More than words, Why Storytelling Breaks Down In Aphasia Recovery

What does it actually mean to recover language after a stroke? Not just pass a test, but tell a story, hold a conversation, explain what happened to you at the airport.

In this episode, I sit down with Dr. Brielle Stark, a neuroscientist and aphasia researcher at Indiana University Bloomington, to talk about discourse: the kind of language we use every day to describe our lives, our memories, and what matters to us. We dig into why standard aphasia tests miss so much of the real picture, what good home practice actually looks like (hint: easy is not the same as useful), and why the myth that recovery stops at six months needs to be retired for good.

We also talk about primary progressive aphasia, what fatigue really means for a post-stroke brain, and why you have seen one person with aphasia, you have seen exactly one person with aphasia.

Plus, Angie brings some receipts from her own story, including a pre-kindergarten math book, a crowded support group, and a very patient friend named Tay.

This is a real conversation between a researcher and a survivor, and that is exactly the point.

WHAT WE COVER

• What discourse is and why it matters more than any test you have been given
• Why aphasia is not just about language and why that framing has kept survivors from getting real help
• What good home practice actually looks like, and why easy is not the same as useful
• Brain fatigue: what it is, what triggers it, and why it is so underestimated
• The six-month recovery myth, and what the research actually shows
• Why you have seen one person with aphasia, you have seen one person with aphasia

Topics covered:

• What discourse is and why it matters for real-world recovery
• Primary progressive aphasia versus stroke aphasia: different paths, different goals
• Why standard tests do not capture how people actually communicate
• What makes home practice worth your time
• The six-month recovery myth, and what the research actually shows
• Brain fatigue, what it is, what triggers it, and why it is so underestimated
• Why "aphasia doesn't affect intelligence" is incomplete and sometimes harmful
• Neuroplasticity: what it means for stroke survivors and what it means for everyone

https://aphasiaadvocates.com/ for Brain Friends Merch

https://aphasia.org/event/ask-the-expert-february-2026/

https://www.cognitiverecoverylab.com/seles

https://aphasia.org/stories/announcing-the-davetrina-seles-gadson-health-equity-grant-program/

Our beloved colleague, Dr. Davetrina Seles Gadson, passed away January 11, 2025. Dr. Gadson was an extraordinary speech-language pathologist and neuroscience researcher who devoted her energy to studying health disparities in aphasia recovery. She was a fierce advocate for improving services for individuals with aphasia, particularly Black Americans. Her research transformed our understanding of these health disparities and shed light on how we can address them. We were privileged to have Dr. Gadson as a cherished member of our lab community for four years, first as a postdoctoral fellow and then as an Instructor of Rehabilitation Medicine. She was still a close collaborator and friend to many of us at the time of her passing. Dr. Gadson was an incredible person—compassionate, inspiring, and full of life. Her dedication to advancing equity in aphasia recovery and her profound impact on our community will never be forgotten. ...

Transcript

Welcome To Brain Friends

SPEAKER_01 0:00

Welcome to Brain Friends, where two neuronerds talk all things aphasia, language recovery, culture, and community. I am Dr. Datrina Celeste Gatson, a clinical speech language pathologist and neuroscientist.

SPEAKER_02 0:13

And I am Angie Cawthorn, stroke survivor and aphasia advocate.

SPEAKER_01 0:19

Welcome to our show. Welcome to Brain Friends. We want to thank all of our listeners for downloading the podcast. We appreciate everyone listening. So please tell a friend to tell a friend that we are here. And we are.

Progressive Aphasia Versus Stroke Aphasia

SPEAKER_00 2:09

Well, I had some espresso because I teach at 8 a.m. So what are we talking about?

SPEAKER_02 2:15

What needs to be said at 8 a.m. Aphasia class. What are you teaching these cats?

SPEAKER_00 2:21

Like, what are we learning? Some intense stuff. So this morning we talked about primary progressive aphasia to graduate people training to be speech therapists, graduate students.

