‘I feel it’s something that irritates her’

Emotions in interpreter-mediated trauma therapy sessions


  • Marta Kirilova University of Copenhagen
  • Line Højland University of Copenhagen




emotion discourse, interpreter-mediated interaction, interpreting strategies, psychotherapy


Interpreting is increasingly being used in psychotherapy, but the presence of an interpreter in the therapeutic encounter is an under-researched area. This paper examines interpreter-mediated trauma therapy with Danish-speaking therapists treating Arabic-speaking patients diagnosed with post-traumatic stress disorder (PTSD). We focus on the notion of ‘emotion discourse’ as a broad term covering how therapists and patients talk about emotional experience, and how interpreters negotiate and mediate it. The data consist of three group interviews with ten therapists and six excerpts from two audio-recorded interpreter-mediated therapy sessions. The detailed interaction analysis explores (1) the therapists’ expectations about interpreting emotion discourse and (2) the interactional strategies that the interpreters use to negotiate and render the interaction between therapists and patients who speak different languages. The findings show that the therapists have clear expectations about what needs to be translated and how, but these expectations remain hidden to the interpreters. The interpreters use various interpreting strategies and orient towards meaning rather than towards verbatim translations. We conclude by recommending that both therapists and interpreters engage in a professional collaboration that requires not only training and awareness of mutually relevant information, but also an updated view of interpreter-mediated interaction as a dynamic collaborative process.

Author Biographies

Marta Kirilova, University of Copenhagen

Marta Kirilova received her PhD in Interactional Sociolinguistics at the University of Copenhagen, Denmark, where she is currently an assistant professor. Her research interests include language and culture, multilingualism and interpreter-mediated interaction. She has published in Nordic and international journals, and edited books and handbooks on the topics of linguistic inequality, job interviews and courtroom interpreting.

Line Højland, University of Copenhagen

Line Højland holds an MA in Social Anthropology and is currently a research assistant at the University of Copenhagen. Her research interests include language and communication in therapy sessions and the co-construction of meaning in interpreter-mediated interaction. A recent publication, co-authored with
Martha S. Karrebæk, is concerned with meaning making in interpreter-mediated trauma therapy
(published in Nordand – Nordisk tidsskrift for andrespråksforskning, 2021).


Angelelli, Claudia (2004) Revisiting the Interpreter’s Role. Amsterdam: John Benjamins.

Angelelli, Claudia (2008) The role of the interpreter in the healthcare setting: A plea for a dialogue between research and practice. In Carmen Valero Garcés and Anne Martin (eds) Crossing Borders in Community Interpreting: Definitions and Dilemmas, 147–164. Amsterdam: John Benjamins.

Angelelli, Claudia (2011) ‘Can you ask her about chronic illnesses, diabetes and all that?’ In Cecilia Alvstad, Adelina Hild and Elisabet Tiselius (eds) Methods and Strategies of Process Research: Integrative Approaches in Translation Studies, 231–246. Amsterdam: John Benjamins.

Angelelli, Claudia (2018) Who is talking now? Role expectations and role materializations in interpreter-mediated healthcare encounters. Communication and Medicine 15 (2): 123–134. https://doi.org/10.1558/cam.38679

Aranguri, Cesar, Brad Davidson and Robert Ramirez (2006) Patterns of communication through interpreters: A detailed sociolinguistic analysis. Journal of General Internal Medicine 21 (6): 623–629. https://doi.org/10.1111/j.1525-1497.2006.00451.x

Baraldi, Claudio and Laura Gavioli (eds) (2012) Coordinating Participation in Dialogue Interpreting. Amsterdam: John Benjamins.

Baraldi, Claudio and Laura Gavioli (2018) Managing uncertainty in healthcare interpreter-mediated interaction: On rendering question-answer sequences. Communication and Medicine 15 (2): 150–164. https://doi.org/10.1558/cam.38677

Bot, Hanneke (2005) Dialogue Interpreting in Mental Health. Amsterdam: Rodopi.

Bot, Hanneke (2007) Dialogue interpreting as a specific case of reported speech. Healthcare Interpreting 7 (2): 237–261. https://doi.org/10.1075/intp.7.2.06bot

Bot, Hanneke and Cecilia Wadensjö (2004) The presence of a third party: A dialogical view on interpreter-assisted treatment. In John P.

Wilson and Boris Drozdek (eds) Broken Spirits: The Treatment of Traumatized Asylum Seekers, Refugees and War and Torture Victims, 355–378. New York: Brunner-Routledge.

Brisset, Camille, Yvan Leanza and Karine Laforest (2013) Working with interpreters in health care: A systematic review and meta-ethnography of qualitative studies. Patient Education and Counseling 91 (2): 131–140. https://doi.org/10.1016/j.pec.2012.11.008

Davidson, Brad (1998) Interpreting Medical Discourse: A Study of Cross-Linguistic Communication in the Hospital Clinic. Unpublished doctoral dissertation, Stanford University, Stanford, CA.

