Coprolalia

Ingrid Müller is a chemist and medical journalist. She was editor-in-chief of for twelve years. Since March 2014 she has been working as a freelance journalist and author for, among others, Focus Gesundheit, the health portal ellviva.de, the publishing house living crossmedia and the health channel of rtv.de.

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Coprolalia means that people use fecal language in inappropriate ways and situations. Coprolalia can be compulsive, as in Tourette's syndrome. The person concerned cannot control the use of fecal language himself. Read all about coprolalia and what to do about it.

Coprolalia: description

The word coprolalia comes from the Greek of copros "Crap, excrement" and lalia "Language". Those affected compulsively utter obscene, vulgar, rude, indecent, insulting and sometimes even hateful words. It is partly sexually tinged strong expressions with which coprolalia patients throw around. The short, harsh swear words are interspersed with no meaning during normal speech, usually between two sentences. So it is to be understood as a kind of interjection. The pitch and pitch of the voice also usually change.

Sometimes, especially in the presence of certain people, there is an urge to rude verbiage. It is not uncommon for them to be family members, such as the mother.

Doctors consider coprolalia to be a neuropsychiatric symptom - both the brain and the psyche play a role. The use of fecal language cannot be controlled consciously, but works compulsively. Affected people feel an inner urge to "fire" real word volleys. This is linked to a feeling of powerlessness. Also, the time at which the coprolalia occurs cannot be influenced with the will. So coprolalia is not a conscious reaction to other people.

All in all, coprolalia is a rather rare phenomenon, mostly related to Tourette's syndrome. This is characterized by involuntary impulses to act - so-called tics. According to doctors, coprolalia can occur in around 30 percent of Tourette's patients. The frequency is very similar in all countries and does not depend on socio-cultural factors. The verbal tic is usually expressed in adolescence, boys are affected much more often.

Coprolalia is not a modern phenomenon either, 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 take place exclusively in the brain. Typical are obscene thoughts and fantasies, which are not spoken as words, but just shoot through the head.

In another variant, copropraxia, patients show involuntary and inappropriate obscene gestures, for example showing the "finger finger" or pretending to masturbate. This, too, is extremely stressful for the patient, and no less for the environment.

In coprography, those affected draw, paint or write obscene pictures or words.

Coprolalia - social problems

Coprolalia is extremely uncomfortable, embarrassing and socially marginal for tic patients. Therefore, many also try to stop the utterance of the impudence and only press out the first letter. But tics can only be suppressed to a limited extent and at some point pave their way to the outside world.

The environment is also usually very irritated if it does not know about the disorder and the vulgar language relates to itself. The answers and reactions of those around you can vividly imagine - they will certainly not be benevolent or positive. And that in turn often has dire social and even physical consequences for the patients - there is also the risk of being physically attacked and injured.

Coprolalia usually occurs for the first time in adolescence, which can lead to social isolation at school or with friends. Especially with adolescent boys, such verbal failures are often a reason to beat up the uncouth counterpart. And the teachers in the school also sanction filthy behavior - especially if they understand the goal of the verbal attack. In some cases, this can lead to expulsion from school.

This usually puts a lot of strain on those affected by tic, because the use of vulgar language is in no way socially acceptable and is considered an insult, abuse and injury to the other. People with verbal tics are rejected and quickly find themselves socially marginalized. Nobody wants to have anything to do with them, let alone show themselves with them in public. The parents themselves are sometimes shocked by the strange behavior of their children. Symptoms can be so pronounced that children are perceived as bizarre, disturbing, and scary.

Coprolalia: causes and possible diseases

Coprolalia is one of the most noticeable symptoms of Tourette's syndrome. Even experts are still puzzling today why patients let go of real cascades of abuse and not use friendlier, neutral words such as “car”, “table” or “tree”. Doctors can only speculate about the causes.

It is known, however, that shouting out foul terms and swearing can also be found in other neurological diseases. Examples are dementia (especially frontotemporal dementia), encephalitis, brain tumors, aphasia or severe traumatic brain injuries. Increased sexual activity is known from various damage to the brain, for example in the right frontal lobe, the limbic system or the temporal lobe. Drugs such as dopamine agonists also sometimes trigger hypersexual behavior - they are used in Parkinson's disease.

Researchers have come up with a hypothesis that could explain the phenomenon of coprolalia. According to this, there are two separate systems for language in the brain: one for the content-rich language formed in sentences, which is located in the right cerebral cortex. The second is supposed to be responsible for emotional vocalizations and is assumed to be in the limbic system. Tourette patients therefore have motor and verbal tics that arise in the limbic system.

Coprolalia or motor tics are not the only diagnostic criteria for Tourette's syndrome. Most of these patients also have other diseases, such as ADHD syndrome.

Coprolalia: when should you see a doctor?

Most of those affected are not significantly affected by their tics or behavioral problems and therefore do not need any medication or medical attention. In general, only around 30 percent of Tourette patients show coprolalia, the rest do not. But anyone who suffers from the tics should go to a child and adolescent psychiatrist, pediatrician or neurologist and get help.

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 stressful for those affected and families. The substances are neuroleptics and act in the broadest sense on the central nervous system. In Germany, the active ingredient tiapride is mainly used. Risperidone, pimozide and haloperidol are also effective - the latter works well, but has significant side effects.

The dose required to control the symptoms is very different from the individual and must be tailored to the needs. So far there is no therapy for Tourette's 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

Relaxation methods (autogenic training, progressive muscle relaxation), training to reduce stress, biofeedback and other behavioral therapeutic measures can also help against the tics. They reduce the stress reactions that otherwise increase the tics. Besides, they can also improve self-control. For example, you can learn to counter the tic with an alternative or to replace it with an action that is socially accepted. Accompanying psychotherapy can help those affected and families to better deal with coprolalia and other tics.

Coprolalia: You can do that yourself

The most important thing is to inform and educate the family, neighborhood, school, circle of friends and the workplace. Because: People with tic are not dangerous, vicious, rude, poorly brought up and not mentally poor. The coprolalia belongs to these people.

Since the tics occur more frequently under stress, those affected should make their lives as stress-free as possible. Learning a relaxation technique can also be helpful. Most of all, it is crucial that the disorder does not lead to social withdrawal. For this, humor, a healthy self-esteem and acceptance of the disease are important. To strengthen this, psychotherapy can help people with coprolalia.

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