‘Through the opening of the mouth, we bring out sounds from the mountain beneath the soul.’ - Does our language matter?

by Marika Mikulak

As a multilingual therapist I work with people in English, Polish and Spanish. For many people I see, English is not their primary language, as it is not mine, but it is the language we communicate in. This experience has made me wonder about the role of language in therapy. With the changing fabric of Irish society, I imagine many of the readers are also seeing non-native speakers or bi/multilingual speakers. Statistics from 2017 show that approximately 13% of the population in Ireland now regularly speak a language other than English or Irish at home, with the most commonly spoken languages being Polish, French, Romanian and Lithuanian (Central Statistics Office, 2017). It will be interesting to see if the 2022 Census results due to be published in April 2023 will show much of a difference here.

Therapy was once based solely on the verbal with Freud’s classical psychoanalysis referred to as ‘the talking cure’. The father of psychoanalysis sat behind a person lying down on the couch not looking at them at all. I thought its purpose was to reinforce the analyst’s role as a blank screen not interrupting the free association. It was not until my visit to the Freud museum in London when I learnt that he placed himself out of the patient’s sight because he apparently could not stand looking at one person after another for eight hours a day.

Throughout the 20th and what we have lived through so far of the 21st century, the focus of therapy has been extended to include the non-verbal with the attention also placed on the body, with the famous book title The Body Keeps the Score (van der Kolk, 2014) or often repeated words ‘the body never lies’. McGilchrist (2009) also emphasises how the body and its connection to the right hemisphere should really be the master and the language associated with the left hemisphere would do better as the master’s emissary.

However, language is still important. It is used to build the therapeutic alliance, rapport and to understand the inner landscape of our clients. It is intertwined with culture and Burck (2004, p. 315) considers language as “culture soaked”. From a systemic perspective, Hall (1996) sees language as a tool that allows us to notice the suture between an individual’s subjective viewpoint and the social and cultural context. Fairclough (1989) connects language to power and unequal relationships within societies and stresses how language contributes to the domination of some people over others. And Donohue (1997) sees language as an art of creation of the world around us and bringing the invisible into the visible:

Each day, our tribe of language holds what we call the world together. Yet the uttering of the word reveals how each of us relentlessly creates. Everyone is an artist. Each person brings sound out of silence and coaxes the invisible to become visible. (p. xv)

That creation can have different meanings for each one of us since the words we use, says Miller (1951), “signify only what we have learned that they signify” (p. 5), hence in therapy we often ask for clarifications, e.g. What do you exactly mean when you say this? Finally, we cannot deny the fact that language is a vital part of human connection whether in those I-It moments in a shop or a post office to those I-Thou moments of true meeting when we share our deepest stories with another.

My focus here is mostly on the role and impact of language for therapists and clients who are bi/multilingual. Do we change if we speak another language? What do different languages mean to us? My own experience of a friend who I spoke Spanish with and who presented herself as a different person in her native language as compared to when she communicated in English is very vivid in my mind. I found it really fascinating how a confident, strong voice in Spanish can become a shy, quiet presence in English. Greenson (1950) refers to this with his concept of different self-representations depending on the language spoken, he quotes one of his clients stating, “in German I am a scared, dirty child; in English I am a nervous, refined woman” (p. 18). This validated the experience of my Spanish friend. Furthermore, Burck (2004) in her article “Living in Several Languages: Implications for Therapy” provides a vast literature review on the subject with interesting points such as: we may present different values and affective content depending on the language used, events may be recalled differently in various languages or even that a person can appear psychotic in one language while coherent in another.

Interestingly, the role of language came up in a session with a Portuguese person I work with. She stated that once she feels very comfortable with someone, often without thinking she starts speaking to them in her native language, or when she misses her country, she switches on the national TV on the internet just to find comfort, familiarity and to reconnect. Burck (2004) confirms this when she writes, “first languages mostly connoted as the language for intimacy, both signifying and engendering closeness” (p. 320) and further on the following page, she says, “the ease in a first language, in which individuals are positioned unselfconsciously, in comparison to a struggle in a subsequent language, could provide a sense of ‘being at home’ in it. A first language could engender a sense of belonging and a sense of authenticity” (p. 321). This is not surprising, since this is the language we are likely to hear when we are in the womb and from our primary caregivers. The significant milestone in our development of starting to speak is also associated with our first language. Hence, as therapists in crucial moments of the therapeutic process we sometimes ask our bilingual clients to say a word or a phrase in their own language and it is not for us to understand it, rather it is for them to truly feel how these words reverberate in them.

Surely, language heard or spoken can also be a source of discomfort depending on our experiences. I remember my grandmother, Jadwiga, who as a 15 year old girl was taken by the Nazis to build trenches. She often spoke about hearing German words and the negative sensations that it evoked in her.

This brings me to another fascinating point, namely how second languages can create distance. It is the other side of the coin really; whilst native languages can offer closeness, second languages provide distance. Here, I am talking about the distance within oneself, between experiencing self and expressing self. For me, swearwords in English do not sound as harsh as in Polish and similarly, words of affection sound deeper in the latter. This point got confirmed in a recent session with a Romanian client whose inner critic spoke to him in English. I enquired if there would have been an affective difference if that voice had used his native tongue and he confirmed immediately and added that then he would have perceived it as harsher. Burck (2004) stresses that the distance can also remove some limitations and thus offer individuals an opportunity to construct themselves anew. One of her research participants, Saskia, said, “It was one of the attractions at the time – speaking a different language and living in a different country allows you to be a different person” (Burck, 2004, p. 322). The emotional distancing connected to the use of the second language has been called the detachment effect and it can have disadvantages, such as difficulties in integrating emotions and experiences, as well as advantages, such as verbalising highly charged material since the language offers some detachment and thus protection (Marcos, 1976). Saskia’s words also point to the contribution of language to the formation of our identity. Dewaele and Costa (2013) quote Imberti who suggests that creating a new self for every language that one speaks is a way of coping, “We need to become new selves to speak a language that does not come from our core self, a language that does not reflect our inner-connectedness with the culture it represents” (p. 35).

