Selective Mutism in Therapy

The therapist I saw in college, having found me to be reticent on nearly every topic, encouraged me to express myself through visual art. She didn’t often give me assignments but instead preferred to let me draw what I wanted and bring my sketchbook to her each week. We’d talk about my creations and what emotions they evoked, and if we both were lucky, I’d expand on the state of my depression and suicidal thoughts. It was a fairly effective way to bypass my verbal barrier, as long as I felt confident in my artistic creations.

One week, while I was showing her my sketchbook, she exclaimed softly in reaction to one of the pages. It was just a little, “Oh!” but it triggered an avalanche of anxiety inside me that blocked off my ability to speak. I started to cry and hid my face with my hands. She asked me what was wrong, but I couldn’t answer. It was like I was trapped inside myself, all my words perfectly accessible in my mind — but incapable of being moved across my lips.

My therapist’s exclamation called attention to a drawing I was already anxious about revealing. It was a simple drawing of the materials I used to harm myself. I had found it nearly impossible to talk about my struggle with self harm, but it was an issue I wanted to work on, so I tried to initiate the discussion with a drawing. It backfired tremendously.

I felt strange – like everything was unreal and far away. I wanted to tell my therapist that I was trying to start a conversation with the drawing – even just to say I felt anxious – but I couldn’t. I felt acutely separated from everything around me and yet intensely aware of my therapist’s attention. I could feel her gaze on me, as if it were exerting physical pressure that made me want to crawl behind the couch and disappear.

My therapist sat with me for quite a while until I regained the ability to speak. I remember commenting on how strange that little episode was, saying that I wasn’t sure what had just happened. She agreed, perhaps not wanting to poke at me when I’d only just returned to verbal communication.

In hindsight, I was new to therapy and didn’t yet have the words to describe my intense anxiety, and I didn’t have the insight to trace incidents like that all the way back to my earliest memories. I’ve always had a problem with being put on the spot and asked to speak in front of people, but I’d minimized that issue in my mind.

I’ve since done a lot more therapy and introspection and am learning to connect the dots. A separate, more recent incident in which I found myself unable to speak led me to do a Google search for “inability to speak under pressure.” That Google search and a conversation with my current therapist have led me to believe that the likely explanation is selective mutism, an anxiety disorder characterized by silence in certain situations that trigger intense social anxiety.

The Beginnings of Selective Mutism

When I was very young, I remember feeling like being silent was the safest action, and if I could just outlast whoever was trying to interact with me, they’d give up and go away – and they usually did. I don’t think my silence was ever a choice, but it aligned more closely with what I wanted when I was young. It was like the expectation of speech created a vacuum around me that was impossible to fight. So I embraced it as a strategy for dealing with painful self-consciousness. I simply shut down.

But as I grew older, I became frustrated with my mental barrier. I recognized that speaking would make the painful attention go away faster – that being silent was attracting more scrutiny and prolonging the anxiety. But I couldn’t seem to break through when I wanted to. I could speak at home, and I could speak to my friends. But around strangers or when put on the spot, my words were locked away.

I’m not sure how, but I made progress. Perhaps I grew out of it to some degree. I got better at tolerating being the center of attention. For the most part, I function just fine now. I can even give presentations without shutting down. What seems to trigger selective mutism in my adulthood is the combination of being the center of attention and feeling shame or embarrassment. If I feel like I’ve done something wrong in my place at the center of attention, either by making a mistake or making a scene, I reach a level of social anxiety that punches me into my own little void.

Present-Day Therapy

Therapy is one arena where shame and embarrassment often come up, and as the client, you’re almost always the center of attention. I’ve practiced talking about the things that make me feel vulnerable and self-conscious enough that for the most part, I do okay now. I talk for most of my sessions, which is a huge improvement. But I had many sessions where I’d reach my limit and stop talking or we’d stumble into a topic that suddenly silenced me. It was very distressing. I’d be thinking a million things at once, trying to get myself to just spit out one of them. Sometimes, my therapist would rescue me and fill the silence. Other times, she would wait.

I would go home and write down everything I couldn’t say out loud and send it to her in an email. Two years ago, I wrote to her about therapy, saying, “…when I get there, I lose the ability to speak. It’s like every week, I have these big hopes that I’ll just sit down and say things and it’ll be easier. And then I sit down and remember I’m me. I have made progress, but the worse I feel, the harder it is to override my silence. […] It feels like I’m just incapable of speaking openly, like I send the words out from my brain and they hit some kind of barrier at my mouth. I don’t know how to fix it, but I’d like to.”

At some point, I figured out that I could break through with a fun fact. My intention was to distract and bamboozle with a stunning tidbit about the biology of scallop eyes or some other interesting concept. It never worked, but I did discover that I could say something when I felt like I couldn’t. There was potential. The longer I go in silence, the harder it is to speak. If I can say something – anything – I sort of reset the clock, and it’s easier for me to get subsequent words out.

Introversion and Selective Mutism

I’m glad that somewhere along the way, I learned how to get my words out in therapy and in life, but I wish I’d known that there’s a term for what I was experiencing. It’s comforting to be able to recognize and label an issue I’d never understood as selective mutism. I’ve always chalked my general quietness up to extreme introversion, but that label never seemed to explain my occasional inability to speak. Now that I know about selective mutism, I think I’ll be a bit gentler with myself when social anxiety crops up.

Somehow, the fact that I experience social anxiety has been quite a recent realization. I knew I was very shy as a child, but I thought that I magically overcame that. Maybe it was wishful thinking. I’ve always worried that my quietness might be interpreted as aloofness, and I’ve been told I’m quiet so often that I’ve developed a little shame pearl – layers of practice to cover up the sharp edges of my grain of silence. Talking is expected, and if I don’t meet that expectation, I feel guilty. As if my lack of social grace might make someone else uncomfortable or ruin their time in some way.

I think I’ve learned to operate in social situations so seamlessly that I forget how much effort I’m putting into them. I feel somewhat adept at socializing, but only because I’m constantly monitoring my own facial expressions and trying to match others’ body language so that I appear comfortable. The rules of conversation – the progression of topics and little linguistic customs – are old hat to me now.

I still default to quietness, which frustrates me sometimes. I’ve often wished I were outgoing and talkative and tried to will myself to be different. I didn’t recognize the legitimacy of what I experienced as a kid or that I’ve been working against it this whole time. I thought I was fighting what I saw as a flaw in my personality. It seemed the introversion was to blame and that if I could just overcome that, navigating the social landscape would be easy and enjoyable. I’ve come to realize that, while I am highly introverted (and it’s not something to be overcome), there’s an additional factor in the form of social anxiety.

Teasing apart introversion and social anxiety is sometimes difficult, so knowing when to let myself hang back and when to challenge myself isn’t always clear. I push myself to talk and engage in conversation, but I’m also working on accepting and appreciating my quiet nature.

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