In Treatment, but in Which Language?

St. Petersburg, Russia.Credit Olga Maltseva/Agence France-Presse — Getty Images

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I have a psychotherapy practice in Madrid, but I often receive email requests for counseling from people in other parts of the world, since I also practice psychotherapy online, via Skype, in several languages: English, French, Italian and Russian. Alex’s email looked like spam, and I nearly deleted it. He wrote in an abrupt English, with neither a greeting nor a sign-off. When I read more closely, I saw that he was seeking therapy, though he didn’t say much else. In his brevity I sensed hesitation, a shade of doubt.

Some hide-and-seek is not unusual in the early phase of the therapy process. Asking for help involves a degree of exposure, which can trigger feelings of shame. For those who are wary about psychotherapy, the online format often appeals, as it avoids the physical, face-to-face confrontation of a classical consulting room and offers the option, or at least the illusion, of anonymity.

I wrote Alex back, asking if he might say a little more.

His second email was a bit longer, perhaps because he now trusted that behind my web page there was in fact a real person available to listen. He alluded to his “continuous work on overcoming my homosexuality.”

At this stage, I would usually invite a client to meet me via Skype to talk at greater length. But I was curious (I am only human): Where was Alex from? Something about his brisk, straightforward and slightly aggressive mode of address felt familiar to me, and I suspected he was Russian. But I am Russian, too. Why didn’t he avail himself of our common native language?

I wrote another email to Alex, listing the various languages in which I practiced therapy, and noting that Russian was my first language. It turned out that he was indeed Russian, and lived in a remote city many miles away from Moscow or St. Petersburg. At that point, we switched to speaking Russian. And we set up a time to talk via Skype.

At the beginning of our first Skype session, I could hear Alex’s voice, but no image of him appeared on my screen. I had anticipated that it wouldn’t be easy for him to unmask. To show me his face, even in a virtual space, was daunting for him. After a few minutes of conversation, I encouraged him to switch on his camera, and his face finally showed up on my screen. What a relief to see the person you are there to help!

I was disappointed by how “normal” he looked. I made a mental note to reflect later on my reaction: Was it prejudice? Was it a reaction to the suspense created by his hiding game? Alex looked like any well-educated, middle-aged Russian man.

He recounted his story, full of heartbreaking details: the stigmatization of a “different” boy, using his mother’s makeup to look “pretty”; the bullying in the schoolyard. He remembered being terrorized. “They called me names,” he said, but he would not tell me which ones. I had to guess, again.

In today’s Russia, prejudice against homosexuals is widespread. There are few support groups. Alex had not been able to find a community in which to address his concerns and conflicts, so he had been reaching out to therapists and hotline counselors abroad — in English.


Talking about himself felt less shameful, I suspected, when done in a foreign language. A non-Russian-speaking therapist would not understand the nuances of the hurtful “names” he had been called. The harm would not be repeated. A foreign language kept him safe, but at the same time, Alex indicated that he had not really been touched by any of these therapeutic encounters. Now — consciously or not — he had made the move to therapy in his native language. 

“Could you tell me what you understood from my email?” Alex asked me. “What is my issue?”

This was a strange test. From his anxious look I sensed that it was important for Alex to hear, in Russian, a description of his suffering. So I laid out what I imagined to be his lifelong struggle with who he was.

The little nasty voices within ourselves usually speak our mother tongue. Alex’s were no exception: They called him “bad” and “sinful.” They used the same insults heard so many times in his childhood. They sounded very much like his drunk uncle, his judgmental sister, his schoolyard tormenters. Alex had internalized these voices, making them part of his own self-image, an unattractive and very fragmented one.

By choosing English as his initial language of self-exploration, Alex had been able to put some distance between himself and the voices in his head, and move toward self-healing. Having been through my own personal therapy in English, I knew how reassuring this linguistic shelter, this “place of hiding,” could be.

Over time, as Alex’s work with me progressed, he would discuss his mixed feelings about conducting therapy in Russian. It was somewhat like coming home, he said, to find your house ransacked by intruders. Russian felt unsafe, at times terrifying. At this stage in our work together, I focused on being there for him, supporting him during this inspection of his “home,” as he cleaned up the mess, restored some order to it, opened the windows to let in some fresh air.

Alex was a courageous person. I was touched by his willingness to keep coming back, to return again and again to the thoughts and feelings stirred up by his homecoming.

The writer André Aciman has reflected on the phenomenon of nonnative speakers who write in English for a living; he calls their English words “priceless buoys with which they try to stay afloat both as professional thinkers and human beings.” Many Russians today, myself included, use English in just this way: as a language of survival, of escape, of independent thinking and unrestricted speech. There are many examples of Russian-speaking writers, most famously Vladimir Nabokov, who used English to tell their stories. When the exile Joseph Brodsky, another example, wrote an essay about his parents after their deaths, he did so in English, he explained, because to “write about them in Russian would be only to further their captivity,” and because, for him, writing in English was “therapeutic.”

But there is also something alien, and alienating, about a borrowed tongue, even if borrowed for the bulk of a lifetime. In the case of Alex, he and I, working together, made it through the arduous journey of re-living and re-describing his life’s experiences, in the original language of his hurt. In the process, he grew a lot, and his narrative slowly changed. He came to accept that he was a complex person, emotionally and physically attracted to members of the same sex, and that he had feminine aspects to himself that he enjoyed, a little girl within who was alive and playful.

Shame stepped back, and Alex could see himself more clearly. I became a sort of mirror in which Alex could examine his newly acknowledged traits. He discovered with surprise not the disgust he expected, but curiosity and acceptance. Sitting in front of our computer screens and studying this reflection together, in our mother tongue, we learned to like him better.