The Silent Treatment: Uncovering Selective Mutism

• Written by Leena Khowal

  Reviewed by Ritika Malik

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Imagine you want to speak but are unable to express the turmoil going on inside. For a 26-year-old man, this was his harsh reality. His name was withheld, but his story echoes the desperate struggles of many. His history revealed a traumatic event from seven years back, which left an unforgettable mark. He witnessed the murder of his friend, a scene that still haunts him. The mutism is a desperate attempt to cope with the anxiety that had been simmering beneath the surface.

As he sat in silence, his body language screamed for attention. His eyes would flutter, his hands would shake, and his hiccups would not stop. It was a cry for help. The diagnosis was dissociative (conversion) disorder, a condition where the body converts emotional distress into physical symptoms. With therapy, medication, and support, he began to find his voice again.

His story is a testament to the human spirit's capacity to overcome adversity. This young man's story is just one example of the struggles that people with selective mutism face every day. But what exactly is selective mutism, and how does it impact daily life? Let's take a closer look.

What is Selective Mutism?

Selective Mutism is characterised by a consistent failure to speak in some specific social situations, despite being able to speak freely in other situations. 

The Total Shutdown

This is when communication comes to a halt. It's like your brain is saying, "Warning:    anxiety alert! Abort all your speech functions!" You might:

• Freeze up
• Feel paralysed by fear or anxiety
• Avoid eye contact
• Refuse to participate in social interactions
• Throw tantrums to avoid talking

Nonverbal Ninja Mode

When words won't come, gestures and sounds take over. You might:

• Use "uh-uh" and "uh-huh" in conversations
• Write responses instead of speaking (because writing is less scary)
• Point, or nod/shake your head

Minimal Communication: The Art of Saying Nothing

When communication is reduced to a bare minimum, it's like playing a game of charades – but without the fun. You might:

• Respond with single words or super short sentences
• Mumble, stutter, or whisper like you're sharing a secret
• Change your voice to sound like a robot

The Mystery of Selective Mutism: What's Behind the Silence?

The exact causes of selective mutism are yet to be found. But, some good guesses are :

Mental Health Connections

Selective mutism often comes in conjunction with other mental health conditions. These conditions include:

• Social anxiety disorder.
• Phobias.
• Autism spectrum disorder.
• Separation anxiety.
• Post-traumatic stress disorder.

Family Ties

Anxiety disorders can run in families genetically. If you have SM, you're more likely to have a first-degree relative (like a parent, sibling, or child) with SM or another anxiety disorder.

Communication Problem

Sometimes, SM can stem from anxiety about communication itself. This might include:

• Auditory processing disorders (when your brain gets confused by sounds around you).
• Learning delays (when learning feels very difficult).
• Speech disorders (fluency issues).
• Disliking your own voice (because, let's face it, our voices can be weird sometimes).

Social Stressors

Some social situations can lead to SM. These include:

• Being bullied. 
• Traumatic events or abuse.
• Family problems. 
• Immigrating to a new place with a different language.

What are the complications of selective mutism?

SM can hurt your life in many ways.

Social Interactions

You try to make friends, but end up standing there like a mute, just nodding and smiling. Your social life is full of awkward silences, followed by the occasional "uh-huh" or "mm-hmm."

Work and Education

Meetings? Forget about it! You're too busy trying to remember how to speak, when to speak and what to say. And don't even get me started on presentations... It's like your brain is playing with you, freezing up your vocal cords just when you need them most.

Daily Tasks

Ordering food? "Uh, yeah... food... please..." Making phone calls? Not possible, you'll stare at your phone, want to speak, but utter a word.

Emotional and Mental Well-being

Anxiety and stress? Check! Low self-esteem? You bet! Depression? Unfortunately, it's a real possibility. But hey, at least you'll have plenty of time to think about your life choices... in silence.

Beating Selective Mutism: Treatment Options

So, you wanna break free from the silence of selective mutism? 

With the proper treatment, you cannot only reduce the symptoms but also eliminate them.

Treatment trio

• Mental Health Therapy: the star of the show! Cognitive behavioural therapy helps you tackle anxiety and other feelings that trigger SM symptoms. It's like a hero cape for your emotions!
• Speech therapy: Time to get chatty! Speech therapy is beneficial when speech disorders accompany SM. You will work with a therapist to find your voice.
• Medications: when therapy is not enough, meds can lend a helping hand. Selective serotonin reuptake inhibitors are the usual suspects, tackling depression and anxiety disorders, and anxiety-related disorders like SM.

Misconceptions and stigma

Here are some of the misconceptions around selective mutism: 

• Selective Mutism is Just Shyness: Nope! Shyness is being a little nervous, but selective mutism is being completely mute, without knowing why.
• People with Selective Mutism are Just Being Stubborn: Uh, no. It's not a choice; it's their brain playing a cruel joke on them.
• Selective Mutism is Rare: Around 1 in 140 people have selective mutism. Not super rare!
• People with Selective Mutism Can't Communicate at All: Not true! They might use writing, typing, or gestures to communicate.
• Stigma: Selective Mutism is a Personal Failure: Nope! Selective mutism is not a sign of any flaw or weakness. Everyone's brain is a little weird sometimes!

The Final Word: Embracing the Silence!!

So, there you have it! Selective mutism might be a little quirky, but it's not something to be ashamed of. It's a reminder that our brains are wired differently, and that's what makes our lives interesting!

So flip the script and, instead of trying to "fix" selective mutism, learn to appreciate the silence. You never know, you might just find a new language – one that's never spoken, but understood.

However, if you feel anxious and need help, you can consult a psychiatrist. 

You can also purchase a health insurance plan that includes free consultations. 

Care Health Insurance offers free consultations to four general physicians and 14 specified specialists, including psychiatrists.

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.