SPEAKER_02 2:34

Primary progressive aphasia. And I just don't feel like it gets the importance that it needs because it is it goes into dementia, but it's so I mean aphasia is misunderstood, but primary progressive, and it took actually. I remember talking to Celeste about this, and she was, and I was like, Well, what's the difference? She says, Well, you're getting better, but with progressive aphasia, they're not getting better. It's a different you both have you both start here, but you're, you know, it's like you and your young and you and your kid brother. You start here at the house, but you take very different paths. Very different paths, very different paths, or maybe your cousin. The point is it's about your home structure.

SPEAKER_00 3:16

Okay, that's exactly right. Yeah. So we're talking today. I mean, it's just a different thing entirely. It's totally different. You know, we're the game plan with speech therapy with primary progressive is to slow it down, but for stroke aphasia, it's to speed it up.

SPEAKER_02 3:33

Progressive primary progressive aphasia is so with aphasia, the with a regular aphasia, I should say, or stroke, that's the difference, is how you received it. So because I got mine acutely, I have a better opportunity for that for that neuroplasticity to come and repair or at least make it workable, versus when it's a slow decline, it's like those bridges are just being tapped at every day. And you're losing a little bit, a little bit, and next thing you know, it's that infrastructure. It's kind of like that movie Um Shawshank Redemption, where he's like chipping away in the tunnel.

SPEAKER_03 4:17

He's chipping it away, and next thing you know, you know, that's a good movie. Oh my god, what do you what do you got to say there, fuzzy britches? Let's ask her.

SPEAKER_00 4:26

Oh my gosh. I used to live really close to that prison in Ohio where it was filmed. Fun fact, yes. Um, been there, crawled through that tunnel. Super cool. So it's a real thing, yeah. Where it was filmed, yeah. Yeah. They oh my god, but you're right, like the onset's totally different. So, like the primary version is very slow onset. But you're right, the brain doesn't have a chance to reform itself because it's under a very slow attack versus a very slow attack.

SPEAKER_02 4:55

And by the time you realize how far that attack is go is going, next thing you know, you you're Bruce Willis, and they're calling it primary uh progressive aphasia, but it's actually a route to dementia.

SPEAKER_00 5:09

Yeah, so dementia is a syndrome, which is a bunch of symptoms together, and primary progressive aphasia is a syndrome, but they're they're caused by diseases. So the disease can have a treatment and the syndromes can have treatments, and so it's you know, it's kind of a complex thing, but we don't have a cure for the disease.

SPEAKER_04 5:30

So we have a cure for any of it.

SPEAKER_00 5:32

No, right now we're just sitting, you know, trying to figure out what's the way to slow it down.

SPEAKER_02 5:37

And for me, we're trying to speed up neuroplasticity. Well, then let me ask you this is there a way to give people with primary progressive efficient, if we're trying to slow it down, the the the little men just just tapping at the bridge. If we can slow them down, is there a way that I can be simultaneously building more bridges?

SPEAKER_00 6:02

Yeah, there's some really cool research out there. So, Professors Maya Henry, Jessica Richardson, Stephanie Grosso.

SPEAKER_02 6:09

Love them. I love everybody you just said.

SPEAKER_00 6:11

Just fantastic people, right?

SPEAKER_02 6:15

Jessica and honey.

SPEAKER_00 6:18

Honey over there. They're doing some cool stuff, showing that you can't you can slow down the progression in some of these. They're called variants in in primary progressive aphasia. You know, we talk about types in aphasias like Broca's aphasia, verniques. They call them variants in in the progressive varieties, so slightly different. They talk about slowing it down and maintaining where you are for longer. And they have shown that speech therapy can be effective in that, but the goal setting's different. It's about improving in a little bit and maintaining rather than thinking about a stroke aphasia where it's like improving and keeping improving. The goal setting's a little bit different, but they are showing some really cool improvements there. So I think it does reflect neuroplasticity. It's just kind of a different way of thinking about it.

SPEAKER_02 7:10

Well, because neuroplasticity is just amazing. But listen, that is not why I called you onto

Legacy Work And The Warm-Up Draft

SPEAKER_02 7:15

the show. Okay. It's not, it's not, believe it or not, but this happens to me all the time. So what happens is this is the thing of where Celeste is absolutely missing in the biggest part for me. She was the timekeeper, she was the note taker. I just showed up with inappropriate statements and really good editing skills. Okay.

