Possible causes of Spasmodic Torticollis.
  Since the time I put my website on the internet, I learned a lot more about S.T. For example, I received many e-mails and there was input in my Guestbook which gave me inspiration and more insight. Although I would never compare myself to a trained doctor, these inputs gave me more overview about the possible causes of S.T which I try to present to you now.

S.T. is a specific form of dystonia; many having S.T. suffer fom other forms of dystonia as well. Whatever the case, S.T manifests itself by an abnormal tension of certain muscles. Now the central question is: what causes this abnormal tension.
 

Neurology.

These days the most commom cause of S.T. is said to be neurological: somewhere in the brain (ganglia) something goes wrong and gives way to a movement disorder. Some speak of inherited causes but there is no evidence this is a dominant factor. Mostly there is spoken about idiopatic causes which means S.T. has a cause ánd a course out of itself. Seen this way, alas it is nothing else but a disease which strikes you out of your own will without you being able to do much about it: it is more or less irreversible. This means once you got the disease it seldom disappears out of itself. So from the medical/neurological point of view the therapy consists not of taking away the causes but by a relief of the symptoms by injecting Boton.
 
 

Psychology.

Another possible cause is the psychological one: you could say the disorder is being psychologised. Before the uprise of neurology especially the last decade, this way of thinking was the dominant one. The psychological explanation states that the origin of S.T. has to do with emotional disturbances which manifest themselves through the body (in this case a "wry neck"). For some this process can take big proportions: for example they consider the turning of the neck to be an unconscious "no saying' because the person in question doesn't dare to speak out normally. The psychological therapy tries to highen the low self esteem and possibly to work up traumatic experiences (from youth). Theoratically the outcome of this approach is an optimistic one; if you find the right therapist which can help you to tackle and resolve the so called disturbed emotions and inner conflicts the outcome should be the disappearance of the symptoms, in this case the "wry neck". In practice however, the pure psychological approach is as far as I know not very succesful because other factors are involved too, for example physiological or mechanical ones.
 
 

Physiology and burnout.

A third possible cause is a physiological one. It is somehow related to the former mentioned cause (psychology) but it has a character of its own. The line of thought here is that for some people prolonged physical as well as psychological stress causes (stress)hormones like cortisol and adrenaline to take too much possesion of the body leading to a disturbance of the normal equilibrance, the so called "homeostasis". This on his turn leads to an unceasing tension of some musclegroups which could be labeled as a kind of dystonia. I myself consider it remarkable that stress affects exactly just the kind of muscles which are involved in S.T.: the muscles of the neck, shoulder and the back of the head.
An ongoing manifestation of "overstress" can lead to a so called burnout. This disease of our modern society becomes rapidly kind of epidemic (in Holland) and I wouldn't be surprised if in the near time more comes to be known about the relation between burnout and S.T.. From the contacts I have from internet I understood that there are several people with S.T. who also have burnout complaints. If you want to know more about the possible relation between S.T. and burnout look at the link I made about this subject.

Talking about therapy from the physiological point of view: in first instance not psychotherapy is recommended but a mix of fysical (recovery)excercises and (probably with psychological help) learning to handle pressure and stress better.
 
 

High sensitivity

A rather unexplored area in relation to S.T. has to do with psychological traits which well might have origins in an inherited predisposition. An American woman called Elaine Aron, has written a bestseller about "The highly sensitive person" (HSP). These people are easy overaroused, often shy, very conscientious and more than average sensitive for social situations. Other traits of HSP's are: very sensible for moods of other people and those of groups, holding on to intense experiences and emotions and difficulty in getting rid of them, but also the capability of "seeing" and feeling things more than average people can often without being able to explain it in rational terms. They tend to "process" events in their lives deeper and more intense than average people which often makes them intitive. This is not always well understood by other people. They then can come in trouble because our "assertive" Western society doesn't always appreciate this kind of character to say for the least. On the other hand, if a HSP him-/herselfdoesn't acknowledge his character and takes consequences out of it he or she will run the risk to be permanently overwhelmed and overstressed. I myself think HSP's have more than average chance to develop S.T. because they are very apt to (social) tensions and as said before, conscientious. Therapy is on the one hand individual, namely accepting your highly sensitive character (and appreciating it as well if you can), on the other hand a sociological one: the recognition in our society that not everyone is as assertive and strong as society might want them to be.
 

Spiritual.

Although you can hardly call this a cause, I also see a spiritual approach to S.T.. Probably also due to their sensitive and conscientious character, people with torticollis seek for deeper causes for their disorder. What is the meaning of my suffering? Why am I convicted to a body which is not entirely in my control? Has it to do with my own personality and attitude and am I myself responsible for that? Is there an inherited cause (nature) or has it to do with the way I am raised (nurture)?  Or is there even a deeper layer, is there a task from my ancestors of which I´m not aware (yet) and do I have a task to fullfil to come to a deeper understanding and awareness in my life? Or is it a task layed upon my shoulder by a higher force which I have to carry out in this life for which I may be rewarded in an afterlife?The last step is a belief in reincarnation: my spirit is eternal but at this moment I´m living in an (imperfect human) body and my task is to learn from it and to evolve to a higher state of beiing in a next life.
 
 

Mechanical.

There's not much known about this kind of cause yet. In response to my website I received amongst others very interesting information from osteopedes ("bone specialists") who made a very convincing point showing how a wrong position of certain skullbones can cause important nerves and bloodvessels which run trough an opening at the bottom of the skull (The Foramen Jugulare) to get into a scrape and overaroused as well. This can lead to a disharmony of the shoulder- and neckmuscles and -possibly- S.T.. Also wryness of other parts of the body, for example one of the feet, can -indirectly- cause torticollis. A Dutch woman with severe torticollis complaints tolded me how she was treated in the US by a computer driven apparatus which outlined her vertical vertebrae in the proper way resulting in a great relief of her complaints. As far as I know not much is further known about this mechanical approach yet. Therapy in this case consists of mobilising the wrongly placed bones which seems to result in creating space for the scraped and/or overaroused nerves and bloodvessels-and thus deminishing of the torticollis symptoms.
 
 

Discussion and epilogue.

In my analysis I mentioned six possible causes. But as far as I'm concerned S.T. is mostly not caused by one factor but by a combination of more factors. Probably much progress can be made by an approach in which neurologists, psychologists, physiologists,and bone- and genespecialists, burnout specialists and probably also people with spiritual gifts work together. This way more insight in our disorder can be achieved leading to a wider rage of effective therapies. I myself think S.T. is often a disorder which strikes the body as well as the mind so looking for the one and only cause doesn't seem very fruitful to me any more.
 
 

February 2002
Zoetermeer,
The Netherlands