Cultural Influences on Pain Perception: A Cross-Cultural Analysis of Native Americans and Alaska Natives

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Cross-cultural psychology explores various psychological phenomena across different cultures, shedding light on how culture shapes human behavior and cognition. In this essay, we will critically analyze cultural response bias in self-evaluation in countries like Japan and Korea, and how this bias is influenced by Confucian values and high-context communication styles. Additionally, we will discuss the higher prevalence of pain symptoms and painful conditions among Native Americans and Alaska Natives, and how historical trauma and cultural beliefs contribute to this phenomenon.

Cultural Response Bias and Self-Evaluation in Japan and Korea

Cultural response bias in self-evaluation is a phenomenon observed in countries like Japan and Korea, where individuals tend to evaluate themselves critically and avoid rating themselves as hard-working (Shiraev & Levy, 2021). This bias can be better understood by examining the influence of Confucian values and high-context communication styles prevalent in these societies.

Influence of Confucian Values

Confucianism, a prominent philosophical and ethical system, has deeply shaped the cultural norms and values in Japan and Korea (Shiraev & Levy, 2021). One key Confucian value that contributes to cultural response bias is modesty. Modesty emphasizes humility and downplays individual achievements, discouraging individuals from boasting about their strengths or accomplishments (Shiraev & Levy, 2021). This cultural emphasis on modesty can lead to a reluctance to overtly acknowledge one’s hard work or success, as doing so might be perceived as arrogant or immodest.

Another influential Confucian value is the emphasis on collective effort and harmony (Shiraev & Levy, 2021). In Confucian-influenced societies, the well-being of the group is often prioritized over individual aspirations. Consequently, people may downplay their personal achievements to maintain social harmony and avoid standing out as exceptional (Shiraev & Levy, 2021). This focus on collective identity can discourage individuals from self-promotion and influence their self-evaluation responses in surveys.

Impact of High-Context Communication

High-context communication is another significant factor contributing to cultural response bias in self-evaluation in Japan and Korea (Shiraev & Levy, 2021). In high-context cultures, communication relies heavily on implicit cues, shared experiences, and nonverbal gestures (Shiraev & Levy, 2021). Individuals in these cultures are often attuned to the unspoken messages and subtleties in communication.

When it comes to self-evaluation, high-context communication styles can make individuals hesitant to express their achievements explicitly. Instead, they may expect others to infer their efforts and accomplishments indirectly based on contextual clues and nonverbal cues (Shiraev & Levy, 2021). Thus, in surveys or self-assessment contexts, individuals might be inclined to understate their achievements to avoid appearing boastful or overly self-centered.

Furthermore, the emphasis on collectivism in high-context cultures extends to self-perception as well. People define themselves in relation to their social roles, group memberships, and relationships with others (Shiraev & Levy, 2021). Consequently, when asked about their own characteristics or achievements, individuals might respond in a manner that reflects their understanding of how they fit into the collective whole rather than emphasizing their individual attributes (Shiraev & Levy, 2021).

Pain Perception Among Native Americans and Alaska Natives

Native Americans and Alaska Natives have reported a higher prevalence of pain symptoms and painful conditions compared to the general population of the United States (American Psychiatric Association, 2013). This phenomenon can be better understood by examining the influence of historical trauma and cultural beliefs on pain perception in these communities.

Historical Trauma and Chronic Stress

Historical trauma refers to the collective psychological and emotional damage experienced by a group as a result of historical atrocities, such as colonization, forced relocation, and cultural suppression (Shiraev & Levy, 2021). For Native Americans and Alaska Natives, the history of colonization, land dispossession, and loss of cultural practices has left a profound impact on their communities. The enduring effects of historical trauma can lead to chronic stress, which is closely linked to pain perception (Shiraev & Levy, 2021).

Chronic stress activates the body’s stress response, leading to the release of stress hormones like cortisol, which can heighten pain sensitivity (Shiraev & Levy, 2021). Moreover, chronic stress can contribute to inflammatory responses that exacerbate existing painful conditions (Shiraev & Levy, 2021). Thus, the historical trauma experienced by Native American and Alaska Native communities can have long-lasting effects on their physical and psychological well-being, leading to higher reports of pain symptoms.

