Lost in translation. Up to 90% of communication is at times non-verbal!
- Páll Matthíasson
- Jun 6
- 7 min read
Interview with Svandís Svavarsdóttir
I know Svandís from the years (2017–2021) when she was my superior as Minister of Health, while I was the CEO of Landspítali - the National University Hospital. We had frequent private meetings and discussed much beyond the usual topics of the healthcare service. She responded positively when I asked her for a chat about various aspects of language that can both hinder and help people understand each other.
Páll Matthíasson: Hello, Svandís. In this issue of The Nordic Psychiatrist magazine, we’re exploring the phenomenon of “lost in translation” from various perspectives - how misunderstanding can impact the effort to help people with mental health issues. We’re also looking at how language itself can create barriers for immigrants who arrive in a new country and don’t speak the language. But one angle I find especially interesting is something you once told me: that a much larger portion of communication than people realize is non-verbal. I found that so fascinating and wanted to hear your thoughts on whether this might be one aspect of how meaning gets lost in translation. Given your background in sign language interpretation, you have a unique perspective on this.
Svandís Svavarsdóttir: It's really fun to revisit all sorts of stuff that might have been buried deep in the drawers of the mind after all these years. But some things stay with you in other jobs - like this awareness of the structure of language. I became especially aware of it in relation to sign language research and the interpretation program we taught for several years at the University - me as a hearing instructor, alongside a deaf colleague, teaching interpretation between Icelandic and sign language.
What’s characteristic of sign language, by nature, is that it’s entirely visual. So elements that hearing people might not consider meaningful do carry meaning in the sign language community. For example, raising your eyebrows or leaning back - things we do in everyday interactions - can determine whether something is understood as a question or a statement. In sign language, that’s systematic - it’s part of the language’s grammar.
This awareness grew in the work environment I was in, constantly reflecting language back and forth between Icelandic and sign language. I began to explore it more and read about it. As you mentioned, studies suggest that the majority of meaning is conveyed through unspoken elements - non-verbal communication. That includes everything layered on top of spoken language: tone, emphasis, pitch - like whether we say, “What are YOU doing here?” versus “What are you DOING here?” or “What are you doing HERE?” These don’t mean the same thing, and we understand that intuitively, without being explicitly taught.
When learning a language, these layers aren't always clearly explained - like how the pitch of the sentence or a pause can change meaning. If you say, “Why did PÁLL come by car?” versus “Why did Páll come by CAR?”, the meaning shifts. These are the features that lie on top of the spoken language: tone, rhythm, duration, pauses. In speech, you must choose how to present it.
Then there’s the purely non-verbal stuff - facial expressions, body language, and mimics like gestures and postures. For example, whether your body is open or closed, or whether you turn your body toward or away from the listener. All of this carries meaning. Some scholars claim that only 7–12% of face-to-face communication is the words themselves. Up to 90% is non-verbal communication!
The most fun is testing this when you go abroad, especially to a place where you understand nothing - not even the writing system. Try speaking Icelandic at a restaurant or store when asking for pants or a swimsuit - you’ll find you’re understood. Because when you're speaking your native language, your tone, expressions, and gestures align with your intended meaning. But if you're speaking a foreign language that you’re not fluent in, all those parameters change. Your body gets stiff, your face tenses up while you're thinking, “Wait, is this in the dative? Is this feminine? How do I say this again?” - and then no one understands you. It might be better to just point to the menu and say in your native language, “Is this a vegetarian dish?” or “What wine would you recommend?”
This creates a kind of bridge because the other person senses your effort and wants to understand. I’ve done this many times - like buying a swimsuit successfully in Hungary, or ordering meals in foreign places.
So in a way, this could apply even if you speak English or another language. It might still be better to speak Icelandic - especially if the other person doesn’t understand either language.
Yes, absolutely. Then you’re leaning more on that large portion of non-verbal communication to convey meaning. Of course, you can’t hold in-depth philosophical or political discussions this way. But if you’re referring to things in the here and now, so much can be communicated.
