Welcome
To
TMDeepWellWords

Psychotherapy With and Without Speech.

Tom Medlar

​

Hello, Jane. My name is Tom. Can you hear me? Blink once if yes, or blink twice if no.
One blink.
Is your name Jane?
One blink.
Is my name Tom?
One blink.
Is my name George?
Two blinks.
Is your name George?
Two blinks.

In psychotherapy I attend to the specific content of what a client is saying, as well as what maybe left out or avoided, what might be hinted at or signaled indirectly. I listen to the tone and pace of a client’s speech, and to gestures and body postures that also communicate meanings. I follow the attention of the client; how one establishes or breaks contact, and if the client is speaking directly to the therapist as they search for new understanding or might be repeating comments they have made to others, or even if they might be speaking to an internal audience more than to the therapist. I pay attention to what the client inwardly attends to and ask questions or make comments to guide their attention to what they might overlook or minimize or avoid.

 

While practicing psychotherapy in nursing homes, I might work with a client with intact cognitive and language skills, or sometimes with someone with a brain injury or a neurological condition, and the individual might even be a non-verbal communicator.

 

Some of my clients use non-verbal methods of communicating such as gestures, or a letter board, or an electronic device for spelling or voicing their typed comments. I may need to extend my patience and concentration when working with a non-verbal client. If an individual can only offer yes/no responses, it is important to clarify and confirm the accuracy of their responses, and
consultations with a speech therapist is needed for that. When documenting the conversations, I might state that I said or asked this, and the client indicated or selected that, to limit assumptions or misunderstandings about the precise communication with the client. When working with a non-verbal client it is, ironically, the non-verbal communication that is lessened, as the client and therapist are focused more on the concrete words or meanings being
generated by the client than on the manner of communicating. MORE