The use of multiple languages during psychotherapies has been noted for over 100 years, since Breuer's famous Viennese patient, Anna O., spoke in English. In this article, the authors demonstrate the meanings of language usage to 3 Chinese people in treatment in Shanghai, China. Like many educated people in Shanghai in the 21st century, they were trilingual, in Mandarin, Shanghainese, and English. Their switches in language during treatment suggested that their current problems had been generated by culture, Chinese governmental policy, social factors, interpersonal and intrapsychic conflicts involving self-states, and the enduring effects of unresolved childhood trauma. Their language-switching was noted during therapy and proved to be useful in resolving their presenting problems.