Family Secrets: Childhood Sexual Abuse

30f6cf470f2d828e104d054e6a86f77bSpeaking with a young woman today, I heard a story I have heard far too many times.

This woman had been sexually abused as a child by a relative, but didn’t say anything out of fear and embarrassment. This relative went on to molest other children in the family until someone finally spoke out.

I’ve spoken to many individuals in the past who were molested by a family member and didn’t say anything not only out of fear and shame, but also because they thought that as long as the molester was perpetrating on them, he would leave their younger brothers, sisters or cousins alone.

In essence, they figured they would suffer through the abuse so that others wouldn’t have to.

The sad part is, in all of these cases, the molester went on to molest other children in the family anyway. In one case, there were three sisters all getting molested by the same uncle and neither knew about the other. All three reported that they didn’t say anything because they thought they were protecting the other sister from the abuse, not knowing that the other sisters were doing the exact same thing.

It was only when this uncle, after years of abusing these sisters, abused another member of the family that he got caught and is now serving time in prison.  By then at least four family members had been abused over the period of several years.

The Threat From Within

We teach our children to be cautious of strangers. We believe that the greatest threat to our child comes from outside of our homes and inner-circles.

1 in 4 women, and 1 in 6 men report being sexually abused as a child. Over 90% of sexual abuse is perpetrated by someone the child knows, loves and trusts. Family members, family friends, teachers, religious leaders and coaches are some of the biggest offenders.

There are many families who have this type of  secret, and some will even tell their children, “Stay away from uncle Bob” because they know they have a perpetrator in their family who for one reason or another is still around.

I even worked with one family who hid their family member’s pedophilic activity, partially out of embarrassment and partially out of  a family’s natural response to try to protect each other. This family member went on to molest at least three children before being sent to prison.

Why Do Children Keep Abuse A Secret

As adult survivors of childhood sexual abuse will tell you, there are many reasons why children will endure sexual abuse for years, some for a lifetime, without telling soul.

For one, children aim to please. They want to make someone they love and trust happy and are often willing to do whatever the person tells them to do.

Abusers also often coach their victims not to tell anyone. Sometimes this is done with threats of violence towards them or other members in their family. Other times it is done with the threat that the child themselves will get in trouble if they tell.

Shame, embarrassment and confusion along with countless other feelings and thoughts can keep a child from telling anyone about the abuse.

Most survivors of childhood abuse I’ve spoken to waited until they were were in their late teens or adulthood before they felt ready to share what they experienced as a child. Many reported that they were afraid that no one would believe them.

How To Help Your Child Break The Silence

We have to teach children the difference between a secret and a surprise. That may sound too simple, but as a start, it is very powerful.

  • Teach them that a surprise is supposed to be about something fun, such as a birthday gift or special party for a friend.
  • Teach them that secrets are something kids shouldn’t keep to themselves, especially secrets that involve touches of private body parts or anything that makes the child feel uncomfortable.
  • Encourage your child not to keep secrets from you.
  • Tell them that touches to private body parts should never be a secret.
  • Let them know that if someone tells them to keep a secret, especially someone older than them (including older/bigger kids), they should tell you or another trusted adult immediately.
  • If a friend tells them a secret, let your child know they should share it with you (the other child could be asking for help).
  • Let them know that it’s never their fault if someone touches a private body part and they will never get in trouble if they tell.

Abuse of all kind (i.e.,  physical, sexual, emotional and neglect) flourishes under the veil of silence. It’s beyond time that we break that silence.

 

 

Embracing Your Teens Sexual Orientation

130403133347-young-lesbian-couple-bed-horizontal-large-galleryWhen I worked as a high school mental health counselor, I worked with a lot of lesbian, gay, bisexual and transgender teens who struggled with telling their parents about their sexual orientation.

Many of them felt like they had to keep their sexual orientation a secret which of course caused them a lot of anxiety and even depression.  Most of all, they were terrified of not being accepted by their family.

Some of them were so scared that they would be disowned by their parents that they contemplated suicide. This was especially true when the youth came from a really religious family/background.

