Bilinguals in Psychotherapy: Language as an Emotional Barrier* L U IS R . M A R C O S , M .D .f New York, N.Y. The English-speaking clinician frequently evaluates and treats patients whose mother tongue is not English. This paper summarizes some of the evidence supporting an emotional-detachment effect associated with speaking in a second language and describes its implications for the psychotherapy of this population. IN T R O D U C TIO N
Patients whose mother tongue is not English comprise a significant pro portion of the psychiatric population. The English-speaking clinician must frequently evaluate and treat patients who lack full command of English. True communication is hampered by this language barrier. Recently, it has been demonstrated that this situation can introduce significant distor tions in the psychiatric evaluation of patients whose knowledge of English is limited. In effect, the psychiatric ratings of a group of schizophrenic patients whose native tongue was Spanish disclosed more psychopathology when the patients were interviewed in English than when they were inter viewed in Spanish (1). The switch in the language of interviewing affected the content as well as the infracontent or paralinguistic component of the verbal channel. For the purpose of this paper, I would like to limit my emphasis to the fact that in their second language patients were found to be significantly more emotionally withdrawn. Specifically, the clinicians in the experiment rated the degree to which the patients gave the impression of failing to be in emotional contact with the interviewer and the interview situation (2). This paper focuses on the aspect that the information-processing mech anisms involved in the speaking of a language which is not the primary tongue may function as an impediment to the emotional expression and affective involvement of the person. The language barrier applies to sub ordinate bilinguals or bilinguals who show a marked difference concerning competence in their two languages. Since patients’ capacity to communi * This study was supported in part by National Institute of Mental Health Re search Fellowship Award No. 1F22MH01827-01. t Dr. Marcos is Fellow, American Academy of Psychoanalysis and Assistant Pro fessor of Psychiatry, New York University Medical School, 550 First Avenue, New York, New York 10016. 552
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cate emotion is a fundamental aspect of the psychiatric evaluation, and a degree of affective involvement constitutes a necessary ingredient in most forms of psychotherapy, the effect of the language barrier on the commu nication and integration of affect appears to be a problem worthy of con sideration. The implications of speaking a second language during psychotherapy, particularly psychoanalysis, have received some attention from clinicians (3-9). Many of the studies :have focused on the problems presented by proficient or “true” bilinguals who display a native-speaker’s mastery of both languages and possess language independence or the capacity to ac quire, maintain, and utilize two independent systems of language (10). There are, however, two clinical reports in the literature which concern themselves with the essentially different problems of subordinate or incipient bilinguals who appear to have an unitary language code since they utilize translation equivalents when speaking in their second language (11, 12). In regard to the issue of the emotional involvement of these patients, the studies agree that speaking in a foreign tongue produces affective detachment in the patient. Basically, this effect is explained as the result of second-language words carrying less emotional components since the experiences during which these words were acquired were of a more “peripheric” nature than the experiences concomitant with the learning of mother-tongue words. This explanation is related to the psychoanalytic hypothesis which considers that experiences, as well as unconscious impulses, are cathected by words in the process of verbalization (13). From a different conceptual framework, psycholinguistic research sup ports the notion that second-language words are less “meaningful” and “provocative” than mother-tongue words (14). Generally, this dimension is measured by the associational responses to stimulus words in the two languages of the subordinate-bilingual individual. Now I would like to focus on the evidence suggesting that the emotional detachment is associated with the more intricate second-language encoding process. E N C O D I N G W O R K IN A S E C O N D L A N G U A G E
Generally, by encoding process we mean the mechanisms whereby a speaker’s ideas, feelings, images, and so forth, become coded into intelligible sounds in a given language (15). This process depends upon a lexical factor or number of words available to the person in a given language; a syntactical factor or capacity for grammatical ordering; and a phonetic fac tor or facility to articulate or pronounce the words. In addition, bilinguals of the subordinate type utilize translation processes as part of their encoding work in the second language (11, 12, 16, 17). Evidently, in comparison with their first language subordinate bilinguals have to perform a more