SPEAKER_00 7:37

I got to talk about Celeste the other day, just to you know, plug her movie here. I did, I did. A student uh asked me the other day, she says, you know, is there anyone doing work in this area of, you know, really thinking about disparities and you know how they affect um stroke survivors, people with aphasia? And I said, you know, there was someone who is whose work is still living. Um so I got to talk about Celeste's most recent paper. So that was cool. The one good thing in academia about publishing is that we do get to have work that lives on. And that is a nice thing. And so kudos for getting that paper out into the world. Yes, kudos for it living on, and yes, and I'm gonna keep talking about it, and I'm excited for you to keep talking about it. So that's the the number one thing I think we can do.

SPEAKER_02 8:28

That's all we can do is just try to bring some understanding. So, first of all, Dr. Brie, we do an icebreaker. It was one of Dr. Celeste's favorite things to do. So we're gonna warm up brain friend style. Okay, so so if you had to choose one starter for a communication tool, like it's fantasy football, and you wanted and you had to pick a starter, a communication tool, what is your first overall pick?

SPEAKER_00 9:05

Oh, well, that's a good question. Uh let's I think my overall pick is an injection of confidence. Ooh, I love that. I think we just need it sometimes. I think we just gotta like overcome that hurdle of I don't know if it's right, but I just gotta do it.

SPEAKER_02 9:24

Oh my god, I love that. And that is so true. I don't know. That is so true. It's off the cuff. No, I love that, and that works in so many an injection of confidence because a lot of it is confidence, and I remember thinking to myself at some point, um, this can't happen. I have to, I have to, and I think there's a point where my confidence definitely took me through some of those darker valleys of brain damage because it's hard to be mind over matter when it's your mind that's what's the matter. Oh, I'm gonna let that marinate. Yeah, let you take that in. And if you want to say it and cite me, that's fine. All right. The point is gonna write an article. Yeah, of course. I mean, I don't know why it hasn't been done. I don't I don't know why I had to bring it up. So, my my overall pick if I had to would be uh pause time, and what I mean by that is I need pause time to be like an offensive line. Because if you give me a clean pocket, I can get the playoff. Okay, but if you rush me, uh finish my sentences, throw a question in, you know, once I've my words have started doing their evasive maneuvers, um, you know, it's just causing more problems. But I think if I can get a pause to protect the pocket and I'll deliver.

SPEAKER_00 10:56

And that like pocket, that yeah, that that like seven-second window where you just got just give me a few seconds so I can survey the field because I'm the quarterback.

SPEAKER_02 11:08

I'm the quarterback, right? It's my I'm definitely I'm the quarterback of my own team, right? But I need that protection, that hedge of protection, and sometimes that may be in the form of a career or or a friend, yeah, but you need that, or or for people just not to be rude, but they don't know they're being rude, they don't know, they don't know. They're trying to help. And I I was always one when people would say, Do you want us to help you or do you want us to let you figure it out? I'm like, if you don't throw me a bone and help me out here, nice of them to ask. No, it is nice to ask, but it's one of those things, like it's like, no, I sometimes asking though, you're like, because it's a conversation, and a lot of times I would want to say one thing, but it that words are just I remember one time I was in my support group, and one of my buddies was talking, and he was talking about getting on a train in New York. He never said train, he said never said New York, he never said anything close. And I could see, I think it was Wendy, Wendy Greenspan. She's like, Yeah, and she's writing things down that he's saying, and we're trying to, and I'm like, he said he took the new train and it didn't work, and he was late for his meeting. And he was like, Yes. Now, how I knew that is because at that time I knew exactly where the brick, the blocks or the walls come out, and that's the cultural thing of being an Aphasian versus a person that can't hear at that level. It's kind of it really almost was like a second language. And when I realized that, I was like, huh. And it's wild because as I'm getting better, I'm losing that ability to understand my fellow Aphasians. That's a paper. I don't know why we're why we're not writing this down. I don't know.

SPEAKER_00 13:02

Yeah, no kidding. So that's yeah, that's really interesting. So as you are recovering, you're kind of almost like forgetting that experience that you have to do.

