I am situationally mute. For anyone that isn’t aware of what that is, it simply means that in certain situations, places or around certain people I don’t want to and often literally cannot speak.

Silence is Golden

Medically (and perhaps better known to most) it is known as Selective Mutism which is not really an accurate description of what’s going on. “Selective” implies we choose when we speak/don’t speak when that simply isn’t the case. (I suppose it could mean our brains select when we go mute without our say so but that’s a reach). “Situational” is much more accurate as it does actually depend on the situation, for instance, when surrounded by new people or a crowded area I will most likely lose speech or find it so much harder to speak [NOTE: I can, if I force myself, make myself speak in such situations through masking but it will drain so much energy from me and will often lead to high anxiety/anxiety attacks or burnouts/meltdowns/shutdowns as a result, all of which could be avoided by just letting me stay silent]. 

For people that don’t experience situational mutism, it’s hard to describe how it truly feels. I guess the closest I can get is by saying that it feels like you’re told you can’t say something but you’re so eager to or how, even if you want words to come out, someone has sewn your mouth shut. So there are times I physically can’t speak from fear of my environment and there are times where I have no energy to get words out and not everyone understands that.

It can be quite disabling to not be able to speak and I’ve found it difficult to communicate in other ways to people in such situations as job interviews or even just to family without seeming rude. Phone calls/video chats can also be very restrictive as I find both extremely difficult, choosing to avoid most phone calls unless with a family member (and even then I would rather text unless in a surprisingly chatty mood). This can be very limiting considering so many things require you to make phone calls in order to access something or find out information ie appointments with doctors, interviews, insurance claims etc. I always get a huge sigh of relief when I see a text chat option on a website but that is hardly there for most companies/services. Among other reasons, I even stopped taking medication a few years ago due to the very fact that I had to call the doctors to ask for a new prescription and that simply was not possible for me to do, showing just how inaccessible day-to-day things can be for me simply because of mutism.

Silence is Golden

Situational mutism – the temporary loss of your ability to use spoken words – is often associated with high levels of anxiety: something that many autistic people experience when engaging or attempting to engage with medical appointments. In one recent study, for example, 78% of autistic adults reported that ‘anxiety makes it harder to communicate’ with healthcare providers1.

In addition, for many autistic people, becoming overwhelmed by “too much information” (sensory inputs, pain, verbal information, social stimuli, etc.) can lead to a reduction in their ability to speak in a given moment. Situational mutism may begin gradually: with slowing or slurred speech or with individuals relying more heavily on formulaic social scripts. They may become increasingly silent and non-responsive, or you may meet your autistic patient at the point when they have already lost their ability to speak by the time they see you.

More than words: supporting effective communication with autistic people in health care settings

Medical Model – ‘Selective’ Mutism

• “a severe anxiety disorder where a person is unable to speak in certain social situations” – NHS definition
• NHS states it usually starts in childhood (2-4 years old)
• The cause is not truly known but regarded as a phobia of talking to certain people, associated with anxiety
• Claims that with treatments (ie. speech therapy, Cognitive Behavioural Therapy or anxiety management) someone is able to ‘overcome selective’ mutism

Social Model – ‘Situational’ Mutism

• “Situational” is preferred over “selective” as you do not ‘select’ or choose when to be mute, it all depends on the situation (person, environment, scenario etc)
• A neurodivergence, NOT a disorder
• it is a communication difference, not a mental illness
• Anyone at any age can experience situational mutism but there is a main focus on children

Autistic situational mutism: Ben & Libby educate Aucademy on Vimeo

The thing about SELECTIVE MUTISM that non-autistics could learn from, is that It is usually a situation that is anxiety-provoking, that causes it. Part of our brainpower goes toward managing the anxiety we feel, which interferes with our ability to answer questions or have a dialogue. As a general rule, high levels of anxiety are detrimental to task performance (Yerkes & Dodson, 1908). So instead of putting us on the spot, consider giving us time to collect our thoughts and calm down if we feel stressed.

For me, phone calls are especially hard, and more so when not planned/unexpected. I usually won’t answer, because there’s little point in doing so, if I know my limitations. Ask us, and remember that one size does not fit all.

This is even more relevant within clinical/care settings, where if we don’t abide by herd rules, we’re either excluded, forgotten about, or chastised. Remember one thing, it’s not that we don’t want to talk; it’s that we can’t. Thank you.

@Clara_MdB

Selective mutism (SM) is described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM-IV) and Fifth edition (DSM-5) as a rare anxiety disorder, characterized by a consistent failure to speak in specific social situations in which there is an expectation of speaking, despite speaking in other situations^1,2 (Americal Psychological Association 1994; 2013).

Communication patterns in SM vary from total absence of speech in almost all situations to lack of speech in only certain situations. The most common situations for the appearance of SM symptoms are in school, where the teacher is the person that the child is least likely to talk to.⁵ Sometimes the child can talk to select students, sometimes to nobody at all. Commonly, the child speaks normally at home with the family, but the opposite situation, where the child speaks at school but not at home, has also been described.⁶

Onset of SM symptoms is reported to be 2.7–4.1 years.⁴ Usually, the symptoms are not noticed until the child starts primary school, which might be explained by the increased social demand and increased demands for performance, making the symptoms more obvious.³ The long interval between symptom onset and detection of problems is probably explained by the fact that children often speak without any problem in the home environment.

Children with autism spectrum disorders and selective mutism

Selective Mutism (SM) is a childhood behavioral disorder characterized by persistent failure to speak in specific social situations despite speaking in other situations.

There is a general consensus that SM is closely related to social anxiety disorder, with an increasing conceptualization of SM as a developmental variant of social phobia (Bogels et al., 2010; Yeganeh, Beidel, Turner, Pina, & Silverman, 2003). Evidence to support the link between SM and social phobia is derived from multiple sources. For one, numerous studies report comorbidity rates approaching or greatly exceeding 50% (e.g., Alyanak et al., 2012; Arie et al., 2006; Manassis et al., 2007), with some co-occurrence rates greater than 80% (Dummit et al., 1997; Vecchio & Kearney, 2005). Additionally, several investigations have revealed that parents of children with SM have elevated rates of social phobia (Black & Uhde, 1995; Chavira, Shipon-Blum, Hitchcock, Cohan, & Stein, 2007).

Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study

Growing up i thought of myself as the bad kid because that’s how many people saw me. I was hyper active and loud and had trouble sitting still and I stimmed a lot. I often acted out because i wasn’t really able to communicate even though i could speak, though I was not trying to be bad. I couldn’t tell the teacher if i was falling behind, or that i was having trouble understanding the material. I struggled a lot and did the best i could but i would often become stressed and overwhelmed so I would shut down. Which caused me to fall even further behind. So I stopped doing homework, it was way to frustrating and overwhelming for me. I couldn’t just raise my hand and say i needed help, or ask anyone for help when i couldn’t even manage to put into words what was wrong and what it was that i didn’t understand about the materials so i ended up falling behind. I couldn’t explain that sitting in class with the fluorescent lights was overwhelming or that the pencil was hurting my hand or that the teacher was going to fast. I couldn’t tell them I hated writing when I would try to write one thing but my hands would write another or completely mess up the word. Which was likely related to disconnect which made speaking so hard.. So everyone saw me as the bad kid, and this is how i grew to view myself. I know now this was not the case. I wasn’t a bad kid, I was a child desperately trying to be heard when everyone was assuming they were hearing all i needed or wanted to say.

Typed Words, Loud Voices: A Collection – Autonomous Press

Further reading,