Re: Selective Mutism

[Guest guest]

A girl in my preschool class had this and a few CBT sessions got rid of

it and she is in Kindergarten now, doing great. She had some other

quirks, worries, anxious behaviors that her parents pretty much ignored,

hoping she'd grow out of them, but when her " shyness " didn't go away and

Kindergarten was looming they finally agreed to get her some help and

they were amazed at how fast and effective the CBT was.

Dana in NC

[Guest guest]

Selective mutism is considered a manifestation of an anxiety

disorder,. I would treat it with play therapy and other

psychotherapies. To " neurologize " it I think is perhaps not going in

the right direction (in the sense of a failture to empathize with what

the child is actually going through subjectively), although I could

see neurofeedback as an approach if it's directed toward relaxation

techniques and anxiety reduction AND (maybe most important) involves a

kind, caring relationship with a practitioner who is essentially

tolerant of the presence of the symptom. And can be conducted without

pressuring the child to talk!

I would imagine that a child with this issue has already received

countless messages that there's something very wrong with her, and a

goal would be to address that as well as the social anxiety.

The " overprotective home environment " in the other case is an

interesting point. Cause or effect? I guess they're suggesting that

the child has separation anxiety disorder -- only feels comfortable in

the (overprotective) home. Still, which comes first? It's hard not to

be overprotective when your child has a severe anxiety disorder.

An important issue is for parents, teachers, and therapists not to

" try to get her " to talk. Rather, to get to the feelings/fears and

consider that, when she feels better, she will begin to feel

comfortable enough to speak in more contexts. This is hard, because

adults generally are gung-ho on symptom removal.

It's quite likely that an anxious kid has anxious parents who find it

hard to tolerate the child's symptom. This very out-there symptom

" means " things about their family and themselves. Mutism is tricky. On

the one hand, it connotes shyness, fear, withdrawal. On the other, it

is a rejection of the world or part of it. People don't like to be

rejected. As tolerant and well-wishing as they may be, it's hard not

to personalize it. Of course, they can't admit that they are

personalizing it, because they know that would be ridiculous, so they

have to put it all back on this intolerable symptom, which they want

and need to disappear with all their hearts.

Neurologizing a symptom like this is tricky. On the one hand, it frees

the person, who can become a " patient " and get all those benefits

(like the benefits of calling depression a " chemical imbalance " or

alcohol addiction a " disease " --- basically, it's not your fault

anymore. It's the fault of you-as-machine. The machine broke! Now you

can put the problem in the hands of a mechanic, who will use the

latest technology to fix it.)

On the other hand, neurologizing the problem can be a way of avoiding

the real, human issues that are often there (yet elusive) in a person

who develops a symptom like selective mutism.

My own opinion is that symptoms are defenses, and defenses are there

for a reason. When the reason for their existence is diminished, and

the client feels safer in the world, the defenses can start to fall away.

Liz

> >

> > Does anyone have any expereince using neurofeedback to work with a

> > young child with selective mutism? I am working with a delightful 6 yo

> > girl who will only speak at home to her immediate family and selected

> > family friends. She has fast activity consistent with her diagnosis,

> > and I am working with her on reducing it, but after 18 sessions, she

> > gestures and points and writes the five words she knows to

> communicate,

> > but still no words.

> >

> > Any neurofeedback suggestions?

> >

> > Thank you Dana Rutschilling

> >

>