Marta Nowak, Małgorzata Janas-Kozik

Dialog w milczeniu - rozumienie i terapia pacjentki mutystycznej     57-63

A silent dialogue - understanding and therapy of a mutistic patient elective mutism              57-63

Streszczenie

Autorki przedstawiają wielopłaszczyznowe ujęcie obja­wów pacjentki z mutyzmem wybiórczym w kontekście procesu psychoterapii i dynamiki obrazu zaburzeń. Artykuł ukazuje, jak przeżywanie uwewnętrznionego obiektu zależy od re­alnej relacji z matką oraz jak wpływa na funkcjonowanie i rozwój dziecka.

Summary

Introduction. Elective mutism is a disorder which usually develops in early childhood and in which a child who is normally capable of speech is suddenly unable to speak in given situations. A necessary condition for an elective mutism diagnosis is proper speech understanding [1].

Aim. The aim of this paper is to present a case of a female patient suffering from elective mutism who underwent a complex psychotherapy according to the psychodynamic trend with the elements of behavioural therapy. The treatment covered the period of 9 months. Additio­nally, the paper presents various approaches and perspectives of understanding the symptoms observed in the female patient.

Materials and Methods. The authors of the paper present the case of a mutistic female patient in the context of patient's family history, as well as her functioning at the Ward of Psychiatry and Psychotherapy of Developmental Age. Applied forms of therapeutic activities covered individual psychotherapy according to the psychodynamic trend, family psychotherapy, group psychotherapy, as well as selected techniques of behavioural impact.

Results. After 6 months of therapy, an improvement within the social functioning, initiating communication and the perception of social norms could be observed. This improvement influenced the changes in the functioning of the girl within the therapeutic relations - initiating dialogues, manife­stations of verbalization of her needs, emotional reactions more adequate to the discussed content.

Conclusions. Only a total insight into the child within the context of the observed symp­toms, as well as a long-term, multidimensional psychotherapy gives a chance of reduction or regression of the symptoms.