Interview with the speech therapists from the first two Speech Therapy Centers for aphasia in Sofia on the occasion of March 6 – the European Day of the Speech Therapist
On March 6, Europe celebrates the European Day of the Speech Therapist - a professional holiday of specialists who help people restore one of the most important human skills - the ability to communicate.
This year's occasion coincides with the development of a new initiative in Sofia – the establishment of Speech Therapy Centers for Aphasia (CRTA). They are part of the Program for the Establishment of Centers for Speech Therapy for Aphasia (2025–2030), implemented with the participation of Sofia Municipality, the Association for Stroke and Aphasia and Sofia University "St. Kliment Ohridski". Kliment Ohridski" – Faculty of Sciences for Education and Arts.
In Sofia, about 10,000 people with stroke pass through the health system every year, and approximately 3,000 of them develop aphasia – a speech and communication disorder due to brain damage. Until recently, access to systemic speech therapy for these people was severely limited.
The first two centers are already working - in DCC-17 and DCC-12 in the Lyulin district. On the occasion of the European Day of the Speech Therapist, we talk with Bistra Molhova, speech therapist at the CRTA at DCC-17, and Jurkie Feyzi, speech therapist at the CRTA at DCC-12.
Our conversation is about the profession, about the difficulties and about those small but priceless moments when the words begin to return.
Interview
I. The profession of speech therapist
How did you choose the profession of speech therapist and what motivates you to work with people with aphasia?
Bistra Molhova:
The profession chose me, I wanted to become a psychologist, but I couldn't get into this specialty. After the first year of speech therapy, I didn't change it for anything in the world. I want to work with aphasia, because it is valuable for people, for some it is even priceless.
Jyrkie Feizi:
Since I was a child, I have wanted to work for the benefit of society and help people in need. I am a very expressive person and I like to communicate with many different people. This profession gives me the opportunity to help others in communication and to feel satisfied with my work. The feeling of compassion and love for the elderly, are the main reasons why I support people with aphasia. To work with older people, you need to really be taught to love them.
What surprised you the most at the beginning of working with stroke patients?
Bistra Molhova:
I was surprised by my reaction to their difficulties. I thought I was prepared, but there were moments when I just froze at the sight of their difficulties.
Jyrkie Feizi:
What really impresses me about them is when I see how little it takes for them to ignite the spark of faith in their eyes. And their eyes shine with happiness. It's an exciting feeling, and the difficulties I'll encounter next aren't as important as we believe in success together.
What do you think people most often do not know about the work of a speech therapist?
Bistra Molhova:
People do not know that we can not only teach someone to say the sounds "P" and "L", but we can also do many other things.
Jyrkie Feyzi:
A lot of things they don't know. Usually their ideas are that we work only with "children who can't say R" and that's it. In recent years, we are more often associated with working with children with special educational needs, but even there they often think that we are just "playing" with children. the surprise is even greater, and the question is always: "And what is there to work with them?". Our profession is in demand, but vague and often underestimated.
What is the moment in therapy that brings you the most satisfaction?
Bistra Molhova:
I am most pleased with the moments of achieved results for users. They are possible only with mutual efforts on both sides, so they bring happiness to both the therapist and the user.
Jyrkie Feizi:
Every small progress is a joy, but the real satisfaction is when the person himself notices it and enjoys it.
II. Aphasia – when words temporarily disappear
How would you explain in simple terms what aphasia is?
Bistra Molhova:
Aphasia is a disorder of speech and speech as a result of a stroke and not only.
Jyrkie Feyzi:
Aphasia literally means "speech decay". It has different manifestations, but in general it is expressed in the lost ability to understand and produce speech.
How does a person's daily life change when suddenly he cannot speak or understand speech as before?
Bistra Molhova:
A person's daily life changes to depressive states and depression.
Jyrkie Feyzi:
A person's whole existence changes. There is a feeling of helplessness and hopelessness, because he cannot name elementary needs and feelings. And when he does not have alternative means of expression, he usually closes himself in and avoids communicative situations even with his loved ones.
What is the most difficult thing for the patient – the loss of words or the inability to communicate with his family?
Bistra Molhova:
The truth is that a person always finds a way to communicate with his family, as well as relatives find a way to communicate. The problem is communication with the outside world, where the loss of words is mainly an obstacle.
Jyrkie Feyzi:
The inability to communicate and express yourself is very traumatic. For sure, the person has a lot of things he wants to share, but he does not have the opportunity.
How do relatives react when they first find out that a speech therapist can help?
Bistra Molhova: Relatives
feel hope and motivate themselves for change, many of them are ready to change their entire daily lives to help, they even become an invaluable part of our work with the person with aphasia.
