Ideas and considerations for the NLP Practitioner.
“We are not judged by the words that we use, we are judged by the relationships that we form by them.” Andrew T. Austin
Aphasia: A disorder of language affecting the generation of speech and its understanding and not simply a disorder of articulation. It is caused by disease in the left half of the brain (the dominant hemisphere). It is commonly accompanied by difficulties in reading and writing. Oxford Concise Medical Dictionary.
In the majority of people (95%), language is lateralised (focused) in the left hemisphere of the brain. For the other 5%, language is lateralised in the right hemisphere.
This appears to hold true for right-handed people, where the left hemisphere is considered “dominant”. However, in approximately 75% of left-handed people, some researchers suggest that language is also lateralised in the left hemisphere. In the other 25% of left-handed people, language appears to show bilateral representation (occurring in both hemispheres). A review of the literature shows conflicting statistics, but as a practical generalisation, we can say that language occurs for most people in the left hemisphere.
The two primary language areas of the brain were named after the early neurologist Paul Broca (1824–1880) and surgeon Carl Wernicke (1848–1904).
Broca’s aphasia
Also called “ataxic”, “expressive”, “non-fluent”, or “motor” aphasia.
Broca’s aphasia is most commonly seen following a cerebrovascular accident within the left hemisphere, in Broca’s area. Head injuries, surgery, and other pathologies can also damage this region. Although an equivalent area exists in the opposite hemisphere, for our purposes here, I refer to the left Broca’s area.
Broca’s aphasia ranges from a mild effect to a total disruption of left-hemispheric speech and language production.
In mild Broca’s aphasia (often referred to as “dysphasia”), the person may demonstrate two classic features in speech:
Telegraphic quality: Speech consists primarily of content-oriented words and lacks functional principles. Words such as “and”, “the”, “a”, “for”, etc. are missing.
Phonemic paraphasia: Words may be rearranged in a manner not dissimilar to “spoonerisms”, so that “walking stick” becomes “stalking wick.”
The classic Broca’s aphasic may be rendered monosyllabic, with the left Broca’s area unable to produce speech and language. The equivalent area of the right hemisphere, the region capable of pressured speech, may remain unaffected. Thus, we commonly observe a patient who can only produce one syllable of an emotionally charged nature.
Whilst in rehabilitation, these patients will favour staff who can decipher their intentions. Quite often, frustration itself will propel the right hemisphere into action to unleash a verbal torrent of “SHIT… shit… shitshitshitshit!!!” with varying emphasis and tonality.
It is these variations that many nurses learn to interpret as meaning, “I need a drink”, “I need the toilet”, or simply “hello”.
With this kind of expressive dysphasia, the listener can begin to discern differing qualities, auditory-expressed submodalities, if you like.
Listen for changes and variations in:
- Tempo
- Volume
- Tone
- Speed of repetition
- Inflection
Although these can be taken to reflect “submodalities”, the parameters of variation are not sufficient for articulation to occur.
Arising from the right hemisphere, these variations reflect more of a sentiment or emotion – analogue communication rather than digital communication. Thus, the attuned listener can discern the relationship (analogue) between the person and the event they are seeking to communicate about.
When Broca’s area in the left hemisphere is damaged, the person commonly loses the ability to write. In my own practice, reactions to attempts to test for agraphia (inability to write) range from the person simply holding the pencil and looking blankly (where there appears to be no recursion to the deficit, i.e., the person is unaware they have even lost the ability because they have no access to the fact the ability exists) through to the person throwing the pencil across the room with a frustrated tirade of “FUCK FUCK FUCK FUCK!!!!” (which his primary nurse translated for me as “I think he wants you to leave him alone.”)
Because expressive aphasia results from damage in the forward regions of Broca’s area, next to the regions of the mouth and tongue on the motor cortex, it is not just the ability to articulate language that is affected, but the very ability to represent it physically that can also be affected.
Thus, we can see why some people remain blissfully unaware of speech and language deficits while others experience immense frustration. Where damage occurs predominantly in the speech areas of the motor cortex, the person may be very aware of their deficit and experience their inability to speak effectively.
In preverbal children, this may account for a degree of childhood “tantrums” where the child is able to represent speech before they are able to verbalise and express it.
Typically, young children can understand much more than they are able to say. Because of the different rates of development across language areas, a complication is that they often do not hear their own verbalised communication. This is demonstrated in the classic example:
“What is your name?”
“Litha.”
“Litha?”
“No, Litha!”
