Getting Ticced Off: Tourette’s Quest

A subject I’m hearing about increasingly frequently is people not playing games to deal with real life issues, but rather developing games to deal with them. And it’s always a fascinating process. A really superb story on NBC today highlights a project by Lars Doucet, who’s making a game that tries to capture the experience of living with Tourette’s Syndrome.

Tourette’s is an umbrella term for those who experience involuntary tics. While it’s perhaps most frequently associated with involuntary swearing, it is in fact a far broader condition that can include all manner of tics, noises and body movements. And as you can imagine, being misunderstood is perhaps one of the most debilitating aspects of the syndrome.

Doucet’s game, Tourette’s Quest, takes the form of a rogue-like. At the moment it’s in a prototype phase, so while playable, is clearly a very simplified version. As you move your yellow smiley face about the grey-tone dungeons, you not only have to make your way through rooms to reach each floor’s exit, but also manage your stress levels as you go. The more stressed you get, the more symptoms you’ll exhibit. At the moment, the only included symptom is a need to compulsively cough, but more are planned to be added as development continues.

What makes it immediately interesting, beyond the very basic stress mechanic, is that the enemies are not aggressive. What look like elves and, er, noses, move slowly around, and don’t pursue you. However, direct contact with them causes you to feel stress. Chopping up foes and picking up dropped and found coins, while not lowering your stress, does make you feel better. But throughout all this, your involuntary coughing changes things. At random, you’ll emit a big red circle as you cough, and enemies that are caught within this get worked up by it. They start to move faster, making getting past them without touching them, and indeed attacking them with your sword, more difficult.

And as NBC points out, this all starts to become a far more compelling experience when you think of this as a gaming metaphor. As a rogue-like, in its current form, it doesn’t offer anything special. But as a way to consider how stress levels impact on behavioural tics that alienate those around you, it’s something to meditate upon.

You can get the prototype of the game directly from here.


  1. CaspianRoach says:

    I like this guy. His other game, Defender’s Quest, is quite great.

  2. Chizu says:

    I saw this on his blog, checking for anything on Defender’s Quest being posted.
    Seems like an interesting idea, though I haven’t given the prototype a go yet, I figured I’d wait for something a little more developed.

  3. clive dunn says:

    Looks a bit like Atic Atac. Those doors.

  4. yendorii says:

    As a lifelong gamer who was diagnosed with tourettes when I was 5 I must say I am quite intrigued and extraordinarily relieved that this doesn’t revolve around swearing, which is the oft used stereotype. I very much doubt that my experience is translatable in this way but I will be playing it and it bothers me not at all that he is making the attempt.

  5. larsiusprime says:

    Oh, hey guys! Wow, thanks for the post!

    I assume you’re referring to this article:
    link to

    I think the NBC news article is a re-post of an article Sophie Prell originally did for the Penny Arcade report, maybe she has some sort of affiliate deal with them.
    link to

    I’m one of the (rare) Tourette’s patients that has “movie Tourette’s” (ie, coprolalia, compulsive swearing), but I specifically wanted to de-emphasize it for now. Even so, the way that manifests is much different in real life than just saying the F-word a lot (though that does happen – but only very rarely). For me at least, coprolalia just makes me more likely to say something inappropriate in the current context, which is usually just weird rather than blatantly offensive. The most common way it manifests for me is automatically saying, “Your MOM is/was {predicate of the last sentence someone just said} !”

    Kinda awkward, and again, not typical of most TS patients.

    • aadi says:

      I have to jerk my head to the left and grunt a certain pitch. My father has to make a kind of leftward punching motion and scream inhumanly. Pretty sure I got the better deal.

      I wish you well with the project. I also wish there were some way to communicate to people what the urge before the tics feels like. I’ve always felt the urge is the core of my experience and have never found an adequate description of it.

      • Axyl says:

        Dude.. I know EXACTLY what you mean. There literally is nothing quite close enough to compare it to. You just… MUST do it.

        My tics evolve over the years.. I used to have insane vocal tics, screeching, repeating vocal utterances of other people… Thankfully, due to some yoga, meditation and a fiery desire to get away from medication.. I now just have a few subtle motor tics, head twitch, eye squints.. that sorta thing.. and I’m able to mask those pretty well with a well timed, fake neck stretch or rubbing fake dust out my eye.

        But that urge…

        • larsiusprime says:

          This is really the aspect of it I’m trying to nail, and I’m not sure if the current prototype really expresses it clearly. As other TS patients have been writing in about, what I’m trying to explain about TS is you have this crazy buildup in your brain, almost like a sneeze, that makes tics inevitable when “the weather is bad.”

