This project investigates the emotional, sensory, and physical burden of physical traumas, focusing on the influence of the language in which the trauma is discussed. Using neurolinguistics applied to trauma, we explore how the trauma experience can be modulated when discussed in a language different from the mother tongue or the one in which the trauma occurred. The study aims to understand the effects of this linguistic approach on individuals' emotional and physical responses, with the potential to develop new therapeutic techniques and more effective treatments for trauma.

Keywords: neurolinguistics, trauma, bilingualism, pain perception, psychotraumatology, pain management

The central hypothesis of this study is that the language in which trauma is addressed can alter the emotional, sensory, and physical burden associated with it. When trauma is discussed in a language different from the one in which it occurred, changes in perception and response to trauma may occur, potentially facilitating recovery and emotional management. This project aims to explore this hypothesis, providing insights for new therapeutic approaches and contributing to the multidisciplinary understanding of trauma.

The relationship between language and trauma is an emerging field of study within neurolinguistics, which examines how the form and content of communication influence emotional perception and processing. Researchers such as Boroditsky¹ and Pavlenko² highlight how language shapes experience and memory. In the context of trauma, this interaction becomes even more critical.

Physical trauma can have a profound and lasting impact, affecting not only the body but also the individual's mind and emotions. Studies by van der Kolk³ and Herman⁴ explore how physical trauma is processed by the brain and how this experience can be modulated by different factors, including language. Van der Kolk,³ in his work "The Body Keeps the Score", argues that trauma is stored not only in memory but also in the body's tissues and cells, influencing the individual's physical and mental health.

Research in neurolinguistics applied to trauma investigates how the language in which trauma is addressed can affect the emotional, sensory, and physical burden associated with this experience. Studies indicate that addressing trauma in a language different from the native one or the one in which the trauma occurred can modify the perception of pain and suffering. For example, Harris, Gleason, and Ayçiçeği-Dinn⁵ found that intense emotions are often attenuated when expressed in a second language, suggesting a possible mechanism of emotional distancing.

This study aims to deepen this investigation, exploring the hypothesis that linguistic modulation can provide a form of neuromodulation, potentially facilitating recovery and emotional management. The research aims to understand the effects of this approach on individuals' emotional and physical responses, providing valuable insights for the application of new therapeutic techniques and more effective treatments for physical trauma.

Understanding these dynamics can revolutionize how physical traumas are treated in medicine, providing a promising path for integrating neurolinguistics approaches into clinical practice. The relevance of this article to the scientific community is significant, as it offers a new perspective on the interaction between language and trauma. The research may reveal neurological and psychological mechanisms that explain why some people exhibit a reduced emotional response to trauma when speaking in a different language. This is crucial for developing more effective therapeutic interventions, especially for multilingual populations. Furthermore, the results can impact clinical practices, mental health policies, and rehabilitation programs, promoting more personalized and accessible treatments. The relationship between language and emotional experience has been a central theme in neurolinguistics, especially in the study of trauma. Evidence suggests that the language in which a traumatic event is reported can modulate the associated emotional, sensory, and physiological Burden, influencing pain perception, memory reconstruction, and therapeutic response. Studies such as those by Harris, Gleason, and Ayçiçeği-Dinn⁵ and Pavlenko² demonstrate that bilingual individuals experience less emotional impact when describing traumatic events in a second language, suggesting a possible effect of emotional distancing.

Additionally, research by van der Kolk³ indicates that trauma is not only stored in memory but also in the body, impacting long-term physical and mental health. In this context, exploring how addressing physical trauma in a language different from the native one can influence emotional and physiological perception becomes essential for developing new therapeutic strategies.

This study investigates the linguistic modulation of trauma, analyzing its effects on emotional responses, pain perception, and therapeutic efficacy. The findings can provide insights for more personalized and effective interventions, expanding treatment possibilities for bilingual and multilingual individuals.

The present study is characterized as an integrative literature review, aimed at synthesizing evidence on the influence of language in coping with emotional, sensory, or physical trauma. The review followed the steps recommended by Mendes, Silveira, and Galvão⁶ which include: identification of the topic and formulation of the research question, definition and application of inclusion and exclusion criteria for studies, literature searches, and data synthesis and analysis.

