Therapy reflections: Why do certain clients not want to talk in their native language in therapy?

#multilingualism in #therapy

Curiously, certain clients prefer to speak a different language than their mother tongue (e.g. English rather than German/Spanish/etc.; Dutch rather than their native German/Spanish/Etc.). And the reason for this is not always obvious. Sometimes, I don’t speak their mother tongue, and then they accomodate me/us, for the therapy to be possible. Sometimes, there might be an intermingling of their vocabulary and they simply feel more comfortable speaking in another language that somehow is more consolidated at this point. This could be the case with internationals that have lived abroad many years and/or went to international English speaking schools or university. They feel that certain content is more easily expressible in the language they use more frequently - and somehow their original mother tongue now has become more simplified. I catch myself sometimes being at loss for words in German or by accident inserting a Dutch word. The slightly shocking realization that one develops an accent in one’s mother tongue might be the price for the enriching experience of living abroad or speaking several languages. Moreover, there might be biological causes like strokes, head injuries or dementia which can also make a client unable to speak a language, revert to one that is familiar, or lose overall fluency.

Language as Avoidance

Some clients do not only have mental content* stored in different experiential levels (e.g. physical, emotional, cognitive, or spiritual) but also in different linguistic levels. For instance, if a client spoke Japanese and Korean in their family home, certain content might be more easily accessible in one of those languages. However, I’ve had it more than once that native Germans prefer speaking in English to me, fully aware that I’m also a native German speaker. Or a native Dutch client wanting to speak English, clearing stating it would be too painful to express themselves in Dutch. This is a sign of avoidance. Often times, when we get to a certain point in therapy, the language switches to the native language - somehow specific emotional content is more easily accessible or verbalized in the language that has been avoided. Maybe the trust between us has grown, or maybe a traumatic experience is more easily utterable in one particular language. Or maybe there is some other reason… but it often seems to be working on a more unconscious level. When, during an intake I notice that one language, that we both speak and would be more common sensical to use, I tend to briefly address it - just as a way to explore if there is an underlying process occuring or a more practical reason.

*mental content like emotions and cognitions are more and more considered to be stored on several intertwined levels from one’s body (see for instance The Body keeps the Score by Bessel van der Kolk or Antonio Damasio’s work on embodied cognition)

Language as Connection

Sometimes languages get mixed up and the client for instance inserts English words, whilst usually talking in Spanish to me. This is completely fine by me, if it somehow is conducive to a better understanding or exploration of a certain issue. On the other hand, my Portuguese is so rusty that I often speak a kind of portuñol (mixing Spanish with Portuguese), just to get my point across. It’s not ideal, but if there is no more fluent therapist or translator available… I guess it’s the best option we have in order to establish a therapeutic relationship. But clients tend to be very pleased being able to speak in their preferred language.

Leila Verkerk and colleagues (2021) investigated multilingualism in psychotherapy and found that “language choice influenced the therapeutic process and its outcome in terms of discussing emotional topics, establishing and maintaining rapport with the client, and managing linguistic and cultural differences.” Verkerk et al (2021) mention that language switching can serve various functions namely:

• to recall specific memories

• to use more socially acceptable language (e.g. for swearing or taboo words)

• to be more precise, use words with a different connotation (to avoid ambiguity)

• to exclude a third person from the conversation (e.g. in family therapy to exclude another family member who doesn’t understand the other language)

• when talking about highly emotional topics, dreams, or traumas

• to decrease the emotional load of a subject, i.e. “language switching occurs when clients try to connect to deeper feelings and when the topic is emotionally intense”

The language used in therapy serves as a tool for connection to achieve understanding and healing. Non-verbal therapeutic interventions do just the same. For instance play therapy or body-based psychotherapies can be just as effective therapies as talking therapies, and at times maybe even more able to help process pre-verbal traumas. I am sure there might be more reasons why clients don’t use one of their native language, that would be interesting to explore, but the use of language in the therapy is mainly a means to an end: to establish a connection.

Reference

Verkerk, L., Backus, A., Faro, L., Dewaele, J.-M., & Das, E. (2021). Language Choice in Psychotherapy of Multilingual Clients. Language and Psychoanalysis, 10 (2), 4-22. https://doi.org/10.7565/landp.v10i2.5542