Elective mutism: psychoanalytic view of the problem

Elective mutism is looked at through the prism of psychological problems leading to a formation of 'voluntary refusal' to speak. These psychological problems are explored through clinical material from the psychotherapy of a 5 year old girl. The major factors significant in this process are 1) excessive ties to mother that hinder the child's social-emotional development; 2) difficulties in discharging aggression in a situation when it is not possible to feel separate from mother; 3) primitive ways of dealing with aggressive feelings based on phantasy and omnipotence; and 4) the symbolic equation of anus and mouth, at the developmental phase of mastery of both speech and sphincter control, as a cause of withholding words.

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