Clinical Social Work Journal

, Volume 33, Issue 3, pp 291–307 | Cite as

Selective Mutism and Self-Regulation

  • Marian B. Moldan


This paper explores selective mutism as a complex anxiety disorder best treated using a multi-modal approach. A case of a young girl is presented to illustrate how selective mutism may be an attempt to regulate anxiety and other emotions. The author demonstrates the use of multiple treatment approaches (e.g., behavioral, cognitive-behavioral, modern psychoanalytic) used in conjunction as a means to overcome the selective mutism and to develop the ability to self-regulate a variety emotions and behaviors.

Key words

selective mutism self-regulation multi-modal treatment modern psychoanalysis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Beidel, D. C., Turner, S. M. 1999Shy Children, Phobic Adults Nature and Treatment of Social PhobiaAmerican Psychological AssociationWashington, DCGoogle Scholar
  2. Black, B., Uhde, T. W. 1992Elective mutism as a variant of social phobiaJournal of the Academy of Child and Adolescent Psychiatry3110901094Google Scholar
  3. Bronson, M. B. 2000Self-Regulation in Early Childhood Nature and NurtureThe Guilford PressNew YorkGoogle Scholar
  4. Cunningham, C. E. 2000Coping with Selective Mutism A Collaborative School-based Approach Consultant’s ManualCope WorksHamilton, CanadaGoogle Scholar
  5. Dow, S. P., Sonies, B. C., Scheib, D., Moss, S. E., Leonard, H. L. 1995Practical guidelines for the assessment and treatment of selective mutismJournal of the American Academy of Child and Adolescent Psychiatry34836846CrossRefPubMedGoogle Scholar
  6. Elson, A., Pearson, C., Jones, D., Schumacher, E 1965Follow-up study of childhood elective mutismArchives of General Psychiatry13182187PubMedGoogle Scholar
  7. Fonagy, P. (1999). Transgenerational Consistencies of Attachment: A New Theory. Paper to The Developmental and Psychoanalytic Discussion Group, American Psychoanalytic Association Meeting, Washington, DC. May 13, 1999. Retrieved 28 June 2002, from the Psyche Matters databaseGoogle Scholar
  8. Giddan, J. J., Ross, G. J., Sechler, L., Becker, B. R. 1997Selective mutism in school: multidisciplinary interventionsLanguage, Speech and Hearing Services in the School28127133Google Scholar
  9. Greenspan, S. I. 1992Infancy and Early Childhood – The Practice of Clinical Assessment and Intervention with Emotional and Developmental ChallengesInternational Universities Press, IncConnecticutGoogle Scholar
  10. Hadley, N. H. 1994Elective Mutism A Handbook for Educators, Counsellors, and Health Care ProfessionalsKluwer Academic PublishersDordrecht, The NetherlandsGoogle Scholar
  11. Labbe, E., Williamson, D. A. 1984Behavioral treatment of elective mutism : A review of the literatureClinical Psychological Review4273392CrossRefGoogle Scholar
  12. Liegner, E. 1974The silent patientThe Psychoanalytic Review61229245Google Scholar
  13. Margolis, B. 1994Joining, mirroring, psychological reflection: Terminology, definitions, theoretical considerationsModern Psychoanalysis19211226Google Scholar
  14. Quackenbush, M. (2002). Distinguished Psychoanalysts Honored. National Association for the Advancement of Psychoanalysis News. Retrieved May 24, 2002, from http:/lwww.naap,org/news02.htmGoogle Scholar
  15. Spotnitz, H. (1963). The toxoid response. In Psychotherapy of Preoedipal Conditions. New Jersey: Jason Aronson, Inc. 1987Google Scholar
  16. Spotnitz, H. 1985Modern Psychoanalysis of the Schizophrenic Patient, Theory of the TechniqueSecond.Human Sciences PressNew YorkGoogle Scholar
  17. Spotnitz, H. 1987Psychotherapy of Preoedipal ConditionsJason Aronson, IncNew JerseyGoogle Scholar
  18. Sroufe, L. A. 1983Infant-caregiver attachment and patterns of adaptation in preschoolPerlmutter, M. eds.  EdbaumHillsdale, NJ19Google Scholar
  19. Stem, D. N. 1985The Interpersonal World of the Infant - A View from Psychoanalysis and Developmental PsychologyBasic Books, IncNew YorkGoogle Scholar
  20. Wright, H., Cucearo, M. L., Leonhardt, T. V., Kendall, D. F., Anderson, J. H. 1995Case Study: Fluoxetine in the multimodal treatment of a preschool child with selective mutismJournal of the American Academy of Child and Adolescent Psychiatry34857862CrossRefPubMedGoogle Scholar
  21. Yanof, J. A 1996Language, communication, and transference in child analysis I. Selective mutism: The medium is the message II. Is child analysis really analysis?Journal of the American Psychoanalytic Association4479116PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  1. 1.Marian B. Moldan

Personalised recommendations