Bilingual Therapy and Mental Health

This post was co-authored by Dr. Aya I. Williams.

The COVID-19 pandemic triggered an unprecedented mental health crisis, one that is still unfolding. The World Health Organization reported that rates of depression and anxiety increased more than 25% worldwide during the pandemic. In the United States, suicide rates that have been declining increased by 4% during that time. For teens and young adults who experienced the sharpest increase, that number is closer to 10%. The American Psychological Association Trends Report has identified the well-being of children and youth as a critical priority for 2023.

Not all were impacted by this mental health crisis equally. While mental health illness is an equal opportunity condition, access to and receiving quality mental health care is still far from equal. Long-existing disparities in accessing and receiving psychological services were further exacerbated when resources became strapped. During the pandemic, racial and ethnic minorities – Black, Hispanic, Asian, and multiracial individuals – bore the mental health burden disproportionally. Often overlooked in such broad racial categories are the lived experiences of individuals who belong to these groups – including the experience of living with multiple languages, dialects, cultures, and identities.

Research on Languages and Emotion

Languages are linked with emotions differently in those who speak more than one linguistic variety. Heritage languages, often learned and used in intimate family and home contexts, tend to be more closely tied to emotional experiences. Second and third languages, often learned in school or work settings, tend to be less emotionally intense. Writer Anaïs Nin described her three languages as the language of her heart, the language of her ancestors, and the language of her intellect.

The ways in which a multilingual’s words unlock feelings are especially consequential for mental health services. In therapy settings, shifting to a heritage language can unleash tears, sighs of anguish, and long-lost memories, whereas shifting to a second language can afford emotional control, rational storytelling, and disclosures of sensitive topics. Changing languages and dialects, known as code-switching, can be a therapeutic tool.

Mental health service delivery in multiple or different languages helps reduce treatment barriers and promote health equity. In a recent study by the Bilingualism Psycholinguistics and Research Laboratory at Northwestern University, the language of multilingual speakers shaped medical beliefs, including how painful or emotionally distressing they found the medical condition to be, what treatments they were willing to accept, and whether they trusted their doctors.

Using Multiple Languages for Healing

By 2030, demands for psychologists who can provide multilingual, multicultural services is predicted to increase by 30%. Psychologists are faced with providing care for linguistically diverse individuals and families through adversities that may include wars, natural disasters, economic downturns, serious illness, and the aftermath of a global pandemic. Overcoming these adversities is not only about the ability to bounce back, but also about the ability to construct a new story, sometimes in a new language. Language is a powerful tool every one of us possesses for creating new meaning in our lives and recasting our identities.

Enabling and empowering words in multiple languages can provide a key to one’s full expression of emotion, healing, and growth. The more words a clinician and a client can use across languages, the more we can harness the power of languages to heal. Through linguistically diverse mental health services, we can reach more currently underserved groups and strive for greater well-being and health equity.

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Professor Viorica Marian is the director of the Bilingualism and Psycholinguistics Research Laboratory at Northwestern University in Chicago and the author of The Power of Language.

Dr. Aya Inamori Williams is a Postdoctoral Fellow in the Bilingualism and Psycholinguistics Research Laboratory at Northwestern University and an advocate for multilingual clinical services.