Jonathan Kohlmeier

Barely Speaking

Treatment of Selective Mutism

My view on behavioral therapy combined with medication in the treatment of SM

Posted Jun 28, 2017

I'm only speaking to this topic from my experience and discussions I've had with doctors over the years. My analysis is not a rather scientific one, but there are many studies that cover this in greater detail and I would urge you to read them before making any final decisions.


Imagine for a moment that I dropped you off in the middle of Anchorage, Alaska and told you that you had to get to New York City. It's a direct distance of 3,360 miles, or 5,407 kilometers. You could get there anyway you wanted but the goal was to get there.

I give you three choices. You could walk, drive, or fly there. Each would take a different amount of time and effort.

You could theoretically walk from Anchorage to New York City but it would probably take a very long time and you would be exhausted by the time you got there. You'd probably also want to give up along the way as well, questioning why you're going there in the first place. I know I would have absolutely no interest in taking this route.

Driving is a slightly more palatable option. It would still take a while to get there but not nearly as long as walking. 

Flying in an airplane would be the quickest option, only taking a few hours. Why walk a few thousand miles when modern technology can get you there in a fraction of the time.

At this point you're probably questioning what any of this has to do with Anxiety or Selective Mutism. I think this is a pretty cool way to compare three major treatment methods into simple terms. 

Think of the walking scenario as being if you got no treatment for Selective Mutism. Anchorage is where you are now and NYC is where you want to go. For a majority of people, Selective Mutism is not something you just grow out of. Theoretically, it is possible, but it will take a very long time, if it does happen at all. And there will be days and days of struggling, pain, and heartache. 

Taking a car would be like pursuing behavioral therapy from an expert who specializes in the treatment of SM. The time difference is exponential and you will most likely get to your destination in much less pain and suffering then walking the same distance. 

Taking a plane would also be quicker. That would be like doing specialized therapy combined with anti-anxiety medication. Flying is the quickest way we know to travel long distances. Combining therapy with medication is the quickest and most effective way of combating Selective Mutism and making sure you reach your goal. It is not an option for everyone but can be an almost sure method of reversing the behavior.

Of course there are risks to everything in life. There are no one size fits all treatment plans for SM. But nowadays there is little reason for someone to suffer with SM for their entire life. There are comprehensive treatment options that can allow for people to live more normal lives who would otherwise be unable to. Without the treatment I underwent when I was younger, I have no doubt I would not be the person I am today. I would never have been able to go off to college on my own and make the friends that I did and learn about what I truly want from my life. 


My next article will go more in depth on how Behavioral Treatment for Selective Mutism worked for me and the process I took.