Your loved one says a word one time but then can’t repeat it
One of the chief complaints about aphasia is that it’s so variable! One minute you have the word, the next minute it’s gone. I frequently hear “I’m having a bad aphasia day”. That’s typical of aphasia, as well.
When you think about aphasia, remember that a stroke or other head injury has caused some brain damage. Your brain is a neural network, which means that the billions of neurons (brain cells) in your brain are connected to each other. When you have a stroke, some of those brain cells and their connections are destroyed. So the usual connections that produced your thoughts, speech, writing, reading, language, etc. have been severed. It’s as though you’re trying to get somewhere in a car and the road has been closed down.
There are no “locations” of information stored in your brain. While some areas of the brain are thought to be responsible for certain functions, all of the areas of the brain work together. Damage to one area of the brain doesn’t usually mean that language is totally gone, it just means that the ability to access that information has changed. So using the driving example, when the road has been closed, it doesn’t mean that your destination has disappeared. It means that the way you get there has changed.
Have you ever had the experience of not being able to recall a word, name, or date? Doesn’t it drive you crazy? Eventually you may be able to say what you were looking for, often when you aren’t thinking about it so hard. The information is somewhere in your head, but you couldn’t access it right away. Now imagine that you have aphasia and this is how your brain works all the time!
So the connections that let you produce the word may work one time but not the next time. I’ve had a client say “I can’t say ‘french fries’”. When I pointed out that he’d just said it, he couldn’t purposefully do it again. The connections have to find new paths to travel to reach the information, and until they’re stronger, you may have mishaps. The person with aphasia isn’t purposefully forgetting words or playing around—the connection routes aren’t stable. Therapy should help to reconnect some of these routes through stimulation and practice. You may find that direct confrontation of naming or speaking isn’t as helpful as producing the same information in a more indirect manner.
For example, a client was trying to say “secretary”, which is a mouthful of sounds to sequence. We wrote out the word so that he could see it, we tried a few times to say it together slowly, but because of his particular type of aphasia, that wasn’t helpful to him. So we did something else for about 30 seconds. I then asked, “You work with someone named Patsy, who is she?” and he said “my secretary”. We got to the response by a different road! What are your experiences with this topic? Let us know!