Cultural Beliefs and Healing Practices

Cultural beliefs and healing practices also play a significant role in pain perception among Native Americans and Alaska Natives (Shiraev & Levy, 2021). In many Native American and Alaska Native cultures, pain is viewed as an integral part of life rather than something to be avoided or eliminated (Shiraev & Levy, 2021). This perspective emphasizes endurance and resilience in the face of pain.

Traditional healing practices often focus on spiritual and holistic approaches to pain management (Shiraev & Levy, 2021). These practices often involve rituals, ceremonies, and the use of natural remedies to address physical and emotional pain (Shiraev & Levy, 2021). The emphasis on interconnectedness between the mind, body, and spirit in these healing practices can influence how individuals experience and cope with pain.

Moreover, the communal nature of Native American and Alaska Native cultures can provide support and solidarity in times of pain (Shiraev & Levy, 2021). The shared understanding and collective coping strategies within the community can foster a sense of belonging and mitigate the impact of pain on individual well-being (Shiraev & Levy, 2021).

Creativity Sparked by Multicultural Experiences

Multicultural experiences, such as those encountered by expatriate artists and writers, have been associated with the creative expansion of ideas (Shiraev & Levy, 2021). This phenomenon can be better understood by examining how exposure to foreign cultures fosters cognitive flexibility, challenges existing mental schemas, and facilitates the integration of diverse perspectives.

Cognitive Flexibility and Openness to Novelty

Multicultural experiences expose individuals to new and unfamiliar situations, customs, and ways of thinking (Shiraev & Levy, 2021). Such exposure requires cognitive flexibility, which is the ability to adapt one’s thinking and behavior to different cultural contexts. When individuals encounter cultural differences, they are challenged to question their assumptions and preconceived notions (Shiraev & Levy, 2021). This cognitive flexibility allows them to adapt and navigate effectively in the new environment while being open to novel ideas and perspectives.

The constant exposure to diverse stimuli in multicultural settings can stimulate creativity by pushing individuals to think outside the box and explore alternative solutions to problems (Shiraev & Levy, 2021). Embracing cognitive flexibility allows individuals to break free from rigid thinking patterns, fostering a more imaginative and innovative approach to various aspects of life, including artistic expression and creative endeavors.

Challenging Mental Schemas and Assumptions

Multicultural experiences also challenge existing mental schemas and cultural assumptions (Shiraev & Levy, 2021). Mental schemas are cognitive structures that help individuals organize and interpret information. However, they can also create cognitive biases and limit creativity by filtering out ideas that do not fit within the familiar cultural framework.

Exposure to foreign cultures confronts individuals with different ways of perceiving and understanding the world, forcing them to reevaluate their mental schemas (Shiraev & Levy, 2021). This process of cognitive restructuring can lead to cognitive dissonance, which occurs when new information contradicts existing beliefs (Shiraev & Levy, 2021). Embracing cognitive dissonance and challenging preconceived notions can facilitate the emergence of innovative and unconventional ideas.

Integration of Diverse Perspectives

Multicultural experiences provide individuals with a rich tapestry of diverse perspectives and cultural knowledge (Shiraev & Levy, 2021). These encounters allow for the cross-fertilization of ideas from different cultures, which can lead to the synthesis of innovative concepts.

By integrating diverse perspectives, individuals can create unique combinations of cultural elements, leading to novel and exciting creative expressions (Shiraev & Levy, 2021). For example, an artist who has been exposed to multiple cultural traditions may blend various artistic styles, materials, and themes, resulting in a fresh and distinct artistic voice.

Individualism and Emotion Expressivity

Research findings have shown that individualism is positively correlated with higher expressivity of emotions like happiness and surprise, while being negatively correlated with the expression of sadness (Shiraev & Levy, 2021). This complex relationship between individualism and emotion expressivity can be better understood by examining the cultural values and norms that underpin these emotional displays.