One curious feature about language acquisition is the resistance a child exhibits to grammatical correction by a third party. This is also demonstrated by a classic example:
Child: “Want other one spoon, Daddy.”
Father: “You mean, you want the other spoon.”
Child: “Yes, I want other one spoon, please Daddy.”
Father: “Can you say, ‘the other spoon’?”
Child: “Other… one… spoon.”
Father: “Say ‘other.’”
Child: “Other.”
Father: “Spoon.”
Child: “Spoon.”
Father: “Other spoon.”
Child: “Other… spoon. Now give me other one spoon.”
Typically, Broca’s aphasia will also involve agraphia.
To experience a little of what this is like, try writing with the opposite hand to which you are accustomed. The intention is there (but in the other hemisphere), yet the writing takes on a distinct childlike quality, the pathways translating intention into motor coordination have not been developed. With repetition, this is rapidly improved.
Curiously, some people find that using their unaccustomed hand can produce mirror-image writing more easily, especially when a mirror is used as visual feedback.
Quick summary for the NLP Practitioner:
The right hemisphere of the Broca’s aphasic is capable of producing “pressured speech” (this is why some people who get emotional/angry will suddenly litter language with obscenities). As a result, this speech establishes an analogue relationship between the person and the subject matter. This relationship is demonstrated by the “submodalities” of what little speech is produced. Damage to the left Broca’s area destroys the ability for the content (digital communication) of speech to be articulated, whether by damage to the areas that engineer articulation or to the motor areas that produce it.
Wernicke’s aphasia
Also called “receptive”, “sensory”, or “fluent” aphasia (pronounced “VER-nick-keys”).
Wernicke’s area is the part of the brain that processes spoken and written language. Broadly speaking, where Broca’s area is concerned with outgoing communication, Wernicke’s area is concerned with incoming communication.
Generally situated in the left hemisphere, Wernicke’s area lies further back in the brain, within the temporal lobe.
Damage to this area classically produces the effect that a person may be able to speak but will not be able to understand another person’s speech to varying degrees.
Also, the outgoing speech of this person may contain numerous errors owing to the fact that their own Wernicke’s areas cannot hear their own speech production.
Basically, their feedback loop for monitoring their own speech is lost (to varying degrees). Perhaps from this, we can begin to re-examine why unaffected people frequently have conversations with themselves.
Wernicke’s area appears to store memories of sequences of sounds that occur in speech. When damage occurs, the person may still hear sounds when someone speaks but fail to recognise them as speech.
Typically, whilst the receptive area of the left hemisphere (content, grammar, and syntax) is damaged, the equivalent area of the right hemisphere operates normally and recognises tunes, rhythm, and child/baby talk. It is this kind of feature that may be of particular interest to the NLP Practitioner when designing “double inductions” as part of NLP/hypnosis practice.
One characteristic of Wernicke’s aphasia is the production of words in “jargon”. On the surface, a Wernicke’s aphasic may appear to be speaking normally, with appropriate punctuation, rhythm, and prose (as sequenced by the right-hemispheric equivalent) but demonstrate serious deficits of content.
The following classic example used by psycholinguists reflects this type of structure:
“Colourless green ideas sleep furiously.”
With this sentence, the rules of grammar and rhythm are followed, and the sentence “feels” right (right hemisphere), whilst the left tells us the content and syntax do not work.
The Wernicke’s aphasic will take this one stage further:
“The stockety wance on my holiday, it ate up the laddersby until, you know, we fell it over and then he danced wither the meal.”
A Wernicke’s aphasic may produce an incorrect answer to a question but still retain an understanding of the correct answer. In a characteristic termed “semantic paraphasia”, the answer produced may not be correct but will bear some relationship to the correct answer.
In the most extreme cases, the person may be rendered completely “word deaf” and will be blissfully unaware that they ever heard speech to begin with. Where a specific function has been totally destroyed, there is a lack of recursion, and thus the person is mostly unaware of a deficit that is painfully obvious to everyone else.
Where insight is retained, Luria (1973) recorded a case where a person with Wernicke’s aphasia had difficulty with the question, “Is an elephant bigger than a fly?” The patient understood the words ‘elephant’ and ‘fly’ but stated, ‘I just didn’t understand the words “smaller” or “bigger”.’ ” Somehow, I always think that the expression ‘a fly is smaller than an elephant’ means that they’re talking about a very small elephant and a big fly.”
Anomic aphasia
Whilst many people are familiar with the two main speech and language areas of the brain, there is a function of the angular gyrus – an area behind Wernicke’s area in the parietal lobe – that is responsible for naming things.