554
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elaborate and difficult encoding work in their second language which in my view constitutes the main factor responsible for the emotional detach ment observed by clinicians. The following is a schematic presentation of first- and second-language encoding process steps: First Language IMAGE — 7°rd — grammatical _ articulation _ W O r d selection ordering ' Second' Language IMAGE —
1st Language
1st Language
word — grammatical — selection ordering 2nd Language grammatical — j . ordering
2nd Language
translation equivalents
. — W ORD articulation
It; is likely that, since the extra cognitive and attentional demands placed upon the subordinate bilingual determine the displacement and concen tration of affective energy, the patient invests the affect in how he says things, and not in what he is saying. Before considering the implications of this phenomenon for psychotherapy I would like to mention some recent empirical findings which support this hypothesis. This first study (18) reexamined the findings that Spanish-speaking schizophrenic patients interviewed in English were rated by clinicians as significantly more emotionally withdrawn (1). The patients were sub ordinate bilinguals with a clear deficit in the English language. To deter mine the differences between the first- and second-language interviews for each patient two bilingual psychiatrists compared the verbal content and ijifracontent vocalizations of the English and Spanish interviews for each patient. Each pair of interviews was judged for differences and similarities in content syntax, ajid infracontent (as speech rate, silent pauses, and speech disturbances). The results of this analysis revealed in the second-language interviews a number of content and infracontent aspects of talking behavior which derives from the special problems posed by the language barrier, specifically, the; encoding process. Thus, in the second language the patients’ verbal productions were shorter, of simpler grammatical structure, and showed translation-process difficulties such as ‘^language mixing” or first-language word intrusions during the second-language interviews. Furthermore, the assumption that encoding work difficulties create the impression of detach ment was strengthened by analysis of the infracontent or vocal component of the verbal productions supported. The analysis of the second-language
BIAINGUALS IN l> S Y G H O T H iS A P y
55ft
interview showed more frequent speech disturbances and longer silent parses, related to encoding difficulty and the speaker’s uncertainty associated with cognitive decision-making in relation to verbalization (19-21). This ex periment, however, presents two important shortcomings which complicate any final conclusion in regard to emotional withdrawal and second-language encoding work: one, the possibility that these findings are associated with the intrinsic characteristics of the particular languages involved cannot be ruled out; two, there is evidence that the psychopathology of schizophrenic pa tients affects verbal behavior. The next study had the objective of investigating relations between kinetic behavior and encoding work in subordinate bilinguals. The experi ment may be considered as an experimental analogue of the common sit uation in psychotherapy in which patients are required to verbalize freely about particular experiences. Only normal subjects were included; four were English-speaking subordinate bilinguals with Spanish as their second language, and four were bilinguals whose primary language was Spanish, and English their second one. Briefly, the procedure consisted of having these bilinguals verbalize similar topics in their two languages. These monologues were recorded on videotape and analyzed by independent raters. The analysis of kinetic behavior was carried out following the coding sys tem developed by Freedman et al. (22, 23). This method, which has been extensively utilized in clinical as well as in experimental work has the ad vantage of having been developed within the conceptual framework that considers nonverbal communication as a participant component of central information processing mechanisms, principally, the organization of thought and the encoding work (22-26). The results of this study demonstrate that both groups of opposite sub ordinate bilinguals during their verbalization in the second language utilized significantly more movements of the type known to reflect active encoding work: Speech Primary Movements. These consist of speech-related hand motor activity, subservient to the spoken word, closely paralleling the formal and rhythmic properties of speech. Punctuating which has a beat quality but does not carry a content of its own is one kind of Speech Primacy Move* ment. Typically, these movements occur in bursts and may take many forms, for example, light fist pounding and vertical movement of the hands and arms. Another kind is the minor qualifiers: repetitive gestures which appear to qualify what is being said but which contain no content prop erty. These movements tend to be small, involving often simply turning of the wrists. A striking finding of; this study, however, was the fact that in their first .language these subordinate bilinguals produced significantly more move·! menfts which are known to be linked to emotional states such as tension and
