I attended an all-day seminar today on social communication.  There was a presentation on traumatic brain injury (TBI), and discussion about how important social communication skills are for people who have had TBI.  Since damage from TBI is often diffuse, complex, and can change over time, there is no easy way to predict what a person will need help with.  The presenter made a parallel to spinal cord injury.  Doctors and rehab personnel can make predictions on recovery, ability, and prognosis based on the level of the injury (C1, C3, C5, etc.).  The same is not true for TBI.  As a result, SLPs have developed checklists and ratings scales.  They assess areas of social communication such as taking turns in conversation, staying on topic, making appropriate eye contact, and staying within “polite” social parameters.  One of the ratings scales is given to both the patient and his/her spouse.  The presenter queried, what did we think a person without TBI would say if he/she assessed him/herself?  In other words, how would we, as healthy-brained humans with a certain competency in social skills, view our abilities?

Dismally, it turns out.  I would have enjoyed if he had actually demonstrated this fact by handing out the questionnaires and asking us to rate ourselves before he told us the results, but I believed him, if skeptically.

Later in the day, as I prepared to trade the goose bumps of the icy conference room for the sweltering humidity of the 88 degree day, I briefly touched in with a woman I used to work with.  She was my SLP supervisor for my clinical fellowship year (CFY), and we developed a wonderful relationship as I adjusted to the stresses, challenges, and rewards of that job.  I made a point to ask her how another supervisor of mine was doing.  I left my old job almost a year ago, and she was undergoing chemo and radiation for aggressive lymphoma.  My SLP supervisor began telling me about her, then backtracked and said, “Well, she had cancer, did you know that?”  and I replied, “Of course.  That’s why I’m asking.”   Why else would I ask?  I was in the office as she lost her hair.  I was there when the secretary sent her home because her stamina would not let her work through the day.  I was there when we played substitute supervisor roulette, with a different person to answer to each week.  Of course I knew. 

Now, three hours later, I replay the conversation in my mind, and I’m thinking not just of what I said, but of how I said it. The conference today reminded us of the importance of the tone of voice we use, and how we teach this skill to our clients.  I feel like I snapped back, like I spoke too soon, or too matter-of-factly.  I feel like I came off as a know-it-all.  I blurted it out.  And, just like the rating scale would indicate for a person with “normal” social skills, I find I am beating myself up mercilessly at my apparent inability to say the right thing. 

All of which seemingly makes me normal.  People with typical social communication skills are aware when they make solecisms, reflect when they commit faux-pas, and it appears that they also harangue themselves about it, to some degree.  I do speak too quickly.  I do blurt things out without thinking.  I do have trouble staying on topic.  I do have trouble making conversation in large groups.  I do feel making eye contact can be challenging. 

Don’t we all?

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