Going Nonverbal
Mar. 4th, 2018 02:29 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
ysabetwordsmithEveryone goes nonverbal sometimes. Under enough stress, the higher brain functions shut down to protect the mind and/or route limited resources to critical areas. You've probably seen someone reduced to silent rocking or incoherent wails at a funeral or other catastrophic situation. For trauma survivors, and people with a language or social disability, everyday life may sometimes get that stressful, so they lose some or all of their ability to communicate.
You can help first by not adding to that stress, second by sympathizing with the situation, and third by reducing the stress so the person can move toward their usual level of functioning. Here are some tips from sometimes-nonverbal people for what to do if a friend goes nonverbal and what to do if a partner does. Some of these are relationship-specific: any time you're close with someone who has a chronic condition that complicates their life, it is polite to ask them how they want folks to respond when those complications crop up. Other tips are useful for emotional first aid in general, such as if you come upon the scene of a car crash and a random stranger is rocking or wailing in horror.
The worst thing about a crisis is usually not knowing what to do and therefore feeling helpless. It's a lot less scary and uncomfortable if you know some things to try. You can usually get a crisis down to an embarrassing nuisance.
EDIT 3/7/18 -- Below is a discussion of what to do if you tend to go nonverbal in a doctor's office.
You can help first by not adding to that stress, second by sympathizing with the situation, and third by reducing the stress so the person can move toward their usual level of functioning. Here are some tips from sometimes-nonverbal people for what to do if a friend goes nonverbal and what to do if a partner does. Some of these are relationship-specific: any time you're close with someone who has a chronic condition that complicates their life, it is polite to ask them how they want folks to respond when those complications crop up. Other tips are useful for emotional first aid in general, such as if you come upon the scene of a car crash and a random stranger is rocking or wailing in horror.
The worst thing about a crisis is usually not knowing what to do and therefore feeling helpless. It's a lot less scary and uncomfortable if you know some things to try. You can usually get a crisis down to an embarrassing nuisance.
EDIT 3/7/18 -- Below is a discussion of what to do if you tend to go nonverbal in a doctor's office.
And for a stranger....
Date: 2018-03-05 04:02 am (UTC)Assume there was a trigger, whether you know what it was or not, and act accordingly. For me, that means treating the person as if they were in shock. Find out if they have a way to communicate, and if they want to. Next is if there is someone they want contacted. I carry a notebook and pen in my purse; that lets me note down anything I'm shown. I've asked if a quiet space would help, and created one by the simple expedient of standing in front of the person and being a wall until they tapped my shoulder. I've wrapped a cloak (I wear one often) around someone who'd gone non-verbal.
The one comment I've gotten most consistently after such events, either from the person themselves once they'd recovered a bit or from whomever they had me call was appreciation that I had not left them alone. Even not knowing what was going on, my presence meant that they did not have to try to deal with officious store managers (I fended off several of those), police (likewise), or other authority figures when they were in no condition to do so.
Re: And for a stranger....
Date: 2018-03-05 09:02 am (UTC)That is true. Like any EFA, there are somewhat overlapping sets of things that work for people you know well or people you don't, and it's advisable to know some of each.
>> Assume there was a trigger, whether you know what it was or not, and act accordingly. <<
Yep.
>> For me, that means treating the person as if they were in shock. Find out if they have a way to communicate, and if they want to. Next is if there is someone they want contacted. I carry a notebook and pen in my purse; that lets me note down anything I'm shown. I've asked if a quiet space would help, and created one by the simple expedient of standing in front of the person and being a wall until they tapped my shoulder. I've wrapped a cloak (I wear one often) around someone who'd gone non-verbal. <<
Good advice.
>> The one comment I've gotten most consistently after such events, either from the person themselves once they'd recovered a bit or from whomever they had me call was appreciation that I had not left them alone.<<
Yeah, even if they aren't up to interacting, it helps to have someone nearby to prevent problems if necessary.
>> Even not knowing what was going on, my presence meant that they did not have to try to deal with officious store managers (I fended off several of those), police (likewise), or other authority figures when they were in no condition to do so.<<
Yyyyyeah. People in positions of authority should be obligated with "First, do no harm." If they don't know basic EFA -- which they should, but often don't -- then they should at least stay out of the way while finding someone competent to handle the situation. One can at least refrain from making the matter worse.
Unfortunately, L-America prefers to train people in power to be control freaks. This causes a lot of avoidable deaths.
If you've been doing this repeatedly, you may well have saved someone's life. Certainly, you have saved a lot of days.
Re: And for a stranger....
Date: 2018-03-07 09:15 am (UTC)Re: And for a stranger....
Date: 2018-03-07 09:33 am (UTC)Half a dozen times is supernary level, though. Most people who've done it at all have only done it once or twice. They don't watch closely for folks in distress, don't know the signs until they get conspicuous, and/or after the first time actively avoid it. You're a treasure.
Re: And for a stranger....