Damage to this area will affect the person’s ability to produce nouns correctly. Situated nearer the visual cortex, the left-hemispheric angular gyrus appears to play an important role in the categorisation of the world.
From Programs of the Brain by J. Z. Young:
The person can’t give the right name. Shown scissors he says, “It’s a nail file.” Told it should be “scissors” he repeats, “Yes, that’s right. Of course, it’s not a nail file, it’s a nail file.” For him, the wrong word had got the symbolic value of scissors. (p.189)
Circumlocution is the strategy employed to bypass this difficulty. This is where a person describes what an object does rather than giving its name. For example, when asked to name an object (a hat), the person might say, “You put it on your head.”
Curiously, where a noun can also serve as a verb, the name may be given only in the context of the verb. For example, Penfield and Roberts (1959) describe a patient who could not name a comb but stated, “Something I comb my hair with.”
As a point of curiosity, I wonder how much this area plays in the creation of nominalisations.
Other verb/noun items that can be used to test (thanks to Joe):
- The stuff you WAX your car with.
- Can you TAPE up the box?
- Something I BRUSH my hair with.
- Help me BANDAGE my wound.
- Can you WATER the flowers?
- I need to BOX up my albums.
- As well as CART, LIGHT, WASH, COOK, PENCIL, LIST, CATALOG, BOOK, REGISTER, TAKE, PROFIT.
Conduction aphasia
This type of problem arises from damage to the nerve fibres connecting Broca’s area with Wernicke’s area (the arcuate fasciculus).
In this type of aphasia, the person has difficulty repeating what they have just heard. They may speak normally (assuming other language areas are intact) and understand speech normally. However, when asked to repeat a sentence, exact replication is not possible, and the person will produce their own version. Typically, the overall meaning remains, but the words differ.
For example, if asked to repeat the word “president”, the aphasic may reply, “I know who that is, Kennedy.” Similarly, someone asked to repeat, “The auto’s leaking gas tank soiled the roadway”, may respond with, “The car tank’s leaked and made a mess on the street.”
Transcortical aphasia
Typically, people with this type of aphasia have both receptive and expressive difficulties, meaning they may understand little of what they hear and have gross difficulty producing speech (to varying degrees). Although similar to combined Wernicke’s and Broca’s damage, the lesion lies beyond these two areas.
In one notable case, an unfortunate woman with severe brain damage following carbon monoxide poisoning demonstrated an unusual facet of speech. Without damage to the primary auditory cortex, Broca’s and Wernicke’s areas, large parts of the visual association areas were damaged, and the speech mechanisms were isolated in function from other areas.
During a protracted hospital stay lasting several years, the only movements she made were with her eyes, which would track movements in the room. She never volunteered communication, never obeyed commands, and never demonstrated any understanding of speech or other modes of communication. She was described as being “not conscious of anything that was going on”.
What was curious, however, was her ability to complete lines from children’s poetry and to repeat back phrases said to her.
For example, if someone were to say, “Roses are red, violets are blue…” she would respond, “Sugar is sweet and so are you.”
Another curiosity was that if she repeated a sentence spoken to her that contained a grammatical error, she would repeat the sentence without the grammatical error.
I have demonstrated this effect when teaching language to NLP and hypnosis students. If a childlike poem is given, such as “Mary had a little lamb, its fleece was (long pause)…” the majority of people will automatically complete the sentence in their own heads.
This effect can be used effectively in hypnosis when speaking to the right hemisphere (via the left ear). The important aspect for the NLP Practitioner to remember is rhythm and tempo, qualities the right hemisphere excels at. Childlike singing, rhyming, and speaking can assist trance as the brain tries to keep up, completing one sentence internally as another is delivered; meanwhile, suggestion can be delivered to the left hemisphere (via the right ear) to equivalent structures that are better at processing complex meaning and analysis.
Some additional aspects of hearing
On a basic neurological level, a spoken word is little more than a complex wavelength of sound, and yet the brain can distinguish meaning and grammar, detect and locate accents, identify the speaker (even if the speaker tries unsuccessfully to disguise their voice), tell the difference between “fa” and “la”, identify tunes, and much more.
The frequency of sound that can be picked up by the cochlea of the ear is commonly stated as roughly 200 Hz to 20,000 Hz. By comparison, a dog is often described as having a range around 67 Hz to 45,000 Hz.
