Monday, April 18, 2011

Medical Mondays: These Lips Are Sealed...For Now.


Happy Monday! Jen Daiker at Unedited has a great question for today. She asks:

"I have a main character who only speaks when it rains...now while that doesn't really matter for someone who lives in Oregon or Washington but for someone who lives in sunny LA that could took forever.

My question: How long could one go without speaking? Would something happen to their vocal cords?"

Well, this question stumped me. I'm going to answer as best I can, but I do have an ENT friend I consulted on this, so when I hear back from him I'll addend this post.

I think Jen is talking about is a problem called Selective Mutism. Adults and children (but more kids are affected, in general) with this condition cannot talk in certain situations (usually social situations) because of anxiety. Often, it's not that they choose not to speak, but that they are forced into a mute state by their extreme anxiety.

(Think Speak, by Laurie Halse Anderson, or the character Charles Wallace in A Wrinkle In Time by Madeleine L'Engle)

Sufferers are fully able to talk and understand language when the problematic situation goes away. Jen's character, for mysterious reasons (fascinating, right?), would start talking again when it rains.


But what if a person couldn't/didn't speak for a really long time? As in, months or years?

I did my best to find case studies of long term, exclusive mutism, and nothing came up. Nothing! So I'm left with hypothesizing instead.

Phonation, or the ability to produce sound is extremely complex. Speech is additionally very complicated. It's not just about the vocal cords, but the multiple soft tissues, nerves, and different cartileges that comprise the "voice box", AND the throat, the lungs, air pressure, the mouth, teeth and tongue, the brain of course, and the speech centers...

My best guess is that without talking for months and months, the first time someone did talk they'd have some difficulty. Possibly some hoarseness, from atrophy of the muscles related to phonation; possibly some dysarthria (poor enunciation of words) from lack of practice and all those other anatomic items you need to speak well. I'd guess that speech would be slow as well.

Thanks Jen for stumping me on a Sunday. Again, if my ENT friend gets back to me, I'll probably addend this post.

In the mean time, speak up and wish everyone within ear-shot a Happy Monday!

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice.

If you've got a fictional medical question, let me know! Post below or email me at
All I ask is that you become a follower and post a link on your blog when I post your answer.

58 comments:

Laura Pauling said...

Just like any muscles I be it would be hard to start talking again after months or years. Very interesting.

salarsenッ said...

This is a great question. All I can think of is how tight the throat might become. But then again, maybe not. I know of nuns and priest who've taken vows of silence. I'm not sure it did anything physical to them. Hmmm...very interesting.

Jess said...

Super-interesting post, and I'm curious about Jen's character. Hope she gets that manuscript published so we can find out how the rain-talking goes :)

Liz Fichera said...

Tres cool! This is very interesting. And what an interesting situation for a character too! I will pop on over to Jen's blog for more...

Jen Daiker said...

This was far more helpful that anything I could find. You've definitely left me with a ton to think about.

To give a little more insight on my character here's the rundown - My MC Rae, loses her sisters a year apart from each other after an evening running in the rain. She's sure she's next but no one will listen and no one will help her search for her sisters. Though they disappeared her parents want to move on and Rae isn't ready. She decides there is no sense in talking if no one listens to her so she zips her lips until the first rain fall, she can hear her sisters within the raindrops.

Led later to an institution known as Rayne Manor she'll learn that there are more secrets in those walls then the one's in her heart.

Thanks for the help and I love the excitement and curiousity I've peaked in so many of your readers :)

Munk said...

(!)

Old Kitty said...

One of my very bestest friends has a daughter with selective mutism. The daughter is now 9 years old and it's still a wrench for her to say anything to anyone outside of her parents. I've also worked with a gorgeous woman who admitted to having selective mutism and only broke her silence when she turned 17 - she forced herself out of her mutism by travelling abroad on her own. I remember thinking then what a courageous woman! My friend with the daughter was more distraught - she can't bear the thought of her daughter not speaking until that age!

Take care
x

Amy Jarecki said...

Great summary and I admire your tenacious research!

Amy

Sarah said...

