Psychogenic mutism, which is also referred to as selective mutism, is mutism without any apparent physical cause.
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 usually centres 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-
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.