Therapy With a Non-Native Therapist: Paul’s Perspective

Have you ever wondered what therapy is like for a native speaker of English with a non-native therapist? Read on to discover what Paul* has to say about his personal experience.

Paul* is from England but lives in Spain. He has been working with a Spanish-speaking clinical psychologist for four months. *Name has been changed to maintain confidentiality

1.        How did you find your therapist? What criteria were important to you when choosing a therapist?

I found my therapist online. I went to English-speaking websites and found a clinic that had a very professional website and seemed to have a lot of good reviews.

It was really important that the therapy itself wasn’t online. (Note: Paul attended online sessions with a female British therapist for approximately six months during the pandemic). I feel like a lot of information is lost when people are face-to-face on a two-dimensional screen. I think that a therapist should be able to monitor your body language, your energy levels, your posture, eye contact… and I think that should inform the questions they ask and the evaluation that they make. So, for me, it had to be in person.

And then, the most important thing was that the person was comfortable expressing himself in English. I also wanted the therapist to be male, because I’d worked with a female therapist online in the past and I wanted to vary the experience. I did want someone older than me, but the person I ended up choosing is probably a good seven or eight years younger.

2.        Why might a native speaker of English choose to work with a therapist who speaks English as a second language?

The most important factor is that you’re living in a country where they don’t speak your native language, and you don’t want to do therapy online. Therefore, you are limited with the number of people that you can work with who speak English natively. The likelihood is you’re going to end up with somebody who has a B2 or hopefully a C1 or C2 level. You need to find someone who is available and has the right price. And that’s gonna be pretty hard.

3.        Before your first session, did you have any concerns about communicating with them? If so, how did your therapist address them?

I did think about some concerns, but I didn’t address them. I was aware, in the first session that he wasn’t as proficient as I would have liked. But I mean, he expresses himself perfectly well. And it actually encourages me as a patient to try and be more concise and clear about how I feel. And also, if he says something I don’t understand, it might not be because I don’t understand it, it might just be because I just haven’t processed what he’s said, so it encourages me to ask for more information about what he wants. So it can actually improve communication, thinking about it. 

4.        How would you describe the way your therapist communicates in English?

So, my therapist, I think like probably all good therapists and unlike me, they’re generally concise. I think a bad therapist is not very concise. I think that’s probably the most important quality of a therapist. You have to be able to ask a really clear question that cuts to the heart of something or you have to be able to make an observation that clarifies an issue quickly. One thing that my therapist does that’s really useful is that he’ll use metaphors or an anecdote to explain an idea, which he’s really good at.

My therapist is very calm, while I’m usually not (laughs), he’s really calm… and he’s incredibly empathetic and really compassionate, he’s not at all judgmental, and you never feel like you’re being judged. He can be straight, but he usually says what he thinks.

5.        Have there been moments where language difficulties or mistakes came up, and how were they handled?

He sometimes chooses the wrong word, but I understand what he’s saying from the context, and I’ve got no desire to correct him. And again, if I don’t understand something that he’s saying, I just ask him to explain it again. And actually, it can be really useful. Because maybe you might’ve just assumed something with a native speaker, whereas this way, you get the opportunity to dig a bit deeper.

Often something that I do is I stop and I think a lot about what’s just been said. In a normal conversation, I might sort of rush into an answer or make a new point because my conversation style is quite energetic and enthusiastic. Whereas when he asks a question, I tend to think about it for sometimes a while… like an uncomfortable while (laughs). Which I wouldn’t do with anybody else.

6.        How do you feel when your therapist makes language mistakes?

There have been a couple of occasions where he’s actually gone into full Spanish for a couple of sentences but I think it’s because he wants to say something and he wants to articulate it in Spanish before he says it in English and then he gets an idea across. But I think sometimes there’s a little bit of frustration in him, not frequently, but there’s clearly something that he wants to say but he’s maybe struggling to say it. Or maybe he just assumes my Spanish is a little bit better than it is?

But anyway, I don’t usually get annoyed if he makes a mistake. But I’ve been an English teacher for 15 years, which is going to influence my reaction. I can’t speak on behalf of anybody else.