SPEAKER_02 13:11

Yes, it's almost like um, you know, if I spoke uh my phone, my my home language, and now I'm no longer immersed in that cultural language, I began to lose it. But I could literally make sense, I could speak fluid aphasion at any point in time before, but I can't now. And that's but anyway, I do have some questions about Discord because that's what we're going to be talking about today.

What Discourse Means In Real Life

SPEAKER_00 13:39

Yes, discourse, yes.

SPEAKER_02 13:41

Discourse, which is your baby, that's your thing, that's your jam.

SPEAKER_00 13:44

I've been thinking. So let me ask you this, friend. What is Discord? So we think about this, and it's important to define it because I think perhaps people think about it in different ways, but the way that I think about it is language we use beyond a single sentence for a specific reason. So, for instance, discourse would be describing what you did yesterday, or describing what you see out your window, or telling a story to a new person you met, talking on the phone. It can be just me talking. It's what we're doing right now. So two of us talking. It could be many people talking at the same time. I tend to focus on one person talking, which is called monologue. The reason I do that is it's a little bit less true to life, because this is more true to life, what you and I are doing right now. But it's a little bit harder to study. It's a little bit harder to kind of control the situation, it's a little bit harder to kind of tease apart some of the things that are happening. So I give away some of the true to life stuff and I take a little bit of an experimental control back. So I focus on the monologue. But there are some great people doing dialogue work out there too. So that's discourse. It's more of what we do in in everyday life, but a lot of the standard tests you probably have done in speech clinics. Who doesn't love the wob? Who doesn't love the wob? They're like, name this picture. So annoying on so many things. Because they tell us information, but they don't reflect what we do as humans in everyday life all the time.

SPEAKER_02 15:35

So let me ask you this What is the test missing that we don't? What is the test that you're giving for discord, the cattle?

SPEAKER_00 15:46

What are they missing that we take into real life? You know, I think we're still figuring this out. So one important thing we figured out is that there's not a perfect test of discourse. So you've probably seen people ask you to describe a picture of some kids stealing a cookie. You've probably been asked to describe the story of Cinderella. You've probably been asked to retell about an important event in your life. The idea behind this is that we know these different tasks, we call them rely on different parts of your brain. So, for instance, an important event is us asking you to draw from your personal memories. And that's actually a slightly different form of accessing language. We're being tricky. Then when we put a picture in front of you, we're accessing language through your eyes, right? When we're asking you to tell Cinderella, we're asking you to draw on a different type of memory. This is like fact-based memory. You didn't experience Cinderella personally, but you have seen it in movies, right? It's kind of like a fact-based memory. So we're trying to figure out like, is there a certain type of person, like for example, someone like you, Angie now, who has a mild aphasia, who might need to be challenged a little bit more, who might need a harder discourse task to really figure out like, hey, do you still have any needs, right? Like, does your language still have any breakdowns at, you know, a really high level that we could work on together? But someone with a more complex or a more severe aphasia may not need that. That might be too hard for them. Right. So that's what we're still trying to figure out. And I think we're closer, but we're also trying to figure out what we can measure from these that is really reflecting what we think is going on. One type of thing we can measure is how informative is the language? Like how much information are you conveying to me? Uh, how complex is your grammar, for instance? How well did you organize that story? Like, did you tell it with a beginning, a middle, and an end? Was it sequenced in the correct order? Did you have a reasonable number of main events if we knew what the main events were, like in Cinderella, for example?

SPEAKER_04 18:05

Right.

SPEAKER_00 18:05

We can measure quite a few different things, but it kind of depends on what we're looking for. All right. That might have been too much information for you.

SPEAKER_02 18:11

No, no, no. That's I think about this a lot. I'm thinking, here's the thing.

