Sociology Week 9
Culture and Pain
Pain as a biological, psychological, and socio-cultural phenomena
Pain components:
• Pain is a physical sensation, which is individually felt and collectively interpreted,
and has behavioural and emotional aspects that are shaped by cultural values and
beliefs
• As such, pain is most readily understood as a BPSE phenomenon
• Pain can be attributed to biological causes, social and spiritual ills, and external events
and traumas
Studying pain can give us important insights into the psycho-social and environmental aspects
of health, illness, and disease.
Interpreting pain- as patient, as a family member or friend or a healthcare provider can be very
challenging
Pain could also be non-specific- widespread and endured persistently over a long period of
time → chronic pain
- It may be treated topically if pain is localized
- If it is more systemic and appears alongside other chronic conditions, actions to adjust
one’s lifestyle and manage stress, sleep regulation, diet and exercise might be more
appropriate
Having the language (and medical, social, and cultural frameworks that are embedded in help
seeking processes)
- to describe symptoms, their appearance, location, and meanings is often an obstacle to
accessing care for pain, particularly chronic pain
Helman (2007) on Pain
Private vs. public pain: to what extent does one publicize pain? Under what circumstances?
Does culture influence its expression – in general? According to the situation? According
to age, gender, etc.?
- How do we communicate pain to both doctors and others?
- How do we judge whether a certain type of pain is ‘abnormal’?
- Reaction-response to symptoms: different people react to symptoms in different ways
→ Who to consult, where to go? Why? How?
We often think pain is a purely physiological concept:
- There are involuntary and voluntary responses to pain:
Involuntary is the physiological sensation
Voluntary is based on culture
Culture influences how, where, when we express pain or decide not to show it?
, Public and Private pain
Helman (2007) explains how the meanings and expressions of pain are socially learned
and draws a distinction between private and public pain. According this distinction, pain only
becomes public through verbal or non-verbal behaviour,
Private pain is translated into pain behaviour depending on various factors related to the social
and cultural context in which pain is displayed and also, according to the psychological
dimensions of the experience.
There are contexts where displaying public pain is appropriate, and other where is not. It also
depends on who is experiencing pain (e.g., children are often less refrained in their public
display of pain, gender influences the public expression of pain).
The form the displaying of pain takes is influenced by the context of the person expressing
pain
Pain behaviour, whether verbal or not, is often standardized within a culture, it is open to
imitation by those who wish to get sympathy or attract attention, by displaying public pain
without any underlaying private pain.
Cultural differences are important in the interpretation of pain as well as in responses to it.
Chronic pain Helman (2007)
- “Chronic pain is truly a private disorder, unlike acute pain that begins suddenly and a
last a short time only , the ‘visibility of chronic pain tend to disappear over time,
despite the individuals continued suffering.”
- “Chronic pain, unlike acute pain whose effect is immediate and visible to those around
the sufferer, often ‘alienate the person from the environment’ rather than increasing
their connection to other people.”
- “Whatever its profound effect it is unreal for the others, while it is so terribly present
and all-encompassing for the sufferer, and this impossibility of the other to empathize
with the sufferer enlarge the latter’s pain experience.”
Ethnicity and pain
Zborowski’s pioneering analysis of the role of cultural factors in explaining differential
responses to signs and symptoms provides a good example of the links between culture and
the response to pain (1952)
Culture and Pain
Pain as a biological, psychological, and socio-cultural phenomena
Pain components:
• Pain is a physical sensation, which is individually felt and collectively interpreted,
and has behavioural and emotional aspects that are shaped by cultural values and
beliefs
• As such, pain is most readily understood as a BPSE phenomenon
• Pain can be attributed to biological causes, social and spiritual ills, and external events
and traumas
Studying pain can give us important insights into the psycho-social and environmental aspects
of health, illness, and disease.
Interpreting pain- as patient, as a family member or friend or a healthcare provider can be very
challenging
Pain could also be non-specific- widespread and endured persistently over a long period of
time → chronic pain
- It may be treated topically if pain is localized
- If it is more systemic and appears alongside other chronic conditions, actions to adjust
one’s lifestyle and manage stress, sleep regulation, diet and exercise might be more
appropriate
Having the language (and medical, social, and cultural frameworks that are embedded in help
seeking processes)
- to describe symptoms, their appearance, location, and meanings is often an obstacle to
accessing care for pain, particularly chronic pain
Helman (2007) on Pain
Private vs. public pain: to what extent does one publicize pain? Under what circumstances?
Does culture influence its expression – in general? According to the situation? According
to age, gender, etc.?
- How do we communicate pain to both doctors and others?
- How do we judge whether a certain type of pain is ‘abnormal’?
- Reaction-response to symptoms: different people react to symptoms in different ways
→ Who to consult, where to go? Why? How?
We often think pain is a purely physiological concept:
- There are involuntary and voluntary responses to pain:
Involuntary is the physiological sensation
Voluntary is based on culture
Culture influences how, where, when we express pain or decide not to show it?
, Public and Private pain
Helman (2007) explains how the meanings and expressions of pain are socially learned
and draws a distinction between private and public pain. According this distinction, pain only
becomes public through verbal or non-verbal behaviour,
Private pain is translated into pain behaviour depending on various factors related to the social
and cultural context in which pain is displayed and also, according to the psychological
dimensions of the experience.
There are contexts where displaying public pain is appropriate, and other where is not. It also
depends on who is experiencing pain (e.g., children are often less refrained in their public
display of pain, gender influences the public expression of pain).
The form the displaying of pain takes is influenced by the context of the person expressing
pain
Pain behaviour, whether verbal or not, is often standardized within a culture, it is open to
imitation by those who wish to get sympathy or attract attention, by displaying public pain
without any underlaying private pain.
Cultural differences are important in the interpretation of pain as well as in responses to it.
Chronic pain Helman (2007)
- “Chronic pain is truly a private disorder, unlike acute pain that begins suddenly and a
last a short time only , the ‘visibility of chronic pain tend to disappear over time,
despite the individuals continued suffering.”
- “Chronic pain, unlike acute pain whose effect is immediate and visible to those around
the sufferer, often ‘alienate the person from the environment’ rather than increasing
their connection to other people.”
- “Whatever its profound effect it is unreal for the others, while it is so terribly present
and all-encompassing for the sufferer, and this impossibility of the other to empathize
with the sufferer enlarge the latter’s pain experience.”
Ethnicity and pain
Zborowski’s pioneering analysis of the role of cultural factors in explaining differential
responses to signs and symptoms provides a good example of the links between culture and
the response to pain (1952)
