Psychogenic mutism as a reaction to psychological trauma, stress and anxiety

Selective mutism is a kind of disease in which the patient refuses to speak. The pathology occurs in both adults and children. The person does not have any physical defects or organic lesions. In childhood, the disease manifests itself more noticeably. Correction and treatment of selective mutism will be required. Symptoms may appear in different ways. Various drugs can be used for therapy.

Symptoms of selective mutism

The most important symptom is a selective method of communication. There may be no speech in certain situations. Selective mutism in children manifests itself in schools and kindergartens. The child cannot speak in the room or office. The baby does not communicate in front of strangers or teachers. In rare cases, children may not speak at home, but in kindergarten or school they talk willingly.

Patients may not use verbal contact, but use facial expressions and pantomimes. If the disorder is in an advanced form, the child may freeze, hide his head and tuck his legs. There may be a pathological attachment to the mother. The following symptoms of selective mutism may be added: delayed speech development, phobias, depression, enuresis.

Clinical manifestations and symptoms

Psychogenic mutism can be diagnosed by the presence of certain signs; the main symptoms include:

• refusal of verbal (speech) communication;
• absence of diseases as a result of which speech functions are impaired;
• clarity of consciousness;
• maintaining the ability to express one's thoughts in writing;
• use of non-verbal methods of communication.

If muteness persists for more than 1 month, this indicates mutism. In some cases, a person is unable to communicate only in a state of excitement or loses speech when in contact with a certain circle of people.

Diagnosis of selective mutism

To identify selective mutism, you will need to visit a neurologist, speech therapist, or psychologist. Doctors will not only help make a diagnosis, but also cure the pathology.

The following procedures may be prescribed to identify the disease:

• General collection of information. First of all, the doctor must know how the mother’s pregnancy went and what illnesses she suffered while carrying the child. After this, he will determine the baby’s reaction to the vaccine and monitor his development. The psychologist should look at the doctor's diagnosis and talk with the child so that he can talk about phobias. After this, comprehensive treatment for selective mutism is prescribed.
• Visit to a neurologist. The doctor conducts various studies, which include the quality of speech, breathing rhythm. The child’s blood pressure can be measured and neurological diseases analyzed.
• Craniogram. The procedure helps assess the condition of the brain.
• Magnetic resonance imaging and computed tomography. The procedures perform the same function as a craniogram, but with more accurate results.
• Electrocardiogram.
• Chest X-ray.
• Electroencephalography. Without this procedure, which helps to find out the level of electrophysiological processes, the disease cannot be detected.
• Blood and urine analysis. The doctor should check your hormone levels.

After selective mutism is diagnosed, the specialist prescribes treatment.

Selective mutism in adults

Most often, selective mutism in adults occurs in women. Representatives of the fairer sex are more emotional and sensitive. Thus, they are predisposed to be overly impulsive. Experts diagnose men too.

Pathology develops in the following cases:

• High sensitivity. If the problem is accompanied by hypertrophied suspiciousness, then after an emotional reaction the patient will acquire pathology.
• Stroke. If a person has suffered a disruption in blood supply, the area in the brain responsible for speech is affected.
• Problems with the vocal cords. They may be due to damage or complete paralysis of these muscle folds.

If a person's mutism is caused by hysteria, then the disease is temporary.

How can I help a mutista?

The process is reminiscent of a joke: the class was late for class.
The surprised teacher asked everyone a question, and was even more surprised when she learned that the whole class was helping the old lady cross the street. Where is there to laugh? The fact is that she categorically did not want to cross the street! The state of mutism in both a child and an adult is often dictated by a feeling of fear, resentment and “betrayal,” and the pathology itself is revenge on the “offenders” for the moral and mental damage caused. And the mutist indulges in this revenge with fierce ecstasy.

Therefore, the “old lady” often has to be “transferred across the street” “with the whole class.” And all the means that can help are good here.

Treatment of mutism is a complex of skillfully combined psychotherapeutic and medicinal effects, provided both in an outpatient and inpatient setting. After understanding the reason that gave rise to the phenomenon of mutism, it is eliminated.