Step 1: Identification of the topic and formulation of the research question

The guiding question was structured using the PICo acronym (Population, Intervention, Comparator, and Outcome), as described by Akobeng. Thus, the following were considered: P: multilingual, bilingual, and monolingual individuals with traumatic experiences; “I”: use of a language other than the one associated with the trauma; “C”: not applicable in this study; and “O”: different emotional and physical pain perceptions when describing trauma in another language. Therefore, the guiding question was defined as: “Does describing a physical or emotional trauma in a second language generate a different impact compared to describing it in the language in which the trauma occurred?”

Step 2: Criteria for inclusion and exclusion of studies and literature searches

The search was conducted in both national and international databases to ensure broader coverage. The databases included were: PubMed/MEDLINE from the National Library of Medicine, Research Gate, APA PsycNet (American Psychological Association), Scientific Electronic Library Online (SciELO), and Google Scholar. Additionally, classifications of chronic pain provided by the International Association for the Study of Pain (IASP) were used.

The descriptors were selected from the MeSH (Medical Subject Headings) and DeCS (Health Sciences Descriptors) vocabularies, as follows: “neurolinguistics applied to trauma” and “multilingual in trauma responses” in English, and “influência da língua na modulação ao trauma” and “multilíngues nas respostas ao trauma” in Portuguese, using the connectors “AND” and “E,” respectively. On the SciELO platform, the terms “trauma” and “neurociências” were used, as the other descriptors yielded no results, and on Google Scholar, the filter for review articles was applied.

The inclusion criteria encompassed: studies conducted with bilingual or multilingual individuals who experienced trauma and underwent therapeutic approaches using a second language; comparison of emotional load in different languages in individuals fluent in two or more languages; articles available in full and online, published in English, Portuguese, or French between 2006 and 2025. The exclusion criteria included: duplicate articles across databases, articles lacking both descriptors and alternative terms according to MeSH and DeCS in their abstracts, and those that did not directly address the proposed topic (Figure 1).

Figure 1 Data synthesis and analysis.

Step 3 and 4: Data synthesis and analysis

The selected studies included in the integrative review were synthesized, and their data were extracted into a table containing the following information: author(s), study design, population, and type of trauma experienced, target brain region, multilingualism protocol, evaluated outcomes, and the effect of the other language on the emotional approach.

The interaction between language and trauma has been a fertile field for investigations in various disciplines, including psychology, neuroscience, and linguistics. This literature review explores how neurolinguistics applied to trauma can influence the emotional, sensory, and physical burden of trauma when addressed in a language different from the native one or the language in which the trauma occurred (Table 1).

Pain Perception The reviewed research suggests that the expression of emotions in a language distinct from the one in which the trauma occurred may modulate pain perception. Harris, Gleason, and Ayçiçeği-Dinn⁵ identified that the emotional response to negative words is reduced when spoken in a second language. This effect can be explained by lower activation of limbic areas associated with emotional processing. Moreover, neurophysiological studies using functional magnetic resonance imaging (fMRI) have shown reduced activation of the amygdala in bilingual individuals when reporting trauma in their second language (Figure 2).

Figure 2 Neural activation when reporting traumas in different languages.

What is Pain?

Pain is a complex sensory and emotional experience, typically associated with actual or potential tissue damage. Merskey and Bogduk⁷ in their definition for the International Association for the Study of Pain (IASP), describe pain as a subjective experience that can be modulated by psychological and cultural factors. Pain is a defense mechanism that alerts the organism to the presence of potential harm, triggering behavioral and physiological responses to protect the body.

How do we perceive Pain?

Pain perception involves a complex interaction between the peripheral and central nervous systems. Nociceptors, which are specific sensory receptors, detect potentially harmful stimuli and transmit these signals to the brain, where they are interpreted as pain. Melzack and Wall,⁸ in their gate theory, suggest that pain perception can be modulated by psychological and emotional factors that influence the opening or closing of "gates" allowing pain signals to reach the brain.

