Mutism In Adults: When Anxiety Leads To Silence…

Last updated by Katie M.

We rarely see adults not speak if they’re physically capable of doing so. This is called mutism! I’ve always been used to this pathology, as a member of my family has selective mutism. If it’s not something that surprises me, I know that outside of my family circle, it’s perceived as something surprising. How does this speech disorder manifest itself? What is its origin? How can mutism be treated? All will be explained.

Mutism In Adults: When Anxiety Leads To Silence…

What’s the definition of mutism?

Mutism can be confused with problems related to deafness, but a person who doesn’t speak has no problem hearing. It’s actually a suspension or disappearance of speech in a person who can speak, there’s no physical problem. It is found in children and adults. Furthermore, it’s considered as a psychopathology, as it most often reflects a generalized anxiety.

The forms of mutism

There are two forms of mutism: total mutism and selective mutism. We may also hear about akinetic mutism, but this is a physical problem, which doesn’t come under the heading of a psychological pathology. Akinetic mutism is an inability to speak because of muscle inertia.

However, for the two other forms of mutism:

👉 Total mutism: As its name suggests, there’s no form of speech. This can last from a few days to several weeks. In most cases, the person begins speaking again by whispering.

👉 Selective mutism: Very often, the child or adult with selective mutism doesn’t speak to strangers, but only to family members. Whispering is also part of their speech pattern.

The source of mutism

As I mentioned, selective or total mutism is caused by an anxiety disorder. However, it may also be related to an emotional shock or a traumatic event. Mutism may be associated with a form of autism like Asperger’s syndrome, but it’s not necessarily related. Many people confuse mutism and autism, but the treatment isn’t the same. It’s also important to look for a real communication disability, such as dysphasia (a neurological disorder related to speech).

➜ Not all causes of mutism are known, but specialists say there is usually a factor related to family history or a phobia, which leads to an anxiety disorder or post-traumatic stress.

The special case of selective mutism

Selective mutism can be confusing for others, and I’m speaking from experience. Sometimes the person is completely mute and one minute later, they turn into a chatterbox. It depends on the social contexts the mute person finds themselves in. If there’s a stranger, no words will come out, but as soon as the stranger leaves the room, the mutism disappears.

As there is anxiety caused by the context, there are particular behaviors that appear: the child or adult turns a “deaf ear”, they have a blank stare, don’t look at the person speaking to them, and express themselves with head or hand movements to communicate.

➜ A person with selective mutism may also have a social phobia and may have difficulty separating themselves from their family.

Selective mutism in adults symptoms

Selective mutism is a social anxiety disorder characterized by a persistent inability to speak in specific social situations, even though the person is able to speak normally in other contexts. Although selective mutism is often associated with children, it can also occur in adults. Here's a list of potential symptoms of selective mutism in adults:

  • Inability to speak in specific social situations, such as business meetings, social events or interactions with less familiar people.
  • Tendency to remain silent or to communicate only by non-verbal means (for example, by nodding, using gestures or writing).
  • Feelings of anxiety, intense fear or panic at the idea of speaking in trigger situations.
  • Preservation of mutism despite efforts to speak, even when the person wishes to communicate verbally.
  • Social isolation or avoidance of social situations where speech is expected.
  • Increased sensitivity to negative evaluation or criticism from others.
  • Other symptoms of social anxiety, such as muscle tension, palpitations, excessive sweating or breathing difficulties.
    Significant impact on daily life, including personal relationships, studies, work or other social areas.

It's important to consult a mental health professional, such as a psychologist or psychiatrist, for a proper diagnosis and appropriate support if you think you have symptoms of selective mutism, or if you know someone who does.

How to treat mutism

Mutism in children can greatly affect all areas of their lives, but it’s even more so for adults, who will find it hard to maintain social ties. The consequences on their lives can be disastrous and lead to social and professional disruption, and even loneliness. Moreover, for those unaware of the problems of mutism, it can be very difficult to understand from an outside perspective. The latter consider mutism to be strange, and it’s very misunderstood. That’s why it should be treated as soon as possible in order to avoid such repercussions.

Cognitive and behavioral therapy: the solution

So, how can mutism be treated? You should seek help from a psychologist and begin cognitive and behavioral therapy. It’s very suitable in the case of anxiety, which is the cause of mutism. The therapist will suggest specific guidelines to progressively reduce the level of discomfort experienced by the mute patient. The behavior will gradually change, and the anxiety will decrease. It’s also possible to consider two other types of therapy if CBT doesn’t work or if the original problem is different:

  • Systemic therapy to work on changing the dynamics of different types of relationships (for example, family therapy).
  • EMDR therapy to work on a traumatic event that may have triggered the mutism.

How to help a person with mutism?

This is the question I asked myself some time ago: how can I help? Foremost, it’s vital that you never rush the person suffering from mutism. Otherwise, they’ll dig their heels in and the anxiety will increase. Moreover, we need to take the initiative to inform as many people around us as possible to avoid complicated social situations and derogatory remarks.

If it’s a child, it’s crucial not to force them to speak. If there is some progress, you also shouldn’t be too enthusiastic to avoid marking the difference. You also need to be able to provide psychological support to see if there are any other related disorders or more complex problems.

➜ If it’s an adult, the work is more complicated. You shouldn’t make them feel different from others because they will tend to lock themselves away in their mutism even more. If they talk to us, it’s good to take the anxiety “angle”. For example, I’ve never spoken to the mute person in my family about their speech problem, but more about their anxiety symptoms. I also talked about my experience and my own anxiety to make them feel less guilty and make them understand that it’s possible to seek professional help to successfully free yourself from your anxieties. You need to accompany them gently and offer your help without ever forcing them, by putting into perspective the solutions that can free you of mutism.

Editor’s note: Very effective therapies

Mutism is a sign of generalized anxiety or a response to an emotional shock. It’s therefore
essential that you contact a psychologist quickly in order to treat the root of the problem. CBTs are very effective for this type of pathology, don’t wait to make an appointment.

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Thank you for writing this article. As a 71 yr old man that has been dealing with childhood abuse issues all my life this article helped me tremendously. I have struggled with mutism since I was a child. You're article opened my eyes that at times I still struggle with being mut...highly stressed situations with others. Thank you! Mike

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