The Importance of Mother Tongue in Psychotherapy


The purpose of the article is to sort out what important role mother language play in talk therapy. Talk therapy is used in some mental illnesses. It is a treatment rather than medicine. By using talk therapy, the therapist makes an interpersonal relationship with his client by using a language to seek out his mental disorder which is being faced by his/her client. Language, a medium to share information between the patient and his therapist, work s as a tool to convince the client to overcome his problems.

The choice of an appropriate language may influence the treatment process and can produce desirable results.

Key points. Language, Mother Language, Psychotherapy, Linguistics, and Paralinguistic features.


Psychotherapy, or talk therapy, a tool to help patients with different mental illnesses and emotional difficulties. CITATION Ame l 1033 (American Psychotherapy Association)Talk therapy, use as a sort of treatment of mental disorder rather than medical. Psychotherapy is used to treat mental illnesses like depression, anxiety, loss, the death of a loved one, coping with daily life.

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Impact of trauma and some of the medical illness. The therapist seeks out the problems which are being faced by patients. The therapist tries to treat him/her by a conversation with him/her. The language that the therapist chooses have the power to influence the process and practice of his treating method. The therapist prefers to use the native language of the client so the patient may talk with him frankly. The patient’s mother tongue is more effective in therapy sessions as it is the primary language of the client and easily understandable for him.

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The patient feels free while talking with his therapist.

Psychotherapy usually conducted in a single client, family, group setting, or couple. Therapy sessions are mostly conducted once a week about 30 to 50 CITATION Ame l 1033 (American Psychotherapy Association). There is an interpersonal relationship between the client and therapist while involving in therapy sessions. Both are needed to involve actively for effective treatment. Therapy can be short term, a few weeks, dealing with immediate issues and long terms for dealing with complex, longstanding issues.

Literature Review

This literature review compiles the important work on the role of mother tongue in Psychotherapy and discusses its impact on the clients. There is a brief history of psychotherapy and the concept of language in treating the patient via language. The literature review also explores the importance of the choice of language in psychotherapy. The choice of language plays a very important role in treating mental disorders rather than medical (psychotherapy). The article also describes the reaction of the mother tongue and second language in the treatment. This article also briefly describes the importance of paralinguistic features to examine the effect of language being used as a medium in psychotherapy. There is a description of two cases that are treated by a therapist using both language in one case and mother language only in the second case. The article also describes the conclusion by the therapist that the mother tongue is more effective in psychotherapy than the second language. Because the patient was treated in the mother tongue was improving more quickly than the patient whose treatment was in both (mother tongue & second) language.

Historical view of psychotherapy and languages

A review of the literature of the last 30 years reveals a remarkably small number of reports on effect of language choice of bilingual patients in psychotherapy (Richard j. Carlson. M.D).

Psychotherapy was first developed in the Middle East during the 9th century by the Persian physician and psychological thinker Rhaze CITATION His1 l 1033 (History of Psychotherapy).In the west, the moral treatment approaches were advent in 18 century. In the 19th century, Sigmund Freud first developed his talking cure in Vienna. According to Freud,” words are the essence of mental treatment “Physical (or Mental) treatment (1905) Breuer’s treatment of Anna. O (Freud, S., Breuer, J..Studies on hysteria 1964) the first documented psychoanalysis, reveals her use of several languages.

The choice of language in psychotherapy

In therapy sessions, language is a primary means of transmitting the information. It is an instrument which is used in treating the psychotic disorder in psychotherapy. Many authors(Buxbaum, E. the role of the second language information of ego and superego, Psychona,1958,Greenson,A (The mother tongue and the mother, Int.J.Psychonal, Krapf .E) the choice of language in polyglot psychoanalysis, Psychoanal 1955)have described that what is the effect of language choice in Psychotherapy. A language is an important tool that influence therapy sessions. The choice of appropriate and effective language enhances the effect of treatment and bring the desired result. The choice of language may tell you a lot about your client’s sense of identity. The therapist brings his/her heart while entering therapy sessions. The language of the heart are the words and actual langue that the therapist uses to explore the innermost of his client to find out the solutions of his mental distress.

Some linguists have proposed that cognitive behavior is influence by the semantic features of the language. An acquired language may be use in psychotherapy in defense- a mean of avoiding anxiety. Language has a powerful influence on the technique and effeteness in psychotherapy.