Date: 2018-03-08 10:07 pm (UTC)I can easily believe people don't know the signs, or don't notice them. I've reached the point where when someone asks "is it that obvious?" my invariable answer is "no, not really. I just see things most people don't." I don't know how other people can miss it sometimes, but I suspect that's in the same category as a fish who doesn't understand how it's possible not to know how to swim. *shrugs* It's in the hard-wiring. Far-memory indicates it has been for a long, long time.
Re: And for a stranger....
Date: 2018-03-09 12:19 am (UTC)I do that with a lot of things.
>> I don't know how other people can miss it sometimes, but I suspect that's in the same category as a fish who doesn't understand how it's possible not to know how to swim. <<
In most categories, there is a range of clues from subtle to obvious. Anyone can recognize a meltdown when the victim is rocking in a corner making awful noises. They might not know exactly what it is or what to do, but they know something is seriously wrong.
But there's a long list of signs leading up to that stage which indicate the person is running out of cope, or the kind of meltdown where the mind just shuts itself off and puts the body on autopilot. Those require more experience to recognize. I learned to spot the checkout version in college because one of my teachers had it. She's a survivor of severe child abuse and one of the first things she told us was how to tell if she'd zoned out, and just wait for her to come back before resuming the conversation.
>> *shrugs* It's in the hard-wiring. Far-memory indicates it has been for a long, long time. <<
Permed skills are awesome. :D
(no subject)
Date: 2018-03-05 07:49 am (UTC)sometimes i'd just find it harder and harder to make noises until i just couldn't speak anymore and sometimes it would just go away, a couple times mid-sentence! inevitably my speech would return after i started to relax a bit. i hope it never happens again, but i've thought about getting some cards printed in case it happens in a situation with a stranger and i don't have a friend or my husband near to help.
Thoughts
Date: 2018-03-05 08:00 am (UTC)A year is good. You're probably into the typical range with that. I wouldn't call it a concern if someone lost their words once a year or so under high stress.
>> it was the worst when i was just getting out of the abusive relationship i'd been in with my second partner.<<
That'll do it all right. Abuse can really mess up your brain.
>> once i determined it wasn't a stroke i figured it was probably either a form of aphasia (which, WHEE) or stress-induced (if not both).<<
Possibly, but there's another explanation. Trauma takes energy to heal. Imagine that as an energy-hog of a program always running in the background of your computer. If you try to run another program with high demand, it can crash. So any extra stress could exceed your operating capacity, just because a chunk of it was tied up in trauma processing. Over time, those equations complete and thus take up less space in your brain, so you jam less often.
>> thankfully my husband is tremendously supportive and understanding.<<
Yay!
>> sometimes i'd just find it harder and harder to make noises until i just couldn't speak anymore <<
That sounds like a running out of spoons error. It's the more avoidable of the two: any time that starts to happen, stop immediately and take a break to restore your energy. Lie down somewhere quiet, cuddle a cat, eat a snack, whatever works for you. Often you can head it off.
>> and sometimes it would just go away, a couple times mid-sentence! <<
That's the system crash version. It's very hard to prevent because it gives no explicit warning. :(
>> inevitably my speech would return after i started to relax a bit.<<
That's good. Since you know relaxation helps, studying methods of relaxing (meditation, progressive muscle relaxation, mudras, etc.) may help prevent speech loss or relieve it faster if it happens.
>> i hope it never happens again, <<
I hope that too.
>> but i've thought about getting some cards printed in case it happens in a situation with a stranger and i don't have a friend or my husband near to help.<<
That's a very good idea. Many people with communication issues carry an emergency card for that reason. You might want one to explain the situation and one with commonly useful phrases like "Please call a ride for me" or "I need a quiet place."
It sounds like you have a pretty good handle on this. Go you! That's a hard problem to solve.
(no subject)
Date: 2018-03-06 04:04 am (UTC)Eta: other than asking someone to come with that is- that's almost worse
For the doctor?
Date: 2018-03-07 07:25 pm (UTC)Get a small notebook. On the first page, write down a few key things you know you’re going to need to communicate, starting with the fact that you have difficulty taking when stressed, and that a medical appointment is very stressful for you. On the next, go on to the things they need to confirm - name, date of birth and so forth.
And I’ll have to finish this when I next get a break in caregiving tasks. Might be tomorrow, even. But I promise, I am not ignoring you.
Okay ...
Date: 2018-03-07 10:52 pm (UTC)* Before interacting with the medical industry at all, ask yourself if it's really necessary. Sometimes it's the best choice or other people force you to do it, but there are many things you can handle yourself. That category will get a lot bigger if you study first aid. There are brief notes online regarding when to see a doctor. There are also handbooks for self-care that include distinctions between what to treat at home and what needs expert attention.
* It often helps to notify providers of special needs. If your need is documented (e.g. someone in care for social anxiety) then they may be legally obligated to accommodate it. Some folks with communication difficulties need a longer or shorter appointment, access to a quiet room, etc.