556
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distress: Continuous Body Focused Movements. These movements consist of repetitive continuous motions which entail the touching, soothing, and stroking of some part of the body or its adornments by the hand. These hand movements are apparently unrelated to speech and the interpretation that this activity is related to affective states has an empirical base. Thus, such movements may be induced by situational stress (27) or arise in “en dogenous” states such as depression or anxiety (28). Since the verbal content of the subjects’ productions was not fundamen tally different, these results suggest that the nonverbal activity of subordinate bilinguals reflects more encoding process work when speaking in their second language. Conversely, in their first language, when communicative de mands are reduced, internal-tension states become evident in kinetic be havior. The fact that these significant findings apply equally to both groups of opposite subordinate bilinguals, indicates that the changes in non verbal activity when speaking a second language are not associated with intrinsic characteristics of a particular language, but rather are consequences of the linguistic deficit or language barrier. The findings of the two studies reviewed give support to the original proposition that the demanding en coding work of subordinate bilinguals’ second language may constitute an impediment for the emotional inolvement of the person. One can now ask what are the implications of this phenomenon for the process of psycho therapy? IM P L IC A T IO N S FOR P S Y C H O T H E R A P Y
In psychotherapy with subordinate bilinguals the language barrier may affect the therapeutic process in diverse ways, retarding as well as facil itating. In the following I will consider the problems and some of the opportunities specific to the psychotherapy of subordinate bilinguals when it is conducted in the patients’ second language. Particularly, I shall focus on the detachment effect of the language barrier. The issues to be consid ered may be particularly relevant to dynamic forms of psychotherapy that nurture self-knowledge, catharsis, experiential insight, and the like. Because of space limitations I will not introduce case histories; clinical illustrations can be found in some of the literature reviewed (5-9, 18). Unintegration of affects and experiences When speaking across the language barrier, a primary consequence of the bilingual’s deflection of both attention and the affective component of the idea in verbalization towards the more demanding second-language en coding work will be the splitting or lack of integration of experience/affect. Frequently the patient manifests this effect by verbalizing emotionally charged material without displaying the expected emotion. This diminu
BILINGUALS IN PSY C H O T H E R A PY
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tion in the affective tone regarding events being verbalized may cause cer tain experiences to remain vague and unreal for the patient as well as the therapist. Affects may also be blocked, and the patient may have significant difficulty in benefiting from therapeutic processes such as catharsis and abreaction. Verbalization of feelings may, then, turn out to be a mere intellectual task, arduous as it may be, which brings little relief to the pa tient. Other implications are die displacement and postponement of affects which frequently prevent the recognition of their motivating connections. At times, the persistent blocking of affect and the lack of gratifying emo tional release give rise to feelings of frustration in the patient which sub sequently set in motion mechanisms of regression and even acting out. This problem seems to occur with special frequency in regard to the therapistpatient relationship. Since intense positive or negative feelings toward the therapist cannot be satisfactorily expressed through second-language verbal ization, patients tend to displace them or to block them; not infrequently, these feelings are manifested in explosive episodes or by acting out in the therapeutic relationship. Reinforcement of obsessive resistances A secondary implication of the language-barrier detachment factor is the facilitation of obsessive mechanisms of defense. It occurs most frequently in patients with obsessive traits. In fact, it appears that these patients cap italize in the extra cognitive demands of the second-language encoding work by making supplementary use of intellectualization, repetition, and reaction formation which determine their further