Speech Language Therapy Thoughts

Sprechen Sie Englisch? – Understanding what it’s like to not be understood

As those who know me well will know, in my earlier years, I struggled significantly to express myself using speech, and am all too aware of how painfully frustrating that is. I have been fortunate however, for the last 15 years or so, to have had speech which has been able to be understood widely by others and on a day to day basis, nowadays I give little thought to my ability to communicate.

For most of us, speech and language are two things that we very much take for granted and don’t give a great deal of thought to – not until we, or someone else that we are close to can no longer communicate – a situation that can develop incredibly rapidly, such as following a stroke or a head injury. Often, your language will be intact, but your speech may not be, meaning that although you know exactly what you want to say, you cannot express the thought in your head unassisted.

Travelling this week in Austria – a German speaking nation – has prompted me to rethink about this, as the foreign country analogy is the best one that I can think of to help people who have had the privilege of intact speech and language throughout their life, the insight that is needed to understand what life must be like with a communication impairment.

Of course, even the foreign country analogy has its limitations, because in a country such as Austria with an education far superior to that of English speaking countries when it comes to languages, you don’t have to look far to find someone who speaks English – although it certainly cannot be assumed – most younger people will have a level of English that is at least sufficient to answer a query about many everyday things, but many from the older generations may not speak English very well (or at all).

However, even despite being somewhere where I can manage to get by without speaking the official language of German, I notice a few things that I’m doing that someone who is struggling to express themselves due to a communication difficulty may do.

  • I fear communication interactions and breakdowns – basically, I don’t want to be any more awkward than I already am. I get nervous when I am going to have to speak to someone, as I know that I will only succeed in my interaction with a skilled communication partner – i.e. in this scenario, someone who is fluent in both German and English. This is something I have no control over – it is pure luck whether I get someone who can understand my language, and so I fear it, because my ability to communicate is no longer in my hands. If I’m not met with a skilled communication partner, my knowledge of German is so poor, that I cannot repair it beyond Ich kann kein Deutsch (I can’t speak German) and walking away feeling defeated and without having achieved whatever I set out to.

  • I am illiterate – I can read and understand things that I’m expecting to see – e.g. I know my station is Schottenring so I can recognise that sign and know to get off the train there, but when a warning sign pops up on the street somewhere, I am completely oblivious to its meaning, and could well be putting myself in harm’s way. It’s frustrating as all I see are characters on a sign. Similarly I look at the list of ingredients in food and have to take a chance on things I don’t recognise and hope it’s not going to taste too awful or worse, turn out not to be food at all. I tried to get money out at a cash point – the first one I used did not have multilingual options, so I had to cancel the transaction and take my card back and find a different bank’s ATM with English options as I was worried I might otherwise make a mistake with my money. Similarly for people who have a stroke or head injury and develop aphasia, they may see the letters as a a jumbled sequence of characters from which they can discern no meaning – unfortunately in their case, translations are a lot less readily available.

  • I employ avoidance strategies – I look for ways to avoid interacting with people in German if possible as to do so is hard. This includes things such as buying a whole lot of things at once so there are fewer interactions required, looking for places where I can purchase things self-service so I can take my time to read through the German text and figure out what to do without fear of judgement from the machine. I am pretty organised and independent so I know where I’m doing and where I’m going and can look like a local that other people may wish to ask questions of (e.g. for directions). To avoid random interactions with people, I put my headphones in, like a big “do not disturb” sign. I seek out restaurants that are welcoming of my “code” by having displayed a bilingual menu. However, I also am careful to moderate the avoidance strategies as I don’t want to miss out either – fortunately for me FOMO trumps a communication barrier, so for example, yesterday evening when I went to one of the night markets and saw and smelled some amazing food being served by someone who could only speak German – we made use of a more basic mutual common code – pointing and gesturing – so that I could get what I was after and not miss out. It felt incredibly primitive though and a bit undignified for us both.

  • Doing everyday things is stressful – as above, even obtaining food becomes harder – I could do my shopping in my sleep at home as I can read all the information, and converse with people easily if required. Now suddenly, I need to think a lot harder to obtain the essentials!

  • I overcompensate – when I have an opportunity to use the limited German that I do have, I apply it as liberally as sunscreen almost by way of an apology for having had to just communicate in English. At the end of an interaction, someone who speaks German may expect to hear dankeschön (thank you very much) firstly to thank you for handing me the food, secondly for handing me my change and then a third time as we part ways at the end of the interaction – in English I’d have simply said “cheers” or “thank you” once, followed by “cya” or “bye”.

  • I lose aspects of my personality – when I’m speaking in English, I’m full of expression, emphasis, enthusiasm, humour and tone when I communicate. I use my communication skills to make whoever I’m communicating with feel more at ease and I hope that I come across as warm and friendly. Similarly, I can use my communication skills to compensate for any deficit that the person I’m communicating with may have, whereas you can’t do that when the shoe is on the other foot.

  • I simplify my interactions to a basic level – when I’m speaking in English, I fluff it up a bit – I choose words that provide better descriptions and tailor words to the audience (e.g. by picking words and phrases that I would anticipate are in the vocabulary of the person I’m talking to, and avoiding words that are unlikely to be in their vocabulary – such as saying bolus to another speech therapist, and mouthful of food to virtually anybody else, or saying snog in England, winch in Scotland and pash in New Zealand), as well as add in extra information to provide more context and clarity. When I’m speaking to someone whose understanding of English is rudimentary, the communication exchange consists of the bare minimum necessary to get my message across – I don’t bother with adding in all those other things as it’s likely they may be misunderstood.

  • I settle for misunderstandings – I asked for a cheese and tomato sandwich and you brought me a cheese and ham one – I can’t really send it back and claim you got it wrong can I? You were doing me a favour by speaking another language and being a helpful communication partner – even though you made an error, I feel responsible because I wasn’t able to make my message clear in your language. I chalk this one up to a communication breakdown and settle for a less than ideal situation.

  • I feel less intelligent – I didn’t step off the plane stupider than when I boarded it at Heathrow. But it certainly feels like it. All my thoughts, opinions and knowledge are locked away in my head just the same as it always is, but most of it can only get out in English and the remainder of it in French – neither of which is particularly helpful in Austria. You feel a lot lower in the social order when you cannot communicate in the same code as everybody else – the three-year-olds around you are in a better position than you because what use is having lots of thoughts and ideas if you can’t get them out? Other people also have no idea of your intellectual ability when you can’t use their code – they quite simply can’t assess you, and being unable to communicate using the language of your environment often is met with unconscious bias that you’re not that smart (and to be fair, the English speaking world isn’t when it comes to foreign languages) – sadly, the same wrong assumptions are made about people who just can’t communicate in the same way as you and I whether due to disease, accident or injury.

  • I feel exhausted – As fun as travelling is, and as exciting as it is being immersed in another language, having to exert that much more energy to understand and to be understood is tiring! For me, I know that next week I’ll be back in England speaking my native language, so I can enjoy the moment and the challenges of being in another country with a different language and see it as a new and exciting experience, but if everyday was met by constant inability to communicate, I would feel pretty worn out, and would likely employ far more avoidance strategies and become more recluse.

Everyone should at some point immerse themselves in a country where they don’t feel strongly proficient in the language to experience what it is like to have a communication difficulty. Then, the next time you encounter someone with a communication difficulty, you can appreciate how frustrating every day is and how anxiety-provoking every interaction is. However, you’ll also realise how with a bit of kindness and understanding on your part (like with the Austrians who so willingly and happily help me out by speaking English) you can make life that bit easier and more inclusive.

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