Paralinguistic (Features) communication in Psychotherapy

Paralinguistic communication includes the aspect of spoken communication that doesn’t involve words. Body language, gestures facial expressions tone, and pitch of voice are the example of paralinguistic features. (
Paralinguistic features provide additional information about the message you are conveying to your client. It also gives feedback on your verbal therapy. When the client in his uttered words, emphasizes the issues that are important for him, he manifests the tone of voice, speed, and clarity of speech, it is assumed the information uttered by him is quite reliable. When a verbal utterance is dominated by non-verbal content, such as groan sigh and munching, and grunting, it reflects the emotional feelings of the client. The therapist showing empathy with his client use the paralinguistic features, facial expression, and eye content to explore more information about his client. Patient with depression and schizophrenia shows the lack of ability to express emotions in their tone of voice. This thing shows that the acoustic characteristics of voice can be a source of discrete monitoring of the patient.

Mother language in Psychotherapy

Mother language plays a vital role in the development of personal, social, and cultural identity. Cognitive and intellectual development is comparatively faster than a second language. The mother tongue help the people to stay connected with their culture which is a very important identity of a client to help the therapist to understand his background features.

Kolers (bilingualism and information processing .Sci am,1968)suggested that bilingual persons have duplicate stores of meaning such that some information is only readily available and expressed in the language in which it was acquired.

The client may express highly emotional material in a second language, but without the effect, the therapist is expecting. In mother language psychotherapy, he feels home and expresses his emotions frankly. He unintentionally can express those aspects of his life which are helpful for the therapist to understand the mental status of the patient, in which she is careful to express in the second language.

Ervin (Language and T.A.T .content in bilinguals.1964) imply that perception of role, recall, and projection of past experiences are three important aspects of the psychotherapeutic process influence by the language used.

Marcos et al. (the language barrier in evaluating Spanish-American patients, Arch Gen Psychiatry,1973)in the studies of Spanish –American schizophrenia patients, founded that the exhibited significantly greater psychopathology when they interviewed in English Regression in linguistics behaviors occurred in the acute phase of psychotherapy episode, as if the client is unable to make necessary efforts to communicate in the second language, which is not automatic in his conscious presentation.

Foner et al (A socio –psychiatric tool for assessing immigrant adaptation 1970) pointed out that learning the new language showed one of the best correlations with adaptation. However, many individuals can learn a new language well but adapt poorly, especially with those neurotic problems. Psychotherapy in the mother tongue is very useful for these individuals.

Lukianowciz (Auditory hallucination in polyglot subjects, Psychiatria et Neurologia,1962) conclude that bilingual patients more threatening voices in their second language, as if this were, perhaps, some defense against the anxiety aroused by such suggestiveness.

The following two patients were treated by the therapist and observed by the writer to search the effect of mother tongue in psychotherapy. Sessions were 40 minutes one a week and ranging from 6 to 9 months in duration. The author's language background was dissimilar to one and similar to the other. The first was Sindhi in language and the second was Punjabi speaking. Sindhi and Punjabi were their first language respectively while Urdu was a second language for them.

Case 1

The patient a 30 years old lady belongs to some rural area of Sindh Province. She can speak Sindhi frequently but cannot speak Urdu as compare to Sindhi. She had a secondary school education. She got admission in intermediate but fail to continue her education due to cultural issues in which girls are not frequently allowed to go to other cities for education. She got married in her teenage and became the mother of 4 children. Her husband was not caring not only for her but for children also.

Her mother in law as also seemed dissatisfied with her due to her poor background. Due to multiple domestic issues, she developed the symptoms of anxiety and severe depression.  In the hospital, she was discovered with some mental disorder leading to more complexity.

The Psychotherapist initiate her psychotherapy in the Urdu her initial episode o therapy, the author observed that his response to the therapist was not as to expectations. After some sessions, the therapist began to use both languages in his conversation with the patient. While converting to her mother tongue (Sindhi), the patient spoke frankly and frequently about her past and problem faced by her. The therapist continued therapy sessions mostly in Urdu but frequently code-switching in Sindhi when speaking of conflict areas. When the patient began to see the therapist speaking in Urdu, she felt him authoritarian toward her and she used the title “Doctor Saab”.It was interpreted by her that she was served by the therapist on professional grounds as he serves other patients. But while speaking in her mother tongue, the title (Doctor Sahb) was switched to “Bhai Jan” (brother) and she became frank in telling her past experiences and he problems.