evasion from emotional involve ment. These defense mechanisms become most evident in patients’ lan guage expressed by their constant preoccupation with the diction (i.e., con cern about wording, grammatical construction, pronunciation, and so forth) and the habitual use of clichés, “sterile language,” and other forms of avoid ance. Protective detachment This facilitation effect of the language barrier has been mentioned by Caruso (9). It is based on the notion that there are important areas of the bilingual’s intrapsychic world that being too threatening and emotionally charged, may only be accessible through the language-barrier detachment. The bilingual patient, then, may be able to reveal in the second language experiences which in the first language would have remained unavailable. Role of the therapist A therapist who is unfamiliar with the detachment effect of the language
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barrier may easily misevaluate bilingual patients’ emotional responses and resistances by neglecting their possible linkage to the encoding process. It is crucial, therefore, that clinicians be made aware of the significance of this linguistic factor. The problems of nonintegration of affect and obsessive resistances may be reduced if the psychotherapist is careful to assess bilingual patients’ language command and their degree of difficulty in carrying out the encoding processes in the second language. This language evaluation will permit the therapist to estimate the severity of the language barrier and, subsequently, to anticipate its possible distorting effects in regard to the pa tient’s specific treatment goals, as well as to plan strategies to minimize, or even capitalize, on this linguistic phenomenon. Finally, it is important for the therapist to realize that, by having two language systems, subordinate bilingual patients offer unique opportunities to study the relations between language, imagery, verbalization processes, and the expression of emotions that are currently thought to be essential to the understanding of dynamic psychotherapy process but are rather inacces sible to analysis in the monolingual patient. SUM M A RY
Evidence has been presented supporting the existence of an emotionaldetachment effect caused by the deflection of both attention and affect toward the more demanding second-language encoding tasks in bilinguals’ communication across the language barrier. The bilingual patients’ dif ficulty in integrating emotions and experiences, the displacement and block ing of affects, and the reinforcement of obsessive resistances may give rise to misinterpretations and distortions of their problems. Conversely, the lan guage barrier may facilitate the verbalization of highly charged material by patients who feel “protected” by the linguistic detachment. It is important that psychotherapists be sensitized to the consequences of these languagebarrier detachment factors in order to minimize their obstructing effects, as well as take advantage of the unique opportunities that they offer to the study of mental processes. R EFE R E N C E S
1. Marcos, L. R., Alpert, M., Urcuyo, L., and Kesselman, M. The Effect of In terview Language on the Evaluation of Psychopathology in Spanish-American Schizophrenic Patients. Am. J. Psychiat., 130:549, 1973. 2. Overall, J. E. and Gorham, D. R. The Brief Psychiatric Rating Scale. Psychol. Rep., 10:799, 1962. 3. Velikovsky, I. Can a Newly Acquired Language Become the Speech of the Unconscious? Psychoanal. Rev., 21:329, 1934. 4. Stengel, E. On Learning a New Language. Int. J. Psychoanal., 20:471, 1939. 5. Buxbaum, E. The Role of the Second Language in the Formation of the Ego and Superego. Psychoanal. Q., 18:279, 1949.
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6. Greenson, R. R. The Mother Tongue and the fytother. Int. /, Psyehoanal., . 31:18, 1950. . .' . '....... / ' , ... 7. Krapf, E. The Choice of Language in Polyglot Psychoanalysis. Psyehoanal. Q., .......................... 24:343, 1955. 8. Lagache, D. Sur le Polyglottisme dans 1’analyse. Psychanal., 1:167, 1956. 9. Caruso, I. A. and Duque, R. T. El Problema de Psicoanâlisis en Lengua Extranjera. Arch. Estud. Psicoanal. Psicol. Méd., 3:7, 1966. 10. Kolers, P. A. Bilingualism and Information Processing. Sei. Am., 218:78, .......................... 1968. 11. Diebold, A. R. The Consequences of Early Bilingualism in Cognitive Develop ment and Personality Formation. In The Study of Personality. Norberck, E., Price Williams, D. and McCord, W. M. Eds. Holt, Rinehart & Winston, New York, 1967, pp. 218-245. 12. Goggin, J. and Wickens, D. D. Proactive Interference and Language Change in Short-Term Memory. /. Verb. Learn. Verb. Behao., 10:453, 1971. 13. Balkanyi, C. On Verbalization. Int. J. Psyehoanal., 46:64, 1964. 14. Lambert, W. A. Developmental Aspects of Second-language Acquisition: I. Associational Fluency, Stimulus Provocativeness, and Word Order Influence. J. Soc. Psychol., 43:83, 1956. 