‘My recovery is in English’: Clients' language choices in multilingual psychotherapy

Background: Psychotherapy is constituted through language. Due to voluntary migration or forced mobility, many people do not have access to therapy in their first language (L1). How multilingual clients manage their languages in therapy is an issue many therapists need to address in their practice. Psychotherapy is about trauma, emotions and identity, and when a multilingual client chooses a particular language, it may influence their emotional expression, cause a cultural misunderstanding, and a distorted presentation of who they are. Aims: In this study, we investigated how clients perceive psychotherapy in a foreign language (LX). We also aimed to provide psychotherapists with more insights into the effect of language choices on the course and outcome of therapy. Methods: We conducted 30 semi-structured interviews with multilingual clients who had experience with therapy in LX. The data were analysed using thematic analysis. Findings: The data revealed that there is not one correlation between language and emotion, and that different backgrounds may lead to different preferences for the language of therapy; for some, LX may be preferred because it provides emotional distance necessary for discussing past trauma; for others, LX feels inadequate for expressing themselves fully. Conclusions: Our data suggest that there is a need for multilingual psychotherapists to learn more about their clients' linguistic and cultural profiles and how they play a role in emotion communication to facilitate a smoother therapeutic process and a more beneficial outcome.