1. Private and Public Pain

2.  Not all social or cultural groups may respond to pain in exactly the same way  How people perceive and respond to pain, both in themselves and in others, can be influenced by their cultural and social background  How and whether, people communicate their pain to health professionals and to others can be influenced by social and cultural factors

3.  Physiological perspective › Pain can be thought of a type of signaling device for drawing attention to tissue damage or to physiological malfunction. › Pain arises when a nerve or nerve ending is affected by a noxious stimulus, either from within the body or from outside it.

4.  Physiological Perspective › Pain is culture-free, in the sense of there being a universal biological reaction to a specific type of stimulus (i.e., sharp objects, hot/cold phenomena). However, the 2 forms of reaction can be differentiated into:  INVOLUNTARY: Instinctive such as pulling away from the sharp object  VOLUNTARY: Removing the source of pain and taking action to treat the symptom (e.g. medicines) or asking another person for help in relieving the symptom

5.  Private Pain Perspective › Pain is felt by a person and signals it to other people, verbally or non-verbally › Pain remains private because there is no outward clue or sign that the person is experiencing pain, even when it is severe  It can be cultural –  CHEYENNE INDIANS: Pain is a ritual from boyhood to manhood  FILIPINOS: Painful episodes among boys to become men (i.e., baptism of fire and blood)

6.  Public Pain Perspective › Public pain depends on the person’s interpretation of the significance of the pain; whether it is seen as “normal” or “abnormal” pain.  Examples: Dysmenorrhea or Heart pain  Normal Pain: Cultural prescription of relief  Abnormal Pain: Biomedical intervention

7.  Physical Pain Perspective › Physical pain is a particularly vivid and emotionally laden symptom, it can only be understood in a cultural context by seeing it as part of the wider spectrum of –  MISFORTUNE  Form of punishment  Moral transgressions  Witchcraft

8.  Permissible pain behavior within a society are learned in childhood and infancy (e.g. avoidance of hot and cold, excessive sports for girls, spanking)  Individual sufferers are encouraged to turn their private pain into public pain within a ritual context of healing (e.g., Chinese mourning rituals or help groups for cancer or HIV positives)