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Strategies and risks in psychotherapy with bilingual patients: the phenomenon of language independence

Published Online:https://doi.org/10.1176/ajp.133.11.1275

The presence of two separate languages, each with its own lexical, syntactic, semantic, and ideational components, can complicate psychotherapy with proficient bilingual patients. If only one language is used in therapy, some aspects of the patients emotional experience may be unavailable to treatment; if both languages are used, the patient may use language switching as a form of resistance to affectively charged material. The authors suggest that monolingual therapists should carefully assess the degree of language independence in bilinguals in order to minimize its impact on therapy. They conclude that study of bilingual patients may provide important insights into the nature of the therapeutic process.

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