What is empathy?

By David Joel Miller.

Why is empathy in short supply?

Empathy is a vital ingredient in modern life.

What is? Series

Empathy.
Photo courtesy of Pixabay.com

Empathy is described variously as, understanding another’s feelings, the ability to identify with and understand somebody else’s feelings or difficulties or the abilities to put yourself in the other’s position. It can have to do with both cognitive understanding and emotional experience.

Empathy is considered a fundamental skill for beginning counselors to have or to develop. I looked this word up in my 1898 Century Dictionary and Cyclopedia only to find – it’s not there!

The word empathy was introduced into the English language in the year 1908.  It came from a German word which had come into use extensively in the 1870s.  There was clearly a need for a word that more accurately expressed this concept.  Originally the word empathy was closely related to sympathy but went beyond the concept of feeling sorry for someone.  Empathy came to mean a ‘felt sense” or an understanding at a deeper level.

Today this word is often used to denote the ability to understand and experience what someone else is feeling.  To really feel empathy and you needed to not only understand what the person may be thinking but what they may be feeling.

In order to develop your understanding of the skill of empathy take a look at the list below of ways to tell if someone is truly empathetic.

Empathy is seeing life through someone else’s eyes.

Empathy is not simply saying I know what you mean or I understand what you are going through.  It is that true desire to actually be able to put yourself in the other person’s position and see what they’re seeing in the way they are seeing it.

Empathy is being genuinely curious about others.

People who are high in empathy are genuinely curious about other people’s lives and what it would be like to live life the way that person lives.

Empathy wants to understand not judge.

To have empathy you have to suspend judgment.  The people who are high in empathy make the effort to understand the other person, their life situations, and what they have gone through.  The goal of empathy is to experience what it would be like to be that other person.

Empathy values the other person’s experience.

Having empathy places a high value on other people and their experiences.  People from other backgrounds can have important contributions to make to our understanding of the world we live in.  An empathetic person does not look for ways to make the other person more like themselves.  They look for ways in which that other person’s thinking and behavior make sense, given their life experiences.

Empathy is a mirror that reflects what is inside us.

As you seek to practice empathy for others you are likely to discover that it says a lot about you.  Looking and listening to other people’s life experiences evokes emotions deep within ourselves.  Much of what we may be feeling about someone else reflects what we would be feeling in that situation.  Deep empathy moves beyond our own experience and attempts to experience things from the others point of view.

Empathy understands feelings as well as facts.

Empathy is about more than simply understand the facts and the situations of someone existence.  The highest form of empathy is to seek to understand how someone feels.  This goes beyond thief understand of facts of someone’s life, to how that person interprets those facts and the feelings those situations result in.

Have you developed your skills for experiencing empathy?

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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What is an Adjustment Like Disorder? (F43.9)

By David Joel Miller.

When is an adjustment disorder not an adjustment disorder?

What is? Series

What is an Adjustment Like Disorder?
Photo courtesy of Pixabay.com

Sometimes people have symptoms as a result of experiencing trauma or stress.  These difficulties are sufficiently severe that we think this person needs treatment but the exact group of symptoms they have doesn’t quite fit a listed disorder.  The new DSM – 5 solves this problem by creating another name for adjustment like disorders.

Other Specified Trauma- and Stressor-Related Disorders (F43.9)

This designation gives us five more ways to categorize problems of everyday living which were caused by stressors or trauma but do not quite neatly fit the defined adjustment disorders.  Below are the five reasons you might get an adjustment like disorder diagnosis.

1. You had a stressor but your problems did not begin until more than three months after the stressor.

2. The problems continue for more than six months even though the stressor has ended but your symptoms have not turned into another diagnosis.

3. You were having an “ataque de nervious.” This particular condition is listed in the back of the DSM – 5 under cultural concepts of distress. While not recognized in the United States as a mental disorder, this particular group of symptoms is widely recognized in Spanish-speaking countries.

4. Another cultural syndrome. There are a number of cultural syndromes that are recognized in a particular geographic or ethnic area.  The cultural syndromes are understood as an inability to cope with a particular stressor.

