On anger

 

“I heard what you recommend, and I want you to know I’m not doing any of that.  Ever.”

“This is stupid.  YOU are stupid!”

“You are the problem with the entire medical system in this nation.”

“I won’t be doing any therapy today, so don’t waste your time.”

“I hate you!”

 

Rehab is hard work.  Just when the body’s natural desire is to rest, patients are asked to participate in several hours of therapy a day—to take advantage of the spontaneous recovery of brain and body to retrain them in a positive way.  It’s hard! 

 

And it’s frustrating.  Many patients are used to doing things on their own, and now they are asked to take annoying precautions like calling for help to get up (to prevent future falls), or swallowing one little sip at a time (instead of choking or aspirating).

 

A lot of patients feel deep resentment toward their new situation.  And it’s completely understandable!  They didn’t ask to suddenly acquire physical and/or cognitive disabilities.  They certainly didn’t ask to experience swallowing trouble. 

 

Sometimes, patients take their anger out on whoever happens to be nearby, especially those responsible for temporary moments of suffering.  Nurses administering shots and medications.  Therapists asking them to do exercises and confront their new disabilities face-to-face.  Family members and friends who encourage them not to give up—when giving up sounds so much easier.

 

Their anger isn’t really toward the nurses, or the therapists, or their loved ones, no matter what they say.  Their anger is really at their new situation.  Nurses, therapists, and loved ones just happen to be “in the wrong place at the wrong time” to receive the brunt of the anger.

 

I can think of some people who have supported me through tough times and received the brunt of my anger and resentment—whether to their face or otherwise.  I’m thinking of some teachers and professors who gave me tough love when I was learning how to navigate academic life.  And some supervisors who gave me real advice when I was learning how to be an independent clinician.  And my siblings, who accompanied me in the journey of growing up.  And of course my mom and dad, who have guided me through all my years—toddler, elementary, puberty, and young adult life—a very scary journey.

 

Who in your life has received the brunt of your situational anger?

 

Let’s take some time to thank those who have been there for us, especially those we did not show much appreciation for.

 

And when others lash out at us, let’s remember that sometimes, they’re mad at something bigger than us.

 

And when we feel like lashing out, let’s pause and choose the kindest words we can find.

***

PS, a brief housekeeping announcement:  the automatic email service offered by blogger is changing and/or ending in July of this year.  I'm still working on figuring out an alternative.  But I still plan to update on the 15th of every month, so if you don't get an email July 15, check out the website for the post!

Sloppy Communication

 

Me:  “Swallow this.”  

Patient:  “Are the Stars playing today?”  (coughs and splutters)

Me:  “One thing at a time.  Swallow.”

Family member 1:  “Why is it so cold in here?  It’s probably because of that covid virus.”

Family member 2:  “Who’s got covid?”

Me:  “Nobody in this room has covid.” (turning to patient)  “Now swallow.”

Patient:  “I don’t have covid!  They did a test!”  (coughs and splutters)

Me:  “One thing at a time.  Swallow.”

Patient:  “You’re the one who brought up covid.”  (finally swallows)

Me:  “Good.  Now swallow again.”

Family member 2:  “Let’s watch the Stars game.”

Family member 1:  “Can’t you see he’s trying to focus on his swallow?”

Patient:  (with a gurgly voice) “Why do I have to swallow again?”

Me:  “Something seems to be going down the wrong pipe.”

Family member 2:  “I can’t hear the therapist.  What did she say?  Why does she want him to swallow again?  Is it because of covid?”

Me: (shouting) “SOMETHING IS TRYING TO GO DOWN THE WRONG PIPE.”

Family member 1:  (also shouting, simultaneous to me) "HE'S CHOKING."

Patient:  “No, I’d feel it.”

Me:  “SWALLOW.”

Patient:  “Let’s watch the Stars game.”

 

Working with patients and families with disabilities has taught me that communication is often messy.  No matter how perfectly I plan my session or how brilliantly I attempt to do patient/family education, something often goes awry.