7.        How did you and your therapist build a strong therapeutic relationship despite any language barriers?

So we do talk about things that aren’t my therapy. Like when I went to a concert, we talked a little bit about the band and live music. There have been diversions in conversation where we’ve talked just a little bit about personal experience or things that we’re interested in which I would just call small talk and is definitely helpful in building a more intimate relationship with somebody. I know there’s a sort of idea that you shouldn’t know anything about your therapist at all but … he’s not forthcoming at all about his life, but if I ask him a question, he’ll answer it and we can share a mutual interest in something and talk about it. I think a blank wall can feel quite cold. I would just find it a bit weird, I think.

8.        What qualities in your therapist stood out and made you feel understood and supported?

So being non-judgmental is probably the most important quality, given the fact that most people are in therapy probably because they have some degree of anxiety about how they’re perceived. Especially in today’s day and age. And I think we’re so subjected to the possibility of being scrutinized and judged in everything that we do all the time whether it be in person or online. Having somebody who you can be really open and frank with, and not feel like that person is judging you is really important.

9.        Have you noticed any cultural differences between yourself and your therapist? How has that affected your experience?

Every session is late (laughs) surprise, surprise.Between 5 and 12 minutes. Every single session. I mean maybe that says something about him not wanting to interrupt people, which is obviously a good quality, or maybe that says something about timekeeping … timekeeping in Spain is …. Relaxed… shall we say?

But you know there are definite cultural differences. I think in the UK, we’re less tapped into family and friends, and the emotions of family and friends because we live more isolated lives. I think he, like a typical Spaniard, has really close ties with all of his personal relationships. And that’s even more difficult for me because I don’t even live in the same country as my close family and friends. So I’m even more isolated.

So I’d say that’s probably a big division between us. But he’s still quite good at understanding where I’m coming from with my issues, even though we probably have different personal lives.

10.  What would you say to someone who might be hesitant to work with a therapist whose first language isn’t English?

I would say not to have any prejudice and to sign up for your first session, but knowing that the first session is always a trial, for any business, even for an English teacher! It’s always a trial. So just work out in that first session if you have a good relationship with that person. If the person is attentive, listens carefully, asks you interesting questions, makes an observation about your behaviour based on the way you are behaving in that moment and seems fully capable of expressing themselves… I would say there’s no problem at all!  

11.  As an ex-English teacher, how do you think language impacts therapy?

I think therapy is all about language. I mean with the obvious metaphorical element of body language, so reading people. But I think therapy is about talking. It’s about articulating feelings and sometimes abstract ideas to make them understandable. Spoken language is the heart of the whole experience, for me. For me personally, I think the trick is to not use language to trick yourself into certain things. Like it’s very easy to avoid stuff that you don’t want to talk about, like to deviate or digress. You do have to be very good at language. And I’m not sure many therapists realize how important language is, cause they don’t come from a linguistic background. They aren’t phonologists. They haven’t taught language or studied the nature of it.

12.  Overall, how would you describe your experience with your therapist?

Right now, I don’t think it would be any better or worse than working with someone who is natively English. It’s very important for me to work with a qualified and experienced professional, that’s more important than whether they’re a native speaker or not.

13.  What would you say to a therapist who might be hesitant to offer therapy sessions in English?

I’d say that you have to challenge yourself in every profession, in order to grow or move forward. You have to take chances. So there’s no reason why you shouldn’t do it.

14.  Mostly, therapists who speak other languages are really anxious about working with native speakers of English because they feel they are going to be perceived in a certain way. What would you say to that?

I think more often than not (laughs) because we’re so self-obsessed I think most people in therapy are thinking about how they come across to the therapist. I’ll be honest- it’s like do I come across as a f*****g lunatic? Um… yeah, I think that’s a problem we all have in the modern age.

I think we’re very image-conscious and how we’re perceived is very important to all of us individually. And I would imagine that at the very least, the person sitting across from you, unless they’re a sociopath, is thinking the exact same thing as you, if not, more so. Cause it’s them that has to expose themselves, not the therapist…