Davidson, Brad (2002) The interpreter as institutional gatekeeper: The social-linguistic role of interpreters in Spanish-English medical discourse. Journal of Sociolinguistics 4 (3): 379–405. https://doi.org/10.1111/1467-9481.00121

Dickerman, Anna and César Alfonso (2015) Words apart: The challenge of using interpreters in psychodynamic psychotherapy. Psychodynamic Psychiatry 43 (1): 129–134.

Edwards, Derek (1999) Emotion discourse. Culture and Psychology 5 (3): 271–291. https://doi.org/10.1177/1354067X9953001

Ekberg, Stuart, Rebecca Barnes, David Kessler, Alice Malpass and Alison Shaw (2016) Managing the therapeutic relationship in online cognitive behavioural therapy for depression: Therapists’ treatment of clients’ contributions. Health Expectations 19 (3): 557–569. https://doi.org/10.1111/hex.12227

Ellis, Darren and Ian Tucker (2015) Social Psychology of Emotion. London: Sage.

Garcés, Carmen V. (2007) Doctor–patient consultations in dyadic and triadic exchanges. In Franz Pöchhacker and Miriam Shlesinger (eds) Health-care Interpreting: Discourse and Interaction, 35–51. Amsterdam: John Benjamins.

Gavioli, Laura and Cecilia Wadensjö (2020) Reflections on doctor question–patient answer sequences and on lay perceptions of close translation. Health Communication 36 (9): 1080–1090.

Goffman, Erving (1967) Interaction Ritual: Essays on Face-to-Face Behavior. New York: Pantheon Books.

Greenberg, Leslie S. (2004) Emotion-focused therapy. Clinical Psychology and Psychotherapy: Theory, Research and Practice 11 (1): 3–16. https://doi.org/10.1002/cpp.388

Gryesten, Jasmin Reyaye, Kathrine Kastrup Brodersen, Laura Glahder Lindberg, Jessica Carlsson and Stig Poulsen (2021) Interpreter-mediated psycho-therapy – A qualitative analysis of the inter-professional collaboration between psychologists and interpreters. Current Psychology. Online first.https://doi.org/10.1007/s12144-021-01345-y

Gumperz, John (1982) Discourse Strategies. Cambridge: Cambridge University Press.

Hale, Sandra B. (2004) The Discourse of Court Interpreting: Discourse Practices of the Law, the Witness and the Interpreter. Amsterdam: John Benjamins.

Haviland, John B. (2003) Ideologies of language: Some reflections on language and US law. American Anthropologist 105 (4): 764–774. https://doi.org/10.1525/aa.2003.105.4.764

Hill, Clara E. (2014) Helping Skills: Facilitating Exploration, Insight, and Action. Washington, DC: American Psychological Association. https://psycnet.apa.org/record/2009-07551-000

Hutchby, Ian and Robin Wooffitt (2008) Conversation Analysis. Malden, MA: Polity Press.

Karrebæk, Martha, Marta Kirilova and Solvej H. Sørensen (forthcoming) ‘You may now speak to your lawyer’ – When interpreters mediate judges’ information to the accused. International Journal of Language and Law

Karrebæk, Martha and Line Højland (2021) En følelse af henrettelse: Om affektive bevægelser i en terapisamtale med tolk. Nordand – Nordisk tidsskrift for andrespråksforskning 2021 (2): 94–113. https://doi.org/10.18261/issn.2535-3381-2021-02-01

Lai, Miranda, Georgina Heydon and Sedat Mulayim (2015) Vicarious trauma among interpreters. International Journal of Interpreter Education 7 (1): 4–23.

Laukka Petri, Hillary Anger Elfenbein, Nela Söder, Henrik Nordström, Jean Althoff, Wanda Chui, Frederik K. Iraki, Thomas Rockstuhl and

Nutankumar S. Thingujam (2013) Cross-cultural decoding of positive and negative non-linguistic emotion vocalizations. Frontiers in Psychology 4: Article 353. doi:10.3389/fpsyg.2013.00353

Mason, Ian and Miranda Stewart (2001) Interactional pragmatics, face and the dialogue interpreter. In Ian Mason (ed.) Triadic Exchanges: Studies in Dialogue Interpreting, 51–70, London: Routledge.

Mirdal, Gretty M., Else Ryding and Mette S Essendrop (2012) Traumatized refugees, their therapists, and their interpreters: Three perspectives on psychological treatment. Psychology and Psychotherapy: Theory, Research and Practice 85: 436–455. https://doi.org/10.1111/j.2044-8341.2011.02036.x

Pawelczyk, Joanna (2011) Talk as Therapy: Psychotherapy in a Linguistic Perspective. Berlin: De Gruyter Mouton.