I see it in my own life too.  Conversations with my family and friends—they’re not optimized; they’re not like the crisp dialogue written in movies and books.  In real life, people talk over each other.  We say what we don’t mean.  Or we say what we mean and are misunderstood.  We misunderstand others.  We apologize (or we don’t).  We get mad.  We interrupt each other.  We fail to listen.  We learn to listen better.  We change our minds and say something different.  We say things in such a roundabout way that nobody can understand what we’re getting at.  We use metaphors that don’t work.  Things get overwhelming.  Nothing goes according to plan.  We all get confused.  We have to work very hard to reach each other.  It’s sloppy.

And you know what?

That’s OK. 

In fact, I think it’s strangely beautiful.

A Valentine Challenge

 Is there someone you’re trying to avoid?  An acquaintance in the community, a neighbor, a coworker, a friend?  Someone whose political opinion or religious beliefs are different than yours, perhaps.  Or maybe someone from a different socioeconomic status, someone with different cultural/linguistic heritage, someone whose social interactions are very different than yours.  Maybe there’s a family member, friend, or acquaintance with a communication or other disability who you have trouble understanding.  Maybe there’s someone at a street corner asking for help that you often pass by without greeting.

When someone takes us out of our comfort zone, sometimes we shy away from them.  We tell ourselves we don’t have time or that someone else could do a better job of it.  We tell ourselves we’ll connect with them another day.  Just not today, not today, not today.

Let’s make that day today.

Here’s a Valentine challenge for all of us:  Let’s connect with someone we wouldn’t usually connect to.  Let’s spread a little love in the world by making the extra effort.

I know this is complicated during the pandemic.  Here are some ideas to get you started:

~Call a family member you don’t usually call.  Even if they don’t pick up, leave them a message telling them Happy Belated Valentine’s Day or Just Saying Hi.

~Write a handwritten note to a friend you haven’t spoken to in a while.  Ask them how they’re doing.  Let them know you’d love to hear from them and let them know how to reach you.

~If someone expresses something you disagree with, listen to them and really try to understand their perspective.  You can respectfully agree to disagree, and even maintain a good friendship!  Our culture sometimes forgets how important it is to respect people whose opinions are different from our own. 

~The next time you see someone asking for money, even if you don’t have anything to give them, at least say “hi.”  I have heard over and over again that one of the challenges of homelessness is the dehumanization felt when everyone avoids your gaze.  (PS, if you do want to give something to them, try filling a quart sized ziplock bag or a pair of tube socks with essential hygiene items like hand sanitizer, toothpaste/toothbrush, soap, and menstrual pads.  Let the package sit for three days before giving it out so it doesn’t expose anyone to covid.  Use hand sanitizer yourself before a safe, contact-free handoff of the care package.)

~Make an extra effort to smile at people you pass by.  We’re all getting pretty good at smiling with our eyes these days.  (Note:  If you’re not a big smiler, you can do the bro head-nod.  Anything to acknowledge the presence and humanity of another can go a long way.)

~Engage in conversation when you would usually seek a way out of it.  You can do this while keeping six feet distance.  This one is especially challenging for me, because I often find myself in a rush to move on to the next thing.

~If you have a family member, friend, or acquaintance with cognitive or communication difficulties, I just posted a handout ofCommunication Tips.  If you find this handout helpful, feel free to share these tips with other family members or friends.  It can feel lonely to experience cognitive and/or communication difficulties, so let’s reach into that loneliness and facilitate positive connections.

~As a bonus challenge, I encourage you to support an organization that facilitates human connection.  How you support them is up to you—whether it’s a five-dollar donation or offering to volunteer or something unique to you!  Look for local, state, or national groups that support education, health, and wellbeing, especially among populations who are often disadvantaged or overlooked by the system.  Supporting equality facilitates human connection in a positive way.  If you want some recommendations, last summer, I posted alist of some empowering organizations.  But I encourage you to find organizations on your own.  Check with your local library for suggestions.  Do they know of a group of English language learners who need conversation partners to practice their English?  Do they know of or offer classes for citizenship?  Do they know of local education initiatives or environmental impact initiatives?  (You’d be surprised how much the environment affects equality!)