So in psychiatry, for instance, if it’s about how someone is feeling today, or whether they should be admitted to a hospital, or what they want to do - that might be better discussed in their native language, if there's no shared language?
Definitely - or at least be aware that there are two channels. One is the actual text, which you might translate with a tool (like Google Translate), to ensure the literal meaning is conveyed. Whether you say “I'm worried” or “I'm very worried” - that distinction matters. But the second channel is the one where you’re resting in a language you’re truly comfortable in. We know this when caring for someone who’s ill or elderly - or a baby. You're not thinking about the text; it’s more intuitive.
Yes, we know this deep inside. I think about how, when we meet dogs abroad or other animals, we usually talk to them in our own language.
Yes, exactly. Some say the language closest to your heart is the one you swear in. Or the one you use when you’re startled - like saying “Oh my God!” And also the language you use when you count.
That reminds me of a time I traveled in South America many years ago with a Belgian couple. One spoke Flemish, the other French. But they spoke to each other in English, which neither spoke well. You wonder - was their whole relationship based on misunderstanding?
Right! That’s actually a real issue when people decide which language to speak with their children in bilingual or multilingual households. Should we both speak our shared language with the kids, or should I speak my native language and you yours - so the child gets exposed to two or three languages early on?
What’s the recommendation?
Well, it’s worth thinking about. We’re most receptive to language through natural acquisition - before puberty, maybe up to age 12. But we don’t usually start teaching foreign languages until after that, when we learn them by memorizing rules instead of just absorbing the language naturally. Technically, we could teach kids 3–4 languages during that early window and do it systematically - but we don’t. We wait until it’s harder!
Svandís Svavarsdóttir: “For families, caregivers, and patients, it's important to read the signs of mania. The vocal range expands, volume increases, pitch goes up and down, body language takes up more space. Suddenly people are waving their arms dramatically - far more than “normal” people.”
Do you see any direct link here to mental health? Any takeaways, beyond just being mindful of how communication works?
I think it could be powerful in mental health settings to introduce these ideas to people. That they become aware that these are tools. How you use your body, and that this should be considered in interactions with patients. That we become fluent in these variables and can apply them consciously - they carry messages.
Two things come to mind. One is about cultural variation in non-verbal cues. These aren’t universal. Like in India, where nodding your head in a certain way means “no,” and shaking it means “yes” - opposite to what we do in Northern Europe. I remember a recent news story about Greenlandic mothers. Anthropologists wanted to highlight that Danish child protection standards were misapplying norms, thinking these mothers were neglecting their kids, when in fact their eye contact behavior was simply culturally different. That’s important to consider - we must be careful when applying our own norms to different environments.
The second point is how this plays out with patients with bipolar disorder. For families, caregivers, and patients, it's important to read the signs of mania. The vocal range expands, volume increases, pitch goes up and down, body language takes up more space. Suddenly people are waving their arms dramatically - far more than “normal” people. Conversely, when someone is depressed, the voice becomes monotone, the body small, withdrawn. I’ve seen this in a family member. It could be powerful to talk to them about it - to ask if they’ve noticed these changes. Because others who’ve lived with bipolar disorder for decades do notice. And recognizing that when you start raising your voice and expanding your body space, you’re doing that at the expense of others in a social setting - that could be insightful.
That’s a way to help people gain insight into their own condition - to see themselves in relation to others. Insight is a concept I’m fascinated by. It’s almost its own domain, and often doesn’t even correlate with illness severity. People with serious mental illness often do well if they have insight. But a mild condition without insight can be very difficult. It’s a complex cognitive phenomenon - understanding your place in the world, the nature of your illness, how others perceive it, what the symptoms are, and the need for treatment. Well, we’ve wandered far and wide - perhaps time to stop. Thank you so much for the chat, Svandís. □
