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Identity

The Topsy-Turvy World of Foreign Accent Syndrome

What if you woke up one morning with a totally different accent? For the hundreds of people with this rare neurological condition, the reality is much more disturbing than you might think.
November 1, 2016, 5:15pm
Photo by Nemanja Jovanovic via Stocksy

When Paula Westberry woke up after a stroke in 2007, the last thing she expected was losing her Boston accent—and gaining a Russian one in return. The 53-year-old former nurse educator and administrator now flips between a number of accents including French and Czech, but currently speaks with a formal British accent. And she certainly isn't the first woman to find herself in this unique position. In fact, she's one of several women who woke up one morning with a completely different voice to the one they went to bed with.

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Earlier this year, Texan resident Lisa Alamia underwent jaw surgery and woke up with a British accent, despite having never visited the UK once. And after developing migraines after a stroke, Elizabeth Barnes traded in her Scottish accent for a Chinese one.

All are thought to be affected by foreign accent syndrome (FAS), a rare speech disorder. Considering that people's accents can change after a spell abroad or after a Netflix marathon, I asked Nick Miller, a professor of motor speech disorders at Newcastle University and co-author of Foreign Accent Syndromes: The Stories People Have to Tell, to explain what actually counts as FAS.

He says that the condition is diagnosed "when a speaker suddenly begins to speak in what is perceived as a foreign accent (or different regional accent of the language the person speaks e.g. [a] Londoner sounds Scottish), even though they have never lived there, never spoken that language, and don't know anyone who speaks that language."

Miller says that the amount of people affected worldwide is unknown as the number is in constant flux. Even so, he says those left with lasting change to their speech is in the hundreds.

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Unsurprisingly, Westberry became the subject of morbid fascination to outsiders. "People only came to my lectures to see how many different accents I could change into," she sighs, "not to hear what I had to say."

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Although it may seem charming—and even a hilarious dinnertime anecdote—to trade your accent for a British, French, or even a South African lilt, that's not to say it doesn't come without its pitfalls. For many of the women I spoke to, FAS changed their lives drastically—and often not for the better.

Some FAS sufferers have been told to "go home" as their accent didn't not match their hometown. Photo by Aleksandra Kovac via Stocksy

Given that voices are a tell-tale signifier of location and social class, it's little wonder that FAS sufferers can feel a loss of identity and a skewed sense of self. "As time went by, the less I remembered who the real me was," Westberry says. "I watched a video of my wedding—the only reminder of what I sounded like before—and I cried for hours because I don't remember her. She is completely gone now."

Westberry struggles with financial instability, and the impact of FAS on her career as a nurse educator was particularly difficult to cope with. "My boss said to me [that] I had two weeks to lose the accent or lose your job. I reached the top of my field and it was taken away from me," she says. "What am I supposed to do with myself? Do I still possess the ability to inspire others as I once did? Or have I turned into a circus act?"

This identity loss is all too familiar for 43-year-old FAS sufferer Tracey Peace. "I definitely don't sound like I'm from Pittsburgh—many people think I sound German, Swedish, Scandinavian, or Croatian," she says. "Even though I am the same on the inside, when I speak, it is not me, it is not how I sound, and not the way I express myself. It's very hard when you open your mouth and the voice of a stranger emerges. I mourn for my lost self."

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I've even been told if I could not speak the language correctly, then I should go back to wherever I came from.

But why are only some people affected by this syndrome and how likely are the chances to wake up with, say, a Jamaican accent? Professor Sophie Scott, the deputy director at UCL's Institute of Cognitive Neuroscience, researches voices and speech. She says that despite an apparent increase in people with foreign accent syndrome, it's unlikely that most of us could wake up tomorrow and have a brand new accent.

"It's actually pretty rare. You have to bear in mind it's very uncommon, it doesn't happen very often," she says. "Pretty much without exception, everybody who's had a verified example of FAS has some kind of neurological damage that's very often a stroke, a head injury, or an infection. There's a variety of different routes to that head injury."

Scott adds that it is not uncommon for people to move to bigger cities where their voice becomes inconspicuous among other accents. This isn't exactly surprising—perhaps the most insidious effect of FAS is a feeling of alienation within their own communities. FAS Facebook groups are awash with sufferers who reveal that they isolate themselves from the general public because of constant "Where are you from?" questions.

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This situation is all too common for Peace. Since her accent changed, she has been forced to make several life adjustments, including creating fictional towns when questioned and preparing her family for constant stares and discrimination. "I have been followed, purposefully engaged in conversation, eyed head to toe, and stared at. I've even been told if I could not speak the language correctly, then I should go back to wherever I came from."

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She says that she has benefited from the understanding of her family and some friends, but FAS has had a negative impact on some of her relationships. "I have one friend who no longer calls or visits simply because she just does not understand accents at all, as our area is just not diverse.

While Peace is fortunate that her husband has been supportive of her condition, FAS put a strain on Westberry's own marriage: "My husband is so angry because the woman he married is gone. He is still by my side taking care of me but he is here out of obligation now. He feels cheated."

Other FAS sufferers have experienced misplaced racism as a result of their accent—English hair salon owner Julie Matthias, for instance, unwittingly became the subject of persecution after residents refused to believe that she came from the local area.

My general doctor—who had seen me for 13 years prior to my event—said this was my sleep apnea.

As if the feeling of personal identity being compromised isn't enough to contend with, those affected have reported that members of the public believe they are putting on accents for attention—and that even extends to medical professionals. Getting a diagnosis right can be difficult, particularly when it comes to doctors who have no prior understanding of FAS.

Peace, who has been consulted by several neurologists, agrees. "Not one of them are willing to diagnose. They are either very honest with me and tell me they have never heard of it and are too unfamiliar with what it is or they pat me on the back and say, 'You will feel better soon,' and not schedule any type of follow up. My general doctor—who had seen me for 13 years prior to my event—said this was my sleep apnea."

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FAS advocate Ellen Spencer, whose accent is a blend of French, Swedish, German and English, says that she had to contend with assumptions that it is a result of inner turmoil: "They don't see brain damage and so assume it is a psychological issue instead of neurological."

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"Because of the sudden, unexplainable nature of the onset, no brain bleed was seen on CT scan or normal MRI of the brain," the Indiana resident says. "It didn't help that the ER doctor and specialists had not seen me pre-FAS. They didn't know what my family doctor knew about me."

While many of the FAS community struggle to see any positives with the syndrome, Peace is adamant that FAS isn't a death knell. She says that it has been instrumental in self-discovery, helping her realize who her real friends are and enabling her to find a new family in the FAS community.

Professor Miller says that the syndrome usually resolves of its own accord as the underlying neurological condition changes, but direct work on pronunciation or talking therapies like CBT can also work. Meanwhile, those affected by FAS remain positive that the condition will be recognized by the public as a legitimate disorder.

While Westberry is now confined at home after an unrelated illness, she is adamant to keep fighting: "I am not sure what kind of fight I have in front of me, but the fight I have already been through has prepared me for anything."