Why Therapy in English Makes a Difference for Native Speakers

For many native English speakers living abroad, life appears full: successful careers, international connections, multilingual skills. But when it comes to therapy, something unexpected often happens. They may find themselves in a fluent, even friendly, second language—but unable to express what truly matters. The words are there, yet something remains unsaid.

Why is it that therapy, more than other forms of conversation, demands the mother tongue?

The answer lies not only in comfort or convenience. It touches the core of psychoanalytic understanding: language is not just communication. It is where the self lives.

The Mother Tongue and the Unconscious
In psychoanalytic theory, language is deeply linked to the unconscious. The mother tongue—the language in which we first formed attachments, heard lullabies, and made sense of joy or fear—is the language of affect. It holds the emotional music of our earliest experiences.

While a second language may suffice in daily life, it rarely holds the same psychic depth. Words in English may come faster, more freely, more viscerally. This is especially true when exploring complex emotional terrain: grief, shame, desire, rage. Without access to this linguistic intimacy, therapy can feel flattened, intellectualized, or subtly self-censored.

As Lacan famously said, „the unconscious is structured like a language.“ But not just any language—your language.

Affect, Nuance, and Emotional Precision
Many high-functioning expats speak their adopted language well. But emotional nuance isn’t about grammar—it’s about texture. A native English speaker may describe their internal world with metaphors, subtext, irony, or culturally embedded reference points that simply don’t translate.

Try describing a childhood humiliation, an erotic fantasy, or a moment of existential dread in your second language. The rawness fades. The language becomes too distant, too tidy. What gets lost is not only precision, but truth.

Therapy works when it reaches what Winnicott called the “true self”—and that self often emerges only when we feel linguistically and emotionally at home.

The Risk of Adaptation
Many English-speaking clients living abroad have adapted admirably. They navigate different cultural codes, switch languages with ease, and perform competence wherever they go. But this very adaptability can become a trap. Over time, the ability to fit in may eclipse the capacity to be authentic.

In therapy, if the client is using a non-native language, this false self may unconsciously dominate. They may stay in roles: polite, articulate, detached. But the deeper material—regression, longing, incoherence—remains just out of reach. Without meaning to, the analytic process becomes compromised.

Speaking in English, then, is not a preference. For many, it is a return to the parts of the self that have not yet adapted, and do not want to.

Therapy as a Return to the Inner Country
There is a particular relief that comes when English-speaking clients return to their native language in therapy. Suddenly, tears come. Dreams emerge. Defenses soften. Not because anything has been forced—but because something in the psyche has come home.

Therapy in English is not about nationalism or linguistic purity. It’s about symbolic resonance. It’s about giving the unconscious the right soil in which to speak. Only then can symptoms become symbols. Only then can the self be reassembled—not in translation, but in truth.

For Those Living Abroad, and Living Between
If you are a native English speaker living abroad, you may find that your inner life feels slightly muted, slightly postponed. You may be “fine,” but something remains unsaid. You may long for a space where your defenses can loosen, where your emotional vocabulary flows without stumbling, and where therapy feels not like a task, but a homecoming.

This is the difference therapy in English can make. It allows the work to go deeper, faster, and more truly. It opens the door not only to insight, but to integration.

A Psychoanalytic Space in Your Language
My practice is dedicated to English-speaking adults who live internationally and seek in-depth, symbolically oriented therapy. This work is not surface-level. It is not about quick fixes or generic advice. It is about slowing down, turning inward, and meeting yourself in the language that shaped you.

If you are ready for that level of depth—and if you are ready to invest in it—I invite you to reach out.

References
Winnicott, D. W. (1960). Ego Distortion in Terms of True and False Self. In The Maturational Processes and the Facilitating Environment. Hogarth Press.
Lacan, J. (1977). Écrits: A Selection. Trans. Alan Sheridan. Routledge.
Bollas, C. (1987). The Shadow of the Object: Psychoanalysis of the Unthought Known. Columbia University Press.