Jyrkie Feizi:
Happy and hopeful. They often ask the question "Will he be able to communicate again as before and after how long?". It is difficult to give an exact answer to such questions, but they still have strong hopes and believe.
III. Therapy – how words "wake up"
How does a first meeting with a person with aphasia go?
Bistra Molhova:
The first meeting is accompanied by excitement on both sides. The important thing is that the person with aphasia smiles, to feel comfortable and calm, not to feel an object of influence. The meeting is aimed at getting to know each other, to understand who loves what and how they will feel good in the therapeutic process. Because the person must agree to work together.
Jyrkie Feyzi:
At the first meeting, it is of particular importance to find out what the person's inner attitude is and how expressed his readiness for the therapeutic process is. Does he believe in himself and in you, does he have positive expectations for therapy? In addition, it is important to take the most detailed speech therapy status, as well as personal and family history. All these data are important for planning the therapeutic process.
Can you give an example of an exercise that seems simple, but has a very strong effect on speech recovery?
Bistra Molhova:
Exercise - the production of the sound "X" has a beneficial effect on the activity of the vocal cords without straining them.
Jyrkie Feyzi:
There are many examples of such exercises. An example of such is the completion of a sentence on your own with a word appropriate to the context (When it rains, we carry ......... (umbrella)). This exercise trains reading/listening comprehension, extracting concepts from semantic memory, building associative and cause-and-effect relationships, logical thinking, mastering the structure of the sentence and much more.
Is there a moment when you see how the "spark" of communication returns? What does this look like?
Bistra Molhova: There
is a moment when communication returns, it is accompanied by amazement in the loved ones, laughter and joy in me and the person with aphasia. This motivates to reach new such moments.
Jyrkie Feyzi: Every
small success leads to this. People are very quickly motivated when there is even minimal progress and they have coped with something elementary. They themselves want to try new things, looking for such a result.
What creative or non-standard approaches do you use in therapy?
Bistra Molhova:
My approach is individual to each person, which means that I often come up with exercises tailored to the needs of the person, as well as to their interests, when possible.
Jyrkie Feyzi:
Art therapy is very suitable as a supportive one, in any case. The activities are very diverse and tailored to the interests and preferences of the particular person. Usually, creative activities where there is a final result and the patient can see his work are the most suitable.
Why are patience and small steps so important in this process?
Bistra Molhova:
Patience and small steps are important because it is the same as with children - there is no way to send them to school immediately after birth. It takes time for their nervous system to mature for the learning process. In working with aphasia, it is important to constantly achieve small successes.
Jyrkie Feyzi:
Every small step leads to certain progress. They are the foundation on which to build and that is why it is important to follow the principle of gradual complication and upgrade in our therapy.
IV. Small Victories
What is the most exciting moment you have experienced in therapy?
Bistra Molhova:
I don't have the most exciting moment, all the successes excite me. :)
What does the first word spoken again mean?
Bistra Molhova: For
a person with aphasia, the first new word or a small success shows that I am right and can really be trusted by saying that we will change things together.
Are there cases in which therapy also changes the person's self-esteem?
Bistra Molhova:
In any case, the change in speech improves self-esteem, self-esteem and motivation.
V. The role of the family
How can loved ones help?
Bistra Molhova:
Relatives provide invaluable support.
Jyrkie Feyzi:
Relatives are the best therapists for people with aphasia.
What are the most common mistakes?
Bistra Molhova:
To speak instead of the person or to hint.
Jyrkie Feyzi:
To spur the man and not give him time.
What would you say to a family that is afraid?
Jyrkie Feyzi:
The possibilities of the human brain are immense.
VI. Trivia
Is it true that a person with aphasia can sing words they can't say?
Bistra Molhova:
It's true.
How long does the recovery last?
Bistra Molhova:
Different for each person.
Can the brain learn language again?
Bistra Molhova:
The brain is the most plastic part of the human body.
VII. Message to people with aphasia
What would you say to someone who is struggling to speak their first words?
Bistra Molhova:
Don't worry.
Jyrkie Feyzi:
"Believe in yourself."
Why is it important to start therapy on time?
Bistra Molhova:
To be as effective as possible.
Jyrkie Feyzi:
So as not to deepen the problems.
If you had to describe the work of a speech therapist in one word?
Bistra Molhova:
Happiness.
Jyrkie Feyzi:
Dedication.
Final question
How would you describe the moment when a person says "hello" again?
Bistra Molhova:
The moment is full of joy, satisfaction, surprise, laughter and smiles.
On the occasion of the European Day of the Speech Therapist, we send greetings to all speech therapists and students of speech therapy.
Your profession is much more than speech therapy. It brings back the ability to communicate, dignity and social life to people who, after a stroke or other brain damage, have lost their words.
Your work brings back hope – word for word.
Happy holiday!