In adulthood, this may be the elimination of a hematoma or surgical excision of a tumor or cyst that affects the functioning of the brain, leading to healing from the akinetic and apalic modification of mutism.

In the case of a psychiatric illness leading to muteness, it is appropriate to use “tongue loosening” antipsychotic and other specially used drugs:

• neuroleptics;
• antidepressants;
• benzodiazepine drugs;
• selective serotonin reuptake inhibitors.

To regulate the functioning of the vessels that supply the brain with nutrition and to enhance metabolism in its tissues, medications are used:

• antispasmodic;
• pain reliever;
• sedative effect;
• nootropic drugs.

Providing psychological assistance to the patient (in the case of selective mutism) consists of:

• in conducting conversations that distract him from living in a traumatic situation, such as a plane crash or an incurable disease in a close relative;
• in working with worries and anxiety, learning actions to overcome stressful situations, mastering social communication skills;
• in the correction of facial expressions and similar measures.

In addition to drug therapy and psychological assistance, additional techniques are used in the form of:

• breathing exercises;
• massage;
• therapeutic and corrective gymnastics;
• art therapy;
• phototherapy.

Instilling social skills is also necessary.

In the case when a mutist patient is bedridden, measures are taken to ensure careful care of the skin, oral cavity and respiratory organs, as well as nutrition (if necessary, tube or parenteral).

Treatment of selective mutism

It is mandatory to use drug treatment. It is not recommended to self-medicate, as this may worsen the situation.

After a thorough examination, the following drugs are prescribed:

• Antidepressants. They help solve the problem. Most often, experts prescribe Prozac and Fluoxetine.
• Neuroleptics. The substances help cure mental disorders. In this case, Frenolone, Gidazepam, Risperidone are prescribed.
• Benzodiazepines. Drugs in this group have sedative, hypnotic and anxiolytic effects. Doctors prescribe Gidazepam, Fluorphenazine, Alprazolam.
• Nootropic drugs. The main component is vitamin B15, it helps prolong life and combats stressful situations well. These drugs include Pirecetam, Salbutamine and Oxiracetam.

The disease can be treated not only at home, but also in a hospital setting. It is important to begin treatment for selective mutism in a timely manner. If time is lost, then neuroses, mental disorders, and social phobias will develop in the future.

Diseases in which mutism manifests itself

Mutism is a symptom of a psychomotor disorder; it can be observed after a concussion and bruise of the brain, severe mental trauma, fire, death of loved ones, as one of the later manifestations of the AIDS-dementia syndrome complex, etc. Catatonic mutism occurs in catatonic schizophrenia due to negativism. Hysterical - for dissociative (conversion) disorders and hysterical personality disorder. Mutism can also develop in neurological diseases, for example, with bilateral damage to the corticobulbar tracts, vocal cord paralysis and severe spasticity.

Correction of selective mutism

In fact, there are many ways to help a patient cope with pathology.

Correction of selective mutism is carried out as follows:

• Breathing exercises. In such a situation, a good specialist is looked for. It will help you learn deep, shallow, rare, frequent and mixed breathing. If you master these basics, you can start doing yoga. It helps coordinate the spiritual and physiological functions of the body.
• Massage treatments. Massage is necessary not only to warm up muscles. Thanks to the procedure, a person will be able to become calmer and recover faster from psychological trauma. Hydromassage is also available.
• Acupuncture. The procedure will help a patient with mutism cope with problems of the nervous system. Acupuncture is prescribed only by your doctor.
• Art therapy. Most people think that the procedure is only for children. Correcting mutism in adults involves working with colors and using it to find unexpected solutions.
• Phototherapy. People love looking through family photos. If the patient is silent, then you can make him talk with the help of photographs. When he sees the exciting moment in the photo, he may start talking.

The goal of treatment is to eliminate the causes of the disease. Eliminate neurotic disorders, as well as improve interpersonal contact.

Correction of selective mutism in children

Selective mutism is mostly a childhood pathology. If even slight deviations in the baby’s behavior appear, you should contact a specialist. Correction of selective mutism in children must be carried out without fail.