 

Happy Valentine’s Week.  Let’s spread the love, one human connection at a time.

To be a Muse

The Muses are taking over the website!  Melete, muse of practice, Aoide, muse of song, and Mneme, muse of memory have been inspiring me in both my speech therapy work and my writing for some time now, so I figured it was time to give them the stage here at the website too.  The Muses inspire and encourage creativity and expression.

I've been thinking:  maybe we're all muses, in one way or another.

A Muse nurtures the creative spark in others, stepping back to watch as they bloom and blossom.  A Muse uses positive language to inspire and encourage.  A Muse is honest, and delivers tough messages with kindness and love.  Like in last month's reflection on strengths and challenges.

Speech Therapists are a lot like Muses.  Our task is to help others to overcome cognitive/linguistic challenges getting in their way of self expression.  (Ok, and to help them swallow and follow safety directions and a bunch of other stuff.)   I think that's why Melete, Aoide, and Mneme are speech therapists--it comes so naturally to them.

Writers, especially journalists, give voice to those they interview.  In more creative genres, writers encourage and inspire connection:  connection with others, with the self, with nature, with the Divine.

And many other roles and professions are best carried out with the mentality of a Muse:  healing professions,  teaching, the restaurant/service industry, working at a library or even a store or business, social activism, religious vocations, marriage, motherhood/parenthood, family relationships, friendship....

Maybe we can all be muses for each other.  Let's make an intentional practice of listening carefully to those around us and encouraging others to be more and more themselves.

If you want to see more of the Muses, follow us on instagram @speakingwithkiki, where their shenanigans get uploaded much more frequently.  I hope the Muses are as inspiring to you as they are to me.

And I encourage you to re-explore the website.  The Muses have made some changes around here!

Listening, Learning, and Answering the Call to Change (with links to empowering organizations)

I am sickened by the recent deaths of Breonna Taylor, Ahmaud Arbery, George Floyd, and now Rayshard Brooks—and all similar unnecessary deaths.  I am angry on behalf of my friends, family members, and patients who have been subjected to judgement, put at a disadvantage, or even put in danger because of their race.  I am afraid for patients of color (especially African American) with communication disorders, who are at higher risk of incarceration and being misinterpreted as hostile.

For the last few weeks, I have been extra intentional about listening and learning.  So far, these are the calls to change that I am hearing:  examine our own biases, follow the leadership of communities we wish to help, and support organizations that empower minorities, even when it’s not “trending”. 

Today, I'm posting a list of some empowering organizations led by (or working hard to empower) people of color--most especially African Americans and immigrants/refugees.  This list focuses on education and religious organizations.  

Remember, it’s no single person's job to support every organization; we are not “saviors”!  We are just humans accompanying other humans on a difficult journey.  With that in mind, please consider supporting some of these organizations with me.

Being Intentional (with an SLP freebie)

Many patients are surprised that my cognitive therapy sessions don’t involve logic puzzles or crosswords.  With me, cognitive therapy looks a lot more like intentional planning for daily life.  Most of the time, the “strategies” I suggest to my patients are practical habits such as repeating new information to themselves, using reminders in their environment, or making sure to double- and triple-check their work.  “But I already do those things,” they protest.

“Of course,” I reply, “these are normal ways of learning and remembering.  But as your body and your brain are healing, you may find you have to be more intentional about doing things that once came naturally or automatically to you.”

Maybe the same is true for soul-healing.

Liking my patients, my loved ones, and myself

Some days, I just don’t like myself.  From the outside in, I notice plenty of flaws.  I have acne, my hair is a wild mess, my posture is slouchy, my attitude is grouchy, I’m impatient and rude and arrogant—and I make plenty of mistakes. 

So I remind myself that even if I’m not likeable now, I’ve got potential.  I’m just in the caterpillar stage.  Someday, I’ll be a beautiful, virtuous butterfly.  I should like myself for my potential…right?

That’s not what Mr. Rogers says.