15. Ervin, S. and Osgood, C. E. Second Language Learning and Bilingualism. In Psycholinguistics: A Survey of Theory and Research Problems. Osgood, C. E. and Sebeok, T. A. Eds. Indiana University Publications, 10:139, 1954. 16. Maclay, H. and Ware, E. E. Cross-cultural Use of Semantic Differential. Behav. Sei., 6:185, 1961. 17. Tanaka, Y., Oyama, T., and Osgood, C. E. A Cross-cultural and Cross-Con cept Study of the Generality of Semantic Spaces. /. Verb. Learn. Verb. Behav., 2:392, 1963. 18. Marcos, L. R., Urcuyo, L., Kesselman, M., and Alpert, M. The Language Barrier in Evaluating Spanish-American Patients. Arch. Gen. Psychiat., 29: 655, 1973. 19. Lounsbury, F. G. Transitional Probability, Linguistic Structure, and Systems of Habit-family Hierarchies. In Psycholinguistics: A Survey of Theory and Re search Problems. Osgood, C. E. and Sebeok, T. A. Eds. Indiana University Publications, 10:93, 1954. 20. Boomer, D. S. and Laver, J. D. M. Slips of the Tongue. Brit. J. Disord. Commun., 3:2, 1968. 21. Siegman, A. W. and Pope, B. Studies in Dyadic Communication. Pergamon Press, New York, 1972. 22. Freedman, N. and Hoffman, S. P. Kinetic Behavior in Altered Clinical States: An Approach to the Objective Analysis of Motor Behavior during Clinical Interviews. Percept. Mot. Skills, 24:525, 1967. 23. Freedman, N. The Analysis of Movement Behavior during Clinical: Interviews. In Studies in Dyadic Communication. Siegman, A. and Pope, B. Eds. Pergamon Press, New York, 1972, pp. 153-175. 24. Freedman, N., O’Hanlon, J., Oltman, P., and Witkin, H. A. The Imprint of Psychological Differentiation on Kinetic Behavior in Varying Communicative Contexts. J. Abnorm. Psychol., 79:239, 1972. 25. Freedman, N., Blass, T., Rifkin, A., and Quitkin, F. Body Movements and the Verbal Encoding of Aggressive Affect. /. Pers. Soc. Psychol., 26:72, 1973. 26. Grand, S., Freedman, N., and Steingart, I. A Study of the Representation of
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Objects in Schizophrenia. /. Am. Psychoanal. Ass., 21:399, 1973. 27. Mahl, G. Gestures and Body Movements in Interviews. In Research in Psy chotherapy. Shlien, J. Ed. American Psychological Association, Washington, D.C., 1968, pp. 295-343. 28. Steingart, I, and Freedman, N. The Organization of Body-focused Kinetic Be havior and Language Construction in Schizophrenic and Depressed States. In Psychoanalysis and Contemporary Science. Spence, D. P. Ed. Interna tional University Press, New York, 1976, pp. 423-450.
Patients whose mother tongue is not English comprise a significant pro portion of the psychiatric population. The English-speaking clinician must frequently evaluate and treat patients who lack full command of English. True communication is hampered by this language barrier. Recently, it has been demonstrated that this situation can introduce significant distor tions in the psychiatric evaluation of patients whose knowledge of English is limited. In effect, the psychiatric ratings of a group of schizophrenic patients whose native tongue was Spanish disclosed more psychopathology when the patients were interviewed in English than when they were inter viewed in Spanish (1). The switch in the language of interviewing affected the content as well as the infracontent or paralinguistic component of the verbal channel. For the purpose of this paper, I would like to limit my emphasis to the fact that in their second language patients were found to be significantly more emotionally withdrawn. Specifically, the clinicians in the experiment rated the degree to which the patients gave the impression of failing to be in emotional contact with the interviewer and the interview situation (2). This paper focuses on the aspect that the information-processing mech anisms involved in the speaking of a language which is not the primary tongue may function as an impediment to the emotional expression and affective involvement of the person. The language barrier applies to sub ordinate bilinguals or bilinguals who show a marked difference concerning competence in their two languages. Since patients’ capacity to communi * This study was supported in part by National Institute of Mental Health Re search Fellowship Award No. 1F22MH01827-01. t Dr. Marcos is Fellow, American Academy of Psychoanalysis and Assistant Pro fessor of Psychiatry, New York University Medical School, 550 First Avenue, New York, New York 10016. 552
BILINGUALS IN PSY C H O T H ER A PY
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cate emotion is a fundamental aspect of the psychiatric evaluation, and a degree of affective involvement constitutes a necessary ingredient in most forms of psychotherapy, the effect of the language barrier on the commu nication and integration of affect appears to be a problem worthy of con sideration. The implications of speaking a second language during psychotherapy, particularly psychoanalysis, have received some attention from clinicians (3-9). Many of the studies :have focused on the problems presented by proficient or “true” bilinguals who display a native-speaker’s mastery of both languages and possess language independence or the capacity to ac quire, maintain, and utilize two independent systems of