Linguistic Dimensions in the Bilingual Patient

In New York City, as in other urban centers, bilingual patients constitute a significant proportion of the population engaged in psychotherapy. Although bilingualism and bilinguals have been extensively studied by educators, linguists, psychologists, and sociologists, psychiatric clinicians have not shown any special interest in these subjects. The existing literature, however, agrees that the linguistic experience of bilingualism has major effects on the individual.1-4 In fact, many early authors considered bilingualism an experience detrimental to the point of predisposing towards schizophrenia,5 mental retardation,6 and even moral deterioration.7 These pessimistic views have been challenged in recent years by authors who have studied bilinguals independently of cultural and social marginality,” two frequent concomitants of bilingualism.9 The purpose of this paper is to summarize the major linguistic aspects or dimensions of the bilingual individual and to describe the most common implications of these dimensions for the process of dynamic psychotherapy. As an introductory step, let us broadly define bilingualism as the practice of speaking two languages, and bilinguals as the individuals involved. In the interest of space, case histories will be avoided.

Language dominance refers to the degree of linguistic competence or command bilinguals have in each of the languages. According to this dimension, bilinguals may be classified as subordinate or incipient, when their linguistic performance betrays a differential competence in the two languages, or as proficient, for some “true” or “pure” bilinguals, when they display a native-speaker's command of both languages. In contrast with proficient bilinguals who often operate the two language systems independently, subordinate bilinguals are considered to have just one language system. Thus, subordinate bilinguals speaking in their second language tend to utilize first-language translat