Psychoanalysis and the Bilingual Patient: Some Observations on the Influence of Language Choice on the Transference

Bilingual patients, those whose mother tongue is not English, constitute a significant portion of patients referred to us in urban areas. These patients present a formidable challenge to English-speaking clinicians who must consider that bilingualism per se may impact on how the patient narrates his or her life story in the treatment process. Neurologic and psycholinguistic literatures suggest that some bilinguals maintain separate language systems. They do not simply have a duplex set of words to refer to experiences, but rather have alternative and not necessarily congruent language-specific experiential inner worlds.

This article selectively reviews the literature on bilingualism as it relates to psychoanalytic and psychotherapeutic work, concluding that the presence of dual language systems modifies fundamental aspects of the treatment process.

I present a case example proposing that when both languages are used in treatment, language switching can trigger powerful shifts in transference phenomena, as affective experiences and early object relations are uniquely revived in the language in which they were lived. I apply aspects of contemporary psychoanalytic thinking to the language acquisition process, advancing the idea that language acquisition is an object relational function.