          THIS is the interior experience of TS – other people just see the tics. They don’t see the weather, and the internal struggle.

          One of the core things about TS is that fundamentally, you can’t just *Suppress* a tic. Well, sorta – you can try, but it usually just makes things worse later on if you do. A really hard thing to communicate to other people is that it’s not just like a bad habit you can fight with discipline and denial. Fighting it head-on with willpower just doesn’t work. Instead, I’ve found living with it requires more of a “go around the mountain” strategy.

          That’s kinda what I’m getting at with the “stress” meter. “Stress” isn’t a perfect metaphor, but it does put the phenomen in terms that non-TS people might have an easier time understanding.

    • John Walker says:

      Hey Lars – cheers for that. I’ve updated with a link to your site, which I meant to do before.

      And wow, you have the *perfect* manifestation of Tourette’s for RPS! “Your mom” comments are our staple : )

      • db1331 says:

        Not to make light of his situation, but this was exactly my thought. Toss in the occasional “What a shame” with the F-bombs and mom jokes, and he’s just one of the crowd around here.

        • larsiusprime says:

          Here’s some interesting nuance for you – although I do have coprolalia and occasionally compulsive cursing, in general I curse much less than your average non-TS person. Part of my lifestyle is to scrub curse words from my everyday vocabulary, because, unlike regular people, I don’t have full control of when and where those words get said. If they aren’t in my head, they aren’t vulnerable to coprolalia outbursts. This lets me survive funerals, commencements, public speaking engagements, etc :)

      • Unaco says:

        Every time someone makes a “Your Mom” joke, an Angel gets its wings.

      • Low Life says:

        Everyone’s expecting it, so I’ll take this one for the team.

        Your mom’s my staple!

      • Premium User Badge

        particlese says:

        Wait, we have “your mom” jokes here?! Are they hiding in the forums, or have I just been distracted by the pun and warface comment threads?

        larsiusprime: That must be wicked. I find that one can make a “your mom” comment out of just about any word or phrase, and I’ve come up with quite a few nice ones whilst making dinner. Much fun as it is, though, I’ll keep to myself. I’m sure you can improvise*, but I’m guessing it doesn’t help to be given a new template. I can only imagine having to share them. (The closest I get is a very strong urge to go for a sprint, which comes with increasingly antsy legs until they’re all run out.)

        *Actually, now that I’ve mentioned it, how much control do you have over the resulting sentences, and does it satisfy “the urge” as much as the default sentence of the moment would? And does the sentence have to be short and to the point, or can it be relatively long and verbose with a punchline and still satisfy? Do you (or the other commenters here) find this varies from person to person? Hope I don’t offend with the prying…the nuances are what particularly fascinates me!

    • Vagrant says:

      I also was diagnosed with Tortures Syndrome as a younger lad. Fortunately I’ve never had verbal tics (that I”m aware of), beyond occasional ‘grunting’ when I was younger. Lots of physical jerks / interaction things though. It’s gotten much, much better as I’ve grown older.

      I’ve actually given some thought to a game about showing people how it feels to have TS; I’ve come up with what I consider to be some mechanics that express some of the sensations you get. I’d be more than happy to give you some ideas if you want.

  6. Dervish says:

    I should make a game about my condition of wanting to shout “NOT A ROGUELIKE”.

    Seriously though, I question whether these games (dsy4ia is another one I’m thinking of) convey or teach anything that isn’t better put in a paragraph of text. I understand that they are expressive for the authors, and that’s fine, but is anyone really “getting it” from the game mechanics themselves? Would they if the game was presented without words to explain it?

    • Sinomatic says:

      It’s more about ‘show’, rather than ‘tell’, I imagine. Something experiential, even if somewhat abstract and metaphorical, can be a powerful learning experience.

    • Aatch says:

      I’d say that you’d need both, ideally. As somebody with a gamut of neurological disorders, the only people that really “get” it are people with similar issues.

      I have dyspraxia, which affects like a million things, but fine motor control is one of them. It is also autism-spectrum so I get a dose of that. I also ADHD, which I didn’t get diagnosed with until I was 20 (after a long time wondering about it). It’s kinda hard to express what it feels like to people that just haven’t had the experience.

      The main issue is that most people only see the outside, or only see what it is like for the people while they are medicated, or see them after they have learned to cope. I’m lucky, I have fairly mild expressions of my issues and have spent a long time mitigating and working around them. There are also the secondary effects, which can be worse than the actual problem in some cases. For me ADHD caused me to constantly doubt myself, think I was lazy and just generally ill-motivated. This was a problem because I never thought of myself as any of those things. It was like thinking that you are blonde and then seeing black hair in the mirror, the reality can’t be wrong, but you can never reconcile it with what’s in your head.

