★ Finding a Place For Profanity

I love to swear. I don't do it all the time, of course, but there's something about profanity that just feels powerful. Perhaps it's because I can't think of any other words in any language that stir up more emotion. Pride, jealousy, misery, envy, frustration, joy, excitement, passion, anger, bitterness, happiness. A small handful of words can make us feel so many things. It's no wonder, then, that profanity is a sensitive topic to so many people. As children, we're told that it is inappropriate to use such language. Therefore, like many children, I took this to mean that I simply wasn't supposed to get caught using such language. The joy of this line of thinking is that I overused swear words to the point that it occurred to me that their real power was to be savored. If I reserved myself somewhat, that declaration of "Fuck!" could pack a great deal more meaning into itself if it was used sparingly.

I maintain this line of thought today.

If ever there is an appropriate time to swear, it would be when one suffers several strokes in succession that render one severely expressively aphasic, dysarthric, and apraxic. In such a scenario, the power of profanity really shines.

Earlier this year, I worked with a patient who experienced the debilitating recurrent strokes I just described. This patient understood her limitations. She recognized faces of the many people around her, and knew where she was and why. She was acutely aware of her inability to express herself verbally, and even more than that, she knew exactly how helpless others thought she was.

Many people who encountered her assumed that she had difficulty understanding things. And while this is true if the word 'things' is referring specifically to things linguistic (and more specifically, complex linguistic), she made it very clear that the ability to decode language had little to do with how well she could think. It's an interesting disconnect, really, and calls into question just how much our brains truly rely on language for thought.

To make matters worse, her expressive aphasia coupled with apraxia made her speech functionally unintelligible. And although she could comprehend varying inflection with ease, she was unable to express any inflection. A cry for help sounded very similar to a cry of pain; unless you were able to see her face, it was very difficult to make the distinction.

This patient's approach, then, was to resort to the glorious use of profanity. When she was in pain, or when she was upset that someone was assuming her to be less capable than she actually was, she would look you in the eye, hold up her middle finger, and say "Fffuuuuuuucckkk!!!"

I was approached on a regular basis by staff members who asked me, time and again, to discourage her from flipping them off. Some found it offensive, while others felt that the residents found it offensive. I made no effort to cater to these requests, however, and informed the staff that every patient has the right to communicate in the best way they can. My job as an SLP is to foster independent communication; this patient was able to express herself in a small but very powerful and easily understood way. I was not about to discourage her from using the most functional means of communication she had, even it was an offensive gesture to some.

In my work as an interpreter, I advocate for everyone's right to speak their mind, and be understood. Similarly, I believe that as SLPs, we must advocate for our patients' and clients' right to express themselves in any way they can. We must also advocate for our clients by educating others regarding their capabilities, and how best to interact with them such that dignity and respect are always maintained.