Luckily none of my students ever went this far, but I did help do grief counseling at a high school after a teen committed suicide due to the guilt and fear he felt about being gay and not being able to come out to his parents.

Some  of the teenagers I worked with turned to drugs and alcohol to deal with their feelings. while others turned to self-injurious behaviors like cutting themselves or acted out behaviorally (running away, skipping school, etc.).

Whenever I could, whenever a teen was ready to come out, I always encouraged them to bring their parents in for a family session. Many of them were too afraid to talk to their parents alone and wanted to do it in an environment where they felt safe.

Unfortunately this was something that rarely happened as many of the teens hadn’t yet worked up the courage to come out to their family.

However whenever it did happen, I always discussed the session beforehand with the teen so that there would be no surprises.

I wouldn’t tell the parents anything the teen didn’t want me to tell them, and I always encouraged the teen to lead the conversation while I would be there primarily as guidance and support.

Most of the parents who came to these family sessions already had some clue that their child wasn’t heterosexual. Many more were in denial. Luckily only a very few were visibly upset or angry.

What I wanted the parents to understand is that they didn’t make their child gay nor can they make them not gay.

This was especially true for male students. Sometimes a single mother would blame herself for not making her son “a man” or the father would blame himself for not being “tougher” on his son.

Parents do not make their children gay and “praying the gay away” or “reparative therapy” only works to temporarily change a child’s behavior at best, while risking permanent damage to  their self-esteem and mental health.

It doesn’t work.

Parents often feel angry, sad, and scared when they find out their child is gay. For many of them, they have to grieve over the loss of their ideal child. Maybe little Johnny is not going to marry Suzy and have 2.5 kids. Maybe Little Johnny will marry Billy and they will adopt 2.5 kids.

Many of them fear what their child will have to deal with from society on top of any other prejudices they may already be predisposed to (i.e, being Black and gay). It’s important that parents surround themselves with supportive people including support groups like Parents, Families and Friends of Lesbians and Gays (PFLAG).

While it’s important for the parents to get support, it’s most important that the parents support their child.

The world can be tough enough for the LGBT community, but it’s even tougher for those whose parents reject them.

The teens I’ve worked with who fared the best mentally and emotionally were the teens whose parents supported them when they came out despite their own personal and religious views.

With the support of their parents it made it easier for them to deal with any other negativity they had to face such as depression and bullying. It also allowed them to blossom into the amazing young people they already were.

In the Diagnostic and Statistical Manual of Mental Disorders, being homosexual was once listed as a mental illness. We now know that it is not. It is not something to be cured or prevented. It doesn’t go away if we ignore it.

Get over it.

Embrace it.

Childhood Bullying Can Have Lasting Psychological Affects

bullying-girls-630x420

It’s back to school time again and while parents are gearing up and are excited about the new school year, I thought it would be a good idea to remind everyone about childhood bullying.

Often bullying is seen as a normal part of growing up, almost as a harmless rite of passage, but we have all seen what bullying can do to some children.Think about the stories that have been in the news such as the boy who committed suicide. In 12 of 15 school shootings in the 1990s, the shooters had a history of being bullied.

These of course are extreme examples, but countless studies continue to show that childhood bullying can cause long-term psychological damage in some individuals.

In a study published in JAMA Psychiatry, a network publication of the American Medical Association, victims of bullying had an increased risk for anxiety disorders and suicide later in life.

The study showed that for some individuals, even when they grow up and are no longer being bullied, the psychological damage is still there and can affect the rest of their lives. That’s why it’s so important to address and stop childhood bullying early in order to prevent future problems.

Kids Who Are Bullied Often Have:

  • changes in sleep and eating patterns
  • loss of interest in activities they once enjoyed
  • health complaints
  • decreased academic performance
  • higher risk of dropping out of school
  • a higher rate of family hardship
  • were 2.7 times more likely to suffer from generalized anxiety disorder
  • 3.1 times more likely to suffer from panic disorder
  • 4.6 times more likely to suffer from agoraphobia
  • had increased risk for depression

Bullying doesn’t just affect the victims either.

