Supported Conversation for Adults with Aphasia (SCA) tm or The Vulcan Mind Meld

vulcan mind meld

Yesterday, I was having a conversation with a relatively new client, whose fluent aphasia is often challenging for us both.   In this case, it was a combined metacognitive talk about his process, a talk about his frustration in not even being able to say his favorite football team name, and a political discussion, and since he is enmeshed in the world of finance, I expected to find him staunchly republican.


His liberal roots began long ago, I learned, when he was a boy growing up in Brooklyn.  Of course, none of these words were in his vocabulary.  His output is like a vast and empty midwestern plain, where occasional scrub brush and grassy clumps can be seen, but where, as listener, you are charged with populating the land with possible plants and flowers.  This is called, “Supported Conversation for Adults with Aphasia” or SCA ™, in which the use of written words, drawings, musical jingles, and hodge podge permits the client to choose, to validate responses, and reveal what he knows, and who he is when language will not serve.  {For further explanation of SCA, please refer to the work of Aura Kagan at Toronto’s Aphasia Institute }

After an hour together, my treatment table is littered with messy pieces of paper that look like this:


and this:

IMG_0510Look, if you will, at the four words in pink at the bottom of the second page.  He was trying to tell me which college football team was his fave. It was going nowhere.  He swept the air with his hand, like erasing a blackboard – an indication we were going somewhere else.   “You know,” he said, “the big guy, the one, the guy…  killed”  For some reason, I wrote “Pres” and he indicated “president” was correct.  Since we had just finished talking about his love of JFK, and sure it was assassination he was referring to, I wrote “Kennedy”.  “No, no, ” he said.  “Back.  Way way back.”  And then, I thought of another assassinated president, and wrote, “Lincoln.”  “Yeah, he said, with a questioning intonation, “and, so????”  And I figured it must be Lincoln’s state of Illinois.  He liked the Illinois team. In that moment, he stopped and looked at me.  “You,”  he said, smiling. “Thanks,” I replied.

The Vulcan Mind Meld doesn’t always work.  But when it does, I salute Mr. Spock.

“It’s only logical, Captain,” he says.  “Live long and prosper.”


About Shirley Morganstein

I am a life participation therapist for people with aphasia, exploring the relational and reflective process.
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