Bager-Charleson et al. (2017) in their article on multilingualism and therapy state clearly that: “Therapists are often unprepared to deal with their clients’ use of other languages” (p.1). They also raise the points that many practitioners do not see it as being that significant in their therapeutic work and that, in fact, work with multilingual clients can push therapists out of their comfort zone. In light of this, Bager-Charleson et al. (2017) suggest that “training about multilingualism as a means of understanding multilingual clients’ different and sometimes conflicting ‘narrative knowing’ and sense of self be integrated in core psychotherapy courses” (p. 17). Do you know any psychotherapy trainings that include modules on multilingualism and therapy? I do not, so it appears that they have identified a real gap.

Multilingual therapists’ accounts show that while their language abilities increase the ability to attune, connect and empathise with their multilingual clients, they might also be more prone to collusion which monolingual therapists may encounter less (Bager-Charleson et al., 2017). I can certainly agree that multilingualism makes me more attuned to clients’ use of various languages. I know from my own experience that many expressions are not translatable and that there are phrases in some languages that capture particular experiences more fully. Am I more likely to collude with Polish clients? This is an interesting question to ponder.

Some researchers on the topic of multiculturalism and therapy suggest that our clients’ relationship with the languages they speak should be a part of the initial assessment. For instance, Foster (1998) encourages therapists to ask questions about why and when the languages were learnt, in what context, and from whom. She also highlights the importance of enquiring about the current use of those languages: to whom they are spoken, what language fantasies, self-talk and dreams are in.

In fact, ‘What language do you dream in?’ was the question I was asked during my first training in psychotherapy. I have to admit that still, nearly ten years later, it remains without a conclusive answer. If you, my dear reader, can answer it, I would love to hear about it. Interestingly, this precise query was at the centre of the controversy in the psychoanalytic circles from the 1930s on. One camp claimed that the unconscious took place in a specific language, while the other argued the opposite, namely the unconscious was language-less (Amati-Mehler et al., 1990). If I had to choose a side, I would opt for the language-lessness of the unconscious.

In conclusion, language can offer comfort or distance and it contributes to who we feel we are. If you only inhabit one language you could challenge yourself to venture out of your comfort zone and be curious about other languages and maybe next time you are sitting in front of a multilingual person in your therapy room, you could be more sensitive to your client’s worlds in different languages and an opportunity may even present itself to explore them. Donohue (1997) says that, “Through the opening of the mouth, we bring out sounds from the mountain beneath the soul” (p. xv). That is a deep and rich place and how we communicate about it is a world to discover and explore.

Marika Mikulak trained as a psychotherapist in the Flatstone Institute in Cork and completed her postgraduate studies in the Metanoia Institute in London. She is an accredited member of IAHIP. She is a lecturer in the PCI Institute and has a private practice. She can be contacted on marika.mikulak@gmail.com

References

Amati-Mehler, J., Argentieri, S., & Canestri, J. (1990). The Babel of the unconscious. International Journal of Psychoanalysis, 71, 569-583.

Bager-Charleson, S. and Dewaele, Jean-Marc and Costa, B. and Kasap, Z. (2017). A multilingual outlook: Can awareness-raising about multilingualism affect therapists’ practice? A mixed-method evaluation. Language and Psychoanalysis, 6(2), 1-21.

Burck, Ch. (2004). Living in several languages: implications for therapy. Journal of Family Therapy, 26, 314–339.

Central Statistics Office (2017). Chapter 5 Diversity. Retrieved on 10/26/2022 from https://www.cso.ie/en/media/csoie/releasespublications/documents/population/2017/Chapter_5_Diversity.pdf

Dewaele, J-M. and Costa, B. (2013). Multilingual clients’ experience of psychotherapy. Language and Psychoanalysis, 2(2), 31-50.

Fairclough, N. (1989). Language as Power. Longman.

Hall, S. (1996). Who needs identity? In S. Hall, S., and du Gay, P. (Eds.), Questions of Cultural Identity. Introduction. Sage.

Greenson, J.R. (1950). The mother tongue and the mother. International Journal of Psychoanalysis, 31, 18-23.

Marcos, L.R. (1976). Bilinguals in psychotherapy: Language as an emotional barrier. American Journal of Psychotherapy, 30(4), 552-560.

McGilchrist, I. (2009). The Master and his Emissary. The Divided Brain and the Making of the Western World. Yale University Press.

Miller, G.A. (1951). Language and Communication. McGraw-Hill Book Company, Inc.

Pérez Foster, R. (1998). The power of language in the clinical process: Assessing and treating the bilingual person. Jason Aronson Inc Publishers.

Van der Kolk, B. (2014). The Body Keeps the Score. Mind, Brain and Body in the Transformation of Trauma. Penguin Books.

IAHIP 2023 - INSIDE OUT 99 - Spring 2023