language (10). There are, however, two clinical reports in the literature which concern themselves with the essentially different problems of subordinate or incipient bilinguals who appear to have an unitary language code since they utilize translation equivalents when speaking in their second language (11, 12). In regard to the issue of the emotional involvement of these patients, the studies agree that speaking in a foreign tongue produces affective detachment in the patient. Basically, this effect is explained as the result of second-language words carrying less emotional components since the experiences during which these words were acquired were of a more “peripheric” nature than the experiences concomitant with the learning of mother-tongue words. This explanation is related to the psychoanalytic hypothesis which considers that experiences, as well as unconscious impulses, are cathected by words in the process of verbalization (13). From a different conceptual framework, psycholinguistic research sup ports the notion that second-language words are less “meaningful” and “provocative” than mother-tongue words (14). Generally, this dimension is measured by the associational responses to stimulus words in the two languages of the subordinate-bilingual individual. Now I would like to focus on the evidence suggesting that the emotional detachment is associated with the more intricate second-language encoding process. E N C O D I N G W O R K IN A S E C O N D L A N G U A G E
Generally, by encoding process we mean the mechanisms whereby a speaker’s ideas, feelings, images, and so forth, become coded into intelligible sounds in a given language (15). This process depends upon a lexical factor or number of words available to the person in a given language; a syntactical factor or capacity for grammatical ordering; and a phonetic fac tor or facility to articulate or pronounce the words. In addition, bilinguals of the subordinate type utilize translation processes as part of their encoding work in the second language (11, 12, 16, 17). Evidently, in comparison with their first language subordinate bilinguals have to perform a more
554
A M E R IC A N JO U R N A L· OF P S Y C H O T H E R A P Y
elaborate and difficult encoding work in their second language which in my view constitutes the main factor responsible for the emotional detach ment observed by clinicians. The following is a schematic presentation of first- and second-language encoding process steps: First Language IMAGE — 7°rd — grammatical _ articulation _ W O r d selection ordering ' Second' Language IMAGE —
1st Language
1st Language
word — grammatical — selection ordering 2nd Language grammatical — j . ordering
2nd Language
translation equivalents
. — W ORD articulation
It; is likely that, since the extra cognitive and attentional demands placed upon the subordinate bilingual determine the displacement and concen tration of affective energy, the patient invests the affect in how he says things, and not in what he is saying. Before considering the implications of this phenomenon for psychotherapy I would like to mention some recent empirical findings which support this hypothesis. This first study (18) reexamined the findings that Spanish-speaking schizophrenic patients interviewed in English were rated by clinicians as significantly more emotionally withdrawn (1). The patients were sub ordinate bilinguals with a clear deficit in the English language. To deter mine the differences between the first- and second-language interviews for each patient two bilingual psychiatrists compared the verbal content and ijifracontent vocalizations of the English and Spanish interviews for each patient. Each pair of interviews was judged for differences and similarities in content syntax, ajid infracontent (as speech rate, silent pauses, and speech disturbances). The results of this analysis revealed in the second-language interviews a number of content and infracontent aspects of talking behavior which derives from the special problems posed by the language barrier, specifically, the; encoding process. Thus, in the second language the patients’ verbal productions were shorter, of simpler grammatical structure, and showed translation-process difficulties such as ‘^language mixing” or first-language word intrusions during the second-language interviews. Furthermore, the assumption that encoding work difficulties create the impression of detach ment was strengthened by analysis of the infracontent or vocal component of the verbal productions supported. The analysis of the second-language
BIAINGUALS IN l> S Y G H O T H iS A P y
55ft
