Hopefully this short case story will provide insight into selective mutism and performance anxiety.
“Debra”, age 30 ,works in the media field for a progressive television network. She entered treatment due to her public speaking performance anxiety. Her panic in speaking situations has created substantial anguish and a challenged mood. She has become overly dependent on beta blockers. This has evolved into a major issue as she wants to get pregnant and needs to not be on medication.
Debra identified as having being selectively mute in elementary school. She never got help for the problem. Her parents were clueless. Her school was clueless.
In treatment she has reflected on her past experience with selective mutism. This has been a difficult process as much of her memory has been repressed due to her defense mechanism of detachment. One situation she did remember was on the playground around 3rd or 4th grade. Playing some kind of “bridge game” all the kids were chanting “talk, talk, talk”. Her response at that time was to smile and think it funny. As the tears were flowing she expressed to me “It was funny then but sad now!”
For any parents who are reading this please be clear; it’s a good bet that the smile you may see on your child’s face, when mute in an interactive situation, is detachment. Detachment or disconnecting from thoughts, feelings, and speaking is the doorway to an avoidant personality!
Not only has Debra’s anxiety manifested in formal speaking situations at work, but also in her personal life. In social situations when she says she has “nothing to say”, or “does not know what to say” symptoms of selective mutism are still at play. Her internal negative and obsessive critical script is inhibiting her verbal performance.
Debra’s story is very common. It highlights the insidious and complex nature of selective mutism evolution.
The carefree days of summer are coming to an end. Outings to the beach, unlimited time with video games, and no homework are much easier to deal with than issues such as a child’s social anxiety, inhibited verbal communication, or social avoidance.
Summer is a time that can enable parents’ denial regarding the insidious and complex problems driven by social anxiety as the performance pressure is off. Jonathan Berent, L.C.S.W., author of “Beyond Shyness: How to Conquer Social Anxieties” states, “the most common response I’ve heard during my 36 years of clinical practice is “don’t worry the child is just shy. He or she will grow out of it”. This point of view comes from teachers, mental health professionals, pediatricians, as well as parents and well intentioned friends. The result of this belief has been a tremendous international void of productive treatment for social anxiety sufferers of all ages. The mental health profession has basically been clueless.
This void of treatment efficacy was the driving force for the creation of Social Anxiety: The Untold Story. This training program for mental health professionals was produced by The Andrew Kukes Foundation for Social Anxiety. Continuing education credits are available for mental health professionals.
Berent adds “the average age of the thousands of individuals who have been in treatment with me since 1978 has been the late 20’s”. The problem accrues with time. Social anxiety becomes very ingrained as fear of embarrassment, humiliation, and shame create avoidant behavior, and often, an overwhelmingly painful mind-body response.
Selective Mutism is an example of extreme social phobia at an early age. In essence, it is a talking phobia. The problem presents as a pattern of the child not talking in numerous situations. In typical selective mutism the child does talk normally at home, but not where there is performance pressure. There are many examples of atypical selective mutism. Selective mutism specifically is a manifestation of obsessive compulsive disorder. Berent adds. “I have worked with many adults who have variations of selective mutism. In fact; selective mutism can be the cause of public speaking anxiety disorder in adults”.
The Silver Lining of Selective Mutism
While selective mutism is a daunting challenge for parents, professionals, and schools, there is an upside. According to Berent, “the earlier there is productive intervention the more potential there is to prevent the problem from evolving into avoidant and dependent personality disorder. Selective mutism is a behavior that is very observable at an early age. The Berent Method of Treatment for selective mutism is parent -focused. Parents learn how to empower their children via non-enabling strategies while teaching emotional intelligence. The Berent Method has been designed to adapt therapy to the specific needs of the problem vs. attempting to fit the problem into the narrow confines of a specific therapeutic modality.
One of the biggest challenges in healing for one who is afflicted with social or performance anxiety is negotiating the defense mechanism of detachment. Detachment is the dynamic and process of disconnecting from thoughts, feelings, and behavioral challenges. Detachment is the gateway to avoidance. When you put this dynamic under the microscope so to speak, there is an element that precedes and breeds detachment. This is the mechanism of “ignoring”. In my working with thousands of anxiety sufferers I have encountered many manifestations of this insidious, complex, and ingrained phenomenon.
Detachment is an adaptive response designed to ward of uncomfortable and anxiety provoking thinking and feeling so that the sufferer can feel safe in real time. The problem with detachment is that it inhibits emotional intelligence, paralyzes skills acquisition, as in learning to control adrenaline, and adds to the non -conscious content in one’s emotional reservoir which recycles and drives the anxiety and panic. A major and profound example of detachment is the over-use and dependence of technology as in video games. Clinically this compulsion of technology over -use shuts down the neural pathways needed for verbal communication. Another example is the 30 year old struggling with pervasive social avoidance who described her compulsion of playing old radio songs in her head to detach from the pressure of interaction. She called her compulsion “radio head”. A high powered attorney architected a career and overall lifestyle that was so obsessively busy that he never had time for thinking or introspection. He said in session “I hate thinking about this stuff”, but he was in treatment for his public speaking panic. Henry, the 8 yr old featured in the following recording, responded with “I think of flying pop tarts” in response to my question “what do you think about when you detach from anxiety”. This was a very advanced interaction in his therapeutic process. Think of it! An 8 year old understanding the concept to answer the question. It is a sign of core healing and the development of emotional intelligence with was the result of The Berent Treatment Method for Selective Mutism. While the parents laughed at his response they did understand the importance of the issue.
The following is a processing session with Henry and his mother. This occurred at session #15 of treatment, which was in the final stage. Please keep in mind that each patient or family has their own learning curve which is dependent on a number of variables. Listen to the high performance and outstanding way this 8 yr old was able to discuss thoughts and feelings.