You can help your child in the following ways:

• Create a positive environment. In a home where there is peace, kindness and mutual understanding, in rare cases a child suffers from selective mutism. The baby must know that he is loved and listened to, no matter what he says.
• Adequate punishment. Don't listen to your child's whims. Most often, children cannot withstand cruelty from their parents, since they have a fragile psyche. You shouldn’t physically punish your child; it’s best to explain that you can’t do that.
• To fulfill promises. All children believe that adults always keep their words.
• Change the baby's environment. If mutism occurred due to psychological trauma, it is recommended to find a new kindergarten or school.
• Visit specialists on an ongoing basis. It is not recommended to treat neurologists or psychologists as those people who cannot help a child.

If the baby stops talking or behaves strangely, then certain measures should be taken. Many people believe that visiting a psychiatrist will affect the child's life. If there is any problem with the child, you should contact a specialist. Failure to act may cause harm to the child and the disease will become permanent.

About mutism seriously and in your own words

It is traditionally believed that mutism - or silence, muteness - is “forbidding oneself to speak.” Prohibition on verbal expression. In fact, the phenomenon has two aspects:

1. First : mutism is a measure to prevent invasion of the individual’s psyche from the outside.
2. The second is the maximum possible isolation of the individual from the outside world within his own defined boundaries. The strictest “veto” imposed by a person on himself, a ban on him crossing his own external borders.

How can such a cruel measure be justified?

Mutism is not just a ban on expressing oneself in words, it is a deeply justified subconscious act of saving the world from the forces that lurk inside the personality kept under “house arrest”. From forces that cannot be released.

These are the same notorious devils who live in an apparently still pool.

As scientists have established, the energy contained in the internal electronic and other connections of the living body of one person is enough to illuminate a small city for several days. The whole question is how to manage it wisely.

If it is managed “in no way”, those same “children-arsonists” appear - pyrokinetics who are capable of igniting and instantly burning an object they do not like to the ground with just their gaze. And this is far from the only phenomenon of the enormous destructive power of man.

Mutism that occurs for one reason or another - regardless of whether it is stress or the “hand of fate” - karma - is always a sign: going into the city is prohibited - dangerous!

It is dangerous both for the “city” - the world in which we live, and for those who are able to enter it. Just as dangerous as those ten days that continue to shake the world to this day.

Outwardly, this eliminated danger looks to parents as the child’s annoying reluctance to speak. For mutism develops, for the most part, in children.

Selective mutism in children

The disease can occur for various reasons, they are all different from each other.

The following factors lead to selective mutism in children:

• The child does not know how to talk with other people and find a common language.
• The baby cannot verbally formulate his desire.
• The child does not have his own space to express unpleasant feelings.
• Negative atmosphere in the house.
• Brain damage.
• Early development of schizophrenia or autism.
• Hysterical neurosis.
• Excitement due to severe fright or loss of a loved one.
• Lack of attention from adults, as well as misunderstanding in the family.
• High anxiety, as well as nervous tics.
• Stubbornness.
• Speech problems.

Such reasons can lead to other problems. Selective mutism will need to be identified in order to prescribe comprehensive and effective treatment. The pathology is an anxiety disorder. The child can feel good and communicate with friends and relatives. If the baby changes the situation, he stops talking. The child cannot say a word because he is afraid.

Selective mutism can persist into adulthood. In this case, various social phobias appear. The problem occurs in those children who have a labile nervous system, as well as isolation, resistance or anxiety for no reason. If a child has anxiety, then he needs parental support in difficult situations.

Most often, pathology occurs in those families where the psychological climate is uncomfortable. Many doctors say that a type of mutism is a neurotic disorder. Children can suffer not only from muteness, but also from depression, timidity, and vulnerability. The pathology is most severe in adolescents. The disease can be inherited.

Treatment of selective mutism in children

Therapy should be aimed at eliminating social phobias, as well as anxiety and depression.

The following methods of treating selective mutism in children are used:

1. Cognitive-behavioural. The procedure is carried out individually for each child. A psychotherapist helps to establish contact and helps to express and overcome bad moments.
2. Behavioral. Group trainings will help develop communication and verbal interaction skills. Correct actions should be supported by attention and praise. The child comes into contact with other people of any age, so he overcomes shyness and embarrassment.
3. Family counseling. The doctor tells adults how to properly communicate with the child. You will need to approve and praise the baby.

