From Performance Anxiety & Selective Mutism to School Shootings & Suicide
The Perfect Storm of Anxiety Builds Momentum in the Educational System Although anxiety disorders are the most common mental illnesses in the United S... Read more
According to The DSM 5, selective mutism is defined as “a consistent failure to speak in social situations in which there is an expectation for speaking despite speaking in other situations.” Also, according to The DSM 5, “selective mutism is a relatively rare disorder with onset usually before 5 but the disturbance may not come to clinical attention until entry into school.”
Social Anxiety: The Untold Story contains approximately 3 hours of state of the art and science self -help for selective mutism. In compulsion it includes rare interviews with children, teens, adults, and families who have resolved the disorder.
Experience at Berent Associates with thousands of anxiety sufferers since 1978 can help facilitate a functional understanding of this disorder and productive treatment.
While selective mutism is mostly understood as a speaking phobia, it is specifically a variation of obsessive-compulsive disorder. Obsessiveness refers to the cognitive or thinking component of worry and anxiety. The compulsion is the verbal shutdown or muteness. In essence, the mutism is driven by the obsessive compulsive mind. In his article “Obsessive-Compulsive Personality Disorder as Etiology for Performance Anxiety,” Jonathan Berent. describes how perfectionism drives performance and social anxiety. This article is highly relevant for selective mutism sufferers of any age.
Clinical experience has demonstrated that selective mutism is not so rare. The statistic that says seven out of one thousand children have it does not provide the full picture: In fact, countless adolescents and adults also suffer from variations of this disorder. Many individuals who initiate treatment for public speaking anxiety at Berent Associates have self-identified as having selective mutism. Jonathan Berent says the most common thing he has heard from patients during almost 40 years of clinical experience is “I do not have anything to say” or “I do not know what to say.” This self-censoring is a component of selective mutism.
Selective mutism impacts individuals of all ages and functioning levels. Many individuals with selective mutism are intellectually intelligent. Selective mutism, however, is a symptom that characterizes a substantial void of emotional intelligence.
The most common mistake that well-intentioned parents and professionals make when engaging the socially anxious or selectively mute child is to invest in the belief that “the child is just shy and will grow out of the problem.” The second biggest confusion is the misunderstanding regarding how ingrained the psychophysiological (mind-body) reflex becomes. The third most common confusion is when the parent says something like “My child only does not talk in school.” While school does usually present the most performance anxiety for the child with selective mutism, objective scrutiny, in most cases, will identify a pattern of verbal shutdown elsewhere. In most, cases selective mutism accrues and becomes more ingrained with time. It is an obvious precursor to avoidant and dependent personality disorder.
There is a silver lining to selective mutism. Given that it is identifiable at an early age, it presents an opportunity to get control of a complex and insidious problem before it works its way organically into emotion and behavior. Parents can have an enormously empowering influence with productive intervention as early as possible.
I believe I have interacted with more individuals with avoidant personalities than anyone in the world! I’m neither bragging nor complaining. It’s just a fact: It’s my job. As a psychotherapist with more than 35 years’ experience specializing in social anxiety—which is commonly comorbid with avoidant personality disorder—I have treated thousands of people with this issue. The overlap between social anxiety and avoidant personality disorder is clear, with avoidant personality disorder involving “more severe and broader areas of personality dysfunction than social [anxiety].” Indeed, the Diagnostic and Statistical Manual of Mental Disorders-5’s identifies social anxiety as a distinguishing characteristic of Avoidant Personality Disorder: “Anxiousness: Intense feelings of nervousness, tenseness, or panic, often in reaction to social situations; worry about the negative effects of past unpleasant experiences and future negative possibilities; feeling fearful, apprehensive, or threatened by uncertainty; fears of embarrassment.”2 Avoidance results when these feelings become so intolerable that the person goes to often extreme measures to avoid the situations in which they may occur. As the fear of embarrassment, humiliation and shame increases, the person enters into an avoidance vortex from which they feel like they cannot escape. Narcissistic behavior results, dominating their decision making and behavior. I have often referred to avoidant personality as a compulsion because the behavior is so ingrained.
Avoidant personality disorder occurs in an estimated 5.2 percent of the U.S. population annually.3 Social anxiety disorder occurs in 6.8 percent, and within that 6.8 percent, almost 30 percent of cases are considered severe.4 Much academic research exists on the comorbidity of social anxiety and avoidant personality disorder; but very little is available to explore the compulsive nature of avoidance. Therefore, I would like to shed some light on the avoidant personality for the benefit of both clinicians and those who are themselves afflicted with this frustrating and debilitating disorder. After all, individuals with avoidant personality are quite skilled at avoiding, which means that (1) the mental health profession as a whole may have limited access to this group and (2) avoidant people themselves may have found few resources out there to help them recognize their own tendencies and relate to others who share them.5
The Perfect Storm of Anxiety Builds Momentum in the Educational System Although anxiety disorders are the most common mental illnesses in the United S... Read more
Three Crucial Points for the Treatment of Adult Selective Mutism An estimated 1 in 700 children have selective mutism (speaking phobia), but adult num... Read more
Having worked with over 10,ooo individuals of all ages with social and performance anxiety since 1978, the most common statements I’ve heard have been... Read more
Mikey age 7, an intellectually gifted child, never spoke in school. The school recommended speech therapy. This proved useless as the problem was sele... Read more
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