Brilliant as always, Lydia. I've treated several children with selective mutism, and to a kid, they've all been loudmouths (in a good, hilarious way) at home, where they're comfortable. Although their teachers weren't sure if they knew any of the academic material, they all did, and one kid even went home and acted out the whole school day in his playroom after school. And ... the good news is that selective mutism is quite treatable.

Jennee said...

(not speaking to you because this is a sensitive subject for me and I'm feeling a little anxiety just reading about it.)

Lenny Lee* said...

hi miss lydia! wow thats pretty interesting stuff. my mom said i didnt say not one word til i was 5 year old and the doctor said i was ok and just didnt wanna talk. maybe its cause of having 4 more older brothers and 1 more older sister so i couldnt get a word in. ha ha.
...hugs from lenny

Bossy Betty said...

I wonder if my family/students/friends ever wish I had a tiny bit of this affliction?

Alex J. Cavanaugh said...

Jen came up with a good one!

Angela Felsted said...

What a great question. I'd heard of selective mutism, but wasn't sure about the permanent sort. I'll have to come back when you hear from your ENT friend.

sarahmullengilbert said...

Wow, such an interesting question and condition. Good luck, Jen!

notesfromnadir said...

Some people just don't have a lot to say. & maybe that's a good thing???

Roland D. Yeomans said...

What an intriquing post, Lydia.

I hypothesized similar conclusions with my reclusive ghoul, Alice. You always make my Monday mornings better for having visited you, Roland

Kate said...

To stop the vocal cords attriphy problem, maybe she could try taking in the shower. :-)

Great story idea though.

Sailor said...

When I think of few people I wish whay are they not having this proble! :)

Olga said...

Your Medical Mondays are amazing to read. For me, it`s a collection of short stores and discoveries :)

Talli Roland said...

Wow - that's quite the question from Jen! Interesting answer, Lydia.

Rachna Chhabria said...

Great question, and amazing answer. Wish all the people who constantly bug me develop this problem. Just joking ;)

Krispy said...

This is a really fascinating topic. Great question and answer! Definitely interested in hearing more if your friend has more to add!

M Pax said...

Interesting. It depends where you are in Washington & Oregon as to how much it rains.

cherie said...

I'm new to your blog but I'm already so impressed. This is a mine of valuable medical information for writers. Thank you so much for sharing your knowledge with us nonmedical people. =)I'll be sure to drop by here more often.

K.V. Briar said...

Facinating as always Lydia! I think it would be a very interesting exercise to write a story where a character was selectively mute. I imagine it would be quite difficult. As a writer I tend to have too much dialogue, maybe I should try writing a character like this!

Karen Lange said...

Wow, never really thought of this. It'll be interesting to see Jen's character when she is finished. Thanks, Lydia!

Emily Rose said...

Very interesting.

Taryn Tyler said...

That is a facinating question. Not a scenario I'd have thought up. I see though, how the soothing mood of rain might releive someone's anxiety if they had a condition like that. (also I love Charles Wallace!)

Jen Daiker said...

I'm loving everyone's views and how people are thinking it through. Thanks to your information I'm already beginning to write the first chapter in the novel and move on my merry way.

Taryn was on to something. My main character relates to rain because she can hear her sisters when it rains (quite possibly dellusional) therefore it releases her vocal cords to speak!

Thanks everyone for your thoughts!

Lynda R Young said...

That is a cool question. And now I'm intrigued about her character too.

Holly Ruggiero said...

Interesting. And I’m interesting in Jen’s book too.

L'Aussie said...

Hi Lydia. I heard a radio program about this over a year ago and I have the details in one of my notebooks which I dont have with me on holiays. I'm sure it was called something else. I'll let you know if/when I find my notes. It was nothing about the rain, though, just some mental decision a person made to be mute.

Denise<3

Donea Lee said...

Wow - kudos to Jen for a fascinating character. And thanks, Lydia, for the info!

Lynn said...

Yes, Jen has come up with an interesting character and especially that it takes rain to get her to talk! Fear is what I have always contributed mutism with but now know so much more. Thanks!