5. Persistent Complex Bereavement Disorder. This condition is listed in an appendix to the DSM under conditions for further study.  Since it didn’t make the list of official diagnoses, researchers needed a way to code it.  The result is this condition ended up here under adjustment like disorders.

I don’t think I’ve ever seen an adjustment like disorder listed in the person’s chart nor have I ever use this particular diagnoses myself.  But when I saw it was right there in the DSM-5 I just couldn’t resist letting you all know about this.  Maybe this illustrates how learning to diagnose mental illnesses is both an imprecise science and an area for continuing learning.

As with the other things we are calling a mental illness this adjustment like disorder needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem this issue needs to be more severe than your situation would warrant. These other issues may need treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

For more on this topic see Adjustment Disorders in the Trauma- and Stressor-Related Disorders category.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Post-Traumatic Stress Disorder PTSD?

By David Joel Miller.

Would you know PTSD if you experienced it?

What is? Series

PTSD
Photo courtesy of Pixabay.com

PTSD is something that we hear a lot about, but most people have only a general idea what it involves.  PTSD was first recognized in returning military veterans. It has since been recognized in children who were abused, in cases of domestic violence, as the result of sexual assaults as well as the result of other traumas. While each case of PTSD is unique, they have many features in common.  Many people with PTSD may also have one or more other psychiatric disorders, some of which are likely the result of traumatic incidents. Below is a list of the features that professionals use to identify PTSD.

PTSD involves a specific trauma.

Something has happened or there was a high risk it would happen.  This trauma involved death, possible serious bodily injury, or a sexual assault. This event needs to happen to you or someone close to you, not just be something you saw on the television.  This event was either violent or sudden and unexpected.

Also included in the definition of a trauma below, are the effects which dealing with the incident has on first responders or other emergency personnel.

This traumatic event keeps forcing its way back into your life.

Part of PTSD symptoms are the recurrent memories of the event.  You may have nightmares about what happened or things connected to that event.  Some people with PTSD experience spacing out or dissociation.  You may also experience flashbacks and in these times it can feel like the event is happening again.

These recurrent intrusive memories are easily triggered.  Both internal triggers, thoughts and feelings, and external triggers, people, places, and things, may bring back the memory.

People with PTSD try to avoid reminders.

There are all kinds of ways to avoid being reminded of something that has happened. You may avoid going to certain places or events. People may turn to drugs, alcohol or other distractions.  They may try to avoid having feelings, or other thoughts about the incident.

Sometimes the brain does this job for you.  You may find that there are periods of time for which you have no memory. Some people describe this as having a blackout or amnesia.  They may avoid activities which are in any way connected to these unpleasant memories.

Behavior changes when you experience Post-Traumatic Stress Disorder.

People with this disorder often become irritable and angry.  They may become either self-destructive or reckless.  Part of this condition is having an exaggerated startle response.  In the aftermath of the trauma, people may develop poor concentration and impaired sleep.  Someone with PTSD may stop engaging in activities that used to be fun, they detach from others and may say that they just can’t feel happy.  These behavioral changes are also characteristic of depression, and the two disorders often occur together.

PTSD can cause cognitive changes.

In the aftermath of trauma, it is common for people to blame themselves.  They may tell themselves that if they hadn’t been there, or had been more careful, it would not have happened.  Negative thought patterns may develop.  People begin to feel bad about themselves, other people, and the future.  These cognitive changes can result in developing depression.

PTSD needs to last a while and not be something else.

This condition is expected to last more than a month after the stressor.  As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnosis. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem we’re likely to think this is something other than PTSD.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

For more on this topic see Trauma- and Stressor-Related Disorders. 

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What are the six types of Adjustment Disorders?

By David Joel Miller.

Adjustment Disorders include six types or specifiers.

What is? Series

What is an adjustment disorder specifier?
Photo courtesy of Pixabay.com

In another post, I wrote about adjustment disorders. You might want to take a look at that post.  You will find it in the trauma- and stressor-related disorders category. But to briefly recap, an adjustment disorder is a time when you experience stress and that amount of stress is more than you can handle.

