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Selective mutism

a severe anxiety condition where a person is physically unable to speak in certain situations

Selective mutism is a severe anxiety disorder where a person finds it impossible to speak in specific situations. This happens when they feel pressured to talk to certain people, causing them to freeze up and make speech seem impossible. It’s a condition that affects 1 in 140 people, usually starting in childhood, yet it’s not well-known and often misunderstood.

Misconceptions about selective mutism can lead to isolation and increased anxiety for those affected by the condition. Gaining a better understanding of this condition is crucial to providing effective support for those living with it.

Common myths about selective mutism

selective mutism
is a choice

Selective mutism is a condition that people do not have control over. The intense anxiety unable people to speak even when they genuinely desire to communicate.

 selective mutism
is just shyness

Selective mutism is a clinically recognised anxiety disorder. People living with it experience anxiety beyond typical shyness.

you can grow out
of selective mutism

If left untreated, it can persist into adulthood. Early intervention, therapy, and finding the right support are crucial to overcome it.

Symptoms

The unique nature of selective mutism can make it difficult to identify, leading to misunderstandings and potential misdiagnoses. Some common indicators of selective mutism include: 

  • Stillness  
  • Frozen facial expressions 
  • Avoidance of eye contact  
  • Displaying shyness or withdrawal 
  • Reluctance to engage in communication in certain situations 

Causes

The causes of Selective Mutism are complex and not always fully understood. Selective mutism is often caused by the presence of another condition. Some of these include: 

Fear (Phobia) 

Selective Mutism can be caused by a fear or phobia of speaking to specific people.  

Anxiety 

Selective Mutism is closely associated with anxiety, and people living with this condition typically exhibit heightened anxiety levels. 

Speech and language disorders 

People with speech and language disorders or hearing problems may find speaking even more stressful. 

Post-Traumatic Stress Disorder (PTSD)

Selective Mutism can also manifest as a symptom of PTSD. In such cases, individuals may suddenly stop talking in environments where they previously had no difficulty. 

“From a personal point of view, selective mutism feels like I am being strangled from the inside out. It feels like someone is trying to pull the tightest knot right in the middle of my throat. Whilst all of that is happening, there are a million words of what I want to say racing through my head in a matter of split seconds.” 

Milo, one of our student volunteers in Change Mental Health, talks about their experience of selective mutism. Read more on Milo’s story here. 

Treatment

Treatment of selective mutism typically involves a multimodal therapy approach, including various therapeutic and behavioural interventions. Here are some options for the treatment of selective mutism:

Behavioural therapy 

Behavioural therapy, such as Cognitive-Behavioural Therapy (CBT), is a crucial treatment approach. It helps people gradually overcome their fear of speaking by setting achievable goals. 

Exposure therapy

Gradual exposure to anxiety-provoking situations can be beneficial. This involves exposing a person with selective mutism to speaking situations in a controlled and supportive environment, progressively increasing the level of difficulty.

Speech and language therapy 

Speech therapy is essential, especially for people with speech and language issues. It focuses on improving communication skills helping the children express themselves more effectively. 

Family involvement 

Parents and friends play a pivotal role in the treatment process. They work closely with therapists to support their child’s progress and create a comfortable and encouraging environment at home.  

School Support 

Collaboration with educators and school staff is essential. Teachers can implement strategies to foster communication, and school accommodations may be needed to facilitate the child’s progress in social situations. 

support

If you or anyone you know requires support, our Advice and Support Service is open Monday to Friday, 10 am to 4 pm, where advisers can signpost you to local support that fits your needs, including our Change Mental Health services. We offer initial advice on money worries and help to deal with emergencies.

Contact 0808 8010 515, email us at advice@changemh.org or fill out the enquiry form on the Advice and Support Service page.

If you are an educator or work in student support, Bloom and Your Resilience provides school staff with the opportunity to develop their skills and confidence in having open conversations about mental health and support young people in transitioning to higher education. Learn more about the different Young People’s Programmes and contact us for more details.  

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