As I have worked with a variety of individuals with Aphasia over the last 15 years, I have always wondered the difference between that individual who would participate in endless therapy if it were possible and free, self-initiates creation of their own home programs, constantly pushes themselves outside of their comfort zone, and ultimately makes quite a recovery.....versus that individual who is content ending therapy early in the process only to find their loved one wanting more for them, they are given home practice but it is rarely touched, and they tend to isolate themselves and do not wish to socialize because, well, it's clearly just not the same as it once was, and ultimately their progress is much slower and usually minimal.
What variables influence patient A and patient B?
Is it motivation or attitude? Perhaps it's related to premorbid personality factors like self-initiation, work ethic, whether they're goal-oriented or not, etc. Or is it concomitant factors like overall health, both physical and mental? Is it influenced by the support you've had in your life premorbidly and currently? Does it have anything to do with age or what life phase you were in when you had your stroke or brain injury? Maybe it's related to where the individual is in the grieving process, and whether or not they've accepted what has happened to them.
I am well aware that this may always be an unanswerable question, but it peaks my curiosity because if we determined what some of these factors are, then perhaps there is something we can do to INFLUENCE those factors....something I can do to help those patient B individuals. Maybe I can do something to change their mindset, shift their focus, and light a fire under their rear so they can kick it into action and make a heck of a recovery....it's what I truly want for each and every one of my patients.
I recently began reading a book titled "You are the Placebo: Making your Mind Matter," written by Dr. Joe Dispenza, who shares multiple documented case studies where simply believing in a placebo lead to individuals being cured of cancer, eliminating tremors from Parkinson's disease, relieved of depression, and much more. Some of these individuals actually demonstrated neuroanatomical changes, demonstrating that these changes were physiological as much as mental. I have yet to complete the book, but have found some of the concepts and questions Dr. Dispenza asks to be quite intriguing, especially when thinking about how we might be able to apply it to our stroke and brain injury survivors.
What if there was a placebo, whether internal or external, that could allow someone with Aphasia to shift their focus from trying to always change and fix their broken communication, to accepting their communicative challenges, believing that they are improving, and setting their mind to believe that they are ok. Their communication is effective and productive, and messages are being sent despite an occasional glitch here and there.
I know it sort of sounds a bit hokey, and potentially too good to be true. However, I have personally observed the power and influence of relaxation, and even some mindfulness techniques, during several of my treatment sessions. There is no question that stress/tension and Aphasia are enemies. When my patients are pushing really hard to get out a word or even a sound, or struggling to formulate a sentence, I always encourage my patients to "let it go....release it," or "stop, reset, take a breath, and try again."
It can be quite interesting how powerful this simple suggestion can be. You see the tension released from their face...you hear them take a breath because they were holding it....you see their shoulders lower a few inches...and you hear the tension release from their voice. Sometimes the harder they push, the harder they try to grab that word or idea from their mind, the further away it becomes. It's almost like the tension is blocking it from coming out. However, once you let that tension go, that word or idea may actually float its way down from your mind and out of your mouth, leaving you to wonder where that came from and where it's been hiding during those moments of struggle.
I have had patients ask if "there is some pill I can take" or "some procedure" that can make my communication come back. If only it were that simple....and I tell my patients how I wish it were, even if it would put me out of a job. Aphasia can be such a debilitating tragedy for those directly and indirectly affected by the disorder. However, what if a simple change in mindset, a shift in focus, and influencing one's thoughts could actually play a role in Aphasia recovery. What if simply believing that you're doing something to make yourself better can actually make you communicate better?
Mind over matter...the power of positive thinking in Aphasia rehabilitation....focusing on communication successes rather than failures. I think that whether you're a Speech Language Pathologist, an individual living with Aphasia, or a loved one supporting a person with Aphasia, it might be an interesting, harmless avenue to explore, and I encourage you to do so and share your experiences...