TL;DR: Usually because talking makes us feel stupid, not because we have nothing to say. After my stroke at fifteen I had word-finding trouble. I could look straight at an object, know exactly what it was, and never reach the word for it. So I went quiet at the Pathways program for most of a year.
I had physical, occupational, and speech therapy every day in the Pathways program at the Shepherd Center. I did not mind the first two. I hated speech therapy. Somebody would set a thing in front of me and I would know precisely what it was, and the word for it would not come. Fifteen years old. Nine months earlier I had been a world champion athlete, and now I could not name an object I was looking straight at.
It drove me crazy. I felt stupid.
So I stopped talking. Silence was the only place that did not make me feel small — and I stayed in it for most of that first year. From the outside I am sure it looked like a quiet kid who was not trying very hard. Inside I was screaming.
I work now as a healthcare keynote speaker, which is a very strange sentence for that girl to read. I have a great appreciation for speech therapists and everything they do, and I did not have one ounce of it at the time. They were not the problem. The problem was that every attempt cost me something, and nobody had told me what it was costing.
So here is what I would ask. When your patient goes quiet, please do not write down uncooperative. Write down embarrassed. A person who has stopped speaking is usually protecting the last bit of themselves they still recognize, and they will come back out for somebody who makes the attempt cheap.
I believe there are things paralyzing all of us—our limiting beliefs, our feelings of self-worth, the things we try to hide because we don’t want other people to see them. But what we need to do is focus on the things we do have and the things we can do.
— I’m Not Limping. That’s Swagger!, Chapter 1
I found the words eventually. It took years, and now somebody introduces Kelsey Tainsh and hands me a microphone for a living.
What helps when a patient has gone quiet
● Make a wrong answer cost nothing. Never finish the sentence for them.
● Name the difficulty out loud so they know you see it.
● Ask yes or no questions on the worst days. Progress still counts.
There is much more of this story in my book, and Chapter 1 is where most of it lives. If your rehab teams or your nursing staff could use forty minutes with somebody who sat on the other side of that table, that is the work I love most as a healthcare keynote speaker.
Book: https://kelseytainsh.com/kelseys-book/ · Speaking: https://kelseytainsh.com/nursing/
What people ask me about the quiet months
What does word-finding trouble actually feel like from the inside?
The thought is completely intact. I knew what the object was, what it did, and what I wanted to say about it. The word simply was not reachable, like a door that will not open in a house you have lived in your whole life. That gap between a working mind and a stuck mouth is what made me want to disappear.
Should families push a stroke patient to keep talking, or let them rest?
Push gently, and never in front of an audience. My family kept talking to me like I was still in there, which mattered more than any drill. What hurt was being asked to perform in a room where somebody might wince. If you want words out of us, make the room small and make being wrong completely unremarkable.
Did you resent your speech therapists at the time?
Honestly, yes. I hated every session and I would have skipped all of them if anyone had let me. I did not understand until years later that they were the ones holding the door open while I refused to walk through it. If a patient is difficult with you right now, that is not a verdict on your work.
Quote Q08 pulled from Chapter 1. Confirm against print edition before publishing.
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