Pain classification

Pain can be classified in several ways, each with important implications for diagnosis and treatment:

1. Acute Pain: Generally associated with recent tissue injuries, such as cuts, burns, or fractures, and tends to disappear as the injury heals.
2. Chronic Pain: Persists for extended periods, usually longer than three months, and may not be associated with visible injury. Examples include rheumatoid arthritis and fibromyalgia.
3. Nociceptive Pain: Results from the activation of nociceptors due to tissue injury, which can be somatic (related to the skin, muscles, and bones) or visceral (related to internal organs).
4. Neuropathic Pain: Caused by injury or dysfunction in the nervous system, potentially resulting in sensations such as burning, tingling, or electric shocks. Examples include diabetic neuropathy and post-herpetic neuralgia.

Emotional response

The findings indicate that emotional responses to trauma vary depending on the language used to describe the event. In a study by Pavlenko,² bilingual individuals reported lower emotional intensity when narrating traumatic events in their second language. This Effect is known as "linguistic emotional distancing" and can be a useful defense mechanism in managing psychological pain. Table 1 presents a summary of emotional responses in different linguistic scenarios (Table 2).

Language and trauma perception

Boroditsky¹ argues that language shapes our perception of the world, influencing how we experience and process emotions. In her study, Boroditsky highlights that different languages can structure the perception of space, time, and causality in distinct ways, which may also apply to the experience of trauma. The hypothesis is that language can modify the intensity and nature of emotional responses to traumatic experiences.

The theory of emotional distancing

Harris, Gleason, and Ayçiçeği-Dinn⁵ conducted studies showing that intense emotions are often attenuated when expressed in a second language. They suggest that using a second language may provide "emotional distancing," reducing the emotional burden associated with trauma. This distancing may facilitate the expression of difficult emotions, making the therapeutic process more manageable.

Physiological and sensory impacts of trauma

Van der Kolk,³ in The Body Keeps the Score, explores how trauma is stored not only in the mind but also in the body. Van der Kolk³ argues that physical traumas can cause neurophysiological changes that impact sensory perception and stress response. He suggests that techniques that address both the emotional and physiological dimensions of trauma are crucial for effective recovery.

Neurolinguistics and trauma modulation

Pavlenko,² in her work The Bilingual Mind and What It Tells Us about Language and Thought, discusses how bilingualism can alter the way individuals process emotional information. Pavlenko suggests that using a second language can help modulate emotional responses to trauma, offering a perspective that facilitates management and recovery.

The influence of linguistic context

Herman⁴ in Trauma and Recovery, explores how culture and linguistic context influence the experience and expression of trauma. Herman argues that culture shapes how traumas are understood and treated. Thus, a multilingual therapeutic approach may not only alter emotional perception but also modify the cultural narrative of trauma.

Memory impact

The findings also point to variation in the accessibility and reconstruction of traumatic memories depending on the language used to report the event. Van der Kolk³ demonstrated that trauma storage involves neural circuits related to language processing. Neuropsychological studies suggest that bilingual individuals access memories in more detail in their native language, while narrating in a second language may lead to a more objective and less emotionally charged account.

Therapeutic efficacy

The literature on bilingual therapeutic interventions shows a positive impact on trauma treatment. In a cognitive-behavioral therapy study conducted by Caldwell-Harris and Ayçiçeği-Dinn,⁹ individuals undergoing treatment in a second language reported lower emotional discomfort when revisiting traumatic events. Figure 3 illustrates the difference in response to treatment depending on the language used (Figure 3).

Figure 3 Impact of language on trauma treatment response.

Recent studies and clinical applications

Ortega¹⁰ in his article Neuroscientific Perspectives for a Theory of Trauma: A Critical Review of Integrative Models between Biology and Culture, reviews how integrative models between biology and culture can enhance understanding of trauma. Ortega¹⁰ suggests that therapeutic approaches considering both biological and cultural aspects of trauma may be more effective, especially when including linguistic elements.

The analysis of selected literature revealed a significant correlation between the language used to report trauma and the emotional and sensory load associated with it. Studies have shown that bilingual and multilingual individuals exhibit different emotional and physiological responses when describing traumatic events in a second language. The main findings were categorized into four main axes: pain perception, emotional response, memory impact, and therapeutic efficacy.

