I stopped by a local Radio Shack last night to pick up a small gizmo for my thingamabob. As I was sorting through the display rack looking for the right model number, I heard a woman asking a clerk a rather complicated technical question about a piece of electronic equipment. Instantly, I recognized the voice as someone I've known very well for years. But when I turned to look at her, it wasn't her; it was her niece (I'll call the niece Martha, not her real name). Unaware of my presence, Martha continued a complicated conversation with the clerk for several minutes.
What's so remarkable about this? I know Martha and Martha's entire family very well, but this was the first time I'd ever heard Martha's voice.
No one in Martha's family ever uses the term selective mutism to describe the young woman's condition. The family seems at a complete loss for explanations whenever they comment on Martha's situation. She does speak with her mother and father regularly, but I've been told by her aunt that she doesn't speak with anyone else. At social gatherings, Martha might pull one of her parents aside to speak or she might whisper in her mother's ear.
I've also been under the impression that Martha has some cognitive impairments. Martha was a special education student until age 21. Now in her late twenties, she lives at home and continues to work in a marginal job that was part of the occupational preparation offered in her special education program. The job doesn't require speaking and Martha is, by all accounts, a valued, reliable employee.
Needless to say, I was startled last night when I heard this very self-confident, intelligent-sounding young woman engage in a complicated discussion with a clerk in a public place.
Martha's aunt and I once had a candid discussion about her niece's situation (initiated by the aunt). At the time, I resisted her plea to get involved by sharing my thoughts on treatment options with the young woman's mother and father. I never stick my professional nose into a situation like this. Family dynamics are complicated and most of the time,it's abundantly clear that getting involved will only stir up distress without helping. Martha needs professional treatment. Her parents are highly educated and aware that professional treatment options exist. Whatever it is that has prevented treatment (I think I know what that is), will not be overcome by an informal "educational" intervention.
When you're a shrink, people sometimes try to pull you into situations like this, often as a surrogate playing their part in a complicated family system. I'm not sure anyone but a shrink fully comprehends the utter futility and potential destructiveness of butting in, even when invited. Psychological resistances are not overcome with informal educational interventions, especially when there is a family system supporting those resistances. Naive informational interventions just set a game of psychological whack-a-mole in motion.
The problem is not that Martha's parents aren't sufficiently educated or worldly. The problem is that Martha's condition works well for her family. In a sense, her condition is not a problem; it is a solution to a family problem. A complex of interlocking family fears and family needs sustains her mutism. Martha cannot get better without putting her family at serious risk of disintegration.
Some family systems theorists might call Martha a family hero. That characterization is a bit too romantic for my tastes, but I do think Martha knows, implicitly, if not explicitly, that it is her job to be disabled. She could talk without any difficulty at Radio Shack because, she assumed, no one that mattered would know.
I think I should keep her secret.
A strenuous caveat: I am not remotely suggesting children's psychological problems are always, or even typically, a solution to family problems. I am not a systems theory purist. I am saying that it seems abundantly clear based on historical facts I know and what I've observed that, in this particular family, the young woman's condition is actually a solution to a serious family problem.