Peräkylä, Anssi (2013) Conversation analysis in psychotherapy. In Jack Sidnell and Tanya Stivers (eds) The Handbook of Conversation Analysis, 551–574. Oxford: Blackwell.

Peräkylä, Anssi and Sanna Vehviläinen (2003) Conversation analysis and the professional stocks of interactional knowledge. Discourse

and Society 14 (6): 727–750. https://doi.org/10.1177/09579265030146003

Perregaard, Bettina (2007) Samtalen i psykoterapi. Copenhagen: Danmarks Pædagogiske Universitets Forlag.

Pöchhacker, Franz and Miriam Shlesinger (eds) (2007) Healthcare Interpreting: Discourse and Interaction. Amsterdam: John Benjamins.

Raval, Hitesh and Jonathan A. Smith (2003) Therapists’ experiences of working with language interpreters. International Journal of Mental Health 32 (2): 6–31. https://doi.org/10.1080/00207411.2003.11449582

Reddy, Michael J. (1979) The conduit metaphor: A case of frame conflict in our language about language. In Andrew Ortony (ed.) Metaphor and Thought, 284–310. Cambridge: Cambridge University Press.

Sarangi, Srikant (2001) A comparative perspective on social theoretical accounts of the language-action interrelationship. In Nikolas Coupland, Srikant Sarangi and Christopher Candlin (eds) Sociolinguistics and Social Theory, 29–60. London: Routledge.

Sarangi, Srikant (2018a) Communicative vulnerability and its mutation in interpreter-mediated healthcare encounters. Communication and Medicine 15 (2): 111–122. https://doi.org/10.1558/cam.40888

Sarangi, Srikant (ed.) (2018b) Interpreter-Mediated Healthcare Encounters. Special Issue of Communication and Medicine 15 (2).

Sarangi, Srikant and Celia Roberts (1999) Introduction: Discursive hybridity in medical work. In Srikant Sarangi and Celia Roberts (eds) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management settings, 61–74. Berlin: Mouton De Gruyter.

traume.dk (2018) Tolkens rolle [The Role of the Interpreter]. Online: http://traume.dk/tolkens_rolle

Tribe, Rachel (2005) Working with interpreters. In Kimberly Holt Barrett and William H. George (eds) Race, Culture, Psychology and Law, 163–176. Thousand Oaks, CA: Sage Publications.

Tribe, Rachel (2011) Working with interpreters and bicultural workers. In Colin Lago (ed.) Handbook of Transcultural Counselling and Psychotherapy, 81–93. Maidenhead, UK: McGraw-Hill Education.

Tribe, Rachel and Kate Thompson (2009a) Exploring the three-way relationship in therapeutic work with interpreters. International Journal of Migration, Health and Social Care 5 (2): 13–21. https://doi.org/10.1108/17479894200900009

Tribe, Rachel and Kate Thompson (2009b) Opportunity for development or necessary nuisance? The case for viewing working with interpreters as a bonus in therapeutic work. International Journal of Migration, Health and Social Care 5 (2): 4–12. https://doi.org/10.1108/17479894200900008

Van der Kolk, Bessel A. and Onno van der Hart (1991) The intrusive past: The flexibility of memory and the engraving of trauma. American Imago 48 (4): 425–454.

Van der Merwe, Helen and Margaret Wetherell (2020) The emotional psychologist: A qualitative investigation of norms, dilemmas, and contradictions in accounts of practice. Journal of Community & Applied Social Psychology 30 (2): 227–245. https://doi.org/10.1002/casp.2439

Voutilainen, Liisa (2012) Responding to emotion in cognitive psychotherapy. In Anssi Perakyla and Marja-Leena Sorjonen (eds) Emotion in Interaction, 235–255. Oxford: Oxford University Press. https://doi.org/10.1093/acprof:oso/9780199730735.003.0011

Wadensjö, Cecilia (1998) Interpreting as Interaction. London: Longman.

Wadensjö, Cecilia (2018) Involvement, trust and topic control in interpreter-mediated health-care encounters. Communication and Medicine 15 (2): 165–176. https://doi.org/10.1558/cam.38681

Wetherell, Margaret (2012) Affect and Emotion: A New Social Science Understanding. London: Sage. http://dx.doi.org/10.4135/9781446250945

Wehr, Hans (1979) Introduction. In Milton Cowan (ed.) The Hans Wehr Dictionary of Modern Written Arabic, vii–xv. Wiesbaden: Harrassowitz.



How to Cite

Kirilova, M., & Højland, L. (2022). ‘I feel it’s something that irritates her’: Emotions in interpreter-mediated trauma therapy sessions. Communication and Medicine, 18(1), 91–104. https://doi.org/10.1558/cam.19797