interview showed more frequent speech disturbances and longer silent parses, related to encoding difficulty and the speaker’s uncertainty associated with cognitive decision-making in relation to verbalization (19-21). This ex periment, however, presents two important shortcomings which complicate any final conclusion in regard to emotional withdrawal and second-language encoding work: one, the possibility that these findings are associated with the intrinsic characteristics of the particular languages involved cannot be ruled out; two, there is evidence that the psychopathology of schizophrenic pa tients affects verbal behavior. The next study had the objective of investigating relations between kinetic behavior and encoding work in subordinate bilinguals. The experi ment may be considered as an experimental analogue of the common sit uation in psychotherapy in which patients are required to verbalize freely about particular experiences. Only normal subjects were included; four were English-speaking subordinate bilinguals with Spanish as their second language, and four were bilinguals whose primary language was Spanish, and English their second one. Briefly, the procedure consisted of having these bilinguals verbalize similar topics in their two languages. These monologues were recorded on videotape and analyzed by independent raters. The analysis of kinetic behavior was carried out following the coding sys tem developed by Freedman et al. (22, 23). This method, which has been extensively utilized in clinical as well as in experimental work has the ad vantage of having been developed within the conceptual framework that considers nonverbal communication as a participant component of central information processing mechanisms, principally, the organization of thought and the encoding work (22-26). The results of this study demonstrate that both groups of opposite sub ordinate bilinguals during their verbalization in the second language utilized significantly more movements of the type known to reflect active encoding work: Speech Primary Movements. These consist of speech-related hand motor activity, subservient to the spoken word, closely paralleling the formal and rhythmic properties of speech. Punctuating which has a beat quality but does not carry a content of its own is one kind of Speech Primacy Move* ment. Typically, these movements occur in bursts and may take many forms, for example, light fist pounding and vertical movement of the hands and arms. Another kind is the minor qualifiers: repetitive gestures which appear to qualify what is being said but which contain no content prop erty. These movements tend to be small, involving often simply turning of the wrists. A striking finding of; this study, however, was the fact that in their first .language these subordinate bilinguals produced significantly more move·! menfts which are known to be linked to emotional states such as tension and
556
A M E R I C A N J O U R N A L OF P S Y C H O T H E R A P Y
distress: Continuous Body Focused Movements. These movements consist of repetitive continuous motions which entail the touching, soothing, and stroking of some part of the body or its adornments by the hand. These hand movements are apparently unrelated to speech and the interpretation that this activity is related to affective states has an empirical base. Thus, such movements may be induced by situational stress (27) or arise in “en dogenous” states such as depression or anxiety (28). Since the verbal content of the subjects’ productions was not fundamen tally different, these results suggest that the nonverbal activity of subordinate bilinguals reflects more encoding process work when speaking in their second language. Conversely, in their first language, when communicative de mands are reduced, internal-tension states become evident in kinetic be havior. The fact that these significant findings apply equally to both groups of opposite subordinate bilinguals, indicates that the changes in non verbal activity when speaking a second language are not associated with intrinsic characteristics of a particular language, but rather are consequences of the linguistic deficit or language barrier. The findings of the two studies reviewed give support to the original proposition that the demanding en coding work of subordinate bilinguals’ second language may constitute an impediment for the emotional inolvement of the person. One can now ask what are the implications of this phenomenon for the process of psycho therapy? IM P L IC A T IO N S FOR P S Y C H O T H E R A P Y
In psychotherapy with subordinate bilinguals the language barrier may affect the therapeutic process in diverse ways, retarding as well as facil itating. In the following I will consider the problems and some of the opportunities specific to the psychotherapy of subordinate bilinguals when it is conducted in the patients’ second language. Particularly, I shall focus on the detachment effect of the language barrier. The issues to be consid ered may be particularly relevant to dynamic forms of psychotherapy that nurture self-knowledge, catharsis, experiential insight, and the like. Because of space limitations I will not introduce case histories; clinical illustrations can be found in some of the literature reviewed (5-9, 18). Unintegration of affects and experiences When speaking across the language barrier, a primary consequence of the bilingual’s deflection of both attention and the affective component of the idea in verbalization towards the more demanding second-language en coding work will be the splitting or lack of integration of experience/affect. Frequently the patient manifests this effect by verbalizing emotionally charged material without displaying the expected emotion. This diminu
