Psychotherapy and language

Psychotherapy being "the talking cure", it seems appropriate for me to ponder about language.

A bit more than half of my clients come to me because I speak their mother tongue (German or French). Why is that language communality so important to them, that for some, they prefer therapy over Skype with me, over trying to find a different therapist "in the flesh"?

For one, it is about feeling at ease in whatever language they do therapy in.
But more importantly, it seems to be about what language structured their brain in their childhood.

You learn to express who you are, and your feelings, at a very early age, in a certain language.

Part of the work we do in session is to look back to find the moments where things may have "gone wrong" and where certain behavioural adaptations have occurred to deal with those problems, to then examine if they are still adapted to the present (they mostly aren't).

To feel at ease with your therapist takes a bit of effort - having to overcome a language barrier can make it that little bit harder.

Yet I have had clients whose mother tongue was obscure enough for them to choose me despite that, and we use English as our common language. It is not per se an impossibility, but it requires both from the therapist and the client an additional layer of effort that may be too much for some.

I enjoy my work in whatever language I use. English has become the one I favour, just because I have been using it every day for the last 20 years. Yet both German and French are still so deeply ingrained in me (and I still regularly read books in both) that even if I sometimes feel it's harder to express myself, I never struggle to understand my clients.

Funnily enough, all the therapy work I have done on myself has never been in my mother tongue. Only rarely do I bump against the difficulty of trying to explain an expression to my therapist that just doesn't have an equivalent in English, and so fails to conjure up the same picture to him that it does to me.

So maybe speaking the same language is just about making therapy that little bit easier.

Maybe in the end, it is not so much about which language we use, but about the willingness to truly hear the other.