Setting personal goals in aphasia

We all have goals in our lives, whether they’re work goals or personal goals. I’ve read a lot about setting personal goals because I find that I tend to become too wrapped up in my idea of “what I should be doing”. And the idea of “what I should be doing” doesn’t usually come from me or something I personally want to do, it seems to come more from comparing myself to others and feeling that I’m not doing enough. I ‘should’ be doing this or that and I’m not.

Now add in aphasia. You have speech goals, OT goals, PT goals and others that aren’t really set by you. Therapists set them because according to whatever it is we do, you “should be” doing something we want you to do by a certain point after your stroke. Typically your goals are created to fulfill an insurance obligation–if you want therapy, you play by the insurance company’s rules. And these rules tend to be restrictive. If the patient doesn’t “show progress”, they’ve got to go.
But, your ‘progress’ is whatever I say you’re doing on your goals that I’ve set.
Sound familiar?

Now think of the goals that you actually have for your recovery. Do you have a burning desire to match written words with pictures? No? That is a task, not a goal. It’s a means to an end, not an actual goal. Your goal is to read, isn’t it? Your therapy goals tend to be real-life activities–you want to speak with your kids, you want to go back to work, you want to drive…you want to be just like you were before all of this happened. Your goals are usually “pre-stroke” performance.

But what if that’s a very rare occurrence? What if 100% just isn’t going to happen? We all tend to read these miracle recovery stories and use them as motivation to keep working. Statistically, this is rare. So, now here we are. “If I can’t get back exactly what I had, then what’s the point?” you may ask me.

And here’s the talk that I give most people at our intensive program.

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