A thesis submitted in partial fulfilment of - Queen Margaret University

natural reaction to the loss of abilities caused by the stroke where a person
realises the sudden and perhaps permanent limitations to their quality of life.
This is equated to the natural grieving process (Code and Herrmann, 2003;
Hinckley, 1998, Lazarus, 1993) incorporating denial, frustration, depression and
finally acceptance (Herrmann, 1997). This stage of depression is seen as
necessary to emotional recovery and must be worked through before
acceptance can be achieved. Kauhanen et al. (1999) state that the severely
debilitating condition of aphasia may contribute to the severity and persistence
of depression in people following a stroke.
While the emotional state of a person impacts upon their quality of life it also
significantly impacts upon their motivation, physical performance and cognitive
and language processing (Beblo, Baumann, Bogerts, Wallesch and Herrmann,
1999). It is generally accepted that people with positive mood states respond
better to rehabilitation than those who are depressed. Positive mood and wellbeing
increase motivation and language and cognitive performance (Beblo et al.,
1999). With the passing of time and the commencement of the psychological
healing process individuals have to face the problems of reintegrating
themselves into their social and community networks (Code, 2003). As with
other areas of their lives aphasia impacts upon the social functioning of an
individual with residual language difficulties and will now be addressed.
2.3.2 Social functioning with aphasia
Social functioning involves participation in an individual’s community in terms of
family relationships and role change, employment and social relationships
(Sarno, 1997) and is important in the development and maintenance of selfworth,
social validity, autonomy and perceived life satisfaction (Frattali, 1998).
Code and Herrmann (2003) stress the importance of ‘intact’ communication in
the development and maintenance of social relationships. Our own perceptions
of our social interactions determine our personal experience of quality of life
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