Mutism: types, causes, symptoms and treatment of "voluntary" dumbness

Mutism: "and on his lips seal", or why are you silent? Language, what, swallowed? !

Speaking, speaking, speaking is one of the man's favorite pastimes, for it is one of the ways to express oneself.

But this is also absolutely necessary for life attribute, because who will risk "turn things" alone, without a company of like-minded people? And to collect it, you need to throw a cry like: the proletarians of all countries. .. or the like.

But, as said Kozma Prutkov: if you have a fountain - shut it up, let me rest and a fountain!

Indeed, we are surrounded by such an abundance of speech, not only written, but also oral, that the ear simply comes to an exhaustion both from one's own and another's verbosity.

Therefore, now on any device - except a refrigerator and a meat grinder - there is a mute button - mute or silent mode. To put it bluntly, it's: shut up, I do not want to hear anyone else!

"Button" "shut up" is also in the person-psyche of a person - and for one reason or another it is pressed. Sometimes.

And then the mutism develops.

About the mutism seriously and with its words

Traditionally it is considered: mutism - or silence, dumbness is "a prohibition to say yourself".Prohibition of verbal expression. In fact, the phenomenon has two aspects:

1. The first : mutism is a measure to prevent intrusion into the psyche of a person from outside.
2. The second is the maximum possible isolation of a person from the outside world within the same definite boundaries. The strictest "veto" imposed by the individual on himself, a ban on crossing her own external borders.

How can such a cruel measure be justified?

Mutism is not just a ban on expressing oneself in words, it is a deeply justified subconscious act of saving the world from the forces that are hidden inside the person under the "house arrest".From the forces that can not be released.

These are the most notorious devils that live in a seemingly quiet pool.

As scientists have established, the energy contained in the internal electronic and other connections of a living organism of one person is enough to illuminate a small city for several days. The whole question is how to use it wisely.

If they dispose of "in any way", those same "warm-up children" appear-pyrokinetics, that are capable of igniting and instantly burning the object they do not like to the ground with their eyes alone. And this is by no means the only phenomenon of the tremendous destructive power of man.

Mutism, arising for one reason or another - regardless of whether it is stress or the "hand of fate" -the pocket is always a sign: the entrance to the city is forbidden - it is dangerous!

Dangerous both for the "city" - the world in which we live, and for the one who can enter it. It is dangerous just like the ten days that still continue to shake the world.

Outwardly, this liquidated danger seems to parents as an annoying reluctance of a child to talk. For mutism develops, for the most part, in children.

About the true causes of psychological dumbness

Among the reasons leading to mutism in children, the palm tree almost always belongs to psychopathological abnormalities in the form of:

• mental retardation;
• hysteria;
• of autism;
• schizophrenia;
• is a depressive disorder.

The second place legally belongs to the hereditary predisposition and environmental circumstances, having the character:

• stress;
• is a tense environment within the family and improper parenting practices.

No less important reasons for the development of this violation are the individual characteristics of the character in the form of sensitivity, isolation, and resentment.

And, finally, the causes of the pathology of a purely physical property in the form:

• wolf mouth;
• short tongue frenulum and the like.

A separate cause of the phenomenon is deafness, when it is combined with dumbness, pathology arises in the form of deaf-mute( sardomutism).

With the difference that neurologists classify mutism as neurosis, psychologists as an inability to establish social contacts, and psychiatrists to deviations of the psyche( along with hysteria, psychoses and schizophrenia).

The development of the syndrome is possible even in older, even adulthood, usually observed in highly sensitive and hypochondriacs with a predisposed to emotional reactions, triggered by a serious mental shock( for example, fear) - hysterical mutism, or disorders of the CNS and the brain of organiccharacter.

In addition to the characteristics of a fine psychic organization, adult mutism develops due to:

• of the consequences of the coma;
• disorders of blood supply to the brain or its somatic disease( tumor or cerebral stroke);
• head injury;
• severe stress or mental trauma;
• mental disorder( depression, schizophrenia).

Categories of mutism and its features in children

Child mutism, developing in the age range of 3-9 years, is characterized in typical cases:

• persistent, continuing for at least one month, dumbness - rejection of speech contact;
• full preservation of consciousness at simultaneous absence of disturbances of work of the voice device;
• inability to speak in exciting situations or its selectivity( in accordance with a specific situation or when communicating with people of a certain circle);
• preserving the opportunity to formulate and express an idea without resorting to oral speech( using non-verbal methods of communication: writing, gesturing).

The division of the phenomenon into categories is justified both by its possible cause and by its typical manifestations.

So, the psychogenic variant of it, based on the psychic trauma of psychogenic psychosis, has the following grades of mutism:

• hysterical;
• logophobic;
• mixed.

In the hysterical version of the speech is lost due to the onset of a sharp mental shock, this disorder can take a period of 3-5 seconds to a couple of days and weeks - inherent in women and children with a particularly sensitive psyche.

The variant of logophobic mutism is dictated by fear of hearing your own speech;is observed for the most part in poorly performing schoolchildren, is not always characterized by a favorable prognosis and a great dependence on the characteristics of the carrier.

The development of the pathological condition in children timid and shy, with a painful attachment to parents and home, causing dumbness when it comes to unfamiliar surroundings and surroundings( children's collective), is called patoharakterologicheskogo mutism attributed to the elective category.

The phenomenon that develops under the influence of hallucinatory voices and intimidating delusional ideas belongs to the class of endogenous-psychotic mutism.

