Chapter

Personhood and interpersonal communication in dementia

Lisa Snyder

in Dementia

Published on behalf of Oxford University Press

Published in print December 2005 | ISBN: 9780198566151
Published online February 2013 | e-ISBN: 9780191754418 | DOI: http://dx.doi.org/10.1093/med/9780198566151.003.0016

Series: International Perspectives in Philosophy & Psychiatry

Personhood and interpersonal communication in dementia

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In the safety afforded by a group of his peers, a man diagnosed with Alzheimer's disease describes a dream he had the previous night. He was trying to get to a gathering of some kind but when he finally arrived, ‘the door was locked.’ After knocking repeatedly, someone finally answered the door, but did not understand him when he tried to speak. ‘I'm standing there and wondering why I can't get in and they don't understand.’

The need to communicate and to be understood is fundamental to the human experience. We live amidst swiftly flowing currents of verbal and non-verbal exchanges that transmit messages for our interpretation and response. We connect, we interrelate, we belong when we are afforded the opportunity to engage in these currents—to define ourselves and express that selfhood in the act of being acknowledged and ‘understood’ by another. In this light, interpersonal communication is a mutual, co-constructed process in which each person offers definitions of self and of what is real for others to interpret, affirm, or challenge. Although these definitions and interpretations are subjective, they often shape the contours of dialogue. Communication builds upon the interlocutors’ previously assembled definitions of selfhood as well as the schemas previously used to interpret verbal and non-verbal cues. Relationships are formed around attachments to certain supportive, destructive, or relatively neutral communication exchanges that evolve from these constructs. The experience of dementia, however, often threatens previously recognized co-constructions of self and reality resulting in progressively alienating communication between those who have symptoms of the disease and those who do not. Misunderstandings abound and it is not uncommon for persons with the disease to feel shut out.

In his seminal work, I and Thou, philosopher Martin Buber writes, ‘All real living is meeting’ (Buber 1958, p. 11). Beyond the confines of language, communication is also—in a pure form—an act of being with another: not only is a space created where messages are given and received, but also connections occur in mutual acknowledgment of the uniqueness of the other. Buber perceives open and honest communication as a true encounter between equals and termed such rare meetings ‘dialogical’ moments. For each person's humanity to be most fully realized they must ‘imagine the real’: imagine as clearly as possible what another person is wishing, feeling, perceiving, and thinking. This chapter introduces a context (namely support groups) as a means to imagine the real, to facilitate dialogical encounters, and to affirm selfhood in people with dementia. Throughout the chapter, statements from individuals with dementia guide and shape the discussion.

Chapter.  8129 words. 

Subjects: Psychiatry

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