Kids Who Bullied Were:

  • 4.1 times more like to end up diagnosed with antisocial personality disorder (which can lead to increased risk of incarceration and delinquent behavior)
  • Abuse alcohol and other drugs in adolescence and as adults
  • Get into fights
  • vandalize property
  • drop out of school
  • Engage in early sexual activity
  • Have criminal convictions as adults
  • Abuse romantic partners, spouses, or children as adults

What About Sibling Aggression?

While parents are usually alarmed to find out that their child is being bullied at school, they often dismiss the bullying that is going on right under their roof. Stopping bullying at home is just as important as stopping bullying at school.

While sibling aggression is often seen as harmless or even good in order to “toughen up” a child, a study done by the American Academy of Pediatric suggests that kids bullied by their siblings end up showing some of the same psychological damage as children bullied by their peers.

It is important that bullying to recognized and stopped early at school, at home and even online in social media when possible.

So as parents are getting excited about the school year, lets not forget to be on the lookout for or ignore childhood bullying. We have lost too many children  to the affects of bullying and are creating too many adults who are psychological damaged from what may have been seen as harmless behavior.

 

The Narcissistic Parent

3049_how-to-get-hired-at-your-next-job-interview_1“I do not love; I do not love anybody except myself. That is a rather shocking thing to admit. I have none of the selfless love of my mother. I have none of the plodding, practical love. . . . . I am, to be blunt and concise, in love only with myself, my puny being with its small inadequate breasts and meager, thin talents. I am capable of affection for those who reflect my own world.” – Sylvia Plath

Sylvia Plath, the poet and author of the quote above was a narcissistic parent who committed perhaps the most selfish and narcissistic act of all. She killed herself by sticking her head in a gas oven while her two children were asleep in the same apartment. She did however seal off  their rooms with towels so that they would live. Why? Most likely so someone could carry on her memory and mourn for her after death.

How do you think this affected her children? Well her daughter, Freida Hughes is an English poet and painter, but she’s been married three times and is currently divorced. Her son, Nicholas Hughes, suffered from depression and hung himself in 2009.

What Is A Narcissist?

To the outside world, a narcissistic parent may appear to be the perfect example of a gentleman or a loving, supportive mother who is passionate about her kids. However, to the child of a narcissistic parent, they are living a constant nightmare of never being good enough and being constantly reminded of it.

A narcissist is someone who has an inflated sense of self-worth. This is different from what’s considered “healthy narcissism” in which you believe in yourself and your abilities in a realistic fashion. You have good self-esteem, but can empathize with other people and aren’t devastated by mistakes or criticism. Your self worth isn’t dependent on other people admiring you.

On the other hand there is “malignant narcissism”, in which the person has a very fragile sense of self that is dependent on how other people see them. These people have an unrealistic, inflated sense which they use to hide insecurities and shame. They need to be praised, admired and approved by others and are deeply hurt by criticism and honest feedback. Their relationships with others tend to be superficial as they focus mostly on how other people reflect on them with little or no care about the other persons feelings. They believe they are better than everyone else, special even, but can get very sensitive and angry when faced with critique.

For a narcissist, everything is always about them. They are extremely selfish individuals who never give recognition, gratitude or appreciation to those around them. It’s “me, me, me” all day, all the time. If they ask you, “How is your day?” and you reply, “Horrible, I just totaled my new Mustang”, they may reply, “I had a Mustang once. A 1968 convertible. Man I loved that car. Brought it brand new off the showroom floor…”. They really don’t care about you and are only looking for opportunities to talk about and inflate themselves.

Imagine growing up having this type of person as a parent? Someone who is practically incapable of loving anyone other than themselves, when as a parent, you have to give so much love to a child.

Why then would a narcissist have children?

A narcissist does not have a child for the reasons most people do. They do not have children because they want to love and nourish another person, they do so in order to create mirrors of themselves and to create an automatic relationship where they have power and control over someone.

