Trapped in Your Own Mind: The Claustrophobic World of Aphasia

<blockquote> <p><em>“Verbal communication, speaking and interpreting, is so vital to being human that many assume when one loses that ability, one loses their mind. His mind is still churning, probably working overtime. It’s his brain that’s been bashed.” </em></p> <p><em>- Helen Wulf, Aphasia: My World Alone.</em></p> </blockquote> <p>Until Bruce Willis’s diagnosis and exit from the stage a few years ago, aphasia didn’t have much traction with the public mind. Stories and newsreels on the topic have exploded since, giving people a rundown of this devastating condition and how life-changing it can be (not least of all for an actor).</p> <p>With June as Aphasia Awareness Month, bodies like the American Speech-Language-Hearing Association are using the momentum to further awareness of the condition along with the effective treatment provided by speech therapists. </p> <p>Despite being relatively unknown, aphasia is more common than you’d think — it’s more prevalent than Parkinson’s Disease, cerebral palsy, or muscular dystrophy, and around two million Americans live with the condition.</p> <h2>Trapped in your own mind, but no less intelligent</h2> <p>Aphasia is a disorder that disrupts our ability to comprehend and produce language, rendering the patient unable or limited in their ability to communicate with others. Unlike dementia, they do not lose their mental awareness and continue to form articulate thoughts — they just can’t express them.</p> <p>In other words, you’re effectively trapped in your own mind, which is nothing short of terrifying. It should be no surprise therefore that psychological and emotional issues are common among those who struggle with the disease.</p> <p>Damage to specific areas of the brain is the cause, with stroke being a prime driver. Head injuries, brain tumors, infections, and Alzheimer’s disease are other examples. </p> <p>Milder variations might spell trouble with recalling the names of objects, while in more serious cases, communication with the patient is borderline impossible. The former can sometimes go undiagnosed because it’s not always straightforward as to whether it’s just forgetfulness with aging or something more serious and specific like aphasia.</p> <p>Depending on what area of the brain is affected and how much damage has been inflicted, patients can wind up with different types of the disease. There are three main types:</p> <ul> <li>Broca’s aphasia</li> <li>Wernicke’s aphasia</li> <li>Global aphasia</li> </ul> <figure><img src="https://cdn.storymd.com/optimized/KAMXgvhLq7/thumbnail.png" alt /> <figcaption>Areas of the brain affected by Broca's and Wernicke's aphasia. <em>Source: National Institute of Health</em></figcaption> </figure> <p>In general, Broca’s aphasia patients can understand what’s being said but they have difficulty expressing themselves, which can be frustrating. Damage to the dominant frontal lobe of the brain is involved, usually the result of a stroke interfering with blood flow to the area.</p> <p>Wernicke’s aphasia, on the other hand, involves damage to the temporal lobe and is a more claustrophobic experience for the sufferer. They can neither understand themselves nor others, yet they intuitively feel that people should be able to understand them. </p> <p>Put another way, they’re not aware that their language skills are impaired, so nonsensical statements are expressed and met with confusion, which is again deeply frustrating. It can be extremely emotionally challenging to live with, and some patients eventually do grasp that they are not speaking properly, furthering their feelings of isolation.</p> <p>True to the name, global aphasia is when both parts of the brain are damaged, so it’s a double whammy of Wernicke’s and Broca’s aphasias. These people are unable to understand or express anything verbally, but some can get by with written communication.</p> <h2>No man is an island, and that goes for aphasia sufferers too</h2> <p>It all sounds quite brutal, but there is hope for some at least.</p> <p>Speech therapists can be enlisted to aid recovery, and many patients recuperate vital skills, even if their abilities never fully return to what they were pre-diagnosis. They help people to cope with their impairment and teach them how to use assistive tools and practice skills; for example, by reading out loud regularly. New communication strategies outside of speech can also be adopted if needed.</p> <p>“Scientific data show that the more you can do something repetitively and intensively, [the more] you will see changes from a language standpoint,” said Carol Persad, director of the University of Michigan Aphasia Program, to Everyday Health.</p> <p>There are exercises that therapists employ to get patients making basic sounds again, including showing them images for the patient to describe out loud.</p> <p>“There is a lot of repetition to try to make associations between words and pictures,” added Persad.</p> <p>Interestingly, simple nouns describing objects are often easier for patients, but prepositions and articles like “on”, “in”, and “the” not so much, likely because they are more abstract than, say, “chair” or “duck”.</p> <h2>Music therapy</h2> <p>There are also amazing off-branches like music therapy that have been proven to help some patients remember words better. </p> <p>Have you ever noticed how, even decades later, you can hum the jingle to some old commercial without missing a note, yet math theorems don’t seem to stick? This is part of music’s incredible relationship with memory, something that’s been exploited to help people with other diseases like Alzheimer’s too.</p> <p>The repetitious, pattern-oriented nature of music makes it an ideal form of mental exercise. Indeed, some aphasia sufferers can barely string a sentence together, yet they can articulate themselves through singing reasonably well.</p> <p>Music is made up of different components — pitch, tempo, timbre, harmony, and rhythm — which are processed in different parts of the brain. The theory behind the therapy is that because music involves cross-hemisphere communication, it lays the groundwork for new neural pathways that can aid in the recovery of language abilities. </p> <p>This goes back to neuroplasticity, your brain’s remarkable ability to repair itself by forming new connections.</p> <p>Starting with a familiar phrase from a favorite tune, therapists find that encouraging frequent repetition of these melodies and words helps the patient to transform their singing into everyday speech over time. The effect lasts as well: therapists find that patients hold onto their improvements, indicative of the brain’s ability for self-repair.</p> <p>According to one paper, the two hemispheres of the brain form a “tandem relationship” through the addition of musical elements in therapy. This way, old neural pathways are re-established, enabling the production of speech.</p><h2>More on Aphasia</h2><ul><li><a href="https://soulivity.storymd.com/journal/rjygrekiyj-aphasia" target="_blank">Aphasia: Types, Causes, Treatment</a></li><li><a href="https://soulivity.storymd.com/journal/lw2z82k18w-primary-progressive-aphasia" target="_blank">Primary Progressive Aphasia (PPA): Causes, Symptoms, Treatment</a></li><li><a href="https://soulivity.storymd.com/journal/wdl72zz04j-music-and-health" target="_blank">Music and Health: What You Need To Know</a></li></ul>