According to another classification, the mutism can be:

• selective( elective) , manifested in loss of speech in a frightening and tense situation;
• akinetic , which is characterized by motor-speech disorders;
• apallic , causing a state of indifference similar to that of a person in a coma with a complete lack of response to irritations emanating from the outside world;
• and selective mutism - persistent refusal to communicate and talk with strangers or in their presence.

The classic picture of the development of mutism in children is the situation of separation from the family with placement in a new social environment, perceived as betrayal by parents and causing reluctance to speak - a form of silent protest against the
situation and its "culprits".

To diagnose - how to do it correctly and quickly?

The phenomenon of mutism is extremely difficult to separate from another psychopathology precisely in view of childhood, when the difficulty is raised by the question: is this a true disease, the caprice of a stubborn - obstinate child or a mental retardation?

The transition of the syndrome to a protracted and chronic course is often promoted by the parents of the child, who expect that it will "outgrow" its dumbness, but for the time being "just hesitates to talk."

To establish the truth, it is necessary to collect information about the entire previous life of the child, including:

• features of the course of the intrauterine period;
• suffered from a pregnant mother's shocks and concussions( mental and physical trauma);
• the child's reaction to vaccinations;
• features the dynamics of its development.

Particular attention is paid to the fears and phobias that are inherent in a particular child: fear of darkness, being alone, panic fear of punishment for the committed offense, because the feeling of guilt in such a child is often completely incommensurable with the punishment method applied.

In the case of the presence of another, concomitant pathology of the psyche and personality, the task of the diagnostic doctor becomes even more complicated - the mistake in the diagnosis is fraught with the loss of precious time and delaying the treatment of the true cause of mutism.

In addition to monitoring the patient's psyche, it is also necessary to study the body that determines its strategy and tactics - the brain. No less important attention should be paid to the study of the general physical development of the organism.

As far as the diagnosis of neurosis( or mental disorder) is concerned, the laboratory and instrumental methods of investigation should come to the aid of the physician:

• craniogram ( an x-ray of the skull), which gives an idea of ​​the brain volume, its structure;
• MRI and CT , performing the same task more accurately and layer by layer;
• EEG , which tells about the level of electrophysiological processes in the brain;
• blood and urine tests of , allowing for the level of hormones in these biological fluids to determine the degree of maturity and development of the body.

Other methods of "investigation" that are appropriate at the moment are also relevant, often similar to the criminal riddle of the case and the involvement of other specialists.

How to help the trainee?

The process resembles an anecdote: the class was late for the lesson. The surprised teacher turned the question to everyone, and was even more surprised when she learned that the old woman was helped to cross the street by the whole class. Where here to laugh? The fact is that she did not want to cross the street!

The state of mutism in both a child and an adult is often dictated by a sense of fear, resentment and "betrayal," and pathology itself is a revenge for "offenders" for causing moral and mental harm. And this revenge gives way to a mutist with a fierce ecstasy.

Therefore, the "old woman" often has to "translate across the street" "all class".And there are good here all the means that can help.

Treatment of mutism is a complex of cleverly combined psychotherapeutic and medicamentous influences, rendered both in the ambulance setting and permanently. After comprehending the cause that gave rise to the phenomenon of mutism, it is eliminated.

In adulthood, it can be the elimination of a hematoma or surgical excision of a tumor or cyst that affects the work of the brain, leading to healing from akinetic and apalistic modification of mutism.

In the case of a psychiatric illness leading to the appearance of dumbness, it is appropriate to use "tongue-loosening" antipsychotic and other specially used drugs:

• neuroleptics;
• antidepressants;
• of benzodiazepine agents;
• selective serotonin reuptake inhibitors.

To regulate the operation of blood vessels supplying the brain with nutrition, and enhancing metabolism in its tissues, medicines are used:

• spasmolytic;
• analgesic;
• sedative action;
• preparations-nootropics.

The patient's psychological support( in the case of selective mutism) is:

• in conducting conversations that distract him from living a psychotraumatic situation, such as a plane crash or an incurable disease in a close relative;
• in dealing with anxiety and anxiety, training in actions to overcome stressful situations, mastering the skills of social communication;
• in the correction of facial expressions and the like.

In addition to medical therapy and psychological care, additional techniques are used in the form of:

• breathing exercises;
• massage;
• treatment and correction gymnastics;
• art therapy;
• phototherapy.

It is also necessary to inculcate social skills.

In the case when the patient-mutist is bedridden, measures are taken to ensure thorough care of the skin, oral cavity and respiratory organs, as well as nutrition( if necessary, probe or parenteral).

Consequences and prevention

Complications and consequences include the difficulties of social and labor adaptation due to lack of speech.

Preventing the development of mutism in a child is the maintenance of a healthy, healthy lifestyle, the advantages of which are proved by the personal example of parents.

In case of development of the disease in an adult it is necessary to create a healthy moral and psychological environment in the home and help the patient in gradual adaptation to new life realities.

The disorder should be prevented from developing further by contacting the child psychologist( psychoneurologist) in doubtful cases. Understand what constitutes arose disorder: a neurosis or a debut of schizophrenia is the prerogative of a specialist doctor.

Only the earliest possible application for medical help allows you to make an accurate diagnosis earlier and begin treating the disease as soon as possible( even at the stage of the syndrome).Otherwise, the situation is capable of forming a persistent perversion of the character with many problems in the future.

The prognosis of the condition is favorable( except for variants of severe mental pathology and organic brain work disorders).