The kind of things that you might find stressful, and how that stress might affect you, can vary a great deal from one person to another.  Adjustment Disorder can be very chameleon like, changing from person to person and from time to time. As a result of this variation and in order to help find the correct treatment for each person, professionals use six different specifiers for various presentations of adjustment disorder.  Listed below are the six specifiers or sub-types of adjustment disorder that are listed in the new DSM – 5.

Adjustment Disorder with Depressed Mood (F43.21).

Sometimes in addition to having difficulty coping with a stressor, as a result of this life problem, people develop depression.  If this goes on long enough or is severe enough they might eventually get a diagnosis of Major Depressive Disorder.  But until that happens treatment will mainly focus on the stressor and the depression that stressors is causing.

Adjustment Disorder with Anxiety (F43.22).

Sometimes the primary symptom that people experience when they are going through stress is an increase in their anxiety.  If this increase in anxiety is related to a specific stressor, is more severe than we expect or goes on too long, Adjustment Disorder with Anxiety is the likely problem.

Adjustment Disorder with both Depression and Anxiety (F43.23).

Anxiety and depression frequently happen to people at the same time.  If this stressor has produced both depression and anxiety, then this specifier should be added.

Adjustment Disorder with Conduct Problems (F43.24).

Sometimes the principle way we know that stress has affected somebody is that they begin to act in inappropriate ways.  This diagnosis with this specifier is most commonly seen in children who rather than show their symptoms as anxiety or depression, begin to act out.

Adjustment Disorder with Disturbance of Emotions and Conduct (F43.25).

When stress overcomes a person’s ability to cope, we may see changes both in their behavior and in their feelings.  This is often the case in children and adolescents but may also be seen in adults with poor emotional regulation.

Adjustment Disorder Unspecified (F43.20).

When the counselor knows that the problem the client has is caused by their reaction to stress but none of the other sub-types quite seem to fit, this category may be used.

As with the other things we are calling a mental illness this problem needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise you may have the issues but you will not get the diagnoses if this is not causing you a problem. If the only time this happens is when you are under the influence of drugs or medicines or because of some other physical or medical problem, this problem needs to be more than your situation would warrant. These other issue needs treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What are Adjustment Disorders?

By David Joel Miller.

You don’t have to be “crazy” to have a mental illness.

What is? Series

What is an adjustment disorder?
Photo courtesy of Pixabay.com

Sometimes bad things happen, and those difficulties in life can overwhelm you. When these things happen, often people get right back up, but if something bad has happened to you and you find that you can’t get back on track you might well have an Adjustment Disorder. Adjustment Disorders are the result of bad things happening to you.

Professionals need to be careful not to turn everything that could possibly happen to someone into some sort of mental disorder.  Beginning professionals are cautioned to avoid pathologizing their clients by being so sure everyone who comes to their office must have some kind of extreme mental disorder.

Stress affects everyone differently.

A particular stress, divorce, for example, can have very different meaning for different people.  One person may become very depressed.  Another might become quite angry.  Some people may even be happy and throw a party.

We know that stress can be quite difficult to handle.  But if someone’s response is far beyond what we expect, then that excessive response gets diagnosed as an adjustment disorder. To be diagnosed with an adjustment disorder your distress as a result of what happened has to be in excess of what we would normally expect.

Because of the large number of possible ways stress might affect someone there are six specifiers or some types of adjustment disorder.

This inability to adjust can result in suicide.

Adjustment disorders have come to be recognized as serious mental health issues because of the high rate of suicide, homicide or other negative behavior that can occur in the aftermath of the stressor.  Things like a divorce, loss of the job, business failure or other negative events can overwhelm a person and exceed their ability to cope.

Adjustment disorder requires an identifiable trauma or stressor.

Just any difficulty coping with life does not get diagnosed as an adjustment disorder. In this condition, we know clearly that something specific happened in your life.  We call this the identified stressor. We expect to see the results of that experience start happening within three months of the original incident.  We also believe that adjustment disorder normally stops all by itself within six months of the time it began.

