The Below, Summarized
The overlap between perfectionism and Selective Mutism is a reinforcing cycle of fear and self-criticism.
Understanding the connection is critical for effective treatment, which often involves a combination of therapeutic approaches to address both the fear of imperfection and the silence it sustains. With patience, empathy, and the right interventions, individuals with SM and perfectionistic tendencies can learn to navigate their fears and find their voices.
Let us strive to create environments that celebrate progress over perfection—one word at a time!
Selective Mutism (SM) is a complex anxiety disorder where individuals, often children/teens, are unable to speak in specific social situations despite speaking comfortably in others, such as at home.
Perfectionism—commonly described as the need to achieve flawlessness—is an often-overlooked aspect of Selective Mutism that can exacerbate the condition and create barriers to communication.
Here’s an exploration of how perfectionism and Selective Mutism intersect, examples of their overlap, potential causes, and effective treatment strategies.
Within the CBT-based S-CAT© program, addressing the whole person is key. For children and teens who struggle with perfectionism where impact of functioning occurs, both educating parents and working directly with the child or teen is key to the development of coping skills and overall, lowered anxiety.
How Perfectionism and Selective Mutism Overlap
Perfectionism is frequently tied to an intense fear of making mistakes or being judged. For individuals with SM, this can mean:
1. Fear of Saying the Wrong Thing: Individuals may feel pressure to speak perfectly, worrying about pronunciation, tone, or word choice. In addition, children/teens may fear making a mistake and bringing attention to themselves.
2. Avoidance of Speech and Overall Communication, Even Nonverbally, Due to Judgment: The fear of not meeting perceived expectations leads to total silence and avoidance, as it feels safer than speaking or communicating imperfectly.
3. Overthinking and Freezing: The thought of communicating, via nonverbal, using a Verbal Intermediary or shaping sounds into words as well as verbal interaction might trigger a mental spiral, where overthinking how to respond leads to freezing entirely. This is one reason why helping the child/teen understand and use the Bridge so they realize it’s OK to bridge down when feeling anxious and they have the opportunity to bridge up when feeling comfortable. In addition, structure, consistency, routine, and predictability help with feelings in control and hence provide an understanding and hence may be more aware of what, when and where = control.
4. Desire for Social Approval and/or Parent/Adult Approval: Perfectionism might magnify the fear of disapproval or negative feedback, deepening the silence and communication avoidance. Many children with SM sense a high expectation from adults in their lives. This is often a result of adults focusing TOO much on speaking when the child may be further down the Social Communication Bridge® with comfort/communication. Parent and adult education (About my Child) and teacher education is key.
Examples of Perfectionism and Selective Mutism
- A child with SM might be unable to answer a teacher’s question, not just due to anxiety but because they’re worried their answer isn’t “good enough,” even when they know it.
- A child may hesitate to answer with fear of disappointing his parent or teacher.
Potential Causes of Perfectionism and Selective Mutism
1. High Expectations at Home or School: Children raised in environments with high expectations may internalize the belief that mistakes are unacceptable.
2. Temperament and Personality: Many individuals with Selective Mutism have a cautious, sensitive temperament, making them more prone to perfectionistic thinking.
3. Anxiety Feedback Loop: The anxiety from SM feeds into perfectionism—fear of speaking leads to silence, and silence reinforces feelings of inadequacy.
4. Social Comparisons: Observing peers who communicate effortlessly can create unrealistic self-expectations.
5. Trauma or Criticism: Early experiences of being corrected harshly or mocked for speaking mistakes may leave a lasting fear of verbal interaction.
Social Communication Anxiety Treatment or S-CAT® Strategies for Addressing Perfectionism in Selective Mutism
1. Behavioral and Exposure Therapy:
- Gradual exposure to communication tasks in low-pressure/stress situations can help desensitize individuals to their fear of imperfection.
- Example: Starting with simple tasks like nonverbal (waving, pointing and nodding) -Stage 1, as well as progression to whispering to a trusted adult (Verbal Intermediary) -Stage 2, then building up to speaking 1-2 words to more elaborate speech -Stage 3, to others, 1-1 then expanding.
2. Cognitive-Behavioral Therapy (CBT):
- S-CAT® is very CBT-based. CBT helps identify and challenge perfectionistic thought patterns, such as “If I make a mistake, people won’t like me.”
- Reframing such thoughts to, “Mistakes are a natural part of learning,” can reduce the anxiety fueling both SM and perfectionism.
3. Self-Compassion Training:
- Teaching individuals to treat themselves with kindness and forgiveness when they struggle with speaking.
- Techniques like journaling about successes, even small ones, can encourage a focus on progress over perfection.
4. Communication Goals and Reinforcement:
- Setting achievable, incremental communication goals, based on the child/teens baseline stage of communication via the Social Communication Bridge as well as taking into consideration the child/teens WHYs of SM as factors into what may be causing the child/teen to have challenges with progression of communication is needed. And then, rewarding efforts rather than outcomes.
- Example: Praising a child for attempting to answer a question, even if they only manage a whisper.
5. Parental and Educator Involvement:
- Training parents and teachers to create supportive, low-pressure environments where focus is on strategies and interventions for social confidence and communication progression.
- Using Direct language. “Let’s work on our goals” vs. “Can you work on your goals” implies confidence vs doubt. Avoiding language like “Just try harder” or “Why won’t you talk?” or ‘You need to…..” or ‘You should…” language. Focusing on patience and understanding is key and shows support.
- Parents and even teachers to voice mistakes they make or worries they may have will help a child/teen open-up and feel safer to take chances.
6. Mindfulness and Relaxation Techniques: Mindfulness exercises, such as breathing techniques or progressive muscle relaxation, can help reduce the immediate anxiety tied to communication.
7. Addressing Underlying Beliefs:
- Helping the individual understand that people value connection and effort more than perfection.
- Example: Role-playing situations to show how mistakes often go unnoticed or are easily forgiven in social interactions.
8. Focusing on the WHOLE Person: ‘mutism’ helps to minimize attention to speaking while respecting the person’s unique needs.
