In this episode you will discover: Identity Is Shaped in Interaction — Narrative identity forms and reforms through relationships and stories shared with others — making connection a core ingredient of recovery, not a bonus Visual Methods Unlock What Words Cannot — Collage-making, photos, and art give people with aphasia a pathway into identity work that talk alone can't always reach. Identity Reconstruction Is a Long Game — People continue navigating complex, shifting identities for years after stroke. Our systems need to follow them farther into that journey, not stop too soon. Sit on Your Hands and Truly Listen — The most powerful thing you can offer is unhurried, attentive presence. Learning to wait and watch — rather than fill the silence — is a skill worth deliberately practicing. If you've ever felt like there's more to aphasia care than the therapy protocol in front of you, or wondered what identity-centered practice actually looks like in the real world, this conversation will give you both the framework and the practical insights you need. Welcome to the Aphasia Access Aphasia Conversations Podcast. I'm Katie Strong from Central Michigan University and a member of the Aphasia Access Podcast Working Group — a community dedicated to supporting better aphasia care. Rianne Brinkman is a speech-language pathologist and linguist from the Netherlands whose PhD project "Who Am I Now?" explores identity changes in people with aphasia through storytelling and creative arts-based approaches. Before her doctoral work — supported by the Dutch NWO Teacher Research Grant — she spent years as a clinician in rehabilitation and aphasia centers, and that deep clinical foundation shapes everything she brings to her research. She teaches in the Speech and Language Therapy program at Hanze University of Applied Sciences in Groningen and conducts her research at the University of Humanistic Studies in Utrecht. Today's conversation feels especially personal to me. Like Rianne, I came to doctoral work after years of established clinical practice, and my own research centers on narrative identity and aphasia through the My Story Project and the PULSE framework. So, when she sought me out at a conference in 2019, I recognized immediately that we were kindred spirits working toward the same questions from different corners of the world. So, let's get into the conversation. Katie Strong: Well, before we dive into your work, I wanted to share something with our listeners. One of the things that drew me to this conversation is that we have a parallel story. We both came to do our PhDs after established clinical careers, and you're in the thick of that journey. I'd love to start with what made you decide to go back, and how did your clinical work shape what you wanted to pursue? Rianne Brinkman: I used to work in rehabilitation for a long time, and then I moved from one part of the Netherlands to another part, and there was not much work for me. So, I got the opportunity to help establish an aphasia center. And of course, if you look at the rehabilitation phase, that's far more deficit oriented, so that's very different than in the chronic phase, where an aphasia center comes into place. So, I really had to change my view of therapy. I had to establish a few groups on identity. I started reading on identity, on communicative participation, on how to do that in groups. So that's really where the interest came from. Katie Strong: I love hearing that. Sometimes as we go into a different phase or area of work, and it really re-shapes our thinking and how we engage with our clients or patients. Rianne Brinkman: Yeah, it does. And in those groups, I worked together a lot with creative therapists, and I learned so much from them, because then I realized that if you use narrative approaches, and you combine them with visual arts or arts therapy, that it can mean so much for somebody. They can get so many more means of expression. So, yeah, I learned a lot from that. Katie Strong: I love that! It is powerful. And I'm really looking forward to talking more about this. I was curious, you know, what the experience has been like from a clinician turned researcher, what you know, what's that actually been like for you? And has there been anything that surprised you most about the transition? Rianne Brinkman: I did not realize that much how much you yourself as a person influences the conversation with somebody with aphasia, you know that co-construction part. So that your identity aspects really influence how the conversation takes place and what somebody chooses to tell you or not. So that is really momentary, and so it's just a snapshot, really, when you do this. So, I became really aware of that. But also, your own norms and values and the way you listen and all those sorts of things. It's just a different way of doing therapy. And then you're doing it as research which is different. I think that's one thing, sometimes I'm a little bit too much the therapist, so I really have to be a researcher again, you know? So, you change between those roles. Katie Strong: Yes, it is a shift, right? Rianne Brinkman: Yeah, exactly, exactly. Katie Strong: Yeah. And thinking about how those two roles are different or powerful, sometimes combined. Well, let's talk a little bit about the work that you're doing. And I want to acknowledge that what we're talking about today really all comes out of your doctoral journey, which is really remarkable. I thought we could first talk about your 2025 scoping review that really mapped the landscape of what we know about identity changes in aphasia, and it also laid the groundwork for everything that followed. Could you walk us through that narrative identity model that came out of the review? Rianne Brinkman: Yeah. That was quite complex, because there's so much written about identity, and everybody defines it slightly in a different way, or uses different words. So, what we tried to do is really get a grip on that literature to see what was written on identity changes in aphasia, and what kind of theory was used. And what we saw was that everything is from a social constructionist perspective, really. But then there are many different philosophers and different authors that write about identity. So, what we tried to do was because, of course, Barbara Shadden, she's very foundational in this work. With her colleagues, she created the four domain interdisciplinary framework. So, we tried to use that in the model as one of the foundations. And then, of course, the work of Paul Ricoeur, who's a French philosopher who writes about that you only shape your identity through interaction with other people which gives meaning to the stories you share with other people. And the work of Bamberg, and he talks about dilemmatic spaces. So what it means, really, is that I think identity, you only shape in interaction, and we tried to visualize that in the model. So, there's an "I" part, and that's about you, the personal domains, and there's the "we" part, and that's about the social domains. We tried to visualize how those domains interact, including temporality, because you shape your identity in the here and now, but also through time. And then in the middle of the model, there's a head with interconnected gears, and that's where it all comes together. That's you at your identity, your narrative identity, a specific point in time. So that's the model in a nutshell. And then you've got, of course, all those personal domains, like your biography, agency and power, communicative abilities, your roles you fulfill in life. And then the social domains are, like your social situation, your cultural background, society and all of that works together, informing, shaping your identity. Katie Strong: It's powerful work, and it is complex. I appreciate the work that you led to be able to assimilate and give us this model for us to be really thinking about narrative identity in a way that takes all of those big thought leaders and helps it become more approachable to those of us that are interested in narrative identity as researchers, but also as clinicians. Rianne Brinkman: That's great. Thank you. Katie Strong: Thank you for that work. And then you have another recent paper. Congratulations, by the way! That paper just came out earlier this year in 2026 and I guess I should say to the listeners, we'll have both articles linked in the show notes, as well as some other resources that will be interesting to explore if you're into this topic. This 2026, article is really the first of its kind to look at identity in this early stage, six to eight weeks after admission to rehabilitation. So, I was hoping you could talk with us about who were these people and what were you doing together in these sessions? Rianne Brinkman: Yeah. So, it's the first session of a longitudinal study, so I'm following those people over two years. And so, there are 22 people with aphasia. Unfortunately, two of them couldn't continue as one of them, I couldn't organize the reflection session, and one of them, I just couldn't reach anyone. But the other 20 people are still in the study, which is really amazing! Katie Strong: That is really amazing! Rianne Brinkman : Yeah, that's really nice. They're all middle aged people who range in age from their 30s to their 60s until 67. They also have different severities of aphasia. Some people were still clinical inpatient, some of them already were outpatient. And then I tried to elicit their story with visual participatory methods in combination with the narrative approach. So those sessions are quite long, sometimes two and a half to three hours, so it's a lot of time. It's really nice to just sit with them and connect. During the first session I did collage making. I just took a lot of magazines with me and scissors and glue and everything, and then we just sat d