If you have a strong reaction to a stressor in the first month after the incident, we call that Acute Stress Disorder, a condition that usually resolves very shortly.

An Adjustment Disorder results in a change in your feelings or behavior.

As a result of this stressor, people find their feelings overwhelming them.  That may become depressed, anxious or angry.  Not only are these feelings negative but they’re far beyond what would be useful.

People with Adjustment Disorders may begin behaving in ways that are just not normal for them.  That may be constantly angry, become violent or begin abusing drugs and alcohol.  Some develop other addictions.

People with an adjustment disorder are at high risk to become violent towards those they blame for their misfortune.

Bereavement is not the same as Adjustment Disorder.

Having someone close to you die is something everyone experiences sooner or later.  Mental health professionals see this loss of a loved one as quite different from Adjustment Disorder. While everyone needs to grieve in their own way, most people eventually get past the loss of a loved one.

In an Adjustment Disorder not being able to adjust damages your life.

As with the other things we are calling a mental illness this needs to interfere with your ability to work or go to school, your relationships, your enjoyable activities or cause you personal distress. Otherwise, you may have the issues but you will not get the diagnoses if this is not interfering with your everyday life.  If the only time this happens is when under the influence of drugs or medicines or because of some other physical or medical problem this adjustment difficulty needs to be more than your situation would warrant. These other issues may need treating first, then if you still have symptoms you could get this diagnosis.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Separation Anxiety Disorder (F93.0)?

By David Joel Miller.

Separation Anxiety Disorder used to be strictly a children’s condition.

What is? Series

Separation Anxiety Disorder
Photo courtesy of Pixabay.com

In the past Separation Anxiety Disorder was listed in the section of the Diagnostic and Statistical Manual (DSM) under the category of Disorders First Diagnosed in Infancy, Childhood, and Adolescence.  Recently in the reorganization of the DSM, this disorder was moved to the chapter on anxiety disorders.

Increasingly we recognize that there are adults who suffer from Separation Anxiety Disorder.  In children, if they have the symptoms for four weeks or more, that meets criteria.  But when we see this disorder in adults we expected it to last at least six months.  This is a disorder which may come and go throughout the lifespan.  It is likely to begin after, or to be triggered by, stressful events.

Separation Anxiety Disorder is about a fear of losing the major attachment figure.

In Separation Anxiety Disorder there is a fear of leaving home or being separated from a major attachment figure.  This is very different from people who are simply afraid of going out of the house, being around crowds, or meeting strangers.  In Separation Anxiety Disorder it is the fear of losing that significant person which causes them extreme distress.

This fear is clearly far more than life circumstances would warrant.  People with this disorder need to know where that important person is it all times.  And they may have an excessive need to stay in constant contact with their major attachment figure.  These people may be given to constantly texting, and may become quite upset if they’re communications are not immediately responded to.

You may also fear being taken away.

Separation Anxiety Disorder is also the fear that something will take you away from that major attachment feature.  People with this disorder worry about an illness, kidnapping or being forcibly taken from a major attachment figure. Some people with this disorder are unable to be in a room by themselves.

Separation Anxiety Disorder can make you refuse to leave home.

The classic example of this is the child who is terrified of leaving their mother to go to kindergarten on the first day of school.  In normal children, if we expect them to get over this fear after a few days.  But in those with Separation Anxiety Disorder that fear continues for long periods of time. We may continue to see this behavior as children get older.  They may have frequent illnesses which keep them at home with their important attachment figure.

Like most other anxiety disorders, Separation Anxiety Disorder typically begins in childhood, but it may well continue throughout adult life.  In diagnosing this disorder the professional looks at the developmental stage of a person to see if what they are going through is appropriate.

Some adults are so afraid of leaving their significant family member that they are unable to venture out into society alone.  They will only be willing to go outside the house, to the store or an appointment, if that major attachment figure accompanies them.

That huge fear of being alone maybe Separation Anxiety Disorder.

An abiding characteristic of Separation Anxiety Disorder is the extreme level of fear of being alone.  Any time this person is separated from their major attachment figure, they become anxious and may even become terrified.