BILINGUALS IN PSY C H O T H E R A PY
557
tion in the affective tone regarding events being verbalized may cause cer tain experiences to remain vague and unreal for the patient as well as the therapist. Affects may also be blocked, and the patient may have significant difficulty in benefiting from therapeutic processes such as catharsis and abreaction. Verbalization of feelings may, then, turn out to be a mere intellectual task, arduous as it may be, which brings little relief to the pa tient. Other implications are die displacement and postponement of affects which frequently prevent the recognition of their motivating connections. At times, the persistent blocking of affect and the lack of gratifying emo tional release give rise to feelings of frustration in the patient which sub sequently set in motion mechanisms of regression and even acting out. This problem seems to occur with special frequency in regard to the therapistpatient relationship. Since intense positive or negative feelings toward the therapist cannot be satisfactorily expressed through second-language verbal ization, patients tend to displace them or to block them; not infrequently, these feelings are manifested in explosive episodes or by acting out in the therapeutic relationship. Reinforcement of obsessive resistances A secondary implication of the language-barrier detachment factor is the facilitation of obsessive mechanisms of defense. It occurs most frequently in patients with obsessive traits. In fact, it appears that these patients cap italize in the extra cognitive demands of the second-language encoding work by making supplementary use of intellectualization, repetition, and reaction formation which determine their further evasion from emotional involve ment. These defense mechanisms become most evident in patients’ lan guage expressed by their constant preoccupation with the diction (i.e., con cern about wording, grammatical construction, pronunciation, and so forth) and the habitual use of clichés, “sterile language,” and other forms of avoid ance. Protective detachment This facilitation effect of the language barrier has been mentioned by Caruso (9). It is based on the notion that there are important areas of the bilingual’s intrapsychic world that being too threatening and emotionally charged, may only be accessible through the language-barrier detachment. The bilingual patient, then, may be able to reveal in the second language experiences which in the first language would have remained unavailable. Role of the therapist A therapist who is unfamiliar with the detachment effect of the language
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barrier may easily misevaluate bilingual patients’ emotional responses and resistances by neglecting their possible linkage to the encoding process. It is crucial, therefore, that clinicians be made aware of the significance of this linguistic factor. The problems of nonintegration of affect and obsessive resistances may be reduced if the psychotherapist is careful to assess bilingual patients’ language command and their degree of difficulty in carrying out the encoding processes in the second language. This language evaluation will permit the therapist to estimate the severity of the language barrier and, subsequently, to anticipate its possible distorting effects in regard to the pa tient’s specific treatment goals, as well as to plan strategies to minimize, or even capitalize, on this linguistic phenomenon. Finally, it is important for the therapist to realize that, by having two language systems, subordinate bilingual patients offer unique opportunities to study the relations between language, imagery, verbalization processes, and the expression of emotions that are currently thought to be essential to the understanding of dynamic psychotherapy process but are rather inacces sible to analysis in the monolingual patient. SUM M A RY
Evidence has been presented supporting the existence of an emotionaldetachment effect caused by the deflection of both attention and affect toward the more demanding second-language encoding tasks in bilinguals’ communication across the language barrier. The bilingual patients’ dif ficulty in integrating emotions and experiences, the displacement and block ing of affects, and the reinforcement of obsessive resistances may give rise to misinterpretations and distortions of their problems. Conversely, the lan guage barrier may facilitate the verbalization of highly charged material by patients who feel “protected” by the linguistic detachment. It is important that psychotherapists be sensitized to the consequences of these languagebarrier detachment factors in order to minimize their obstructing effects, as well as take advantage of the unique opportunities that they offer to the study of mental processes. R EFE R E N C E S
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