EMDR in a second language: working with expats and bilingual clients

Memories are tied to the language they were formed in

In a classic study, Marian and Neisser (2000) interviewed Russian–English bilinguals who had emigrated to the United States. When interviewed in Russian, they recalled more experiences from the Russian-speaking period of their lives; in English, more from the English-speaking period. This is called language-dependent recall: a memory is easier to reach in the language in which it was experienced.

A second language can create distance

Many bilinguals say that emotional words hit harder in their first language. Laboratory research supports this. In a study by Caldwell-Harris and Ayçiçeği-Dinn (2009), emotional phrases in a foreign language produced weaker skin-conductance responses, a physiological sign of arousal, than emotional phrases in the participants' native language.

For trauma specifically, Schwanberg (2010) studied Spanish–English bilingual patients with childhood trauma and found that traumatic memories were accessed with more intensity in their first language.

This distance can help and hinder at the same time. It can make it possible to talk about something that feels unbearable. But in EMDR, where a memory needs to be activated enough to be processed, working only in a second language may leave part of the memory untouched.

Bringing the first language into EMDR

In a clinical paper in the Journal of EMDR Practice and Research, Ateş-Barlas (2022) describes how a client's first language can be integrated into the standard EMDR protocol, even by a therapist who doesn't speak that language. Practical options that follow from this work:

• Ask which language the memory “lives” in. What language was spoken at the time? Which language do the voices in the memory speak?
• Let the client put the negative and positive cognitions into their first language, and translate them for you. A belief like “I am worthless” can land very differently in the language in which it was first said to them.
• Let the client think in their first language during sets. Bilateral stimulation needs no language at all. Only the short reports between sets need to be in a language you share.
• Check again in the first language. If a target has reached SUD 0 while you worked in the second language, ask the client to bring up the memory once more with the first-language words. Residual disturbance may show up.
• Use language deliberately for regulation. If a client floods, switching back to the shared language can help create distance and bring them back to the present.

Expats: more than language

For expats, language is bound up with other things: homesickness, cultural norms about showing emotion, family far away, and sometimes a migration story with its own losses.

• A memory from home can come with a whole cultural context. Give the client room to explain it without having to translate every detail.
• Future templates often involve situations in two countries, such as a visit home or a conversation with family in the first language.
• Present triggers can be specific to life abroad: bureaucracy in a language you don't fully master, feeling like an outsider, distance from support at home.
• A therapist who speaks the client's first language isn't always available, or even preferred. Some clients deliberately choose therapy in their second language. Both are valid choices; discuss them openly.

Online makes multilingual EMDR easier

Online sessions widen the choice of therapist. A Polish expat in the Netherlands can work with a Polish-speaking EMDR therapist, or with a Dutch therapist in English, without travelling. The bilateral stimulation itself works the same in any language, and the Remote EMDR interface is available in English and Polish.

The scales need extra attention with bilingual clients too: see how to use the SUD and VoC scales.