      The advantage of a game is that it allows the player to somewhat project themselves into the life of the avatar that they are controlling. It allows the game to convey certain emotions that are otherwise incredibly hard to convey purely in text. For this game, the idea that some uncontrollable thing makes the game harder is supposed to convey the frustration and embarrassment that TS suffers feel. It doesn’t even need to reflect reality, it needs to reflect perceived reality. It doesn’t matter if no one cares, if you think everyone cares then that might as well be true.

      Mental illness and neurological problems are difficult subjects because they require people to try to explain something that has no words, has no metaphor. Relating it to something everyday almost always leads to a misunderstanding. E.g. Clinical Depression is like being sad all the time. It’s true, but also not true. Similarly ADHD isn’t just being easily distracted, it’s being always distracted. People with ADHD are people that get distracted in a sensory-deprivation tank. It’s almost impossible to verbally (or textually) convey what it’s like to have ADHD. Even from a post-medication perspective, that previous sentence is the best I can do and that isn’t even close to conveying what it is like.

      I don’t know what it must be like to have Tourette’s, but that is why games like these are important. We (well I anyway) don’t want to be pitied, we want to be understood. These games are a good way to get there,

    • Phasma Felis says:

      A paragraph of text wouldn’t’ve gotten mentioned on RPGnet.

      The advantage of addressing things like this in popular media isn’t necessarily that popular media is better at expressing them. It’s that people pay attention to popular media. It lets regular dudes learn something without having to go search for it or having it shoved down their throats.

  7. Axyl says:

    I actually have Tourette’s Syndrome. Was diagnosed at age 12 by a fluke catch from the Educational Psychologist. I’m 31 now.. and a life long gamer. This has my interest.. I’ll give it some time and post back some thoughts if anyone would be interested. :)

  8. larsiusprime says:

    Quick question John W:

    Here’s a link to my ongoing dev log in the Tigsource forums, which, along with my personal blog (, will be the go-to place for updates on this project:
    link to

    Would it be appropriate to put a link to that in the main post, or is this mention in the comments enough?

  9. Eddy9000 says:

    I’m not a sufferer myself but I’ve worked with Tourette’s as a psychologist, and I’m really pleased that the focus in this game hasn’t been on swearing, which in itself challenges one of the biggest misconceptions around this syndrome. Just out of interest are there any plans to represent physical tics such as involuntary movements, perhaps by having the player character move involuntarily? Could be interesting. Reminds me a bit of a GameCube game that I can’t remember the name of where you had a sanity meter that caused all kinds of things to happen when it got whittled down, I think it even made your monitor look like it switched itself off at points.

    (Just as an aside, I once worked with a gamer who was depressed by taking a character in the Sims, totally wrecking all of his mood bars and having my client do all the tasks to make him happy again, to demonstrate how attending to basic needs and breaking tasks up could improve general mood and have a knock on effect of making other tasks easier. Just an example of how games can have therapeutic value. )

    • larsiusprime says:

      Yep, the next tics I intend on adding are physical ones. Simple stuff, ranging from making you move involuntarily in the wrong direct for a step or two, or perhaps making you drop whatever is in your left or right hand, will make a pretty big difference. I’m drawing mostly from my own symptoms here.

      The GameCube game you’re thinking of is Eternal Darkness, which is a favorite of mine :)

      • Guvornator says:

        Eternal Darkness is amazing. And so creepy.I loved the sense of impending doom. Why no one else has tried to use that wonderful narrative structure, I’ve no idea…

    • Ich Will says:

      Eddy – Do you know of any place I can use to learn about techniques to help someone in my life with depression? So much info on the web is more miss than hit but maybe you know of a (free) resource which can give me the info I need to both understand what they are going through and try to help them. They absolutely will not see anyone, it has been so stigmatized in their family while they were growing up that they would rather run away from everyone and everything than see a professional of any description.

      • Eddy9000 says:

        I couldn’t really give any professional advice unfortunately, not having done an assessment or knowing the context etc. A couple of friends of mine have found this book helpful, but I must admit I haven’t read it myself. It can be difficult when people won’t approach services, but the priority for your friend really should be to seek professional advice.
        link to

  10. Toberoth says:

    This is really fascinating stuff! More games that explore things like this, please :-)

  11. Randomer says:

    Hey Lars. Not on the subject of Tourette’s at all, but I just wanted stop in and say how much I enjoyed your panel at PAX Prime this year. Also, I’m still loving Defender’s Quest after many months, enough that I recently bought a second copy of for the wife. Keep up the great work!

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