Psychotherapy can be supplemented with speech therapy sessions. Encouraging your child to pronounce words correctly will help reduce the child's insecurities.

Selective mutism can be eliminated within the first six months. The patient's condition will gradually improve if there is psychotherapeutic intervention. Disease prevention means giving the child the opportunity to choose, express himself emotionally, and have the right to express his opinion.

Kinds

The main symptom of the disorder is the lack of speech activity in the child. However, depending on the form of the defect, it can manifest itself in different variations and be accompanied by accompanying symptoms.

The most common types of mutism are:

• elective;
• psychogenic;
• endogenous-psychotic.

Selective mutism

It is also selective, or selective mutism manifests itself episodically, under certain circumstances. The child behaves relaxed, active, chatting incessantly in the family, but in the garden or at school, with strangers, he remains silent. That is, he retains the ability to speak and understand speech, but he does not want to use it in certain situations.

Selective mutism, as well as negativism, can manifest itself in relation to an individual or environment. In this case, the mutist withdraws, averts his eyes, “shrinks,” does not respond to someone addressing him, or communicates with gestures. This form of the disease becomes a sign of social phobia.

Typically, this form of mutism occurs in children over 4 years of age. Their speech development up to this point corresponded to the norm, and they began to talk on time.

If a defect manifests itself as a negative reaction to an individual person or circumstances, then it is accompanied by pronounced negative emotions. Against this background, the baby experiences spasms in the neck, caused by contraction of the vocal cords and clenching of the jaw. This provokes an attack of fear, which aggravates the child’s condition and contributes to the consolidation of a neurotic response to this person or situation.

At first, parents scold the silent person, interpret his behavior as whim or stubbornness. This position is fundamentally wrong. Since neglect of this circumstance leads to social disadaptation.

Psychogenic mutism

Psychogenic mutism often manifests itself in 2 forms: hysterical and logophobic.

Over-emotional children with unstable moods are susceptible to hysterical mutism. It manifests itself under the influence of a strong stressor, or it can become a way to attract attention and achieve what you want.

In front of a 10-year-old girl, a car hit and killed a man. For her it was a great shock. Her legs stopped working, she could not stand and fell. Speech was lost, she ignored all questions addressed to her. Then inhibition gave way to excitement. She started running and jumping with a smile on her face. After treatment with psychotic drugs, the consequences of the shock were eliminated.

Logophobic mutism becomes a manifestation of an obsessive fear of hearing oneself speak. More common among schoolchildren. It can manifest itself in certain cases, for example, during public speaking. Or the child has a fear of pronouncing certain words. But there are times when children are afraid to speak in principle.

The logophobic form of the defect can form for several reasons. For example, as a result of low self-esteem, when there is a fear of hearing negative feedback from others. Or as a result of chronic fatigue.

This may be a consequence of acquired fear, in which the child has instructed himself to remain silent. For example, a mother suffering from alcoholism, while intoxicated, showed physical and verbal aggression if her son approached her and began to tell or ask for something.

The language barrier also plays a role in the flourishing of logophobia when children find themselves in an area with a dialect that is new to them.

But there are also physiological causes of the disorder. One of them is halitosis, that is, a person develops bad breath, which is associated with the extensive growth of pathogenic bacteria in the oral cavity. The child is embarrassed to speak because he is afraid that if he opens his mouth, those around him will smell the stench and make him laugh.

Endogenous psychotic mutism

Such pathological silence manifests itself within the framework of endogenous diseases. Schizophrenia is a prime example of this. With this psychotic disorder, the list of symptoms often includes catatonic mutism, which is part of the catatonic syndrome. It usually manifests itself in the form of the disease of the same name and becomes a sign of negativism.

As a rule, this form of mutism is characteristic of the stage of catatonic stupor, and occurs along with motor retardation.

In addition, there are delusional and hallucinatory mutism, which appears within the framework of delusional ideas and visions, as well as manic, depressive and mixed.