There is a phrase from my mother tongue that lives at the center of how I practice. It is in Igbo, the language of my family, and it does not translate cleanly into English. The closest I can get is this: Ịhụ Ọnọdụ Onye. See the person. See the whole person. See the situation a person is sitting in.
I was raised on this phrase. It is the thing my grandmother said to me before I left for school, before I left for university, before I left for the United States. To see the whole person is the discipline of being in relationship -- and it is the same discipline psychiatric care should be.
I want to write briefly about why I offer care in Igbo for patients who want it, and why -- if your first language is not English -- I think it is worth asking about with whoever you see.
Why language matters in psychiatric care.
Psychiatric symptoms live in language. When I ask a patient how they have been feeling, I am asking them to translate an internal experience into words I can understand. When I ask a patient about their family or their losses or what scares them at three in the morning, I am asking them to do that same translation, often about the most private parts of their life.
For patients whose first language is not English, that translation happens twice. Once from their internal experience into the language of their childhood. Then again from that language into English, in real time, while sitting in front of a stranger. The second translation costs precision. It costs nuance. It costs the specific word that would have caught the specific feeling.
Some of the most important psychiatric work I have done with patients has happened in the moments when they switched languages. A word in Igbo for grief that does not exist in English. A phrase for shame that English cannot quite hold. The version of themselves they show in their first language is often the version that needs the care.
This is not a niche service. It is a clinical one.
I offer bilingual psychiatric sessions in English and Igbo. For patients who would like it, sessions can be primarily Igbo, primarily English, or move between the two as the conversation requires.
I want to be clear: this is offered as part of the clinical work, not as a cultural performance. If you would rather we speak only in English -- because you are more comfortable, because your Igbo is rusty, because you prefer to keep that part of your life separate from your medical care -- that is your choice and I respect it. The lane is available for patients who want it. It does not change the practice for patients who do not.
What this means for patients who are not Igbo.
If you are not Igbo, this post is still for you. The principle behind it -- that psychiatric care should meet you in the language of your interior life -- applies to every patient, regardless of background.
For monolingual English speakers, that means the dialect and register matter. The English you use with your closest friend is the English you should use with your psychiatric provider. The vocabulary that captures your grief, your fear, your hope -- bring it. I will adjust to you, not the other way around.
For patients whose first language is Spanish, Mandarin, Tagalog, Arabic, Vietnamese, Russian, or any of the other languages that live in Las Vegas, I cannot offer bilingual sessions. What I can offer is the recognition that your English is your second language, and the willingness to slow down, ask, re-ask, and check that I have understood what you are actually saying. That recognition makes a difference.
One last note.
The phrase at the top of this post -- Ịhụ Ọnọdụ Onye -- is not a tagline for me. It is the discipline I was raised in. I bring it into every appointment, whether the patient is Igbo or not, whether we share a language or not, whether we share a culture or not.
To see the whole person is the work. The rest follows from there.
— Nkemdilim Nwofor, PMHNP-BC