Pictures Speak 

A user-led training project providing Communication Support Training
for Health and Social Care Workers

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How it started

I would like to tell you about our project, which started in the London Borough of Camden. We give training to care workers. We show them how to support people who have communication difficulties. We believe that when you work with someone who finds it difficult to use words, you have to help them so that they can be understood, and so that you can understand them. We must all learn how to do this.

How did it start? During the spring of 1995 my husband, John, was a worried man. Unfortunately he couldn't tell anybody about it, because he couldn't speak. He'd had a stroke early that year, which had left him unable to write and neither could he read anymore. His worry showed on his face. When I asked him what was wrong, every time he would just shrug a 'what is the use,' shrug. I bought a kiddy's paint set and drawing paper and left it by his bedside to give him something to do, because there was no television to watch in the ward either.

Two Figures

That started him painting. He'd been drawing and painting ever since then. Everyone, including the staff at hospital, saw and admired his work.

When he was discharged from rehab I packed his paintings and drawings into a big plastic bag and took them home. And forgot about them.

Four years later I opened the bag.

'Hey, this looks good,' I said about the drawing of the Two Figures. 'What does this mean?' I asked. 'You drew it long ago - in 1995'. John smiled. He pointed to himself, and then to me. Him and me. Then he frowned and took the picture from me. Putting it on his lap, he pointed to the dark bit in the middle, between the two figures. Shaking his head, he looked up at me from his wheelchair. A real sad look.

'Does it mean you were worried about something when you drew it?' I asked. Yes, he nodded, moving his finger up and down over the dark bit between the two figures, frowning deeply. Then he made swinging movements with his good arm, from small to large. A widening gap.

'Ah!' It dawned on me. 'You were worried about us - that we would split up?' Yes, he nodded. 'Are you still worried about that?' Another nod. 'But why - when we're still together?' John pointed to his genitals, and to mine. And at the picture, the bottom bit. The figures in the drawing have no bottoms.

'By golly, John. You mean you've been worried all this time that you and I were going to split up because we're not having sex?' Now the nod was very slow, his lips pursed in anger. And you were telling us about it in your picture, but nobody was listening!'

I felt like kicking myself. I still do. Neither I, nor any of the speech and language, occupational, physio- therapists (and there had been many) had spoken to John about his fears, which were plainly to be seen in his paintings and drawings strewn all over his bed and locker all those months. Not even the resident psychotherapist on the rehab ward (who at the time felt that there was no need for her services as John had not 'asked' for counselling), had noticed. We had all been too busy trying to get him to say words, to brush his teeth, to re-learn to make tea, to transfer, to walk. All important things. But no more important than his non-verbalised fears. Nobody had been listening. All of us were ignoring him when he was speaking through his pictures - trying to start conversations through his drawings.

So we started Pictures Speak, to make sure that those involved with people with communication difficulties - in hospital, in the community, at home - would realise how important it is that THOSE OF US WITHOUT COMMUNICATION DIFFICULTIES have a DUTY to learn to communicate effectively with those who have difficulty using words.