Why Telling A Story Gets Hard

SPEAKER_02 18:16

I went the very first time, and I tell the story actually a lot, because it was such a light bulb moment for me. Okay. Um, I went to Aphasia Access the very first time I went, and I did a poster. I was with the Adler crew. Shout out to Adler. My man Joe was with me. He's a fellow Aphasian, and Joel Jessica Obermeyer was the person in charge. So we go to Baltimore, I do the thing on the poster thing. I come back, I'm talking to my buddy Tay, my friend, and she's like, All right, all right, all right. Tell me what happened. Bring I had the story ready. I was gonna tell her about how I was triumphant, I was that was awesome. I had a good story about the ride down between me and my husband. It was a whole thing. I was ready and I went to go tell her, and walls went up, and my words went into evasive maneuvers. And that was the first time I was like, okay, stop. I was talking fine a minute ago. Yeah, and that's the first time I was able to recognize in real time like no, no, no, this is and it felt different because a fa and this is what the part you don't necessarily know because I have it. Aphasia feels it's tangible almost. Like it's it's not like oh, it's just missing, it's it's taken, it's restricted. It's not that you know what I mean, it's not like it's gone, it's restricted. You knew they were there, but you couldn't access it. I couldn't access it. So I had all this information. I had this great story I wanted to tell, but I couldn't tell it. That's right. So I could talk. So what is the thing that makes me able to have general conversation, but yet I wanted to tell a story that obviously I had just lived earlier that day. But it was so tangible, like it was so it was like, oh my god, stop, what happened? And she got it too. She was like, No, you were I saw it.

SPEAKER_00 20:20

So when we're restricting our vocabulary really specifically, that can trigger some of these, you know, kind of what you'll call like a phasic tendencies or walls that you're talking about because you can't talk around it. We're trying to restrict your access a little bit to see what the problem causers are for lack of and and one of the reasons we have these discourse tasks is to try and get at like what are those triggers for some people. For some folks, it's really obvious triggers like like verbs are really hard for some folks, like really specific verbs are hard. Time of day can be a trigger for some folks. It's not even something about the vocabulary, it's just something about the time of day when people do these things that's more of a trigger.

SPEAKER_02 21:10

Fatigue and the fatigue is a big one. Oh my god. You can't overstate that in any way. It's so like that brain fog. It's it is the murky waters of aphasia, is what I called it. I mean, it was it's and it's so dark and just murky, is the verbs that I use to describe it because and it's so unexpected. And that's the thing that a stroke will take things from you you did not know were up for grabs again.

SPEAKER_00 21:41

No, I mean, and we still don't know like where is this like what is this fatigue? Like, people are still trying to quantify, like, what is this coming from? Like, and sometimes it's from what I've heard, just like crippling. Like, you wake up one day and you're like, Why am I so tired?

SPEAKER_02 21:55

Yeah, and you're exhausted and you've gotten enough sleep.

SPEAKER_00 21:58

Yeah, right.

SPEAKER_02 22:01

You're at home watching the reruns of family feud. Okay, who doesn't love Steve Harvey? The point is you've done absolutely nothing. And you're like, oh god, you're drinking water, hydrated, and you are beat. But you know, again, when you put water on the motherboard, it's gonna have problems. And at the end of the day, it's brain damage. And once I accepted the fact that I have brain damage, one at one point I didn't, and then after the stroke, I did. It's like everything can go into that box. But sometimes we call that box aphasia. No, there's a lot, there's a lot more to that box. And that's the thing. Like when they say an aphasia, it doesn't affect your intelligence, it's just your language. I have I get triggered on that. I don't know, Rangie.

SPEAKER_00 22:54

Tell me more.

SPEAKER_02 22:55

No, because here's the thing I can't tie my shoe, I can't sign my name, I can't add ten dollars to the tip of my hairdresser, and you're telling me I'm just as smart as I was before the stroke. I see. Yeah, somebody's lying. Or they don't know what they're talking about. I see. And that's how I felt about my. I questioned if I even had a phasia for the longest because of the way it was being described and what I was going through. And then I meet my therapist friends, and they're like, Well, I don't know why no one's coming to therapy. Well, that's why. That's why. Because what you're saying and what I'm experiencing are matching up. And I'm paying you $40. I don't want to be here anyway. I'm exhausted. And you're like, You're not selling it. I'm like, I got lost getting here, and you're around the corner.

SPEAKER_00 23:50

What are you talking about? I got bigger fish to fry here. I am disoriented and tired.

SPEAKER_03 23:56

And you're like, Oh no, you didn't lose any of that. And I'm like, I don't know, John.

SPEAKER_02 24:01

I don't know how to make rice.

SPEAKER_00 24:03

Yeah, you yeah, you probably had some other stuff going on too. Yeah. I mean, in many cases, yeah, there are a variety of things going on, right?