The results of this research corroborate the hypothesis that the language used to report trauma significantly influences the emotional, sensory, and physiological burden associated with it. The findings indicate that expressing traumatic events in a second language may attenuate the emotional response and modulate pain perception, which has important implications for the development of innovative therapeutic approaches.

Highlight of original and relevant findings

The results reinforce the findings of Harris, Gleason, and Ayçiçeği-Dinn⁵ by demonstrating that the emotional response to negative words and traumatic events is reduced when narrated in a second language. This phenomenon, known as "linguistic emotional distancing," can be explained by the lower activation of the amygdala when processing information in a language different from the native one.^11,12

Moreover, Pavlenko² research demonstrated that the memory of traumatic events is more detailed and emotionally charged when reported in the native language, while narration in a second language leads to a more neutral and objective account. These findings are consistent with studies by Schrauf and Rubin, which suggest that the native language is more associated with autobiographical memories and deep emotions.

An innovative aspect identified in this study was the difference in therapeutic response when the intervention is conducted in a second language. Patients undergoing therapy in a language other than their native one reported lower emotional discomfort when revisiting traumatic events, suggesting a protective effect of the second language in emotional regulation.⁹

Critical comparison with pertinent literature

The findings of this research align with the work of van der Kolk³ who proposes that trauma is not only stored in memory but also in the neurobiological circuits of the body. However, while van der Kolk³ emphasizes the need for therapeutic approaches based on bodily expression, our results suggest that linguistic mediation may be an equally relevant factor in trauma desensitization.

Furthermore, works such as those by Marian and Kaushanskaya¹³ indicate that bilingual’s exhibit differences in memory encoding and access depending on the language used, reinforcing the hypothesis that the emotional distancing observed in our research is a real phenomenon with potential clinical applications.

Identified problems and possible solutions

1. Individual variability: Some people may not experience the emotional distancing effect, suggesting the influence of individual factors such as language proficiency and cultural experiences. Future studies should consider variables such as age of second language acquisition and sociocultural context.
2. Methodological limitations: Most of the studies cited use self-reports, which may be subject to bias. The use of more objective physiological measures, such as functional neuroimaging and heart rate monitoring, could enhance the validity of the results.
3. Lack of longitudinal studies: The influence of language on trauma perception is a recent field, and there is a need for longitudinal research that follows patients over time to assess the efficacy of multilingual interventions.

Implications and recommendations

The findings of this study have significant implications for clinical practice and the development of more effective therapeutic strategies for bilingual populations. Integrating neurolinguistics into psychological treatments could provide innovative alternatives for treating trauma-related disorders (Table 3).

The complex interaction between language, culture, and trauma is highlighted. The studies suggest that linguistic modulation can reduce the emotional and physiological burden of trauma, providing new perspectives for the development of more effective treatments. The integration of multilingual approaches in trauma therapy may not only facilitate emotional expression but also promote a more holistic and effective recovery. It provides a solid foundation for understanding how neurolinguistics can be applied in treating physical trauma, especially when considered in different languages.

The use of neurolinguistics as a therapeutic application is a recent topic, and further research is needed in the area to clarify all the mechanisms related to this therapeutic approach.

The results of this study have the potential to revolutionize the way physical and emotional traumas are treated, offering new therapeutic approaches based on neurolinguistics insights. The research may contribute to understanding how language can be used to facilitate recovery and improve the quality of life for individuals affected by physical trauma. The results of this literature review reinforce the hypothesis that the language in which trauma is addressed can modulate the emotional, sensory, and physiological burden associated with it. The emotional distancing promoted by the use of a second language may be a useful resource in managing pain and treating trauma, providing insights for innovative therapeutic approaches in multilingual contexts. Future experimental research may deepen the understanding of the neurobiological mechanisms involved and validate the clinical applicability of these findings. This study reaffirms the importance of the interaction between language and emotional experience, providing evidence that language choice can significantly influence the perception and response to traumatic events. The findings suggest that using a second language may be a viable therapeutic tool in emotional regulation and minimizing the impact of trauma.

However, methodological limitations and the need for longitudinal studies highlight the importance of future research exploring the variables involved more comprehensively. The enhancement of therapeutic approaches, considering bilingualism as a relevant factor in trauma treatment, could revolutionize clinical practice and contribute to better mental health outcomes.

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