Culture and Language in Therapy with New and Expecting Parents

Recently I attended a lecture sponsored by the Postpartum Health Alliance on “Cultural Considerations when Working with Expecting and New Parents.” The lecturer happened to be an old friend of mine, Dr. Mariela Shibley, Psy.D. She shared with a group of maternal mental health practitioners, First Five home visitors, and other professionals interested in helping pregnant and postpartum women. As I focus on helping women of childbearing years in my psychotherapy private practice in San Diego, I always look forward to learning more and connecting with other practitioners at the PHA lectures. You can see more posts inspired by the PHA lectures here: Postpartum Couples and the NICU Experience.

Mariela shared some of the basics of cultural competency, including John Berry’s (1980) model of Acculturation, which looks at how much an individual wants to identify with her host culture and culture of origin. As an immigrant to the United States, and someone who is fluent in multiple languages, she shared personal and professional experiences.

The part of her lecture I found most fascinating was a look at language in therapy with bilingual clients. Dr. Shibley presented findings from her doctoral dissertation. She looked at language differences in therapy and found a clear difference in the quality of a client’s disclosure. Regardless of how proficient in English someone is, there is a difference when they switch to, as I often say, “the language of their dreams.”

In Dr. Shibley’s research she found some of the following differences:

Abby’s take on which language a bilingual person should use in therapy:

This resonated with my own experience providing bilingual therapy to native Spanish speakers. Often times I help adults with themes of attachment, which includes how they relate to people on a basic and instinctive level. And when do we first form attachments? As babies. So of course it makes a difference to speak in the language we heard as babies!

Many times in psychotherapy clients like to feel more in control. It is the therapist’s job to help them manage any uncomfortable feelings that may come up. We discuss the intensity and I help my clients feel like they are in control of the intensity. It’s just like getting a massage when the massage therapist asks if the pressure is too much or too little. If our work is to shallow, we won’t get anything accomplished. If it is too intense, then we might be creating more pain without any benefit. I let my clients know that it is their right and responsibility to give me feedback on the intensity, and to let me know how intense they want to work that day.

I often provide therapy to bilingual speakers of both Spanish and English. Usually I let the conversation flow between the two naturally, letting my client choose which language to use and when to use it. My “take home” from Dr. Shibley’s research is that we can and should be more aware and deliberate about which language we are using. It is one more tool to help us control what qualities we would like to elicit in therapy.

Join the conversation on bilingualism:

Something I learned about myself when I was living in Spain and first mastering Spanish is that personality changes when we switch languages. When I was first learning to speak a new language in a new country, I was living with people who did not speak any English. I found that when I lacked the right words I became more animated and expressive, almost as though I was trying to make up the difference with charades! Fortunately my language skills have improved over the last 16 years, but I still feel a little different en español.

What about you? Do you speak more than one language? Do you feel any different?? Please comment below.

In addition to the comments here on this page, this post generated some great comments on Google+. Since I interact with more people from outside of the US, not surprisingly, more of them speak more than one or two languages. Here are two examples:

Maria: “Wow! Abby this is amazing ! I never really thought about the deep relationship of the languages that we speak to our emotional roots. The first language that I learnt to speak was Urdu that my parents spoke, then I studied Arabic and English at school. Fell in love with English literature so the language became an integral part of my life thereon. Punjabi I acquired because being the regional language of the place where I lived, that was the language of majority. And it has some of the most soulful Sufi poetry one can imagine, that inspired me to learn the language better. I picked up a smattering of words from Spanish, Hindi, French and Farsi but not enough to hold an intelligent conversation :))
Urdu, English and Punjabi being the dominant languages in my life, I switch back and forth between them in my dreams. My deepest and most intense dreams are always in Urdu though. I feel knowing another language is like having another soul in the body. Our thoughts grow out of these souls and intertwine like branches of trees
growing too close to each other.”

Gill: “I’ve been thinking the same things described in the article myself.
You know my “special” relationship with my parents. So every time I’m about to have a call with them I practice with my husband the “worst case scenario” in the form of “what they might ask and how I should answer”.
We do it in English, and it feels so easy to say things. But when I think how to translate it in Russian, the same content suddenly becomes too “emotionally loaded” or even something I would never say in Russian.
I noticed this difference in “emotional state” when I speak different languages long ago.
For example, English is for me the “brain language”. I communicate content with it, not emotions, because I somehow fail to connect to it on an emotional level.
It’s also difficult for me to read books in English, as I understand the content but “don’t see pictures”. And this is just boring while reading a good book.
It’s also the only language I can say a couple of swear words in, which would happen in Russian only if there is a gun pointing to my head (literally).
German would be the next in line. It’s a bit better than English in that regard. Reading a book in German does trigger some pictures, but it’s still far away from this madness of emotional roller coaster that is Russian to me.
Funny story: Urdu/Hindi is the language I speak the worst of all, but it does trigger lots of emotions. Unlike English or German, Urdu/Hindi is not so strict on word order in a sentence, and there are so many untranslatable tiny words that bring the particular mood – the same way Russian language is doing it.
Re in which language to do therapy: If I had therapy sessions, I would prefer to do it in English, exactly for the reason to have an emotional distance to the issues.
But I would agree with the article. Sometimes emotional distance needs to be eliminated, and the mother tongues is better suited in this case.
Re language of my dreams: Haha. I really thought hard about it, but I don’t know the answers. My dreams are typically in pictures, and I don’t remember anything that had people talking talking. Interesting question, though. I will keep an eye on it ;)”

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