Toward a Resolution of Selective Mutism:
Understanding Obsessive Compulsive “Syndrome”

It’s relatively easy to identify the child immersed in a world of verbal inhibition and shutdown. Think about it. The more the child is mute, the more the child stands out in any social environment. This objective reality is in opposition to the child’s belief that they are more unobservable when mute. It’s easy to think of the verbally shut down child as “shy”. It’s easy to think of this child as having a talking problem. It’s easy for schools to respond to the challenge with speech therapy, which in most cases, is not productive.

It’s a lot harder to understand the inner workings of such an individual, which is a complex integration of physiology, behavior, thought, and emotion. Think of FATE. F= function (physiology), A = action (behavior), T = thinking (cognition), E = emotion. It was not the tip of the iceberg that sank the Titanic. It was the ice below the surface that sank the ship. While talking is a behavior that needs to be nurtured for the selectively mute child, understanding selective mutism as a symptom of obsessive compulsive syndrome, in my clinical experience, is crucial for effective treatment and resolution of the core issue. Obsessive compulsive “syndrome” includes dynamics of both obsessive compulsive disorder and obsessive compulsive personality disorder.

The person afflicted with obsessive compulsive disorder relies on repetitive-ritualistic behaviors (compulsions) to relieve obsessions (unwanted distressing thoughts that won’t go away). Unfortunately the compulsions are part of an endless cycle of thoughts and behaviors to no-where. In the case of selective mutism the cognition and emotion of worry and anxiety trigger the verbal shutdown of mutism (compulsion). Add to this an evolving sense of toxic perfectionism and excessive rigidity, which are primary characteristics of obsessive compulsive personality disorder, and you have a perfect storm for anxiety.

Perfectionism deprives the sufferer of happiness and success. The dynamic of “good enough” is never good enough. This morphs into perfectionism which is a symptom of insecurity. This dynamic occurs in all developmental stages and becomes more ingrained over time. The “never good enough mentality” creates tremendous emotional pain and becomes content for an avoidant and over-dependent psyche.

OCPD is “toxic perfectionism.” It is designed to stave off feelings of intense anxiety caused by fear of being scrutinized or judged. “If I am perfect, no one will know I am nervous.” “If I am not perfect, I will be humiliated by the focused attention on me.” The avoidant psyche refers to individuals of all ages impacted by selective mutism. In fact, the specific driving force behind much public speaking anxiety, in formal and informal scenarios, is often selective mutism -based content such as thoughts and beliefs like “I have nothing to say” or “I don’t know what to say”. In essence the individual is being censored by his or her internal critical script. For information on performance anxiety and the internal critical script click here. Consider the human resources consultant who never spoke at her weekly team meeting where 20 people were positioned around a table. She told me obsessively; over and over in treatment sessions “she had nothing to say”.

Typically the young child who is immersed in the distress of selective mutism is enabled by care-givers. Unintentionally; caregivers mistake “nurturing” for “rescuing” as it can be excruciatingly difficult to witness the child imprisoned in the selective mutism moment. The verbal freeze of the selectively mute child can create uncomfortable and confused emotions for parents, teachers, and mental health professionals. The interview “Mother Resolves Break Your Heart Syndrome to Cure Selective Mutism” can add insight into this dynamic.

The Berent Method teaches parents of children with selective mutism to access the under-used neural pathways required for verbal performance. Treatment utilizes the leverage of the parents to nurture children through the insidious, complex, and ingrained avoidance-dependence-anxiety dynamic.