* If at all possible, choose practitioners who are trained in trauma-informed care and practice client-centered care. The techniques used for those needs will carry over very well when you have trouble talking.
* Keep a record of your own health and what to do about it. In my experience, offices do a shitty job of recordkeeping anyway. You want stuff you can point to if your words conk out. Make sure all your ongoing complaints and anything like allergies are listed. The best I've found is the WRAP Workbook, which is fully customizable and meant as printouts for a 3-ring binder. Originally designed for mental issues, it adapts well to anything else that impairs your functionality.
* Make pages of things you often need to say when you find it difficult to speak. You may want one page for general needs ("Please help me find a quiet place.") and one for medical needs ("My X hurts.") If you're going in for a specific complaint, make a page for it before you go in. Then just point to what you need to say.
* There are alternative communication cards for medical needs. As this is a common need, many good options exist. Premade cards you can just print up as needed. A customizable communication board is ruinously expensive, and even the good phone apps are not cheap. The cheap ones are rarely good, but you can always look.
http://aac-rerc.psu.edu/_userfiles/Bilingual_board.jpg
https://i.pinimg.com/originals/98/11/16/981116c6e97a27f9161f6170cc2ef2eb.png
https://i.pinimg.com/originals/62/f1/16/62f1164a78c78b09bfd7ed076359965b.jpg
For spiritual pain:
https://cdn-images-1.medium.com/max/1600/1*5MTLX5ORfptYX8yBIMztFw.jpeg
* Consider American Sign Language or other meaningful gestures. Some dentists will give you a whole minikit for "yes, no, maybe, okay, stop, that hurts," etc. The same set covers basic needs in other contexts.
* Anyone who disrespects you for using alternative communication, who refuses to take no/stop for an answer, or who treats you as less of a person due to your speech challenges is an insensitive asshole and should not be trusted. If you are free to work with someone else, do so. Not everyone is a giant dick.
* Is the main problem face-to-face conversation and/or being in an office? If so, try using alternatives. Telemedicine is booming, where you can talk on the phone, video chat, or email with a doctor. Some people with social anxiety, communication issues, or other challenges find this much better than an office visit.
* Is the problem that you find medical topics and/or people in general stressful? If so, study relaxation techniques. One of my favorites for offices is mudras. If you have access to therapy, and it doesn't just increase your stress, then many therapists can teach relaxation skills. If that's unfeasible for you, practice on your own.
* Consider as-needed mood soothers. This can be anything from over-the-counter stuff like chamomile to a prescription for 1 valium. As most temporary language loss stems from stress, damping down the stress will reduce the chance of going nonverbal.
* Is your reason for seeking health care based on monitoring? If so, explore self-monitoring or telemonitoring options. This is another booming area where technology makes it easier to track things that used to be hard to see. Then fewer facetime visits are needed. Check wearable tech and phone/tablet apps for this.
http://www.businessinsider.com/the-best-apps-for-healthy-food-exercise-sleep-and-good-habits-2016-7
https://themighty.com/2017/06/mental-health-apps-recommended-by-people-living-with-mental-illness/
http://www.mobihealthnews.com/content/31-new-digital-health-tools-showcased-ces-2017
http://medicalfuturist.com/top-healthcare-wearables/
http://searchhealthit.techtarget.com/essentialguide/Wearable-health-technology-in-medical-and-consumer-arenas
* Are you concerned about people violating your boundaries while you cannot speak to defend yourself? If so, consider setting up protections in advance. A patient advocate or lawyer may be able to help if you can afford them. If not, you can set up a safety call with a friend who will confront practitioners if you don't respond that you're okay at the predetermined time.
I hope this helps.
Re: Okay ...
Date: 2018-03-10 07:14 pm (UTC)Continuation....
Date: 2018-03-08 10:23 pm (UTC)I'll second notifying the office in advance if at all possible.
Get any forms you can to fill out ahead of time, like medical history forms.
Write out the basics on a page they can copy. Height, weight, list of medications, list of medical conditions.
On a separate page, write out what you're coming in for. Put it in a number format if possible. For example, from my own appointment yesterday:
1. Symptoms: Severe headache, severe sinus congestion, severe non-productive cough.
2 No fever, minimal nasal discharge, no impaired breathing. (I'm asthmatic, so any respiratory infection hits my lungs ridiculously quickly.)
3. Extreme fatigue.
Skip half a dozen lines (which also gives you room to add things you may think of), write a similar numbered list of questions you have.
Questions for cards you can pull out might include "what medication are you giving me, what does it do, and what are its side effects?" or "are there activities I should avoid?"
If you have something specific in mind, and want to talk about it, feel free to PM me. I'll be happy to help if I can, and if I can't I'll say so. Meanwhile, hugs if you want them.
Re: Continuation....
Date: 2018-03-09 12:05 am (UTC)