They speak with their hands and fingers. Also in the case of major sorrow. There is no other way. Not being able to speak is not the greatest loss.
Occasionally, fiction is more convincing and real than documentary. And sometimes short is more effective than long. A married couple with a large and unspoken loss. Even if they did have words for it, they still couldn't have spoken. They speak with their hands and fingers. Even in difficult conversations. Because it's all they can do.