Elective mutism

Elective mutism was historically defined as a refusal to speak in almost all social situations, despite having the ability to do so, while selective mutism refers to a failure to speak in specific situations and is strongly linked to social anxiety disorder. Unlike selective mutism, elective mutism was often associated with defiance or trauma. The term "elective mutism" was first introduced in 1877 by German physician Carl Wernicke as "aphasia voluntaria," describing children who refused to speak despite normal ability. In 1980, the DSM-III included elective mutism, defining it as a continuous refusal to speak in almost all social situations. It was associated with excessive shyness and anxiety but not linked to social anxiety disorder at the time. The DSM-IV renamed the condition to selective mutism in 1994, aligning it more closely with social anxiety. Torey Hayden's 1980 study identified four subtypes of elective mutism: symbiotic mutism (linked to controlling behavior in families), speech phobic mutism (characterized by fear of hearing one's voice), reactive mutism (a response to trauma or abuse), and passive-aggressive mutism (used as a form of hostility). Culturally, elective mutism is often portrayed in literature and media, frequently involving characters who stop speaking after traumatic events. These portrayals often depict silence in all situations, which does not align with the modern understanding of selective mutism. Examples include films like *A Good Woman Is Hard to Find* and *The Prophet*, as well as novels such as *Fifty Shades of Grey* and *Hannibal Rising*. However, these depictions often romanticize ...