Having control over other people is the narcissists ultimate goal. From an early age the child of a narcissist learns to realize that they exits to please their parent and to be a reflection of them.

Like any child, the children of narcissist will try to please their parent, going through great lengths of anguish and frustration to please someone who will never be pleased for long. One day, if they are lucky, they will realize that it’s the parent who is not quite right, not them.

Until then, these children learn that they are a reflection on their parent and will try to mold themselves, mentally and behaviorally into being that perfect representation their parent wants.

This creates much anxiety as the child is continuously trying to be what they are not in order to please the parent and when they fail, which they will time and time again, they are exposed to punishment that can range from physical to psychological.

These children are often mentally on edge and tormented by the unpredictable and sometimes confusing nature of the narcissistic parent. They may think over and over again that they are a failure, that something is wrong with them . The child may experience a great deal of shame and low self esteem because they don’t feel constantly loved. They are taught that they are only as good as the parent says they are and that they’ll only be loved if they are completely compliant.

Take for example a child who throws a tantrum in the store. Most parents may remove the child, redirect them, or try some other tactic to calm the child down. A narcissistic parent is likely to chastise the child by saying something like, “You’re a spoiled little brat. You always find a way to ruin my life.” Such harsh words for a narcissist are nothing, even directed at their own child.

On the other side of this poor parent-child attachment is neglect. The narcissist parent may be so self-absorbed that the child is neglected and nearly forgotten. Their needs, desires and aspiration always thrown aside for the sake of the parents’ wants and desires.

For example, a daughter going to her high school prom may have all of her desires for the dress she wants and the way she wants her hair styled cast away in favor of what her mom wants her to wear and wants her hair styled. If she doesn’t go along with this and protests, then her mother may call her an ungrateful child and refuse to help her with her big night.

Later in life, these children grow up and often develop narcissism themselves or end up in drama filled relationships with toxic partners because they grew up believing that they were bad and don’t deserve good things to happen to them. They often question if they are deserving of love.

In a healthy relationship with a healthy partner, these individuals wouldn’t know how to respond to unconditional love and would be filled with so much anxiety and discomfort. Understandably they would seek out other individuals who are emotionally unavailable, cold and critical just like the narcissistic parent they grew up with. It’s familiar and sadly, even comfortable to them.

Hopefully, through good relationships, friendships and sometimes therapy, these children are able to recover from the wombs of growing up with a narcissistic parent and not succumb to them.

 

 

 

 

Psychological Truama: A Brief Overview

Psychological Truama: A Brief Overview

Psychological trauma is sometimes hard to understand. Because of this, many people who have suffered from it do not realize how it affects their lives. More sadly, many parents who have children that have undergone psychological trauma, do not realize the importance of getting them help because they do not realize the damage that has been caused.

They believe that children are resilient and will get over or forget something traumatic that happened to them when they were one, two, three or four yeas old. Depending on the child, the traumatic event and what protective factors were or weren’t available to the child after the event, that child may suffer psychological damage for life.

Psychological trauma is the unique individual experience of an event in which the individual’s ability to integrate his/her emotional experience is overwhelmed or the individual experiences a threat to their life, body or sanity.

A traumatic event creates an overwhelming feeling within a person where they are not able to cope and are left to feel as if they will be killed, seriously injured or psychologically damaged. The person may feel overwhelmed emotionally, cognitively and/or physically. This type of situation is common with abuse, entrapment, helplessness, betrayal, pain, loss and/or confusion.

Trauma is a very broad definition and includes responses to powerful one time events such as natural disasters like Hurricane Katrina and crime, deaths, and even surgeries.  It can also include responses to repetitive events such as combat, urban violence, concentration camps and abusive relationships.

The key component in trauma is feeling helpless and endangered. No two people will experience the same traumatic event the same. As a matter of fact, what may be traumatic for one person may not be at all traumatic to the next.