Pruning my Garden: from Tolkien to Pinker and beyond

I sat with my cousin on the floor in the corner of the bookstore, poring over Elvish grammar and the rich world of Tolkien’s languages.  A seed was planted.  Over the next few years, I tended to my little metaphorical garden, writing in Tolkien’s alphabets and languages, learning Spanish, practicing my broken Portuguese, and adding broken German to the mix.

Unfortunately, some of the plants in my garden grew thorns.  My love of words and grammar turned me into the grammar police, trying to “correct” everyone’s sentences, even in my own family.  “Don’t end sentences in prepositions,” I would say, or, “Mark all your adjectives with an LY.”  I wanted everyone to speak Academic English, and I was frustrated by deviations from the rules of Strunk and White.

Then I encountered Steven Pinker.  My friend Sofija lent me The Language Instinct.  Pinker's work exposed my metaphorical garden for what it really was:  full of toxic weeds.

"What do you do?" Shifting our small talk

In the United States, our small talk is very direct.  After asking someone’s name and maybe where they are from, the next question is usually, “What do you do?”

In a culture that defines a person’s worth by their productivity, it can feel very vulnerable to say you don't have a 9-5 job.  This subject can feel especially raw for people with newly acquired disabilities that precipitated a career change or an early retirement.  

Even for the traditionally employed, this question can be daunting.  Brené Brown, who researches the human condition, wrote about this in her book The Gifts of Imperfection:  “Most of us have complicated answers to this question.  For example, I’m a mom, partner, researcher, writer, storyteller, sister, friend, daughter, and teacher.  All of these things make up who I am, so I never know how to answer that question” (page 114).  While the roles I fill are different than hers, I can still think of a long list of words to describe myself, most of which aren’t career related.

No matter our state of life, the question “What do you do?” can tempt us to oversimplify our self-worth.  To this predicament, I offer three solutions to help us begin to value ourselves differently.

The Power of Praise: Research-based ways to Encourage and Empower

Sometimes, I fail.  I don't finish my daily to-do list.  I overcook dinner.  My words fall flat, or worse, hurt someone’s feelings.  Too often, my response to myself is harsh:  I’m lazy, I am not a good cook, I’m a bad communicator.  My failures define me.

Conversely, when I succeed, I own a success as if it is a part of me.  I am a great planner, a gourmet cook, the next Madeleine L’Engle.

Praising and criticizing myself for my innate abilities can create the illusion that my successes and my failures define me and determine my worth.  That’s a lot of pressure!  Also, I am reinforcing the idea that my successes and failures are due to innate abilities, which are difficult to change. 

The good news is that our dignity is inherent, no matter how talented we are (or aren’t).  And we do have the power to try again if we want to.  So how can we use our words to remind ourselves—and others—that our successes and failures do not define us?  How can we use our words to encourage each other to keep trying even when things don’t work out the way we hope?

This is Who I Am: an interview with my friend Sydney

"This is Who I am and That's How it's Gonna Be”

An interview with my friend Sydney

My friend Sydney always has something helpful to say when I most need to hear it.  Sydney and I met as coworkers at a pediatric clinic.  The more time I spent with her, the more I learned about her courage and positivity.  Sydney is athletic, courageous, funny, and charming.  She is a great movie buddy—we love watching movies like Wonder Woman and Star Wars together.  Sydney is also very open about her experiences growing up with and living with an intellectual disability.  The other day, I invited her to share some tea and popcorn at my place so she could tell her story.

Communicating when it isn't easy

Communication is connection. For most of us, it's easy. A sideways glance. Hands on hips, feet tapping. A kiss on the cheek.

Sometimes, we use words. "Did you see that?" "Please take out the garbage." "I love you." Like magic, the words we conjure in our brains turn into sound waves, travel through the air, and become words summoned in the brain of another.  The written word is equally mysterious. Arbitrary shapes become stories, poems, proverbs. You are reading my words now, somewhere far from the tapping of my keyboard.

So what happens when there is an interruption to the brain? Imagine a blindfold, cotton in your ears, marbles in your mouth. Not so easy now.