Species / approximate hearing range (Hz)
- Human: 64–23,000
- Dog: 67–45,000
- Cat: 45–64,000
- Cow: 23–35,000
- Horse: 55–33,500
- Sheep: 100–30,000
- Rabbit: 360–42,000
- Rat: 200–76,000
- Mouse: 1,000–91,000
- Gerbil: 100–60,000
- Guinea pig: 54–50,000
- Bat: 2,000–110,000
- Beluga whale: 1,000–123,000
- Elephant: 16–12,000
- Porpoise: 75–150,000
- Goldfish: 20–3,000
- Owl: 200–12,000
- Chicken: 125–2,000
Frequency refers to how many times the tympanic membranes vibrate per second in response to sound channelled down the ear canal.
These vibrations are sent to the cochlea, where they are converted into nerve impulses that travel down the cochlear nerve and are sent to the primary auditory cortex in the opposite hemisphere to be processed.
In this region, something pretty cool occurs: neurones of auditory areas are “tonotopic”. This means different frequencies of sound stimulate neurones in different arrays, they respond to different sounds in different ways.
Depending on the frequencies and patterning of sounds, for example, in music, different effects can be achieved. The variables here are huge. Playing Eminem to my elderly grandmother is unlikely to induce a good feeling in her; yet to my younger brother, it’s literally music to his ears.
Sound has a powerful impact on neurology. For example, at Woodstock 1999, Limp Bizkit achieved a phenomenal crowd response along the lines of “Let’s go break stuff,” aided by the rhythms and tunes – in rapport with the band and with each other. Compare this with the original Woodstock, where a similar rapport occurred, but with a different outcome.
Ohio psychologist Jaak Panksepp achieved a similar effect with his chickens, who appeared to enjoy The Final Cut by Pink Floyd. These chickens, having been played various tracks by Panksepp, would tend to sway about, look pretty chilled, and start passing around the joints.
Music can evoke a wide range of emotions. Many people recognise the “They’re playing our tune” effect, where the tune not only evokes an emotion but also acts as an anchor to a shared moment.
Music can be angry, sad, happy, exciting, etc. and can be all these things even without lyrical content. Sometimes artists use deliberate incongruencies to evoke a particular effect. Some of the best examples can be seen with the punk band The Sex Pistols playing with the London Philharmonic Orchestra or in songs where lyrics tell a tragic story masked by a happy, upbeat tune (such as Springsteen’s “For You”).
As RB warns, be careful what you sing to yourself inside your head, and be especially careful with country and western music.
As anyone who has suffered an evening in a karaoke bar can testify, the quality of the voice greatly affects how the overall effect is experienced. I’ve heard many a good Springsteen tune massacred by a cover artist, and yet my friends will suggest (somewhat blasphemously) that it is Springsteen’s gravelly voice that is not in order.
As NLP practitioners will be aware, a lot of emphasis is placed on the quality of the practitioner’s voice. For anyone seeking to improve their practice, I seriously recommend purchasing a decent sound recorder so that you can record client sessions – a lot can be learned here.
A common effect when people hear their voice for the first time on tape is that it doesn’t sound like their voice, and they frequently don’t like it much. Here is the bad news: this is exactly how you sound to other people’s neurology too.
Given the way Broca’s (production) and Wernicke’s (understanding) areas operate, your external dialogue will sound different from your internal dialogue – and will affect your own neurology in the way it affects other people.
Using a good recorder (and it is worth spending the extra money) enables you to recalibrate your voice against how you experience it from the inside.
Your tonality and presentation will enormously affect the impact communication has on the neurology you interact with, whether it is your own, your lovers’, or your clients’. If you use tone to create the right internal environment in the recipient, the content of communication will land in the right parts of their neurology.
It is not enough to just say the words and hope for the best, you’ll just be singing bad karaoke to your clients. Learn to calibrate your voice to your internal representation; learn to calibrate your voice to your client’s responses.
Think chickens. Think Pink Floyd’s The Final Cut.
Practice: different voices; learn to shout; learn to sing; learn to vary your states.
And most of all, be nice to yourself. Frequently, when I elicit clients’ internal dialogue strategies where they verbally beat on themselves all day, I have a conversation that goes a bit like this:
“Would you talk to your child that way?”
“No.”
“Would you encourage your child to talk to himself that way?”
“No.”
“Would you talk to your wife that way?”
“No.”
“Would you talk to your pet dog that way?”
“No.”
“Would you talk to your plants that way?”
“No.”
“So you are telling me that it’s ok to talk to yourself that way?”