Abstract

The aim of this article is to sort out the role of mother language in psychotherapy. Psychotherapy is a sort of treatment which is used in some of mental disorder. It is a treatment rather than medicine. In psychotherapy, the therapist makes an interpersonal relation with his client and use language to seek out the mental disorder which are being faced by his/ he client. language, the medium of conversation between client and therapist, is used as a tool to convince the client to overcome his problems. The use of an appropriate language may influence the treatment process and can produce desirable results.

Introduction

Psychotherapy, or talk therapy, is a way to help people with a broad variety of mental illnesses and emotional difficulties. (American Psychotherapy Association).It is a sort of treatment of mental disorder rather than medical. Psychotherapy is used to treat the mental illnesses like depression, anxiety, loss, the death of loved one, coping with the daily life. impact of trauma and some of medical illness. The therapist seeks out the problems which are being faced by the client and tries to treat him/her by conversation with him/her. Language is the tool used by therapist to influence the process and practice of his treating method. The therapist use the language which is the native of the client so that he may talk with him frankly. But the mother tongue is more effective in psychotherapy because the client understands it easily and feels free while talking with his therapist.

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

Literature Review

This literature review compiles the important work on the role of mother tongue inn Psychotherapy and discus 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 choice of language in psychotherapy. The choice of language play very important role in treating the mental disorder rather than medical (psychotherapy).The article also describe the reaction of mother tongue and second language in the treatment. This article also briefly describes the importance of paralinguistic feature to examine the effect of language being use as a medium in psychotherapy. There is description of two cases which are treated by a therapist using both language in one case and mother language only in second case. The article also describes conclusion by the therapist that the mother tongue is more effective in psychotherapy than the second language. Because the patient was treated in 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 last 30 years reveals a remarkably small number of reports on effect of language choice of bilingual patients in psychotherapy.

The psychotherapy was first developed in Middle East during the 9th century by the Persian physician and psychological thinker Rhaze (History of Psychotherapy).In west the moral treatment approaches were advent in 18 century. In 19th century, Sigmund Freud first developed his talking cure in Vienna.

According to Freud,” words are the essential of mental treatment “Physical (or Mental) treatment (1905) Breuer’s treatment of Anna. O the first documented psychoanalysis, reveals her use of several languages.

The Choice of Language in Psychotherapy

In therapy sessions ,the language is a primary mean of transmitting information. It is an instrument which is used in treating the psychotic disorder in psychotherapy. Many authors (Buxbaum,E.the role of second language in formation 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 describe that what is the effect of language choice in Psychotherapy. Language is the important tool which influence the 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. Therapist bring his/her heart while entering therapy sessions. The language of the heart are the words and actual langue which therapist use 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 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 don’t involve words. Body language, gestures facial expressions tone and pitch of voice are the example of paralinguistic features.( www.teachingenglish.org.uk/article/paralinguistics).

Paralinguistic features provide additional information about the message you are conveying to your client. It also give the feed back of your verbal therapy. When the client in his uttered words, emphasize the issues that are important for him ,he manifest the tone of voice ,speed and clarity of speech ,it is assumed the information uttered by him are quite reliable. When verbal utterance is dominated by non-verbal content, such as groan sigh and munching and grunting ,it reflect the emotional feelings of the client. The therapist showing empathy with his client use the paralinguistic features, facial expression and eye content to explore the 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 show that the acoustic characteristics of voice can be a source of discrete monitoring of the patient.

Mother Language in Psychotherapy

Mother language play a vital role in the development of personal, social and cultural identity. Cognitive and intellectual development is comparatively faster than second language. Mother tongue help the people to stay connected with their culture which is 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 affect the therapist is expecting. In mother language psychotherapy, he feels home and express his emotions frankly. He un intentionally, can express those aspects of his life which are helpful for therapist to understand the mental status of the patient ,in which he r is careful to express in 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 aspect of 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 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 correlation with adaptation. However, many individuals can learn a new language well but adapt poorly, especially with those neurotic problems. Psychotherapy in mother tongue is very useful for these individuals.

Lukianowciz (Auditory hallucination in polygot 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 language background was dis similar to one and similar to the other. The first was Sindhi in language and second was Punjabi speaking. Sindhi and Punjabi was their first language respectively while the Urdu was a second language for them.

Case 1

The patient a 30 years old lady belong to some rural area of Sindh Province. She can speak Sindhi frequently but cannot speak Urdu as compare to Sindhi.She had 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 dissatisfying with her due to her poor background.

Due to multiple domestic issues, she developed the symptoms of anxiety and severe depression.

In hospital she was discovered with some mental disorder leading to more complexity.

The Psycho therapist initiate her psychotherapy in Urdu language.in her initial episode o therapy, the author observed that his response to therapist was not as to expectations. After some sessions the therapist began to use both language 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 Sahb”.It was interpreted by her that she was serving 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 the much interest in conversation with the therapist. It showed that it was just a professional session which 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 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 hospital in outpatient department.

She was treated for 6 months .Her present complaints were feeling of depression, anxiety and unhappiness with her marriage and life in combined family system.

She was born in rural are of Punjab province and her mother tongue was Punjabi. She had higher secondary education certificate and was teaching as tutor in her home. She considers herself to be a very helpless individual and her family members were not paying her respect. Here husband was also a poor farmer and was unable to live with here in their own isolated house.

The patient was also 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 Urdu language to give the impression that the therapist is considering her some 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 therapist and explored her past in very explaining manners. It was observed that she was more in contact with feelings and important issues.

She improved here treatment more faster and decide to cope with issues in confident.

The duration of therapy sessions last for only six months and the patient was fully improved.

Discussion

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

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

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

Summary

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

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