Selective Mutism In Adults: Symptoms, Causes, And How It Is Treated In Therapy
Selective mutism is an anxiety disorder in which a person who suffers from it is not able to speak in specific social situations; However, in others, these people are able to speak and communicate completely normally, being completely functional.
This disorder normally develops during childhood and tends to disappear in adolescence or adulthood; However, some cases have been detected in the adult stage. Selective mutism in adults has diagnostic criteria similar to those found in childhood, so in this article we will include those that appear in the DSM-5.
In this article we are going to explain What is selective mutism in adults? and for this it is important that we see what the main diagnostic criteria are and also the symptoms, as well as its etiology or the possible causes of its development.
Selective mutism in adults presents diagnostic criteria quite similar to those that occur in childhood since the international diagnostic manuals do not contemplate the classification of this disorder independently of that which develops in childhood, which is when it usually develops in most cases.
Selective mutism, according to the Diagnostic and Statistical Manual of Mental Disorders DSM-5, is made up of the criteria that we are going to discuss below.
The basic criterion would be that there had been a consistent failure to speak in those particular social situations in which there is an expectation to speak (e.g., when speaking to a group of people who have just been introduced to that person), even though in other situations that person is capable of doing so (e.g., when speaking with friends or family).
Another of the criteria that a case should meet to make the diagnosis of selective mutism is that the alteration interfere with academic and/or work achievements (more common in the case of selective mutism in adults) or in social communication.
Furthermore, the duration of the previous criteria should be at least 1 month so that we can consider the diagnosis of selective mutism in adults and, of course, in children and adolescents.
On the other hand, the fact of not being able to speak in those contexts that we had mentioned in the first criterion cannot be attributed to the lack of knowledge of the spoken language required in the social environment in which the person operates.
Notably This alteration could not be better explained by the existence of a communication disorder and it does not occur exclusively during the course of schizophrenia or another psychotic disorder, nor does it occur during the course of an autism spectrum disorder.
What are the main symptoms of selective mutism in adults?
Now that we have seen what the main diagnostic criteria for selective mutism are, it is time to explain what are the main symptoms that should be taken into account when detecting, evaluating and/or diagnosing a possible case of selective mutism in adults.
Some of The main symptoms or warning signs of selective mutism in adults They are the ones we are going to list below:
Possible causes of selective mutism in adults
Regarding the possible causes of selective mutism in adults, it is worth mentioning that there could be a series of hereditary or genetic factors shared with other conditions such as social anxiety disorder or social phobia. Furthermore, some studies have observed some environmental and temperamental risk factors that could influence the development of selective mutism in adults. Some of these possible causes are what we are going to see below:
Psychotherapy treatment
When addressing anxiety disorders in therapy, which would include selective mutism in adults, The most common thing is that psychological therapy and also psychopharmacological treatment are chosen because both treatment modalities have been effective in this type of disorders.
However, psychological therapy has proven to be more advantageous compared to the use of psychotropic drugs by presenting better long-term results, as well as a lower relapse rate and the absence of side effects. That is why below we will explain the most used techniques in psychological therapy to address anxiety disorders.
Before explaining the different psychological techniques most used in therapy for selective mutism, it is worth mentioning that it is important to start by identifying the specific symptoms presented by the patient with whom we are going to work in therapy in order to know what the symptoms are. and signs it shows. Psychoeducation should also be used to explain to the patient what the techniques that will be applied during the therapy sessions consist of, as well as those factors that influence the maintenance of selective mutism and what its causes are.
1. Relaxation training
One of the most used techniques for the treatment of selective mutism in adults is relaxation training, which could include breathing exercises, attention management exercises, and/or progressive muscle relaxation training exercises. The latter is the most popular and basically consists of carrying out a series of tension-distension exercises of various muscle groups gradually, in order to achieve greater control and perception of muscular sensations, as well as relaxation. of the different muscle groups voluntarily.
It should be noted that progressive relaxation training has turned out to be a very valid option for the treatment of a large part of anxiety disorders, both when used individually and when applied in conjunction with other psychological techniques and/or therapies. .
You may be interested: “6 easy relaxation techniques to combat stress”
2. Social skills training
Another of the psychological techniques that is most commonly used for the treatment of selective mutism in adults is social skills training. This technique can be used individually or in conjunction with other genetic techniques framed within the cognitive-behavioral therapy model in order to improve the quality of the patient’s communication, their interpersonal and relational relationships, as well as to increase the repertoire of behaviors that are suitable depending on each social situation.
Social skills training includes techniques such as reinforced rehearsal of behaviors useful for various situations in order to improve the patient’s behavioral repertoire, modeling by the psychotherapist, and also homework assignments so that the patient patient reinforces the learning developed in therapy. This can also be complemented with other techniques such as cognitive restructuring, successive approximation, behavior analysis and vicarious learning, among others; being very useful for both selective mutism and social phobia.
Related article: “The 6 types of social skills, and what they are for”
3. Live exhibition and/or in imagination
Among the main techniques used within the psychological treatment for selective mutism in adults we can also find exposure, which can be both live and in imagination, through which the patient should come into contact with those situations that cause anxiety until that associated anxiety is significantly reduced or ends up disappearing.
In this case, the feared stimulus to which the person should be exposed would be those social situations in which it is impossible for them to speak. This exposure is usually carried out gradually (e.g., starting with exposure in imagination during therapy sessions and/or through homework) until, finally, the person is exposed to the feared real stimulus or situation ( (e.g. exposing yourself to situations where it is very difficult or even impossible to talk to other people).
Notably When applying exposure training, the person can previously resort to some relaxation technique, such as progressive muscle relaxation, before exposing oneself to the feared situation. In this case we would be using a widely used psychological technique known as systematic desensitization.