Emphasis on Self-Expression in Individualistic Cultures

Individualistic cultures prioritize personal autonomy, self-expression, and the pursuit of individual goals and desires (Shiraev & Levy, 2021). In such cultures, individuals are encouraged to express their emotions freely and openly as a reflection of their authentic selves. As a result, expressions of positive emotions like happiness and surprise are more likely to be displayed outwardly, as they align with the cultural emphasis on self-affirmation and self-expression (Shiraev & Levy, 2021).

Furthermore, individualistic cultures often value assertiveness and self-assuredness, which can lead individuals to openly express their positive emotions to assert their confidence and competence (Shiraev & Levy, 2021). Celebrating personal achievements and joyous moments is seen as a way of asserting one’s individuality and success in these cultures.

Suppression of Negative Emotions

On the other hand, the negative correlation between individualism and the expression of sadness can be attributed to the cultural norms surrounding vulnerability and self-reliance (Shiraev & Levy, 2021). In individualistic cultures, expressing vulnerability or dependence on others is often perceived as a sign of weakness or inadequacy. Consequently, individuals may feel pressure to suppress or downplay their feelings of sadness to maintain an image of emotional self-sufficiency.

Furthermore, expressing sadness openly can be seen as burdening others with one’s emotional struggles, which goes against the cultural value of independence and self-reliance (Shiraev & Levy, 2021). Instead, individuals in individualistic cultures may cope with sadness privately or seek individual solutions to their emotional challenges, emphasizing self-control and resilience.

Implications for Mental Health and Well-being

The cultural differences in emotion expressivity have significant implications for mental health and well-being. While the positive expression of emotions like happiness and surprise can contribute to a positive and optimistic social atmosphere, the suppression of negative emotions like sadness may lead to emotional repression and psychological distress (Shiraev & Levy, 2021).

In cultures where the expression of sadness is discouraged, individuals may be less likely to seek emotional support or share their emotional struggles with others, potentially exacerbating feelings of isolation and loneliness (Shiraev & Levy, 2021). The pressure to maintain a facade of emotional strength can also hinder healthy emotional processing and prevent individuals from addressing the underlying causes of their sadness.

Historical Perspective on Homosexuality as a Mental Disorder

The historical inclusion of homosexuality as a mental disorder in the DSM-II in 1968 reflects prevailing societal norms and prejudices at that time (American Psychiatric Association, 2013). This categorization was a product of the prevailing cultural attitudes and biases towards homosexuality, which were influenced by religious beliefs, moral judgments, and limited understanding of human sexuality.

Societal Norms and Prejudices

During the mid-20th century, many societies held deeply ingrained prejudices against homosexuality (American Psychiatric Association, 2013). Homosexuality was often viewed as immoral, sinful, and deviant behavior, influenced by conservative religious beliefs and cultural traditions. The stigmatization of homosexuality as a mental disorder further reinforced these prejudices, perpetuating discrimination and marginalization of LGBTQ+ individuals.

Additionally, the prevailing view of heterosexuality as the only acceptable and “normal” sexual orientation contributed to the pathologization of homosexuality (American Psychiatric Association, 2013). Non-heterosexual orientations were considered deviations from the societal norm, leading to their classification as mental disorders.

Limited Understanding of Human Sexuality

At the time of the DSM-II’s publication, there was a limited understanding of human sexuality and sexual orientation (American Psychiatric Association, 2013). The complexities and diversity of sexual orientations were not adequately recognized, leading to an oversimplification of human sexuality into rigid binary categories of “normal” and “abnormal.”

The medical and psychiatric communities lacked the scientific knowledge and evidence-based research to challenge prevailing misconceptions about homosexuality. The decision to classify homosexuality as a mental disorder was largely based on societal beliefs and opinions rather than empirical data.

Progress Towards Destigmatization

In the early 1970s, the American Psychiatric Association acknowledged the need for change and initiated discussions to remove homosexuality from the list of mental disorders in the DSM (American Psychiatric Association, 2013). This marked a turning point in recognizing the harmful impact of pathologizing homosexuality and acknowledging the importance of scientific evidence in psychiatric classifications.