By switching from Urdu to Sindhi, the patients expressed her conflicts more effectively. The paralinguistic featured were also varied in code-switching. Facial expression and voice quality were also quite different in different languages. While speaking in Urdu language, facial expression was not showing much interest in conversation with the therapist. It showed that it was just a professional session that will range for some weeks and end in no comfort. The eye contact was also not effective as it showed some hesitation and difficulties to express her innermost emotions. While in conversation in her mother tongue, this paralinguistic communication was quite different from the therapy episodes in a second language.

The duration of the sessions was 9 and half months consist of 40 sessions.

Case No 2

The patient, a 26 years old housewife came to the hospital in the outpatient department.  She was treated for 6 months. Her present complaints were feeling of depression, anxiety, and unhappiness with her marriage and life in a combined family system. She was born in a rural area of Punjab province and her mother tongue was Punjabi. She had a higher secondary education certificate and was teaching as a tutor in her home. She considers herself to be a very helpless individual and her family members were not paying her respect. Her husband was also a poor farmer and was unable to live with here in their own isolated house.

The patient was also a frequent Urdu speaker. But the therapist decided to use her mother tongue in whole therapy sessions. During the first session, she preferred to speak in the Urdu language to give the impression that the therapist is considering her uneducated lady by using her mother tongue. But soon, in initial episodes, she switched to her mother tongue and became very frank with the therapist. She showed here extraordinary trust to the therapist and explored her past in a very explaining manner. It was observed that she was more in contact with feelings and important issues.

She improved here treatment faster and decide to cope with issues in confidence.  The duration of therapy sessions last for only six months and the patient was fully improved.


Two different cases have been described in this article to see the impact of language in psychotherapy. The focus is to explore the fact of whether psychotherapy is better in mother tongue or second language. In the first case, the therapist, initially, use second langue to treat the patient but as he observed that the response was not according to his expectations, he also started to use the mother tongue of the client. When switching to the mother tongue, the therapist observed that the patient was feeling easiness and frank to tell about his past and other issues that she was facing. But in using a second language. The patient was feeling as it was a professional interaction between the patient and the client.

In the second case, the therapist uses only the mother tongue of the patient and observed that the patient's response was faster than the previous case. The patient was improving quickly and exploring his past and problems very frankly. The therapist was succeeded only in six months and the patient was fully recovered from his mental disorders.

The mother tongue proved very effective because the patient was feeling home while conversing with the therapist in the mother tongue. In the second language,( in the first case) the patient was facing some difficulty in therapy sessions and was not ready to explain his problems. But as switching to the mother tongue, the result was different from the use of a second language.


Psychotherapy is the treatment of mental illnesses other than medication. The therapist uses langue as a tool to treat the patient by convincing the patient to overcome mental disorders. The choice of language is very important in psychotherapy because it is the mean of treatment. The language used in psychotherapy has a great effect on the therapy process.

Two different patients were treated by psychotherapy by a therapist using language. The patient who was treated in the mother tongue was very quickly getting improvement as compared to the patient was treated in both (mother tongue& second) language.


1.Buxbaum, E.: The role of the second language in the formation of the ego and superego. Psychoanal, 18: 279-289, 1949.
2. Ervin, S.M.: Language and T.A.T. content in bilinguals. J Abnorm Soc Psychol, 68:500-507, 1964.
3. Freud, S., Breuer, J.: Studies on Hysteria New York: Avon Books, 1966.
4. Greenson, R.: The mother tongue and the mother. Int J Psychoanal, 3I: 18-23, 1950.
5. Kolers, P.: Bilingualism and information processing. Sci Am, 218: 78-86, 1968.
6. Krapf, E.: The choice of language in polyglot psychoanalysis. Psychoanal Q, 24:343-357, 1955.
7. Lukianowicz, N.: Auditory hallucinations in polyglot subjects. Psychiatria et Neurologia, 143: 274-294, 1962.
8. Marcos, L.: Lying: a particular defense met in psychoanalytic therapy. Am J Psychoanal, 32: 195-202, 1972.


Updated: May 19, 2021
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The Importance of Mother Tongue in Psychotherapy. (2020, Sep 08). Retrieved from

The Importance of Mother Tongue in Psychotherapy essay
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