When Aphasia Is Not The Whole Box

SPEAKER_00 24:12

But we strokes affect a lot of people.

SPEAKER_02 24:14

Everything we put everything under this one umbrella of aphasia, which is unfair and untrue. There's a praxia, there's a graphia. There's a lot of things. Oh my god, the teasing out is ridiculous.

SPEAKER_00 24:30

Yeah, my my PhD is actually in neuroscience. Yeah, I'm not a speech therapist, so I I think about this a lot where it's nearly impossible to have brain damage that affects a function. It's just not how our brain is organized. It's like it's just unheard of to have brain damage and knock out like your pinky, right? Like it's just not like it's very hard. Like it just doesn't happen that often, right? Just because of how our brain is, you know, wired. That's such a small area. And our language system is what we call associative cortex. It's not primary motor. Like this is a primary motor function, it's developed very early. Our language system is not that. Like our language system doesn't develop fully until we are much older. Like our comprehension system develops first. So, you know, we're pretty good comprehenders when we're kids. I mean, we're pretty good by about five or six. We're pretty darn good at talking by the time we're eight. But we're not great at reading or writing until we're 10, 11. Right. Like it takes us a long time.

SPEAKER_03 25:48

Yeah, by the time it really gets.

SPEAKER_00 25:50

Yeah, I mean, it's it takes us a long time. And so that's how many years our brain takes to develop those highways to send information quickly. Whereas we are born with a pretty well-developed motor system. It still develops, don't get me wrong, right? I mean, we can't walk when we're born, but you know, it it's pretty well developed compared.

SPEAKER_02 26:13

But that would actually be the strength, not even the motor context. It's this you don't have the strength to walk.

SPEAKER_03 26:19

What you actually have the motor, but you have the system there. No, I see what you're saying.

SPEAKER_02 26:25

I see the difference.

SPEAKER_00 26:26

And there is a huge nuance of what has to be learned versus what is innate. And so in the language system, when you have a stroke, it's never gonna wipe out like a function because that's not how it was developed, right? It's not like you were born with a language cortex, like innately there. Right, right. So, you know, there's some thoughts about this that are out there that people disagree with, but I think we pretty well know that this isn't we're not born with that when it develops over time. So, and everyone's different. Your language brain, we know for a fact looks different than my language brain.

SPEAKER_02 27:06

Does it you've seen one person with a phasia? You've seen one person with that's exactly it.

SPEAKER_00 27:11

We're working with a a gentleman who has a right hemisphere stroke, he was strongly left-handed before a stroke, he has a broke as aphasia now. Right hemisphere stroke, but like, is everyone who's left-handed right hemisphere dominant? No, no, that's not always true. In this case, he is, but he also has some strongly other right hemisphere things that are typical in a right-handed person. So it's totally different. It's just everyone is unique.

SPEAKER_02 27:42

So that would be the what's the big thing in the middle of the brain? The clocus callosum? Corpus callosum. Pretty good. Close enough. Yeah, yeah, pretty good. Yeah, good work. I'll just blame the aphasia. You have no idea. I'll drop that thing like Uno card. Absolutely.

SPEAKER_00 27:56

That was a mic drop. Good work.

SPEAKER_02 27:58

So, would that be why this guy is able to do use?

SPEAKER_00 28:02

It's fascinating. We're still learning, it's called lateralization. So the lateralizing of one function. It is more common in left-handers to have a right-sided language system, but it's not that common. It goes. They call it brain.

SPEAKER_02 28:24

That's another thing. That's another thing. You don't know about and that's that's the thing that always concerns me. That's right. Put myself into this, you know, field of work or whatever.

SPEAKER_00 28:37

Is that oh, you don't know someone's baseline? Oh, what was I saying? You don't know.

SPEAKER_02 28:41

Oh, people's baseline. People's baseline. How do you know if a person was intellectually challenged before? It's tough, right? It's like and you're giving them a wob, assuming that they had a literal decent baseline, and maybe they already were weren't gonna pass it on their best day.