For instance, earlier this week I did crisis counseling with four female inmate workers who were out clearing road debris when a man came out of the woods with a machete and chased them back to the van. The man was apprehended, but the four women were brought to me to be evaluated.

Out of the four women, three appeared to be handling the situation relatively well, even able to laugh and joke about the incident while also describing it as terrifying.

One woman however, was obviously more shaken up. She sat nearly stone faced with tears in her eyes, not saying a word during the counseling session. I quickly learned that she was the last woman to make it safely to the van and was the one whose life was most in danger. She also has a history of mental health problems which may make her predisposed to developing signs of trauma which include:

  • Shock, denial, or disbelief.
  • Anger, irritability, mood swings.
  • Guilt, shame, self-blame.
  • Feeling sad or hopeless.
  • Anxiety
  • Fear
  • Nightmares
  • Flashbacks
  • Avoidant behavior

Out of the four women, she is the one I most worry about and the one I will observe closes during the days to come to see how she processes this trauma and to help walk her through it if needed.

That is the interesting part of trauma and why trauma is defined by the experience of the survivor.  We can’t say one event will cause trauma and another will not or that one person will be traumatized by this experience while another will not. Trauma is too broad for such simple explanations.

 

“Big T” versus  “Little T”

It’s hard to go through life without being traumatized in some way. Most of us have experienced some type of event that has affected us either consciously or subconsciously. It could be the divorce of our parents, being bullied in school, seeing a pet die when we were young.

Many of us don’t even know we walk around caring these traumas with us or how they affect our lives.

For instance, a man whose favorite pet died when he was five may never like pets for the rest of his life and grow angry and anxious when his kids ask if they can have a pet.

These types of traumas are called “Little Ts” or “Little Traumas”. They do not have the severe impact that  “Big Ts” or “Big Traumas” usually have such as flashbacks, avoidant behavior, severe anxiety and nightmares that lead to a diagnosis of PTSD. Still, “Little Ts” can unconsciously disrupt our lives.

Most men I’ve worked with in anger management don’t even realize why they are so angry, why they hit their wives or bully their children. It’s only after some intense introspection that most of them can identify traumatic events in their childhood such as being bullied by their own father, watching their father beat their mother or watching their mother go through abusive relationship with one man after another, that they realize the reason they carry around so much anger.It’s once we deal with the root causes of their anger that they began to truly heal.

I myself as a child watched as my father often abused my mother. I never had any nightmares, flashbacks or anything that would make it a “Big T”. I never felt that my own life was in danger, but I did feel like my mothers’ life was.

Still, one of the affects it had on me was that for many years I thought that’s what love was. That if you loved someone you fought, made up and then fought again. It wasn’t until I was in college that I learned I was wrong. For many years, that “Little T” of watching my parents fight had me living in a world where fighting verbally and physically meant love.

A woman I counseled with was claustrophobic and afraid of the dark. She had no ideal why until one session we processed the fact that her older siblings used to play a game where they would lock her in a closet when she was very young. They thought it was funny, but she was tormented. She never viewed that as a traumatic event until years later, sitting across from me crying.

Trauma doesn’t have to be a negative word. Often times the way we respond to trauma, the way it changes us, the way we adapt to a traumatic event, is natural given the coping skills, circumstances and knowledge we have at the time.

The topic of trauma is too broad to cover in one post. I’ve actually been on a radio talk show discussing trauma twice within the last two months and will likely be on a third time because it is such a huge topic.

My bottom line for this post is to help others realize that you don’t have to go off to war or survive some horrific event to suffer from the affects of trauma. Even “Little Ts” can rob us of our full quality of life and “Big Ts” can devastate us.

Once we recognize this, we can change it through self help, the help of loved ones and even professional help if needed and reclaim the joy and full life we deserve.

 

 

 

You Are A Gift

iStock_000018620938_Medium-500x333Earlier today I was speaking with a fifteen year old girl in our juvenile detention center. She is experiencing depression and is 6 weeks postpartum so I was concerned about her. As we talked, I started to understand some of the sources of her depression.

