Can therapy work in a language that is not my first?

Why does the worst year of your life sound so calm in English?

Your English arrived in a narrower set of rooms than your first language did, so it comes with less attached to it. You describe the year everything fell apart in accurate, well-ordered English and feel almost nothing while you do it. Then one phrase in the language your grandmother used arrives, and your throat closes on it. Nothing has changed in the facts. What changed is how much of you the words are connected to¹. First-language emotion words sit in more company: they were learned in more situations and used in more ways, so each one pulls more with it.

This has nothing to do with vocabulary. You know the word precisely, and the precision is part of the difficulty. You met it in lessons, at work and in careful conversation with strangers, while the same word in your first language holds a kitchen, a playground, a funeral and everything since. One of them is accurate. The other is loaded.

What does your body do when you change language?

The feeling arrives before you have decided anything. Something in the hour reaches you, your chest tightens or your eyes sting, and only after that do you go looking for words. In your first language the looking is almost instant. In a later one it becomes a task you can feel yourself doing.

• The feeling is not reduced. It lands at full strength, in your chest, your jaw, your stomach.
• The search is where the distance opens. The seconds spent hunting for the English are seconds spent thinking about the feeling instead of being in it.
• The sentence you deliver is the third version. You felt it, you put it into words, then you cut it down to the words you had available.

That is why a well-made sentence in a later language is not evidence of calm. It is evidence that you had time.

When does the distance do you a favour?

The distance earns its place when a memory is still too hot to take hold of directly. People arrive apologising for not working in their mother tongue, and they have no reason to. A language that holds the memory slightly further off is sometimes the only one in which the first sentence gets said at all. Clients tell me things in English they have never said in any language to anyone, and the English is part of what makes them sayable: it is not where the shame was installed.

What matters clinically is whether you are choosing the cooler language or living in it. Using it on purpose for part of an hour, to get the first sentence out, is work. Having arrived in it years ago and never come back is something else, and it is rarely visible to the person doing it.

When does fluency hide you from your own therapist?

It hides you at the moment you sound composed and are not. Your therapist hears a steady voice and a well-built sentence and moves on, and you let them, in relief and in disappointment at the same time.

• Fluency reads as composure. A therapist who does not know you are working in your third language takes the calm surface at face value.
• The hour flattens into explanation. Careful, well-organised speech makes it easier to describe a feeling than to have one.
• It costs you more. An hour of precise emotional work in a later language takes more out of you than the same hour in your first. Say so when you start to fade.
• From the inside it feels identical. Hiding in a language and simply speaking a language are indistinguishable while you are doing it.

What a later language shifts is your handling of a feeling rather than the feeling. Asked whether they would push one man off a footbridge to save 5 others, 18 per cent of people said yes in their native language and 44 per cent in a foreign one², which is read as a weaker emotional pull in the foreign one. Yet unpleasant images provoked negative feeling of the same strength in a second language as in the first³, in a study that analysed 22 of its 37 volunteers and set the rest aside for reacting too weakly in their first language. Neither of those took place in a consulting room. Together they tell me the distance shows up in what you decide, not in what you feel.

Read more about how to know if a therapist is right for you.

What happens when a couple argues in a shared second language?

Both of you are slightly muffled, and neither of you knows by how much. Whoever sits nearer their first language has more room in a hard conversation: more words, more speed, more precision at the point where precision counts. That advantage is nobody’s fault, and it does not sit evenly: the partner carrying the heavier end is the one who goes quiet first.

When the exact word will not come, you reach for a nearby one. Your partner answers the sentence you did not mean, you feel unmet without being able to say where it went wrong, and their reply comes back in the same approximate language. Two or 3 exchanges later you are both arguing about something neither of you said.

Something else runs underneath it. You want your partner to understand the thing exactly, and you are relieved when the rough translation lets you both move past it. Both are live at once, which is why these arguments end in a truce that settles nothing.

What helps is deciding in advance what happens at the moment a word goes missing: a pause rather than a guess, and permission to say the sentence in your own language first and translate it afterwards. Read more about expat couples therapy.

How do you make therapy in a second language reach what you came for?

Tell your therapist about your languages in the first session, and use your first language whenever it holds the true word.

• Name your languages. Say which ones you speak and which one your childhood happened in.
• Name the private ones. Say which language you dream, count, swear and pray in.
• Report earlier therapy. Say whether you have worked with a therapist in another language, and what that was like.
• Plan for running out of words. Decide together what you want your therapist to do when the word will not come.
• Say the key sentence twice. Once in the working language and once in your first, even if your therapist does not understand it, then say what changed in you.
• Switch mid-sentence. If the Danish or Arabic word is the accurate one, use it and translate afterwards. The switch is where something arrives.
• Describe the gap. Say the phrase, then say what the translation leaves out. I work in English and Danish, and I will still ask for your first language when it holds the true word.

All of this assumes you know which language you are in and why, and there are people who do not. A later language that has become somewhere to live rather than somewhere to speak from is hard to see from the inside, and it takes another person to notice it with you. The steps are the wrong tool altogether when the difficulty turns out not to be about language: what looks like a problem of translation is sometimes a long habit of keeping people at a fixed distance, in every language you have. Which of those you are in is not something I could tell you from here. You are welcome to book a session or the free 30-minute call and start with that question.

Questions people ask

How do I choose between a therapist who shares my first language and one I could start with now?

A shared first language is a real advantage, and for most internationals in Copenhagen it is not on offer, so how a therapist handles your languages matters more than which ones they speak. Ask a therapist you are considering what they do when a client runs out of words.

What should I tell a new therapist about my languages?

Say which languages you speak, which one your childhood happened in, and which one you would reach for if you were frightened. That takes a couple of minutes of a first session and changes how everything after it is heard.

Will my therapist mind if I switch into my own language mid-session?

A therapist used to international clients will welcome it, because the switch marks the point where something real has arrived. Say the phrase in your own language first, then tell them what the English version leaves out.

What should I do if I suspect I am hiding behind my English in therapy?

Say the suspicion out loud in the session, because naming it is the one move that does not depend on your being right about it. Your therapist can then watch for the pattern with you instead of taking your fluency at face value.

Does this work online, or should I sit in the room?

Both suit second-language work, and the room gives your therapist a little more of what you say without words. I work in English and Danish, in central Copenhagen and online.

I work with many people in their second language, and my page on expat psychotherapy says more about how we make room for that.

Sources

1. Diakonova-Curtis, Bilingualism as a tool in psychotherapy, Psychotherapy Bulletin, 2016
2. Costa and colleagues, Your morals depend on language, PLOS ONE, 2014
3. Morawetz and colleagues, Second language use facilitates implicit emotion regulation via content labeling, Frontiers in Psychology, 2017

How this article was written: I choose the subject and the angle. An AI assistant researches and drafts. I read the draft, correct and improve it and stand behind every clinical statement. The professional and clinical judgement is mine.