In children, the attachment figure is likely to be their parents or caregiver.  In adulthood people with this disorder are likely to become very anxious when separated from their spouse, partner or their children.

If that important person is not home, then you can’t sleep.

People with Separation Anxiety Disorder find that they are unable to sleep when the major attachment figure is not in the house.  They may stay up all night on those occasions when that person they’re attached to needs to be gone overnight.

The person with Separation Anxiety Disorder will have a constant need for reassurance.  This need may result in frequent phone calls or other efforts to contact the attachment figure who is not there.  This constant need for reassurance may begin to interfere with their partner’s ability to work.

Separation Anxiety Disorder causes nightmares about being separated.

In this disorder, the content of the nightmare is that the important person will be taken from you or you from them and that you will never ever be able to see them again. These nightmares can be recurrent and play a role in maintaining the other symptoms.

Separation Anxiety Disorder can make your physically ill.

Symptoms of this disorder can look just like a physical illness.  These symptoms may include headaches, inability to eat, nausea, or even vomiting if there’s a chance that you’ll be separated from this major attachment figure in your life.

People with Separation Anxiety Disorder are likely to be described by others as needy and insecure.

There is help for Separation Anxiety Disorder.

While this condition often begins in childhood and may continue well into adulthood, someone with this issue does not have to continue to suffer.  There are treatments available.  If you or someone you love suffers from this condition, consider getting professional help.

More on this and other anxiety disorders see:  Anxiety

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

See Recommended Books.     More “What is” posts will be found at “What is.”

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

What is Selective Mutism (F94.0)?

By David Joel Miller.

Selective Mutism is the failure to speak at times when speech is necessary.

Can't talk

No speech. Selective Mutism.
Photo courtesy of Pixabay.com

Selective Mutism is an interesting disorder. It is one of the less common anxiety disorders and one which commonly first appears in childhood.  This disorder often co-occurs with Social Anxiety Disorder.  As with all the anxiety disorders, Selective Mutism may continue well into adulthood.

Selective Mutism is not the inability to speak or the willful refusal to speak.  Selective Mutism occurs when someone chooses not to speak in a particular situation even when not speaking may cause them difficult.  Children with this condition will avoid starting a conversation with other children.  When spoken to they will fail to respond.

Selective Mutism gets noticed when children begin to attend school.

Children with Selective Mutism do poorly in school because they do not respond verbally to the teacher and do not read out loud.  Those with this disorder may use other ways of communicating rather than speaking.  Sometimes they will point, grunt or used personally significant gestures.  They may also be willing to engage in social activities when speech is not required.

Children with Selective Mutism are able to speak normally at home with their parents or primary caregivers.  They may be unwilling to speak in the presence of close relatives including cousins, aunts and uncles, and grandparents.

Risk factors for Selective Mutism.

Children who are shy are at extra risk to develop this disorder.  Having parents who are withdrawn or growing up in a socially isolated environment may also be risk factors.  It is possible that having overprotective or controlling parents increases this risk.  There’s some evidence that children with this disorder have difficulty understanding the things that are said to them.  Having Social Anxiety Disorder or a family history of it may also increase the risks.

Other problems may accompany Selective Mutism.

People was Selective Mutism also frequently are shy and experience social embarrassment.  They may be isolated and withdrawn.  Children with Selective Mutism may be clingy and become easily upset.  They many also exhibit temper tantrums and oppositional behavior.

Having this disorder early in life and not getting treatment for it puts the child at extra risk for poor development and failure to learn needed social skills.

Things that are excluded from a Selective Mutism diagnosis.

To get this diagnosis, this condition of not speaking even when you need to speak must go on for at a month or more.  If the thing keeping you from speaking is the result of not knowing the English language or being bilingual in some way, this is not a case of Selective Mutism.

Also excluded from the definition of Selective Mutism are things related to speech fluency.  If the person involved is experiencing an episode of hearing voices, if being psychotic, or a schizophrenia-like condition, this also is outside the definition of Selective Mutism.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5, some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

More “What is” posts will be found at What is.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books