The Creative Portfolio of Melissa K. Vassar-Belloso

Searching for Words: A Real Look at Selective Mutism

by Melissa K. Vassar-Belloso

Conversations are part of everyday life but we’ve perhaps all experienced being at a loss for words. There are many different reasons we might run into that loss for words. Sometimes we aren’t sure how to respond or can’t find the right words, but sometimes it’s not a matter of choice. Selective mutism is perhaps a condition you’ve never heard of or know very little about but today we’re going to discuss what this condition is and how it affects the daily lives of those on the autism spectrum.

Overview

  • What is Selective Mutism?
  • Selective Mutism and the Autism Spectrum
  • Diagnosing and Addressing Selective Mutism
  • Supporting Those With Selective Mutism
  • Conclusion

Selective mutism is a complex anxiety disorder characterized by a person’s inability to speak and communicate effectively in select social settings such as school or work.In most cases those afflicted by this condition are still able to speak and communicate in settings where they are comfortable or to people they are comfortable with. While many with this condition have  an underlying social phobia or social anxiety, the disorder is quite debilitating and painful in its own right. Those with selective mutism have an actual fear of speaking and of social interactions where there is an expectation to speak and communicate.

Selective mutism, as the name implies, is not experienced on a constant basis. Many afflicted by it can communicate and socialize normally when the setting or people are ones they feel secure with. The loss of being able to communicate verbally is a result of extreme levels of anxiety. It is almost akin to an extreme state of stage fright but with the world being the stage. But perhaps the real challenge with this condition is understanding why it’s something worth worrying about. You might think that anxiety about unfamiliar places and new people is somewhat “normal” and doesn’t need to be labeled or that being at a loss for words is even somewhat a common man’s plight and you wouldn’t be completely in the wrong to be in either camp.

What adds weight to selective mutism is that it is an extreme form of those common issues. Very much like when I discussed how anxiety disorders can’t be lumped into just being normal anxiety, selective mutism is an extreme and damaging state of being at a loss for words. It is not only rooted in an unhealthy level of anxiety but can cause long term damage to socialization and forming personal connections with others. Healthy socialization is key to many things in our lives. Children with poor or stunted social skills grow into adults that have a much more difficult road to success in life.  Because we have a society so heavily rooted in verbal communication, selective mutism can be a a damaging factor in educational success,personal relationships and career growth among other things.

Surprisingly, there is little understanding in our society about the true impact selective mutism can have and very limited research into it in comparison to other conditions. The majority of information available on it tends to only look at how it manifests in children but as I’ve discussed in past blogs, disabilities and disorders don’t vanish in adults. Selective mutism can affect adults as well and causes much more impact than I think the documentation of the condition implies. Selective mutism is often a co-morbid to other conditions, most commonly autism, but that doesn’t mean it should be treated as a lightweight condition.

Selective mutism is a common condition that is experienced in the autistic community. Like autism itself, selective mutism can be experienced in varying degrees. I myself experience it most when facing phone encounters more than in face-to-face ones but there are some who have the opposite experience or maybe both scenarios. To me the link between the two conditions is a rather perfect  but unfortunate marriage. Autism as a condition creates an uneven playing field when it comes to socialization on its own but also creates a perfect breeding ground for selective mutism.

Like moisture and mold, the two conditions fit perfectly together and create a perfect storm. Autism is marked by deficiencies in being able to read others, interpret emotions and cues and respond appropriately which naturally causes significant anxiety. This anxiety can easily build to dangerous levels and create a perfect foundation for selective mutism to occur. When we discuss diagnosing it as a condition as it relates to the autistic community, it can introduce an interesting roadblock. That roadblock is that some in the autistic community already have a non-verbal component to their behaviors.

In a past blog I’ve discussed motor skills as they relate to autism and that those on the spectrum can experience a wide range of impairment to motor skill development. When it comes to speech many on the spectrum have varying degrees of proficiency in verbal communication. Some can be partially or completely non-verbal due to their autism. This can make it more complicated to identify when selective mutism is present. It could even be reasonably argued that perhaps selective mutism is just a potential component to autism or a natural byproduct in some cases. Because research on both conditions is still somewhat inconclusive, it would be impossible to concretely say what the tie between them truly is, but understanding that there is indeed a bond there is crucial to bringing selective mutism to the attention it deserves so that proper research can be on a nearer horizon then it is now.

