There are all sorts of things that happen in your brain to connect a word to its sound, meaning, or an object that you see; these all activate different pathways in your brain. When there are more serious things that go wrong (like brain injury / damage), you can get various forms of [aphasia](https://en.wikipedia.org/wiki/Aphasia) and [verbal agnosia](https://en.wikipedia.org/wiki/Auditory_verbal_agnosia). Sometimes focusing on one aspect of a word (like its sound or spelling) makes it hard to activate another aspect of a word (like its meaning or an object it represents), because they emphasize those different neural pathways- it’s like trying to consciously pat your head and rub your belly at the same time, when you would normally do these things automatically and unconsciously.
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