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It might make for compulsive viewing but all hell would break loose as social conventions collapsed, which is why we need to control ourselves in public. This control is achieved by mechanisms in the front part of the brain that regulate and coordinate behaviours by inhibition. These frontal regions are some of the last to reach maturity in the developing brain, which is one of the reasons why young children can be so impulsive. They have not yet learned how to control their urges.

For the Tourette’s sufferer, somewhere along their developmental path, something has gone wrong with aspects of their impulse control. Their tic symptoms are like spasms that seem to be automatically triggered. Some tics are just simple twitches but others are more complex and disruptive, such as coprolalia – the urge to shout obscenities. Many of us have felt like swearing out loud on a number of occasions, but some Touretters are unable to stop themselves from doing so. Drugs that influence the activity of inhibitory neurotransmitters can alleviate many of the tics but, so far, there is no cure for Tourette’s syndrome. Touretters have to fight a constant battle to control their tics and these battles are worst when there are other people around. As the pressure to behave normally in a social situation increases, the urge to tic can be like an itch you can never scratch – and the more you try to stop the tic, the more the urge builds up, just like a sneeze. Not surprisingly, social encounters can be extremely stressful, making the condition worse as Touretters try to control themselves in the crowd. I expect that many of us have these impulses in social situations, but why?

I think the answer is related to the problem faced by those with Tourette’s Syndrome. The presence of others triggers anxiety as we become self-conscious in public. We feel that we are being monitored and evaluated, which makes the need to appear normal more critical. This fear in turn increases levels of anxiety. As our anxiety increases, we lose control over impulses and urges.

Where does that self-consciousness come from if not from others? Babies are not initially self-conscious. After all, who can be if they have little control over bowel movements? Somewhere along the path of childhood we start to develop a sense of self-identity and pride. As we discover who we are, we come to value our self, based on what others think. Earning respect and social acceptance from others is probably one of the major preoccupations that we can have. But, you might argue, who is in control of these anti-social thoughts and actions if not the self? The answer is that others both trigger those reactions as well as suppress the need to express them. On our own, there is no need to conform, but we did not evolve to live on our own.

Early social development begins by copying others and we continue to do so throughout our lives. The self illusion ensures that we are either oblivious of the extent to which we mimic others or think that we deliberately copy others. When we act socially we think that we are calling the shots and pulling the strings but this belief in autonomy is part of the illusion. We are much more dependent on others than we appreciate. We want to be part of the group but that, in turn, means we have to control our behaviours. We cannot just do whatever we want and be accepted. We want to be valued by others but before we can fulfill that obsession with self-esteem, we have to be able to gauge what others think of us. That requires developing an awareness and appreciation of what others think – something that takes a bit of experience and know-how.

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The Looking Glass Self

After his career has faltered, über-male model Derek Zoolander, protagonist of the 2001 film Zoolander, looks at his reflection in the muddy puddle next to the sidewalk and asks himself, ‘Who am I?’ To answer this, he decides that he must embark on a journey home. It’s a familiar story of self-discovery – where we seek to find the answer to who we are by following the trail of evidence right back to our childhood. Most of us, including superstar male models, have this sense of origins. We think of our self as travelling a path in time from childhood to adulthood, punctuated by life events and the people along the way who have influenced us and shaped who we are.

Our self exists in the reflection that the world holds up to us. In 1902, American sociologist Charles Horton Cooley coined the term, ‘the looking glass self’ to express the way that the self is shaped by the reflected opinions of others around us.1 People shape themselves to fit other people’s perceptions, and these vary from one person and context to the next. Spouse, family, boss, colleagues, lover, adoring fans and beggar in the street each hold a looking glass up to us every time we interact and we present a different self. Each person or group may think they know us but they cannot because they are not privy to the all the different contexts in which we exist. This is the familiar lament of celebrities who complain that the persona they present to the general public is not the true personality they hold privately. More than that, Cooley argued that there is no real identity that exists separately to the one created by others. We are a product of those around us or least what we believe they expect from us. He summed up this notion of the self illusion in this tongue-twister of logic, ‘I am not what I think I am and I am not what you think I am; I am what I think that you think I am.’

Consider the different questions and implications raised by Cooley’s looking glass self. How do we develop a sense of self in the first place? How do children develop an understanding of what others think and, more importantly, what they think about them? This must be especially important during that most difficult time of adolescence when children try to find their true self. How is our identity shaped by the characteristics that are imposed on us by biology and cultural stereotypes? All of these questions reflect upon the sense that the self is defined by those around us.

Man in the Mirror

When Derek Zoolander looked in the puddle and saw an incredibly good-looking face, he immediately knew who it was staring back at him in the reflection. However, this seemingly trivial ability to recognize one’s self is not something that everyone can do. As we age, brain death can progressively destroy everyday functions that we take for granted – including those that generate our sense of identity. Take TH, a seventy-seven-year-old Australian man who would look in the mirror and describe the gentleman staring back at him as a ‘dead ringer’ for himself, but it was definitely someone else.2 TH had normal intelligence and was not crazy, but he could not appreciate that the reflection in the mirror was his own. When asked where this man in the mirror had come from, TH replied that he must be a neighbour in an adjoining apartment. He confabulated a bizarre story to fit with his experience of the stranger in the mirror, but the truth is TH has a rare neurological condition called ‘mirror misidentification’ in which patients think their own reflection does not belong to them. They appreciate the likeness, but there is no self-recognition. Something in the face-processing circuitry of their brain has failed to register their own outward identity. There is no flicker of familiarity.