SPEAKER_00 29:03

Yeah, we talk about the importance of uh getting a really thorough case history when we're talking to graduate students, but you know, you do have these folks who don't have a good case history. Like we have individuals here who have been unhoused for a decent portion of their lives, who come into our hospital system, who don't have family, who don't have medical records in the system, who we do not have a case history on these folks. We do not have a good baseline. We don't know, right? We cannot make the assumption that they do or do not have a pre-existing condition of any kind. Right? We just we don't have that information. And I think that's fairly like common in big cities, too, probably more common in big cities than here. You're right. That is that we know education has a bearing on scores. So a lot of these assessments that you're talking about do have standard scores that are we call it weighting by education, so they'll be slightly changed. But does I don't know if that's everything, right? That doesn't necessarily account for everything.

Home Practice That Is Actually Useful

SPEAKER_02 30:12

In reference to people getting better and working on, and this is I think gonna lean into the neuroscientists of you. People want to do home practice. What is good home practice that is worthy of your time versus what is like just busy work? Like what's gonna really put some meat on the bone, as it were.

SPEAKER_00 30:36

So I did my PhD in tablet-based therapy because I was really interested in this question. And I didn't do it with the intent of putting speech therapists out of a job. I did it with the intent of how could we supplement what people are doing anyway, because we knew this idea of dose was important. What is it? So neuroplasticity, so dose is this idea of neuroplasticity happens at a higher rate the more we do something and the more often we do it. So, for instance, if you were to go to therapy every day, that would be better than going once a week. But our insurance in the US is crap. And most people also don't have time to do that. So, like, there's no way, right? Like, we just can't do that.

SPEAKER_04 31:24

Right.

SPEAKER_00 31:25

So, my my thought process with thinking about tablet-based therapy is like, okay, Angie can go twice a week. That fits with her schedule and her availability and money and all these things. But then at home, the therapist could get an app that she could program to be at the correct level for Angie to challenge her, send her back with it so Angie could practice every day. And then when she saw her, she wouldn't be losing anything in the meantime.

SPEAKER_04 31:56

Right.

SPEAKER_00 31:56

So I think the happy medium is that the practice is challenging.

unknown 32:00

Okay.

SPEAKER_00 32:02

If it's easy, I don't think you're getting any bang for your buck. Okay. I think that's number one. Okay. I think that that might ruffle a few feathers. Why would it ruffle a few feathers? I don't know. People are like, but I just want to watch TV and listen to audiobooks.

SPEAKER_02 32:18

Don't get me started. I don't want to get in any trouble either. I'm trying to keep a listener. I don't want any trouble, but no, I get what you're saying. Because I I was going to see my father right after I had my stroke. I was like, let me see him in person. Now he was going through beginning signs of dementia. He was still there though. He was good enough to know he knew his daughter had a stroke and he wasn't happy about it. But so I was like, Let me go see him so he can see me. And you know, so I about to get on the plane. I go to five below, and I'm like, now mind you, less lest we forget, I'm a finance manager. I get the book, a fifth grade book, math book, because I'm gonna work on it on the plane. I got four hours, why not? Third grade book. I'm like, oh god, what are they teaching these children in third grade? Oh my god. I had to take the pre-kindergarten book, which so now I'm walking out of five below. First of all, my tails between my legs, and when I tell you Brie, tears were streaming because I would I felt so defeated on what I thought I could do, and then what was the reality of it, but again, what my baseline was yeah, but you were challenged, but I was challenged on helping the rat and the mouse. I'm sorry, he's not a rat, the mouse, the little guy Alex, find his cheese. It was very demoralizing to me that I'm working on this book, but you were challenged, but baby, it was putting in that work, and I was like, I don't know how much cheese this is supposed to be. Cheese, Alex. Damn it, you need to be on a diet, Alex. That's what Angie's saying. You're doing too much. It was it was really a thing for me to kind of get my bearings of where I thought I should be, where I thought I lost, and the washout of the bridge that had happened, and that didn't happen until two months in post-stroke, when I realized, and that's another thing, people don't realize by the time they get through their eight weeks of therapy, that's when they begin to realize how bad it is. Oh, I see.

SPEAKER_00 34:28

We have no idea of like everything happening.

SPEAKER_02 34:32

I assumed my talking was the least of my concerns because I could think fine. It wasn't like my thoughts were jumbled. Bree, before I let you go, because I know you got to get up out of here.

