Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for February 10th, 2012

Mutism: The Meaning of Silence

Posted by Dr. Vollmer on February 10, 2012

Alina, six years old, did not speak for her entire kindergarten year. She learned to talk in full sentences by three, and she was a very bright and articulate child, but she was “scared” she told me in kindergarten so she never said one word. Her mom reports that she was not too worried about that, since she felt that Alina would speak when she wanted to. The psychoanalytic saw is that children become mute when there is a family secret. The child is afraid to say the wrong thing, so to make sure that does not happen, the child does not speak at all. Alina came to my attention, not because she was mute in kindergarten, but because the mother was concerned that she was mean to her younger sister, age four. I was perplexed by her history of mutism. To be mute, especially for an extended period requires an amazing amount of tenacity. It is like the anorexic who does not eat, even though they are starving. The control suggests that the child might feel out of control and so not speaking might be one way to feel that life has some order. My guess is that this relates to her relationship with her sister. Alina’s unhappiness might first be manifested by her mutism and now is manifested by her aggression to her sister. I am excited to see how my relationship with Alina unfolds. I am optimistic that together, Alina and I can work through play an understanding of what is troubling her.

Posted in Child Psychiatry, Mutism | 4 Comments »

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