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Diagnostic criteria for Selective Mutism

A. 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.

B. The disturbance interferes with educational or occupational achievement or with social communication.

C. The duration of the disturbance is at least 1 month (not limited to the first month of school).

D. The failure to speak is not due to a lack of knowledge of, or comfort with, the spoken language is required in the social situation.

E. 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.

Thoughts on diagnosis

I would like to take a moment to address the title DSM; an acronym for The Diagnostic and Statistical Manual of Mental Health. It is important to do so because I believe that it is easy to get lost in highly emotive words such as Mental Health. We still live in a society where mental illness is often stigmatised and ridiculed. Although, as time progresses and more research studies are conducted our understanding of human psychology is thankfully becoming less enigmatic.

These developments are instrumental in providing an enlightened understanding of the factors involved in the forming and maintenance of patterns of behaviour; helping to shed light on behaviours that are often lazily labeled as 'crazy'. I use the word lazily because I believe that there is a tremendous depth to a person's behaviour, a depth that we dismiss when we describe somebody in one word such as 'crazy', 'abnormal', 'weird' without looking beyond our prejudices and taking our segmented, instinctual reactions as truth.

I propose that, that which we label as 'crazy' is that which we don't understand because we cannot find an avenue within ourselves where we feel we can relate to behaviours that are unlike our own.

Each person has their story, their reasons, their personal pivotal moments. Some will develop patterns of behaviour that will help them take on the world, many will learn to get by, others will learn patterns that do them more harm than good sometimes to extents that compromise their ability to function and enjoy life.

The DSM is made up of a collection of recurring groups of destructive behavioural traits that have been given titles such as "Obsessive Compulsive Disorder", "Anorexia Nervosa", "Selective Mutism" etc. These are behavioural traits that are maintained and strengthened over time and impinge on a sufferer's quality of life.

Many psychologists believe that identifying the destructive behaviours and their underlying basis is the first step in helping their client find peace of mind.

The main sentiment that I hope will resonate through this note is the idea that a diagnosis is not something to be feared, but in fact celebrated. Being able to put a label on destructive behaviours allows a person to focus on what can be changed to make life less distressing. Having a diagnosable disorder doesn't equate 'madness', as I am sure you know that things are rarely that black and white; but rather that there have been many before you that have suffered with the stranglehold of the same entrenched bad habits have and have been helped to neutralise behaviours that have escalated into destructive extremes.

Breaking The Silence