Starting Therapy in English When You're From another country

What to Expect and Why It’s Okay to Be Nervous

Starting therapy is a brave and important step. Doing so in a second (or third) language can feel like an even bigger challenge. If you’re from another country, like Germany or Spain and living abroad or simply prefer to speak English in a therapeutic setting online, you’re not alone. More and more people are choosing to explore therapy across cultures and languages. It can be incredibly enriching, but it also comes with unique questions and feelings.

Why Therapy Feels Different in English

Language carries not just meaning, but emotion, culture, and habits. If you're from Germany, you may be used to a more direct or structured communication style. In Spain, emotional expression might be more familiar and culturally encouraged. In English-speaking therapy, especially if you're working with someone trained in a different therapeutic tradition, the tone might feel softer, more exploratory, or simply “different.” That’s okay. In fact, using a second language in therapy can help you see things from a new angle. It can allow emotional expression that might feel “stuck” in your native language. It might even help you access parts of yourself that feel safer or more flexible in English.

Common Thoughts and Fears

“What if I don’t find the right words?” Your therapist understands. You don’t need perfect grammar to express deep emotions. Silence, gestures, and simple words are enough. Therapy isn’t a language test, it’s a space for you to be human.

“Will they understand my cultural background?” A skilled therapist will be curious and respectful. You’re allowed to bring your full cultural self into the room. In fact, that can be an important part of the healing process. I have an open mindset, with heritage from both Germany who taught me about german tales and culture. By living in Spain I strive to be part of the culture here. Maybe you will show me new aspects that I didn´ know before. 

“Is it okay to mix languages?” Absolutely. Many bilingual clients switch between languages in sessions. Sometimes a feeling is best described in the native language and probably I will understand, even if the rest of the session is in English. That’s not only okay, it’s often therapeutic.

What You Might Gain

Therapy is a journey toward yourself, no matter which language you take the journey in. Be patient with yourself. You don’t need to “perform” in therapy. Use your own words even if they’re mixed. Emotion doesn’t need translation. Ask questions. If something feels unclear, cultural or linguistic, talk about it. And sometimes, speaking in a second language can open doors to healing in ways you didn’t expect. So if don´t have swedish or english as your first language, and considering therapy in English: it’s okay to feel uncertain. It’s okay to not have all the words. What matters most is that you’ve show up and that you’re willing to begin.