Psychogenic Mutism

stk32518aogPsychogenic mutism, which is also referred to as selective mutism, is mutism without any apparent physical cause.

What Is Psychogenic Mutism?

Mutism can be caused by a number of conditions, including deafness, speech delays, and developmental disabilities. But psychogenic mutism occurs when someone—usually a child—who is capable of speaking stops speaking. A child who meets a stranger and does not respond to questions is exhibiting a moment of psychogenic mutism. When mutism lasts longer than brief periods of time, however, it can inhibit communication and may require treatment. In most cases, the mutism occurs only in certain contexts, such as in school or large groups. Rarely does mutism occur in all contexts.

While it might seem like a person with psychogenic mutism is simply refusing to speak, they actually feel physically unable to speak, and forcing the person to speak is unlikely to work. Some of the causes of psychogenic mutism may be general anxiety or past trauma. For example, a child who is learning to speak might stop speaking if he or she is molested or threatened.

Treatment for Psychogenic Mutism

Treatment usually centers around discovering and addressing the underlying cause of the mutism. Treating therapists and physicians should rule out other causes, such as throat pain, injuries, hearing problems, or developmental delays. Psychotherapy to resolve the underlying conditions or stressors is often helpful. In some cases, anti-anxiety medications prescribed by a psychiatrist or doctor are utilized as part of treatment for psychogenic mutism.

Parents of children with psychogenic mutism may need to make lifestyle changes, such as moving the child to a different school or coming up with alternative ways to communicate with the child. Pressuring someone with psychogenic mutism to speak using punishment and other coercive tactics can increase anxiety and cause the mutism to last longer. Family therapy can help parents and children cope and move forward from psychogenic mutism.

References:

  1. A.D.A.M. Editor Board. (2012, February 11). Selective mutism. Selective Mutism. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002513/
  2. Selective mutism. (n.d.). American Speech-Language-Hearing Association. Retrieved from http://www.asha.org/public/speech/disorders/selectivemutism.htm

Last Updated: 08-18-2015

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  • Yvette S.

    March 28th, 2019 at 5:00 PM

    Hi I am just wondering if mutism occurs following trauma, would it be the Broca’s area of the brain that would be affected ??? Thank you very much. Yvette

  • Susan S

    September 9th, 2019 at 2:31 AM

    For how long after the trauma would a child be ready to start speak again

  • Ruth G

    October 8th, 2019 at 3:42 AM

    The child may not start talking for a long time or manifest other symptoms of trauma if the trauma that caused the mutiny isn’t sorted out, giving the child a safe place to talk in their time about what happened will enable them to heal, also ongoing trustworthy environment will ensure full recovery. This is true for anyone who has suffered trauma of course

  • Leona

    November 6th, 2019 at 5:37 AM

    My daughter has selective mutism and I am trying to get her homeschooled (this is her wish) but she won’t speak about it. How would we get her diagnosed with SM?

  • Arely

    April 27th, 2020 at 5:02 PM

    I wanted to know if it was possible to develop after such a traumatic event, similar to a shooting and PTSD. How long will it last and what will be the process for them to slowly talk again if it can last years.

  • Kashfia

    June 7th, 2020 at 6:05 PM

    Do people become mute due to current shock? If the answer is yes, is it temporary or permanent?

  • Nurse

    August 31st, 2020 at 2:38 AM

    I had trauma from my mother’s pregnancy, and throughout childhood. My mom feared for her life, as my dad was severely mentally ill. He went to a mental institution when I was 2y2m old, and I started talking well into my 3rd year. It was at that time that I started talking in full sentences, but I had a lisp. I was finally diagnosed at age 55 with Complex PTSD from childhood.
    So, it really depends on the sense of safety in the environment, if and when speaking occurs.
    It’s not by “choice,” but when the nervous system calms down enough to allow speaking to happen.

  • Jelena

    January 10th, 2021 at 6:41 PM

    I myself have suffered from Sm from a very young age. My only true safe place and pnly trust worthy place to be myself and express myself was due to my theater class as a freshman in high school. I have myself finished my degrees in thester and child development and arts are an amazing outlet for any child shy and non willing to talk or judt need an extra fun loving push for expression. Just cause your child isnt van Gough pr b Mozart or A Marlin Brando or Joan Crofard does not mean creative classes dont help a person become and grow to themselves through art .

  • Mercedes

    May 5th, 2022 at 2:53 AM

    My name is Chantal,
    My voice box was taken out. Therefore, I became mute at the age of 62. My family is not supportive and I need some type of social group that I can relate to. I am very lonely and depress. PLEASE advice where can I go.

  • Charlotte Menten

    May 5th, 2022 at 8:29 PM

    It can be especially hard when those close to us aren’t a source of support Chantal. Reaching out to a therapist or counselor can be helpful in these situations and may even have more resources when it comes to specific support groups. To find a therapist that fits your needs, please enter your city or ZIP code into the search field on this page: https://www.goodtherapy.org/find-therapist.html. Once you enter your information, you’ll be directed to a list of therapists and counselors who meet your criteria. You may click to view our members’ full profiles and contact the therapists themselves for more information. Please reach out directly if you need help finding a therapist. We are in the office Monday through Friday from 8:00 a.m. to 4:00 p.m. Mountain Time, and our phone number is 888-563-2112 ext 3. Kind regards, The GoodTherapy Team

  • Jacqueline Hood

    May 30th, 2022 at 6:37 PM

    I just came across this article, and it is important to note that typical Selective Mutism (SM) is NOT trauma-based. It is mostly genetic and is recognizable by an early inhibited temperament and an inability to speak in certain settings, with certain people, or in certain situations. It is usually noticed when a child enters school and is found not to be able to speak to certain caregivers or peers, and sometimes not at all. It is recognizable more as a list of “Okay” and “Not Okay” individuals, places, and/or situations with whom/in which the child can speak, and has a very compulsive quality. The brain has made an arbitrary set of rules that the child feels compelled to follow. The child with Selective Mutism will generally be able to speak normally with certain people and in certain settings/situations while being unable to speak with/in others. In contrast, in trauma-based mutism, the child will initially speak normally in most/all situations, but suddenly stop speaking, even to caregivers. The non-speech behavior post trauma is much more pervasive. Typically, trauma-based mutism has a sudden onset and an abrupt end. When the mutism abates, it typically does so in all settings at once. This is completely different from a more genetically and compulsive/anxiety-based mutism. I have been treating SM for over 20 years. When I come across trauma-based mutism, it presents very differently and should be treated with a trauma-based focus, often with non-directive play therapy; whereas, with typical SM, you would use a cognitive-behavioral focus, and non-directive play-therapy is contraindicated (can make things worse).

  • Adam

    July 23rd, 2022 at 5:15 PM

    My 16 month old’s speech was progressing fine. He could say a few words and he would happily use baby sign language to indicate he wanted a nap, or milk, etc. Now he says nothing either by voice or with signs, apart from shaking his head. We try to get him to ask for what he wants but he will only shake his head in response. He is this way in all settings. To my knowledge, there was no trauma but the onset was sudden. I’m a unsure of how to proceed.

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