Selective Mutism - Understanding a Child's Silence

I've been seeing a young girl in my private practice for about three months now, who I am totally fascinated with. Until recently, I had no idea she remains completely silent in class except for Spanish and Music. She is in Kindergarten and is 6. At She has a 9 year old brother, who at the first session informed me that she doesn't speak and that he will speak for her. At home it's a different story. She talks, plays, and wrestles with her brother. She is also aggressvive at times, acts out inappropriately and uses profanity.

So what's going on with this six-year old girl? That's what I've been seeking to understand and figure out since beginning to see her. I first thought I was working with a child with ODD, oppositional defiant disorder, a diagnosis from the DSM IV manual. The more I work with this young girl, the more I begin to see an intelligent, witty and athletic child, who is doing the best she can to cope with her surrounding environment. She loves animals, loves sports and loves to win. After speaking to her teacher, I realized that this kindergartner is silent throughout most of the day. Some how, she keeps it all together without speaking or uttering a word. She has pretty good peer relations, but definitely has her triggers. The clinical term given to children who do not speak is called Selective Mutism. Many will report that selective mutism is about control, but it is not. It is a social anxiety disorder that causes children to clam up for fear of being laughed at and fear of social embarrassment. It is found in less than 1% of mental health settings and can develop into other issues later in life if not treated. It usually occurs before the age of 5, but does not become recognized until a child enters school.

One of my therapeutic goals is to help my client improve her self-confidence and to decrease her social anxiety. As an art therapist, I do this by incorporating play, art and games. It has taken about 3 months for this child to feel comfortable and to begin to trust me and to not act out or miss use my art supplies or toys. Though this child does exhibit signs and symptoms of ODD, it is due in part to her underlying anxiety disorder. It makes sense that a child who remains silent for a good portion of his or her day, would at some point need to some how release all their built up feelings and emotions. I continue to learn, and try to understand how this child perceives her world. Part of my job as her therapist, is to help her develop healthy and constructive coping skills to handle her world. Becasue at six, she already sees her world as being scarey and unpredictable. I have to help her learn tools to not only cope, but to handle disappointment and unpredictability.

Women, Food & God - A book review

Women, Food & God - a book review
I'm reading a new book titled Women, Food & God by Geneen Roth. If you've ever suffered from or continue to suffer with emotional eating, she shares many wonderful thoughts, ideas, wisdom and laughs on not only her own journey with emotional eating, but of those who attend her retreats. Roth is new to me, but, as I soon found out, she has written on the subject of emotional eating for may years. Feeding the Hungry Heart, When Food is Love, Breaking Free from Emotional Eating and many more. She talks a lot about why diets don't work, and I couldn't support that idea more. When we diet, we for the most part, don't look at our relationship to food or to the feelings that trigger our food issues. All we are concerned about, is dropping the pounds and looking good. We don't go deeper into what is behind what drives us to over eat or eat the wrong foods or have cravings. I try to ask myself when I'm craving something, what am I really craving right now? Comfort? Excitement? Not to be alone? And what would happen if we actually sat with those feelings? We want a quick fix. We don't want to go deep into our feelings, because hey, what might be down there?She reminds us of the importance of being in the here and now when eating and recognizing and feeling the feelings that come up instead of heading for the refrig to mask them with food. We have a whole arsenal of feelings inside of us though we tend to not want to feel many of them, mostly feelings such as, loneliness, fear, anxiety, sadness and or boredom. We'd rather eat a bag of chips, Oreos or ___________you fill in the blank, then feel the feelings. Roth reminds us that feelings won't kill us. We might cry, we might feel uncomfortable, but they won't kill us. Here is where I recommend keeping a journal. Write your way through the feelings. Collage your way through the discomfort. Turn on some music. Call a friend. Go for a walk. She writes about being aware of the Voice. That voice that has been present inside of us since our little brains could make sense of them. The negative and positive messages that still scream in our ears. The voice that maybe says, "You're not wearing that outfit are you?" Or, "You're not going to eat that are you?"And how these statements can trigger an internal reaction or thought about ourselves and inturn sends a message about ourselves to our core. She stresses the importance of listening to our bodies. Where in our bodies to we experience a feeling? How does it feel? What shape is it? What color is it? I use this a lot with art therapy when I ask a client to create an image of what they are feeling in their bodies. We live so disconnected to our precious bodies that we stay in our heads where all the lies dwell about ourselves. The lies that say, we our too fat too thin, too this too that.I especially like The Eating Guidelines, which include things like: Eat when you are hungry. Eat sitting down in a calm environment. Eat what your body wants. Eat until you are satisfied. These are just a few. I recommend you pick up the book at the library and savior Roth's wisdom and expertise on the subject. Until then, eat mindfully.

Art & Pain

I read recently that Liam Neeson turned to art-making after his wife died to aid in his healing process. Others throughout time have used art for its cathartic benefits including Frida Kahlo, to name just one. It is no secret that art, music, poetry and other forms of self-expression aid in the healing process. But how? From a neuroscience perspective, art activates the emotional brain (amygdala ) quicker and easier than the left thinking brain. Art allows for feelings and emotions to be expressed instead of leaving them unaddressed where they can trigger anger, frustration and sadness in the brain and body. Art provides a calming and relaxing experience that supports the immune system, decreasing blood pressure and physical pain. When we focus on a creative practice, our minds are not focused on the pain or distractions of illness. Have you ever doodled? Doodling is a great example of how we can refocus our brains to a creative practice providing a distraction from worry, anxiety and many times physical pain.

Not only does art provide a tool to express feelings non-verbally, but it provides a vehicle to gain a sense of control when much of our lives can feel out of control. It offers a sense of accomplishment. It can be done at home or in the hospital or during medical treatments. Words can not always explain the impact an illness has on one's life, but art offers that opportunity. When we engage in art-making that isn't product focused, but rather process-focused, we can allow the enjoyment of self-expression to be present. We can let what happens happen and not be caught up with how something should look, but rather let the process unfold without judgment. With art-making, clients can give voice to the aspects of their lives that provide joy and to those that are challenging and painful. The art-work then becomes a tool to discuss life with a chronic illness.

Be well in body, mind & spirit.