourselves, sometimes referred to as having a thin stimulus barrier. More often than other people, those of us with TS feel bombarded and overwhelmed by too much input. It feels as if the "volume" of the messages I get is turned up louder and I cannot turn it down. This can be physically and emotionally uncomfortable and make interacting with others more difficult. However, I have found that when I am able to step back and look at all that I can take in, there is a tremendous richness of experience to use in my creative process.

For example, I can sometimes feel a deep connection in my body with the movement of someone or something I am watching, such as a dancer performing or a bird flying. Although I am only in contact with the person or bird by watching with my eyes, I can feel its movement physically in my body and enter into its experience. John S. Hilkevich described a very similar ability to connect viscerally when he wrote, "With the same intensity of a Tourettic tension, I can feel in my body the hop of a rabbit or the surrender of a hawk in flight to the winds." (Don't Think About Monkeys, 1992 Hope Press.)

Many of us with TS experience life very intensely and feel feelings deeply, perhaps due to our thin stimulus barrier. Although in everyday life some people -- both with and without TS -- find our intensity difficult to deal with, in artistic contexts it can be used to increase the impact of a piece on the audience. A strong impact is important in a performance because you need to communicate a lot in a short amount of time.

Because I feel experiences so intensely in my body and TS involves letting out excess energy through movement, it comes fairly naturally to express my experiences through movement. This facility is especially helpful when I want to let words evolve from body impulses and movement or turn verbal scenes into movement pieces. Moving back and forth between words and movement can add to the richness of the images created.

Below are two examples of improvisations I have done in class. As these scenes demonstrate, sometimes we are given specific characters and situations to develop, and other times we create characters and scenes by drawing from our personal experience.

My teacher asks for two volunteers to do a scene. A male classmate and I run up on stage. My scene partner is given the role of a man sitting in his new home watching television. He has to convey, without saying it directly, who I am as a character and something about our relationship. I have to accept his offer and develop that character.

Through listening to the content and tone of what he is saying as well as watching his body language, I quickly figure out that he has cast me as his wife with whom he is having a disagreement about painting the new house. We create a comedic scene using the TV show both to withdraw from our argument and to project our emotions onto its characters.

After a few minutes our teacher directs us to continue the scene just in movement. She asks for two more volunteers whom she casts as the husband and wife in the TV show. They play out those roles for a few minutes and then are directed to continue just in movement. My partner and I are asked to pick up our scene with dialogue again and incorporate anything new added by the couple in the TV show.

There are several major challenges in improvising this piece with its two interconnected scenes. My ability to stay focused is really stretched when I have to listen to the other scene while continuing my scene in movement. What comes most easily to me is moving back and forth between using dialogue and just movement in order to convey the action.

I am on stage alone to create a brief solo piece that will start off, and hopefully inspire, a new round of improvising. Edgy, wired TS energy has been plaguing me during the last few days. I decide to draw on that energy to create my piece.

I start my improvisation playing a growling lion. This lion represents my TS energy trying to take me over. I alternate between playing a person with TS and playing the lion, using movement to transition between the two.

The person searches for ways to deal with this monster lion. She tries screaming at it. When the lion roars back without fear, the person tries another tactic. She asks with gentle movement and words, "What if I'm nice to you? Will you be quiet?" The lion roars back, "No I won't. I will keep on making trouble for you." The person with TS is left with an unresolved dilemma -- how to deal with this wild internal energy.

After performing this piece, I feel physically calmer but a bit emotionally vulnerable from taking the risk to share such a personal experience. The audience appreciates the depth of my sharing. They tell me that the person with TS, the lion of TS energy and the piece as a whole were all very powerful and that they have a new understanding of the intensity of the TS energy I have to contend with. Two people say they can relate personally to the piece because they too experience inner struggles (although not as intensely) and the dilemma of how to deal with internal energy that sometimes feels out-of-control. The impact of my piece on the audience is reflected in the increased energy and intensity of all the pieces that follow and in the theme of one of them.

As people with TS often say, it feels like our TS has "a mind of its own." The freedom of improvisational movement theater helps me live with my TS in a more integrated and centered way. When there is more space for my TS to "speak," I can let out the struggle energy that it creates and get to know it better. On a physical level this is a great release. The increased familiarity helps me feel more at home in my mind and body. While experiencing the power of this energy more fully can occasionally be frightening, it is worth the benefits I gain.

When I do not have to spend as much attention and energy fighting, containing, and suppressing my energy, there is more space for all the parts of my "real" self--physical, mental, emotional and spiritual--to open up, explore and create. I can let more of myself flow, get to know myself better, feel better about myself, and bring more creativity to other aspects of my life. I can create artistic pieces to communicate to other people a sense of what having TS feels like. These pieces educate people about TS and provide a connection to other struggles of being human.

During the last few years I have begun to feel as if the potential that has been bottled up inside me for years is slowly starting to blossom. Performing improvisational movement theater has been one of the major catalysts of this change. It has helped me begin to live my life more fully and with greater passion and joy.

If you are excited by what I have described and want to experience the freedom and creativity of Improvisational Movement Theater, here are several ways to start.

-- Put on music and move in whatever ways feel good. Use your voice to make any kind of sounds you want or to speak or sing. Do this alone at home or with friends.

-- Improvise on a musical instrument, allowing your physical and emotional energy to flow through the instrument. If you do not already play an instrument, try improvising on a drum or with your voice.

-- Dance outside to the sounds of nature in the woods, in a large field or on a beach.

-- Take a movement theater, dance or acting class. Look for one that emphasizes improvisation or developing your own pieces.

-- Get together with some people in your local Tourette Syndrome Association chapter, (children, teens and/or adults) and create scenes that express your experiences with TS. You can do this just for yourselves or perform the pieces as a way to educate others about TS and what it feels like living with it.

For added inspiration, read the story "Rhythm Man" in the book Don't Think About Monkeys. The author, David R. Aldridge, brilliantly describes the interweaving of his TS energy with playing the drums.

MONKEYS INTERACTIVE:

1. Is there an art form that you feel especially connected with or that has helped you cope with TS? Send us a letter. We will quote some of the letters in our Reactions column.

2. Are there other ways of working with TS that you would like to see covered in Monkeys Online?