Is it better to have psychotherapy in the client’s native language?

Orison S. Marden, an American author, once said: “We make the world we live in and shape our own environment.” The world we are making today is a global one, with many people enjoying the freedom to live and work in different countries within their lifetime. By doing so we shape our own environment and let that environment shape us. We use more than one language daily, adapt to different cultures, and learn to tolerate differences while trying to keep our own personal and cultural identity.

Speaking of his experience of immigration to the United Kingdom during WWII, Freud (cited in Urdang, 2016, p.156) referred to “the loss of the language in which one had lived and thought and which one will never be able to replace with another for all one’s efforts at empathy.” Language plays a major role in a person’s identity formation, memories and experiences. In fact, when switching to a different language, multilingual people often change parts of their identity, even adapting their tone of voice and gestures. In psychotherapy, language contributes greatly to the formation of therapeutic alliance, trust and understanding. It is often linguistic nuances, subtle gestures, cultural symbolism and language-specific idioms that enable a therapist to fully relate to and empathise with the client. So would therapy be more effective if it was in the client’s native language?

To answer this question, we must first attempt to define “native language”. “Native language”, is the language to which a person was exposed from birth or during a “critical period” (a term often used in linguistics connected to language acquisition in early childhood). However, this does not include bilingual or multilingual people who have been exposed to more than one language. It is common for people to be exposed to different languages at different stages of life or relationships. For example, a child may speak one language at home and another at school, university etc. Notably, language matures with us: the older we grow, the more our language skills and vocabulary change and adapt to our needs, environment and experiences. Therapists today are not only often exposed to bilingual or multilingual clients but are likely to be one of them too so it is important to note the role of the language in the therapy dynamics.

My own experience as a bilingual client who has had personal therapy in both English and Serbian (my native language) gives me a great insight into the change of dynamic and focus of therapy. With my English therapist I rarely spoke about my primary family and I observed the relationships with my parents and my life events before I left Serbia more rationally and objective, more from an adult perspective. My English allowed me to describe them well, but I now realise how emotionally distant I became while I tried to retell the events from my past unconsciously adjusting them not only to another language, but also to another cultural perspective. There are many words that lose some of the meaning when translated, or others that are so culturally specific that their meaning is completely lost in translation. Interestingly, I only became aware of this when I started therapy in Serbian, years later.

As most of therapies derive from Freudian psychoanalysis, it is interesting to note that Freud himself worked in English while he was German. Djakonova (2016) reminds us of the case of a German woman who fled the war and worked with an analyst in English, refusing to speak German. It in only when, later in therapy, she started to use her native language that she was able to deal with her childhood anxieties and trauma of the war. Similarly, as a therapist I worked with a French client in London, who insisted on having a French-speaking therapist, but in therapy he spoke only in English. Three sessions later, when he became more emotionally engaged he started speaking French, but he abruptly ended therapy saying that it was too difficult for him to process and never returned.

This experience left me wondering if I took the right approach as a therapist, and what could I have done differently. Maybe if he saw a French therapist, he would not have escaped and distanced himself the way he did and his therapy would have been more effective. Djakonova suggests using bilingualism as a tool in therapy, paying attention to the patterns of switching the languages in therapy because we often feel more comfortable speaking about taboos and touchy personal subjects in the second language.

Finally, in my opinion if the client is willing to reach a therapist in their native language, it is often the best option to do so and with the globalisation and development of modern technologies, the access to online psychotherapy and meeting a psychotherapist in your own language wherever you are, has never been easier.


Diakonova-Curtis, D. (2016). Bilingualism as a tool in psychotherapy. Psychotherapy Bulletin, 51(4), 38-42.
Urdang, E. (2016). Human Behavior in the social environment: Interweaving the inner and outer worlds. New York, NY: Routledge.