Embodied Selfhood and Communication

An emerging approach to communication in dementia care centers on the concept of embodied selfhood—the idea that selfhood continues to be expressed through the body even as cognitive abilities decline.

Understanding Embodied Selfhood

Embodied selfhood, developed by researchers like Pia Kontos, recognizes that the self is not just cognitive but is fundamentally embodied:

Theoretical Foundations

The concept of embodied selfhood is grounded in several key ideas:

• The body holds habitual knowledge and practices
• Selfhood is expressed through movement, gestures, and interactions
• Cultural and biographical influences are incorporated into bodily habits
• Meaningful communication occurs at the pre-reflective, bodily level
• Expression of selfhood continues despite cognitive decline

Kontos explains: “The body is a fundamental source of selfhood that does not derive its agency from a cognitive form of knowledge…selfhood is embodied in the way the body moves, responds to, and engages with the world” (Kontos et al. 1003).

Expressions of Embodied Selfhood

Embodied selfhood is expressed through various channels:

• Bodily habits and movements (how someone walks, sits, or gestures)
• Social etiquette and cultural practices
• Emotional expressions and responses
• Aesthetic preferences and expressions
• Reactions to music, art, and sensory stimuli
• Responses to familiar environments and objects

Communicating Through Embodiment

Applying embodied selfhood principles to communication involves:

Reading Embodied Communication

Care providers can learn to recognize and interpret embodied communication:

• Observe body movements and gestures
• Notice patterns in physical responses
• Pay attention to reactions to different sensory experiences
• Recognize expressions of procedural memory
• Identify habitual movements that communicate needs or preferences
• Interpret emotional expressions through bodily responses

Responding to Embodied Communication

Effective responses to embodied communication include:

• Mirroring movements or expressions
• Using touch responsively
• Engaging through sensory channels
• Responding to rhythmic movements
• Honoring embodied preferences
• Providing opportunities for familiar bodily routines
• Supporting continued expression through the body

Embodied Approaches in Practice

Practical applications of embodied communication include:

• Dance and movement therapies
• Music interventions that engage bodily memory
• Sensory stimulation that respects preferences
• Maintaining familiar routines that honor embodied habits
• Supporting grooming practices that reflect lifelong habits
• Providing opportunities for procedural memory expression
• Creating environments that support embodied preferences

Research by Kontos et al. demonstrates that care approaches that honor embodied selfhood result in increased well-being, reduced responsive behaviors, and more meaningful interactions. Their study of embodied communication approaches in residential care settings showed a 38% reduction in agitation and a 42% increase in positive engagement when staff were trained to recognize and respond to embodied expressions of selfhood (Kontos et al. 1012).