Retiring The Six-Month Recovery Myth

SPEAKER_02 34:46

I'm gonna ask you one quick question, and that is I want one belief about a phasure recovery you want to replace, retire. I'm sorry, I want, ah, let me start again. All right, Bree. So I'm gonna let you get, I'm gonna let you go. Before I let you get up out of here, I have the smart cookie question, and that is what is all right, one belief about a phasure recovery you want to retire, and what do you want to replace it with?

SPEAKER_00 35:19

Oh, that's a really good question.

SPEAKER_02 35:21

Okay, what belief about neuroscience you want to recover? And what would you want to replace?

SPEAKER_00 35:28

I still hear it from people, so I'm gonna say it. The fact that people stop recovering after six months or a year.

SPEAKER_02 35:40

You still say that.

SPEAKER_00 35:42

I have heard it recently from well-educated people. Recently. And I am, I don't know. I don't know where it's coming from, I don't know what textbook it's in, but it's somewhere. And I will find it. I don't know where it is. I will say definitively, at least, you know, in our research studies, and we've worked with hundreds of people, many, many, many people. We've continued to talk with people who say, hey, it's been 20 years, and I still feel like I make gains. They're they're small, you know. Yeah, improving.

SPEAKER_02 36:17

I have videotapes of me talking after my like sixth or seventh month, and versus even if I go back to the first episode of Brain Trice, I can hear the improvement. Oh, yeah. It's night and day. Again, feel free to go and listen to episode one of Brain Trans.

SPEAKER_00 36:34

Oh, I will now platforms, you know what I'm saying? I did listen to it when it first came out, so now I'll revisit 92 countries.

SPEAKER_02 36:41

Wow, 14,000 downloads, and I'm just doing stroke and aphasia and carrying my girl's legacy. That's right.

SPEAKER_00 36:50

Or not I do have a weird brain. Hold on. Okay, there you go.

SPEAKER_02 36:56

Literal brain friend. Oh, you are see, and who's coming with props? Brie.

SPEAKER_04 37:02

We could just do it.

SPEAKER_02 37:04

Riel Stark. So here's what I'm taking away from this episode and the research breakdown.

Takeaways And How To Support

SPEAKER_02 37:13

First is that everyday stories and conversations where a is where aphasia really shows up. It's in those just those regular conversations that you have. Um but that's also where the bro growth shows up. And that's what Dr. Bree was talking about. Second, is that good therapy and good home practice should feel meaningful and challenging, not just busy work. And if you're out there wondering whether your brain can still change years after your stroke, I promise you it can. I am getting better every day. Friends of mine are improving every day. So it's all about staying positive, it's all about still doing the work, even when it feels like it's not going. The train is still on the tracks, guys. So, anyway, let's get back to it. I thank you so much for joining me today, being on Brain Friends, taking the time and just spreading the knowledge of neuroscience and Discord and explaining why I can BS with my friend, but can't go through a whole story without walls and evasive maneuvers showing up like I'm on Star Trek. So I appreciate you. I appreciate you. And thank you.

SPEAKER_00 38:44

It's been a pleasure, Angie. Always awesome to see you, but also to keep Celeste's legacy alive because it's awesome.

SPEAKER_02 38:51

And it's an honor to have her legacy attached to this wagon. And it's she came into my life for a season. Yeah. A season. An important season. Uh, such a season. We built this, and she's like, You got it. It's like she handed me the baton, and I'm like a thousand miles and running. So, Bree, thank you so much for for spending some time with us, being on Brain Friends. So, we will see you next time. Say goodbye.

SPEAKER_00 39:21

Until next time, my friend.

SPEAKER_02 39:23

All right, until next time. So, to all my brain friends, until next time, take care of your brain, take care of your body, and take care of each other. Peace, y'all.

SPEAKER_00 39:34

Peace. Peace. Brain friends, we did it. All right.

SPEAKER_01 39:46

We hope you enjoyed this episode of Brain Friends. Please leave us a five-star review on Apple Podcasts or your favorite streaming platform. Also, make sure you subscribe to our YouTube channel.

SPEAKER_02 40:00

Brain Friends the Podcast.