"Who am I? " - 
Identity in Aphasia 
Editor's Note - Sharon Rennhack:  
If you find this newsletter helps you and  it gives  you important information and treatment and practice ideas, please be sure to share with others on Facebook and in other social media communities. 
Our topic for this month's edition is identity  and how identity is effected by  aphasia.   
As human beings, one of the most powerful and creative things we can do in life is to make choices, to choose.  Having intent and being  intentional in our choices is ultimately how we live a life that we are comfortable with;  the concepts of intent,  choice, and  socialization  create our self-identity, leading to our freedom and self-autonomy. 

Self Identity is comprised of relatively permanent self-assessments. These include personality attributes, knowledge of one's skills and abilities, one's occupation and hobbies, and awareness of one's physical attributes.  For example: I am a writer and a singer;  I like Classical and country-western music.  I am a kayaker and I have red hair.  Before my stroke,  I worked at a major  24- hour news  outlet as a writer and researcher.  My stroke and aphasia destroyed my sense of myself  because I was not able to say those words I listed above, which defined who I was.  AND, for a period of time following my stroke, I could not even imagine how to create those sentences.   

My journey from identifying myself as a stroke/aphasia survivor to newsletter editor, practice coach and Conversational Group leader at aphasiatoolbox was long and arduous  -  as it is for most people with aphasia.

In this edition,  we  discuss  identity and possible loss of identity:  ie, what happens when aphasia from stroke or traumatic brain injury interrupts the identity process?   How does a person  with aphasia  regain thought, cognition and intent -  that is, their own self-identity? And, how do others  perceive a  person with aphasia ( ie Social Identity)? 

In this edition,  we  include:

-  Michelle Clemens -  our newest ATB client;
In his video, Bill Connors  interviews  Professor Barbara Shadden on identity and aphasia;
- research on identity and  aphasia;

When you have questions about aphasia,  the answer is aphasiatoolbox .   We ARE the aggressive, effective  aphasia recovery you're looking for. 
For information on how we can expedite your recovery using the most effective and affordable tools,  contact us for your no-cost, no-obligation appointment with an aphasia recovery expert. 

"I am  determined."

Aphasia Toolbox client Michelle Clemens  declares: "I am determined." She is determined to retain her personal and social identity while she continues to pursue her goals and travel the pathway of recovery.  

Clemens  was a reporter at Action 2 News/WBAY (Green Bay, Wisconsin) when she had 
a ruptured brain aneurysm and stroke on May 11, 2017. 
Her recovery has given hope and determination to other stroke and aphasia patients as her journey has been covered in detail by  WBAY.  
Michelle says:    "
Thank you to my WBAY family and viewers who will always have a special place in my heart. 
Thank you all for your prayers, encouragement, and continued support through my journey. "

Bill Connors interviews Dr. Barbara Shadden on identity and aphasia:

Dr. Shadden is a University Professor in Communication Disorders and Co-Director of the Office for Studies on Aging at the University of Arkansas. She is a regional rep for the National Aphasia Association. Barbara's experience with aphasia includes 33 years of clinical practice, 28 years of facilitating a stroke support group, and 13 years as the wife of a stroke survivor with aphasia.  She can be reached at bshadde@uark.edu .   "It was such an honor to interview Barbara and learn from her.  She has been a true leader, as a professional and a consumer, in aphasia treatment, recovery and support.  Her work has been both authentic and useful", offered interviewer Bill Connors.

Research on Identity and aphasia 
In this month's edition,  we include key and current articles on identity following stroke/aphasia.   We include key articles written by Prof Barbara Shadden;  see also the interview  in this edition with Barbara and Bill Connors.  

1.   Aphasia as identity theft: Theory and practice Barbara Shadden (2010),  Aphasiology,   19:3-5, 211-223,
The impact of aphasia on identity is frequently acknowledged, but there have been few theoretical or   research  publications  focusing on identity as an explanatory construct in understanding quality of life  issues for persons  with aphasia and their  significant others. This article is abbreviated from a keynote  address at the 2004 Clinical  Aphasiology Conference.

Barbara Shadden, Joseph Agan, Topics in Language Disorders, July/September 2004, Volume :24  Number 3 , page 174 - 186 
This article discusses identity as it relates to aphasia and the resulting impact on life participation.   The relationships  among social identity, language, and social interaction are considered from  the sociocultural perspective. 
Episode #5 - Insights and "Aha!" Moments About Aphasia Care with Professor Emeriti Barbara Shadden,  Premiered on March 10, 2017

4.   Improving quality of life in aphasia-Evidence for the effectiveness of the biographic-narrative approach, Sabine Corsten, Jürgen Konradi, Erika J. Schimpf, Friedericke Hardering & Annerose Keilmann (2013) Improving quality of life in aphasia-Evidence for the effectiveness of the biographic-narrative approach, Aphasiology, 28:4, 440-452, 

Caused by the constraints in communication, people with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered which is crucial for QoL. This increases the severe loss of QoL. In sociocultural theories, it is postulated that identity is created through social interaction with others. In telling life stories, people build meaning and affirm identity. Biographic-narrative approaches use such life stories to support identity (re)development after disruptive events like stroke. Specific communication skills are needed for this, i.e., biographic-narrative competency. Therefore, such approaches have to be modified for the use in people with aphasia.

5. Social identity and stroke, Sharon Anderson, Kyle Whitfield (2013), Scandinavian Journal of Caring Sciences 2013, 27 (4): 820-30
Over 85% of the people survive stroke; and of those, over 80% are discharged to the community. However, the majority do not recover completely. Loss of identity is a commonly reported experience after stroke. Studies focus on the individual survivors' use of their own cognitive resources to adapt to change, rather than examining the effects of social interactions on stroke survivors' identities. Social relationships are the foundation upon which survivors rebuild skills to engage with the world, yet little is known about the ways in which families, friends and neighbours provide a context for the recreation of a sense of self and activities after stroke. 

6. Changes in identity after aphasic stroke: implications for primary care, Benjamin Musser, Joanne Wilkinson, Thomas Gilbert, Barbara G Bokhour, International Journal of Family Medicine 2015, 2015: 970345
Stroke survivors with aphasia experience difficulty associated with their communication disorder. While much has been written about aphasia's impacts on partners/family, we lack data regarding the psychosocial adjustment of aphasic stroke survivors, with a paucity of data from the patients themselves. 


 News: Stroke/Aphasia

Abstract Background: Many factors that contribute to successful living with aphasia intersect with the benefits one can get from attending an aphasia group. Affiliated with Toastmasters International, Gavel Clubs (GCs) for people with aphasia (PWA) provide a range of communication activities that promote public speaking and leadership skills. The constructs of communication confidence and  quality of communication life (QCL) were introduced over a decade ago but have not been widely investigated.  April  2018

Damage to some of the pathways that carry information throughout the brain may be responsible for attention deficit in patients who have had a subcortical stroke in the brain's right hemisphere, according to a study published online in the journal Radiology. Researchers hope the findings may provide a measure for selecting suitable patients for early interventions aimed at reducing cognitive decline following stroke. May 2018

3.    Vagus Nerve Stimulation Enhances Brain Plasticity
The new treatment may help restore function to stroke victims.  May  2018

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