Research, conversations with other multilinguals, and my own personal experience have all demonstrated how strongly language can impact our sense of self. Depending on the language we are speaking, and the culture we are surrounded by, we may see our own selves differently, and interact differently with others due to linguistic and cultural influence.
These findings are especially important to consider in a therapy setting. When the way an individual sees and expresses themself is so intricately tied to language, how does this impact the therapeutic relationship? There are two parties involved in the client-therapist relationship, and it’s important to consider the impact of language on both.
When the way an individual sees and expresses themself is so intricately tied to language, how does this impact the therapeutic relationship?
As we know, it is significantly easier to express ourselves in our native language, for the most part. With a wider vocabulary and lexical range, and increased fluency, we can more easily achieve accuracy when communicating our sentiments, thoughts, and struggles. However, in a multicultural, globalized world, receiving or providing therapy in our native language is not always a possibility.
How Language Impacts The Client During Therapy
As a bilingual Canadian in a French-speaking province, I grew up well acclimated to receiving health services in both French and English. And, as a die-hard therapy advocate, I have received counselling in both languages as well. What I quickly noticed, however, was how differently I felt during a French session versus an English session.
When speaking with a French counsellor, I found myself more closed off – like I was holding a part of myself back. Despite wanting to be open and vulnerable, I felt an invisible barrier. Even with my best efforts to break it down, I found myself struggling to portray my truest self.
My experience (and the experience of many others) serves as insight into how language, culture, and one’s personal experience with each can play a role in the way one portrays themself. Generally speaking, in French culture, interactions often seem to start out slightly more surface-level; there is a certain formality to interactions with new people, particularly in a professional setting. While I say this with love for my French-Quebec culture and roots, there is a diminished level of warmth when compared to my English-speaking side.
But I realized there was also another layer: as Quebec is a province torn by language laws, a misdirected desire to preserve French, and (dare I say) discrimination towards languages other than French, I had always felt a stigma in being bilingual. Bubbling just below the surface was a lack of security in who I was – I had tried to hide my bilingualism for most of my life. And so, I carefully portrayed myself the way I believed society wanted to see me, curating my every interaction. Despite being proud of my bilingualism now, I could so deeply feel the influence of French culture (and my own experience with it) in my therapy sessions.
I could so deeply feel the influence of French culture (and my own experience with it) in my therapy sessions.
Therapists need to understand that how an individual is presenting themselves can be hugely impacted by the language they are speaking. In my own case, for example, it took me much longer to open up to my therapist. The way I presented my feelings and emotions was also a lot more tactical; like I was there to get a job done. When I spoke about my feelings regarding things that had occurred in my past, I felt slightly removed from them – like I was describing something that had happened to someone else. I also felt like I prepared for my appointments much more, and walked in to strategically tackle a list of things I had planned to address. While preparing for a therapy session is definitely a positive in many instances, in this case it felt like it took away from my ability to walk in authentically.
For an individual receiving therapy in a non-native language, the effects of language can be compounded. Aside from cultural influence, they may struggle with the feeling of being misunderstood. Struggling to explain one’s emotions, and feeling like things are being lost in translation can be frustrating. I think the therapist will play a key role here – in first being conscious that the individual may be struggling with the language, and responding in a way that facilitates a less stressful interaction for the client.
I don’t think there is a right or wrong language to receive therapy in. However, the impact of language, and the way someone learns to communicate in it – either due to cultural influence or personal experience – can greatly impact the efficacy of a therapy session. By understanding the complexity of language on a person’s presentation of themself, a therapist can work to break down that barrier with their clients.
Conducting Therapy in a Non-Native Language
Research demonstrates that therapy should be conducted in the client’s language of proficiency. This puts the onus on the therapist to adapt to the language of their client. However, it’s also so important for a therapist to feel at ease with the language they are conducting therapy in.
Is this to say that psychotherapy cannot be conducted in a therapist’s non-native language? Absolutely not. Psychotherapy is an intricate combination of art and science; to say that psychotherapy purely depends on immaculate, effective linguistic expression would be incorrect, and reduces it to one mere component. While some approaches to psychotherapy may be more scientifically-oriented than others, there is always a method to the madness, so to speak; therapy methods and techniques are cross-linguistic and cross-cultural. A great therapist can apply their knowledge and expertise, regardless of whether or not they are working in their native language.
I do think language training and cultural training become extremely important for a multilingual clinician, or a therapist working in a multicultural environment. Each language carries its own nuances, expressions, and variations in how things are expressed. The way an emotion or feeling may be expressed in one language or culture can be entirely different to another. Many therapists working in their non-native language have shared with me the anxiety they have felt in not understanding certain nuances, or being unsure of how to respond in a way that feels culturally appropriate to the client. Training in these areas can level up a therapist’s ability to understand their clients, and express themselves more effectively in order to better assist.
[…] language training and cultural training become extremely important for a multilingual clinician, or a therapist working in a multicultural environment. Each language carries its own nuances, expressions, and variations in how things are expressed.
And while it is, of course, important to ensure they feel confident communicating in the language being used during a therapy session, there even may be benefits to providing therapy in a non-native language. The multilingual clinician has the ability to work from a differing perspective, and adopt new outlooks – which is greatly beneficial for understanding and connecting with their client. And at times, when the client and therapist may both be working with their non-native language, the power dynamic that sometimes exists in a therapeutic setting is eliminated. Both the client and therapist are on common ground and must work together to understand each other. The attention and care that goes into this type of interaction has the ability to positively impact the relationship.
It’s critical that psychotherapists are culturally informed and sensitive to the language barriers that may arise. They also should be trained in the cultural nuances of a language. Without a deep understanding of the language their client is speaking, there is a risk of misconstruing the client’s communication. However, by learning to become an effective communicator in a second or third language, and becoming culturally informed on the populations they are working with, there is an opportunity for an even stronger, more beneficial therapeutic relationship.
Conscious Mental Health 
excellent article!!!
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