Selective Mutism Is The Rarest, ‘Misunderstood’ Anxiety

In the UK, an estimated eight million people are living with anxiety at any given time. But not all types of the condition are equally common.

According to the Cleveland Clinic, for instance, about 7% of the US population experiences social anxiety. Selective mutism, meanwhile, is “the least common anxiety disorder”, affecting somewhere between 0.47% and 0.76%.

HuffPost UK spoke to BACP-accredited therapist and anxiety expert, Kamalyn Kaur, about the phenomenon.

This “is an anxiety disorder whereby someone is unable to speak in certain situations, despite being able to speak comfortably in others,” the therapist said.

“For example, a child may talk freely at home but be unable to speak at school, or an adult may struggle to speak in particular social or professional settings but be absolutely fine when with close friends.”

Kaur stressed that even though people with selective mutism can speak freely in some situations, that doesn’t mean they’re choosing to stay silent in others. They might desperately want to talk, but their ability to do so is hampered by anxiety.

• Not being able to talk in situations that make the person with selective mutism feel anxious, vulnerable, and exposed,
• Freezing or becoming very still,
• Avoiding eye contact,
• Difficulty responding, even non-verbally,
• Appearing withdrawn or expressionless,
• Intense fear of being judged or drawing attention to themselves.

When we asked Kaur whether she thinks the condition is misunderstood, she replied: “Yes, I think it often is.

“Selective mutism is less widely understood than conditions such as generalised anxiety or panic disorder, and it can be mistaken for shyness, defiance, rudeness, or simply a lack of confidence,” she added.

“One of the biggest misconceptions is [due to] the word selective, which can make it sound as though the person is consciously choosing when not to speak. In reality, the inability to speak is often… outside their control”.

Accepting you have the condition and trying to remove the pressure to “just speak more” is a great start, the anxiety expert said.

“In fact, telling someone to ‘just speak more’ can be some of the worst advice, as it minimises the condition and can make the person feel inadequate… For someone experiencing selective mutism, it isn’t that simple; their inability to speak in certain situations is driven by anxiety, not a lack of willingness or effort.”

Treating selective mutism can begin with professional therapy, which could be useful in identifying the anxiety behind the behaviour.

Other helpful tools might include understanding your triggers and anxiety patterns, trying manageable, gradual, expert-led exposure therapy, cognitive behavioural approaches, and confidence-building.

“The key and important thing to remember is not to pressure, shame or punish someone for being unable to speak, as this can increase anxiety. Creating a sense of safety, a non-judgemental space, and gradually expanding communication is generally much more helpful,” Kaur ended.

In general, “Greater awareness is important because when selective mutism is recognised early and responded to with understanding rather than pressure, people can receive the right support and avoid years of misunderstanding (and labelling).”