The decision to remove homosexuality from the DSM represented a significant step towards destigmatization (American Psychiatric Association, 2013). It signaled a recognition that homosexuality is a natural variation of human sexuality and not a mental disorder.

Lingering Beliefs and Misconceptions

Despite the progress towards destigmatization, some individuals continue to hold onto outdated beliefs about homosexuality as a mental disorder. These lingering misconceptions may be fueled by personal prejudices, cultural influences, or misinformation about human sexuality.

Promoting education and increasing awareness about sexual orientation and gender diversity are essential to challenging these unfounded beliefs and combating discrimination against LGBTQ+ individuals. It is crucial to emphasize the importance of evidence-based research and the acceptance of diverse sexual orientations to foster a more inclusive and understanding society.

Motivation Types in Buddhist and Western Societies

Buddhist and Western societies may encourage two somewhat different types of motivation: maximizing and satisfying (Shiraev & Levy, 2021). These motivation types are shaped by distinct cultural values and philosophical perspectives, influencing how individuals pursue their goals and find contentment in life.

Maximizing in Western Societies

In Western societies, individuals are often driven by a maximizing orientation, which emphasizes achievement, ambition, and striving for the best possible outcomes (Shiraev & Levy, 2021). The cultural emphasis on individual success and material gains fosters a competitive and goal-oriented approach to life. People in Western cultures are encouraged to set high standards for themselves, work hard, and continuously seek self-improvement.

Maximizing motivation can lead individuals to focus on external markers of success, such as wealth, status, and recognition (Shiraev & Levy, 2021). The pursuit of more, bigger, and better becomes central to their lives, and they may feel dissatisfied unless they achieve their highest aspirations.

Satisfying in Buddhist Societies

In contrast, Buddhist societies often encourage a satisfying orientation, which prioritizes contentment, harmony, and inner peace (Shiraev & Levy, 2021). Buddhist teachings emphasize the impermanence of life and the importance of finding joy and fulfillment in the present moment. Instead of constantly seeking external achievements, individuals in Buddhist cultures focus on cultivating inner happiness and reducing desires and attachments.

Satisfying motivation is rooted in the principle of non-attachment and detachment from material possessions and worldly ambitions (Shiraev & Levy, 2021). Rather than striving for external success, individuals in Buddhist societies seek contentment in simplicity and mindfulness, valuing the quality of life over the quantity of possessions.

Balancing Perspectives

It is essential to recognize that these motivation types do not represent fixed categories in isolation but rather exist along a continuum. Both maximizing and satisfying orientations can coexist within individuals, and individuals in Buddhist and Western societies may adopt varying degrees of each motivation type depending on the context and personal preferences (Shiraev & Levy, 2021).

The interplay between these motivations can lead to a balanced approach to life. For instance, in Western societies, individuals may find fulfillment and contentment in achieving their goals and aspirations (maximizing), while also valuing the importance of gratitude and inner peace (satisfying) in their pursuit of happiness.


In conclusion, cross-cultural psychology provides valuable insights into the ways culture influences various psychological phenomena. Cultural response bias in self-evaluation is influenced by Confucian values and high-context communication styles in Japan and Korea. Pain perception among Native Americans and Alaska Natives is shaped by historical trauma and cultural beliefs. Multicultural experiences foster creativity by promoting cognitive flexibility and challenging existing mental schemas. Individualistic cultures encourage emotion expressivity for positive emotions but may suppress negative emotions. Historical biases and prejudices once pathologized homosexuality, but progress has been made towards destigmatization. Buddhist and Western societies differ in their motivational orientations, highlighting the role of culture in shaping individual motivations (Shiraev & Levy, 2021). Understanding these cultural influences is crucial for fostering empathy, promoting inclusivity, and appreciating the diversity that enriches our global society.


American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders. (5th).

Shiraev, E. & Levy, D. (2021). Cross-cultural psychology: Critical thinking and contemporary applications. (7th ed. ). Routledge. ISBN: 978-0-367-19939-5