When you're suddenly unable to talk
12 August 2016, 13:03
Most of us have been in situations where we were speechless. Often when we receive bad news or have strong emotions we are unable to utter a word. But some people do not need shocking news to be dumbstruck – they simply can’t talk in certain situations.
Just like Rajesh Koothrappali from the popular TV sitcom Big Bang Theory who can’t speak to women without alcohol, they suffer from a rare disorder called selective mutism.
The Selective Mutism Group, a non-profit research organisation, estimates that every 1 in 1 000 children is affected by this disorder. Therefore, it has a higher prevalence rate than autism (0.5 per 1 000), Tourette’s disorder (0.5 per 1 000) and obsessive-compulsive disorder (0.5 to 1 in 1 000).
An anxiety disorder
According to the Selective Mutism Foundation selective mutism is “an anxiety disorder characterised by not speaking outside the home to select individuals, or in select settings, which continues for more than 1 month”.
It most often affects children and in the latest edition of Diagnostic and Statistical Manual of Mental Disorders (DSM), the failure to speak is not due to any disability, but rather because of anxiety within a social context. It’s important not to confuse this disorder with general shyness. For example, a child might be able to speak at home, but at school he or she simply can’t talk.
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- The inability to speak interferes with school, work and social life
- Lasts for at least a month
- Not due to a communication disorder (e.g. stuttering)
Selective mutism is usually treated with a combination of psychotherapy and medication. There are several behavioural therapies that psychologists would be able to use:
- Cognitive Behavioural Therapy (CBT) can help with expressing yourself and dig down to underlying causes of anxiety.
- Behavioural Therapy (BT) is effective when reinforcement social skills training are used. Research from Selective Mutism Group also indicates that systematic desensitisation (exposed to progressively more anxiety-provoking stimuli) is also an effective method.
In more severe cases anxiety medication can help a person maintain momentum during a conversation. There’s a lot of evidence that Selective Serotonin Reuptake Inhibitors (SSRIs), such as Prozac, can be useful for anxiety disorders.