Why Can’t I Think of Words While Speaking?

Imagine this: You get home from your favorite restaurant and want to tell your family about the spectacular bananas foster you had for dessert. Yet, when you are trying to describe it, you cannot come up with the word banana. Instead, you can only describe it as a yellow fruit.

Frustrating, right? When these kinds of word-finding difficulties occur often, it’s usually caused by a particular type of language disorder called aphasia. This occurs after a brain injury, such as a stroke. There are many different types of aphasia and they affect how someone understands and expresses verbal or written language in various ways.

When someone has specific difficulty retrieving words, it’s called anomic aphasia, or anomia. We will examine what anomic aphasia is, explain how you treat it with speech therapy, and provide tips for how you or a loved one can better communicate when dealing with this disorder.

Aphasia and Speech Therapy

Aphasia does not affect your intelligence level. Instead, it affects how you communicate. It makes it harder for you to communicate what you know in the same way or with the same ease as you did before a brain injury or stroke. Speech therapy helps you improve your communication skills.

Aphasia can cause different symptoms depending on which area of the brain was affected by an injury. In fact, the word aphasia is generally considered an umbrella term. There are eight types of aphasia that fall within two overarching categories:

Expressive Aphasia (Non-Fluent) 

With this form of aphasia, you know what you want to say but have trouble expressing yourself with ease or with fluency. You may speak in short sentences, omit words, or have difficulty making your words come out crisply and clearly. 

Receptive Aphasia (Fluent)

This form of aphasia makes it difficult to understand what you hear or read causing difficulty interpreting what others are saying. You may speak fluently and incomplete sentences but the content of your sentences may not be logical or make sense to others. 

What Is Anomic Aphasia?

Anomic aphasia is a type of fluent aphasia. 

“While it’s considered a milder form of aphasia, it can have a profound effect on your ability to communicate and carry out activities of daily living with ease and confidence. It is frustrating since you feel like you have the words on the tip of your tongue, yet still cannot say what you want to say,” said Open Lines® founder and executive director Dr. Jessica Galgano. 

This experience can apply to written and/or spoken language. There are several hallmark characteristics of anomic aphasia. For example, you may have strong comprehension skills but have difficulty understanding information within long, complex sentence structures. You may also struggle to understand words when there are high levels of background noise, visual distractions, or any stimuli that compete for your attention. 

Notably, people experiencing anomic aphasia can repeat words and phrases on command. Their conversational speech may be relatively fluent, meaning they are able to converse in sentences. However, Dr. Galgano noted there is difficulty retrieving specific words, especially verbs, adjectives, and nouns that a person may want to say in spontaneous speech. 

“People report knowing what they want to say, but they have difficulty finding the exact word they are thinking of,” she said.

Having difficulty retrieving specific words is key in knowing if you or a loved one have developed anomic aphasia. You may notice it happening more than normal and it could impact your ability to communicate your message clearly and efficiently.

Why Do I Struggle to Think of Words?

Struggling to think of words, especially after a brain injury or stroke can be a symptom of aphasia. This difficulty arises from damage to the language centers of the brain, which disrupts the pathways necessary for word retrieval.

The brain’s ability to process and produce language becomes impaired which leads to the frustrating experience of knowing what you want to say but being unable to find the right words. Emotional factors such as stress and anxiety can exacerbate these difficulties to make it even harder to recall specific words when speaking.

Tips to Help Recall Specific Words While Speaking

To improve word retrieval while speaking, try incorporating some effective strategies. Start by practicing generative naming drills and engaging in semantic feature analysis tasks to enhance your brain’s word retrieval processes. Using circumlocution strategies, or describing a word when you cannot recall it can also activate related semantic systems. This aids in word-finding during conversation. Engage in regular, focused speech therapy sessions to practice these techniques under the guidance of a licensed speech-language pathologist.

Word Retrieval Activities for Adults with Aphasia 

You may notice how pulling up the words you want to say is making it difficult to share information at work, connect with friends and family, and carry out everyday activities. This may impact your confidence in communicating and cause you to feel exhausted, burdened, or even embarrassed by these challenges. Fortunately, treatment for anomic aphasia is well-researched and effective.

Speech therapy treatment techniques are founded on principles of neuroplasticity. In other words, they help the brain grow and reorganize after sustaining a stroke or traumatic brain injury. These techniques include practice, repetition, and salience and combine drill-based exercises and functional activities to improve the speed and fluency of word retrieval.

“This may include generative naming drills and semantic feature analysis tasks, such as Verb Network Strengthening Treatment work aimed at improving the speed of word retrieval to produce precise sentences efficiently,” Dr. Galgano said.

Dr. Galgano said other techniques include using circumlocution strategies — how you describe a word when you do not know it — to activate related semantic systems for improved word-finding during the conversation. Semantic Feature Analysis treatment uses verbal or visual cues to describe features that help activate networks of related words in your brain. 

Communicating With a Loved with Anomic Aphasia

If you know someone experiencing anomic aphasia, Dr. Galgano suggests helping to improve their participation and confidence in conversations using the following strategies:

Acknowledgment of Competence

People with aphasia often report they are perceived as incompetent due to difficulties in verbal communication. This has a direct impact on psychosocial well-being. Acknowledging their communicative competence is essential.

Reveal Competence

For starters, acknowledge any frustrations they may be experiencing and verbally acknowledge they know what they want to say. Additionally, you can help by eliminating distractions such as noises, too many visual stimuli, or distractions made by other people.

It is important to make sure the person with aphasia can respond and/or express what they know, how they feel, and their opinion. Some ways to do this include asking them if they can give you clues by describing, showing, pointing, writing, or gesturing; asking yes or no questions; and providing adequate time to respond.

Verify Responses

Make sure you understand their message by summarizing, reflecting, or expanding what they communicate.

Seek Help for Anomic Aphasia

If you’re struggling with communication difficulties, it’s time to turn to Open Lines®. Contact us via phone (212-430-6800), email [email protected], or by filling out our convenient contact form. Improve your communication skills and unlock your potential with Open Lines® Speech and Communication in New York today!