The Unfiltered Brain: Understanding Coprolalia
Coprolalia has recently gained public attention after a Tourette’s advocate and attendee of the British Academy Film Awards (BAFTAs) blurted out profanities. A particularly poignant moment was when racial slurs were shouted at two African American actors, Michael B. Jordan and Delroy Lindo. The incident has sparked heated discourse and outrage. As often happens, media coverage has largely focused on the controversy rather than the context. Were John Davidson’s outbursts intentional?
What is coprolalia: Coprolalia is the involuntary use of socially inappropriate or taboo words. It is a type of complex vocal tic often associated with Tourette syndrome. However, it can also occur in certain focal seizures. Approximately 10-15% of people with Tourette syndrome experience coprolalia (Cavanna & Seri, 2013).
Why does it happen? The brain constantly generates thoughts and impulses, but these get filtered out before reaching conscious action in neurotypical brains. This process of gating, allows the brain to suppress unwanted motor or vocal expressions, regulate impulses, and filter socially inappropriate responses (Ganos et al., 2014). The gating system is disrupted in Tourette syndrome. When the gate does not function properly, vocal or motor tics may be released involuntarily.
The Neuropathology: Studies using Functional Magnetic Resonance Imaging (fMRI) have pointed to disruption in certain neural networks (Gates et al., 2004). While an MRI takes a detailed picture of the brain’s structure, an fMRI looks at brain activity by measuring blood flow. These studies of activity during coprolalia have suggested dysfunction in the cortico-striatal-thalamo-cortico (CSTC) circuits, which are important for filtering impulses.
The limbic system, especially the amygdala, has also been implicated, which could explain why taboo or emotionally charged words are preferentially triggered (Stern et al., 2000). If a person with coprolalia is near someone who belongs to a group culturally associated with a specific taboo word, that word may be more readily activated within their language networks.
The incident that unfolded at the BAFTAs understandably sparked intense reaction. But the story is nuanced. The vocal outbursts in the context of coprolalia are not a reflection of character, prejudice, or choice. Its cause is rooted in the brain. However, in this moment we can appreciate that two things can be true: harmful words have impact and neurological conditions deserve informed understanding.