During our session, she revealed that her mother also gave birth to her when she was fifteen and that her biological father has been in prison since she was three years old. Her mother is currently married to a verbally and physically abuse man that she feels her mother places before her in order of importance, attention and affection.

As this young lady and I talked, she described how she grew up feeling like a burden to her young, single mother and how after her mother had other children and multiple boyfriends, she was always made to feel like she was “in the way”.

It became very apparent that this young woman, consciously or unconsciously, had a baby at fifteen years old, partly so that she could have someone in her life that didn’t make her feel like a burden, but gave her the unconditional love she has been yearning for. However, due to her own psychological damage, she now sees her 6 week old baby as a burden and if she doesn’t learn to change the way she views herself, she will pass on that damage to her child.

What I discussed with her this morning and will try to instill in her is this:

We are the greatest gifts we can ever give ourselves. We are also gifts to other people and the Universe. Our children, if we have any, are also gifts.

Too many people grew up being made to feel, even as children, that they were a burden. Maybe they were born to parents who themselves were brought up in painful situations where they did not truly know how to love and appreciate others.

Maybe their parents conceived them as a resolution  to fixing a broken relationship or “save” a troubled marriage. Maybe their parent expects them to be their caretaker, or they were simple born during a difficult time of their parents lives and they were never able to be truly enjoyed, loved, appreciated and viewed as precious gifts as children.

Many of us have grown up never feeling truly accepted and carrying these feelings on unconscious and conscious levels that we were and are a burden.

This is how people can fall into a deep depression or become suicidal, thinking that the World would be better off without them.

This type of thinking is what keeps people from truly connecting with other people on any level or truly enjoying life.

Because of this they end up beating themselves up all the time with negative self-talk, not appreciating themselves, walking around apologizing for themselves, feeling like other people know better and are better than them.

For those of us who have received this terrible message growing up, it’s time to change it.

You are not a mistake. You are not here by accident. You are here because we are supposed to be here.

Our lives have purpose and intention.

We don’t have to apologize for being here or for being ourselves. We don’t have to beat ourselves up over our past mistakes or experiences that have helped create who we are now. We don’t have to be ashamed, apologetic or doubt the beauty that is our unique selves.

We are not a burden and if our parents are the ones who tried to put that on us, it’s time to recognize that it is their issue and not ours. We don’t have to carry that with us. We can let it go.

We are precious gifts and today we will start treating ourselves as gifts to others, the Universe and especially ourselves.

Too Scared To Talk: Children with Selective Mutism

142005745The other day I was speaking to a mother who was describing her son’s symptoms to me. She reported that he had difficultly and sometimes just couldn’t speak at all in various social situations, especially at school and around strangers. He had been tested for Autism and that was ruled out. She was very frustrated with her son, but also felt bad for him because she could tell that he was also in distress. She just couldn’t understand why her son would suddenly become mute in social situations when he was such a funny, outgoing and talkative kid at home.

After listening some more, I realized that her son did not have an autistic spectrum disorder as she still believed, but that he had what is called Selective Mutism.

Selective Mutism is the inability to speak and communicate in social settings, but the ability to speak in settings where the child feels comfortable, relaxed and secure.  Many parents think their child has absolute control over this, hence their frustration, but Selective Mutism is an anxiety related disorder .

90% of children with Selective Mutism also have social anxiety or social phobia. While many parents initially think their child is faking or playing games, Selective Mutism is very painful and debilitating to the child.

Children with Selective Mutism have a real, paralyzing fear about speaking and therefore this totally impairs their ability to develop social relationships or to participate in social situations.

Not every child expresses Selective Mutism in the same way. While some children are totally mute in social situations, others can only manage to whisper while some will remain perfectlu still, seemingly unable to speak or move, while less severe children can manage to speak totally normal to a select few individuals in social situations.  This type of anxiety goes well beyond the normal range of shyness seen in other children.

A very select few children with Selective Mutism don’t appear to be shy at all. They actually do a very good job trying to mime their way through social situations.  In these children, Selective Mutism may be a symptom of something else, such as the child initially being mute and never grasping communication and are basically stuck in the nonverbal stage of communication.

