Sometimes the hardest part of communication is not the words themselves, but the way we interpret what we don’t understand.
A family friend once shared how, when trying to communicate with certain colleagues – they felt like their words left their mouth and fell through the floorboards — picking up dust and distortion before landing somewhere else entirely. What they meant and what the other person heard often felt worlds apart.
My son offered a powerful analogy that helped everything make sense – “It’s like you’re both looking at the same thing on a computer. You see graphics. they see text.”
It was a simple yet striking way to describe what happens in communication with someone who has aphasia. You might be sharing the same moment, looking at the same situation, but experiencing it in completely different ways.One person is taking in emotion, tone, and visual cues — like seeing the full graphic interface. The other is reading line by line, processing fragmented information like text that must be decoded.
This story illustrates a broader truth: we often misinterpret what we don’t understand.
When communication feels hard or confusing, we may assume someone isn’t listening, doesn’t care, or is being difficult — when in reality, their brain is simply processing language in a different way.
Aphasia changes how someone communicates, not what they know or who they are. It means the route to understanding looks different. It might require fewer words, more visual support, extended time, or just patience and presence.
When we stop forcing understanding through our own lens, and instead adapt to how someone else receives information, connection becomes possible again.
It’s not about saying less. It’s about saying it in a way that can be received.
Sometimes, the deepest understanding happens in the quiet spaces between words.
I regularly use Dr Dan Siegels Wheel of Awareness mindfulness exercise and have suggested it to others. But how may someone with Aphasia experience the Wheel of Awareness?
The Wheel of Awareness, developed by Dr. Dan Siegel, is a mindfulness tool that guides attention across different aspects of our experience — from our five senses, to bodily sensations, mental activities, and a sense of connection with others.
https://drdansiegel.com/wheel-of-awareness/
For someone with aphasia, engaging in this practice may feel different. While the guided words might not always land clearly or fully, the person can still sense and respond to what’s being felt in their body. The experience may be less verbal and more somatic or intuitive.
Rather than visualising thoughts or narrating sensations, someone with aphasia might:
– Tune into body signals like warmth, breath, or tension
– Experience rhythms in the guide’s voice as soothing, even if not fully understood
– Respond more to tone, pauses, or repetition than to specific instructions
– Feel a general sense of safety or agitation based on how the practice is delivered
In this way, the Wheel of Awareness still holds value. It offers a structure for noticing and integrating experience — even if the ‘spokes’ of attention are accessed through sensation rather than words. For those living with aphasia, the practice may open space for calm presence, even when language is quiet or unclear.
What the Research Says
Research shows that aphasia is a language disorder caused by brain injury, most commonly from stroke, that affects speaking, understanding, reading, and writing—but not intelligence (Code & Herrmann, 2003). People with aphasia often retain full emotional and cognitive capacity, even when their ability to express themselves is disrupted.
In trauma-related cases, similar disruptions in language can occur. Studies show that childhood trauma can impair interoceptive awareness—the ability to sense internal bodily states—leading to body dissociation and emotional dysregulation (Barrett & Simmons, 2023). These disruptions are often linked to the insula, a brain region that helps integrate internal sensing with emotional and verbal processing (Craig, 2009).
The insula is also involved in coordinating speech. Damage to this region, whether from trauma or stroke, can result in speech production difficulties and a breakdown in awareness of bodily signals (Dronkers, 1996). This explains why some individuals with aphasia or trauma may struggle to connect language, emotion, and bodily experience, even when cognitively intact.
Mindfulness-based practices like Dr. Dan Siegel’s Wheel of Awareness may offer therapeutic benefits by gently restoring interoceptive awareness and supporting emotional regulation—even for those with language difficulties. Practices that emphasise tone, rhythm, and bodily sensation may be especially helpful.
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