While the majority of research into this condition focuses on children and adolescents, I can tell you personally that this condition isn’t limited to that age group and can affect adults. The first step to truly understanding this condition is grasping that it, like autism, isn’t limited to children. Since research is so scarce and definitive roots aren’t there, I’d rather take a different route here. We can sit around and guess all day about the science and medical aspect but what about the personal aspects and the things a research study can’t really tell you about the condition?

I am an actual person who suffers with selective mutism and one of the things I found while experiencing it is that the articles on it don’t tell you what you really need to know about it. The most important thing to understand about selective mutism is what it doesn’t say about a person. Having selective mutism doesn’t mean a person doesn’t want relationships. In fact, many with the condition still have a desire to make friends and form ties with others. They just don’t have the means to act on it properly. Think of it as knowing you need a hammer to put in a nail but all you have is a wrench.

Another dangerous myth around this condition is that it is a choice. In children especially, it can be conceived as a form of defiance or manipulation, but this is incorrect. Selective mutism is not a choice. Many afflicted by it want to talk to others but are genuinely unable to. Perhaps the most offensive misconception is that selective mutism is a sign of a learning disability and as I discussed in a past blog, motor skills are not a sign of intelligence. Not being able to speak is not a given that a learning disability or lesser intelligence is also present.

Aside from the myths, the second biggest thing to understand is why it’s important to get a diagnosis and address the issue in the first place. Some opinions, lay and professional, suggest it is something you can outgrow and that’s incorrect. Untreated selective mutism will persist into adulthood and cause significant difficulties. It is  important to remember that selective mutism is an anxiety disorder at its core. Anxiety disorders are nothing to scoff at and can cause long term damage when left untreated. In addition to the obvious factor of the anxiety becoming potentially worse over time, it can also lead to depression,social isolation,poor self-esteem,low academic performance,difficulty forming personal and professional relationships,poor workplace performance, self-medication and suicidal behaviors.

Key to actually identifying selective mutism is to find patterns. Selective mutism will be characterized by notable difficulty in verbal communication  alongside significant spikes of social anxiety but can be further identified by linking it to a specific environment or situation. For instance, if you notice you have high anxiety and non-verbal periods in just a certain setting or around certain groupings of people, it might be a sign selective mutism is present. Once you do identify it, the condition can be treated much like any form of an anxiety disorder with therapy and possibly medication, but may also benefit from cognitive or dialectical behavioral therapy in some cases. Getting the treatment for this condition is important. It may seem like a minor condition but remember that no anxiety disorder is to be taken lightly and no amount of quality of life is worth sacrificing.

Beyond medical support, personal supports are crucial to those dealing with selective mutism. Creating an environment where the person feels secure and clearly communicating that you understand the person’s struggle is crucial. Help the person create alternatives to verbal communication if needed and try to alleviate the pressure they feel about communicating verbally as much as possible.

Never make the person feel bad,broken or wrong about their difficulties verbalizing. This will just increase the anxiety they feel and make them less likely to heal. If you are a person they feel comfortable speaking to then make sure you let them practice better communication and ease their anxieties by getting the socialization they’re able to. Never pressure or force them to socialize. This will just add to the anxiety they already have and add a layer of shame to it. If the person takes a chance at socializing, acknowledge it positively and avoid criticizing it unless absolutely necessary. It’s important for the person to be able to celebrate those small victories so they can gain confidence to socialize more and have less anxiety about new social situations. Far beyond medical support, those who are  afflicted by selective mutism need understanding,patience and a helping hand to navigate socialization. The more you can create a sense of security for them, the less they will have to fear the world around them.

Selective mutism may seem obscure or insignificant  at first glance, but understanding it is a key piece to understanding a condition that affects the quality of life for many people in our modern society. Whether it’s for you or an afflicted person in your life, remember that anxiety disorders are very real and a very serious matter. If you feel that selective mutism is affecting you, get the help you need and take your life back. If you’re supporting a person with selective mutism, remember to do what you can to learn about and understand the condition before judging. It’s a condition that often is much more than it appears to be on the surface. Bringing awareness and proper research to this condition will only come when we as people make an effort to understand it and the people affected by it on a daily basis.

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