Why Does A Child Develop Selective Mutism?

Most children who have Selective Mutism have a genetic predisposition to anxiety. This means that it is inherited. Almost from infancy on, these children may show severe separation anxiety, moodiness, frequent tantrums, inflexibility, show extreme shyness and have sleep problems.

Some children with Selective Mutism may have Sensory Processing Disorder (DSI), which basically means they may be sensitive to sounds and lights, and that they may perceive environmental and social cues differently than most people. They become easily frustrated, angry, confused, withdrawn or act out because the signals they are receiving from their brain are alerting them to danger and fear causing them to have anxiety.

Up to 30% of children with Selective Mutism also have a speech, language, processing or learning disorder which can increase their anxiety and inability to communicate effectively in social situations.

There is no evidence that abuse or trauma causes Selective Mutism, which is different from Traumatic Mutism.

In Selective Mutism the child can usually speak normally at least in situations where they are comfortable. In Traumatic Mustism, a child witnesses or experiences a tragedy so devastating that they can’t comprehend it, they stop speaking altogether in every situation suddenly.

Selective Mutism can progress to the point where the child stops speaking and becomes totally mute, but that is usually gradual and when negative reinforcements cause the child to slowly start limiting the places and people he/she feels comfortable talking to.

Diagnosing Selective Mustism

Most children are diagnosed with Selective Mutism between the ages of 3 and 8. Most of these children have already exhibited severe symptoms of anxiety. If a child stops speaking for more than a month than the parents need to take the child to a doctor.

Here is the diagnostic criteria for diagnosing Selective Mutism. Note that this criteria shouldn’t be the only criteria used to diagnose or rule out Selective Mutism since each child and case is different:

DSM-IV-TR (2000):
1. Consistent failure to speak in specific social situations (in which there is an expectation for speaking, e.g., at school) despite speaking in other situations.
2. The disturbance interferes with educational or occupational achievement or with social communication.
3. The duration of the disturbance is at least 1 month (not limited to the first month of school).
4. The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language required in the social situation.
5. The disturbance is not better accounted for by a Communication Disorder (e.g., stuttering) and does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder.
Associated features of Selective Mutism may include excessive shyness, fear of social embarrassment, social isolation and withdrawal, clinging, compulsive traits, negativism, temper tantrums, or controlling or oppositional behavior, particularly at home. There may be severe impairment in social and school functioning. Teasing or goading by peers is common. Although children with this disorder generally have normal language skills, there may occasionally be an associated Communication Disorder (e.g., Phonological Disorder, Expressive Language Disorder, or Mixed Receptive- Expressive Language Disorder) or a general medical condition that causes abnormalities of articulation. Mental Retardation, hospitalization or extreme psychosocial stressors may be associated with the disorder. In addition, in clinical settings children with Selective Mutism are almost always given an additional diagnosis of Anxiety Disorder, especially Social Phobia is common.

Many parents, teachers and even professionals do not understand Selective Mutism because research is so limited. Many think the child is being defiant, controlling, that they are just shy and will grow out of it, or that they have some other disability such as autism.

Children with Selective Mutism tend to want friends, they are just too anxious to develop friendships easily while children with autism tend to not care to have any friends at all.

When considering seeking treatment for a child with Selective Mutism, parents should be careful not to find a professional who believes that Selective Mutism is behavioral and about the child being defiant or controlling. These type of professionals tend to try to use punishment and forcing the child to speak as treatment, which consequently increases the anxiety of the child and worsens the condition.

Good professionals who understand Selective Mutism will focus on making the child feel comfortable, decreasing anxiety and helping the child learn coping skills to deal with anxious feelings. This is often done with a combination of therapy and medication and as a collaborative approach with the professional, parents and the school.

Dealing with a child with Selective Mutism can be frustrating, but understanding what Selective Mutism is and is not helps decrease the frustration.

For more information and help, go to http://www.childmind.org