Ciara said...

Intriguing. Wow, that is a going to be a fascinating character. I've read some books where characters had selective mutism, but nothing like this.

The Words Crafter said...

I wonder if this is the same as the little girl's condition in House of Cards. She was autistic, but she also stopped speaking when she saw her father die.

Wow, very interesting.

Yeah, I'm cheating, but it's bedtime and I thought I'd check in :)

Heather Taylor said...

For the three years I've lived in LA, it has rained more than you might think. Though this is an interesting circumstance for this character to be in, I think she might speak sooner than later.

DEZMOND said...

ah, Lyds, this was super interesting. Since, as a book translator, I spend ten hours in the utter silence of my office, sometimes I think I will forget to speak :)

foldingfields said...

this is a very interesting question and answer. I am fascinated by characters who are either mute or selectively mute. My favourite book, THE BONE PEOPLE has a mute character that is more alive than some of the other characters simply through gestures and action. What a challenge for a writer!

Kerri Cuev said...

Interesting condition and having it applied in a story....wow! Sounds good!

Jonene Ficklin said...

How intriguing, and what a great idea for a book! Learning how the body and brain would respond is fascinating! I can only imagine how much time it takes to research these. Thanks for another great post!

Anita said...

What an amazing post! And so timely for me. One of the characters in my WIP doesn't talk, and now I can put a name to his condition. COOL. Thanks so much for posting this, and for dropping by my blog, too. ;)

Phoenix said...

Fascinating topic! I'm looking forward to hearing some more input from your ENT friend too. :)

PS Charles Wallace is one of my favorite characters in all the books I have read. I ADORE him!

Rachel Morgan said...

Very interesting question. Hadn't thought about that before, but I guess the muscles would suffer from lack of use, just like any other.

lbdiamond said...

Hmm, that IS an interesting question!

Jennifer Hillier said...

Neat! I always wondered what would happen if somebody didn't speak for a long time.

I love this blog. Sigh.

Missy said...

What an interesting post, enjoyed reading it!

ensouling said...

I'm wondering (late to the party, sorry) if the answer would be in people who've been in comas for months or even years. Could there be a clue there somewhere?

Alleged Author said...

Whoa...that was a really great question! I kind of wondered about something like that after reading a book about a boy who went mute due to his rape. I wish I could remember the title though. He never did speak again. It was sad.

Susan Fields said...

Very interesting question! That reminds me of Raj on Big Bang Theory who can't talk when a woman is around unless he's drinking alcohol. I guess it got to be too tough for the writers to work around, because now you almost always see him with a drink. :)

LTM said...

wow. What an interesting question, and what an intersting post!!! Now I'm wondering what tha hay Jen's working on! And I'm thinking I should read A Wrinkle in Time... :D Thanks, Lydia~

Jayne said...

Haha! Selective Mutism - I think my husband has this. Kidding. Sort of. Your Medical Monday posts are fascinating. Always something interesting here! :)

Heather said...

This is really interesting. I've heard of cases of children not speaking for a while due to trauma and I've often wondered about this. Thanks for the info!

KendallGrey said...

Thank you for visiting my blog yesterday, Lydia. I love meeting new writers, and I'm so glad you visited because I often have medically-related questions for my stories. Now I know exactly whom to visit when I do! :-)

Carol Riggs said...

That's an interesting question, and post! Yes, I think your postulating would be correct. Raspy, unused vocal chords from being out of practice. UNLESS...the person talks to themselves when no one else is around. Then their voice wouldn't be hoarse the first time they say something in public.

Kristin Rae said...

Great question, Jen! And I find it interesting that not speaking for a long time would cause atrophy of the muscles used for speech... makes sense, just never would have thought about it. Useful info! Thanks!

Steve MC said...

The narrator of "The Lock Artist" has this, and I think there's a scene in "Hotel New Hampshire" where Amanda Plummer speaks for the first time in years and struggles to get the words out.

I've gone a few months without talking, and at the end, just talking for ten minutes would leave my throat sore for a day, like I'd been yelling the whole time.

 
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