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Selective mutism is a psychiatric condition in which children stop speaking to all except their closest family members. Analytic material from a 4 1/2-year-old selectively mute child demonstrates how his symptom of mutism was embedded in a character structure in which not only verbal dialogue but play and other nonverbal communication were disrupted. Because communication was severely limited, I modified my analytic technique. Despite obstacles to communication, conflicts from different developmental levels were revived in the transference. Even in these difficult circumstances, analytic work in the transference resulted in significant change.
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