Continuum Introduction

| |

Maribel Alvarez, Ph.D.

A few years ago, an article came across my desk that challenged many of my assumptions.1 The article described how a person’s ethnic background and identification influenced their reported experience of pain; how one perceives, labels, responds to and communicates pain was shown to be relatively similar across cultures, at least 65% of the time. The other 35% was largely influenced by a category the authors called “emotionality,” which included the attitudinal responses to pain based on either one of two culturally-based elements: stoicism or emotional expressiveness. For example, according to the research Puerto Rican patients in the study were more likely than others to admit “losing control of themselves” when describing to others in their social circles how their pain felt. Black patients were more likely than Irish patients to indicate that complaining about their pain did not do any good, therefore they tried to bear it since ‘it’s something nobody else can fight’ for you.’

I confess that even with all my training in anthropology, my first reaction to this article was of surprise. Is it truly possible that our cultural ways of being are so fine-grained as to influence something as universal and pan-human as pain? And to what degree are these alleged “cultural” reactions also not yet another form of stereotype? Aren’t human beings, first and foremost “human?” The lessons to confirm the importance of culture in how we deal with pain, grief and end of life have come to me in small increments of experience. When my mother was dying, she opened up for the first time ever in her life to talk about the painful toll of exile in our family’s history. Our mother-daughter dialogues by her bedside were solely focused on cultural dimensions of our family’s “losses” and “gains” for having been uprooted from our native land. And yet, there we were: a mother and daughter like thousands others who have sat together at the moment when death nears.

In this publication, and through the community-research process that yielded the data we present here, two poles of reality appear as a continuum — humanity at large on one end and the specificity of cultural ways ever present on the other. This continuum is both instructive and filled with tension. Ethnography is a method that teaches us to look into others’ experiences — to learn empathy at the most intimate levels of everyday life. The field workers whose work is represented here entered this fraught terrain with the greatest sense of dignity and responsibility. Yet, we all recognize that this is barely the tip of the iceberg. There are always truth that were not spoken; fears and joys that were kept private. We are grateful, though, for what we learn here, today. One’s unique experience (based on ethnicity or faith or lack there of, etc.) does not preclude the other truth: we are all in this together. That sense of democratic pluralism runs through this publication: we are all living and dying –together—in our multicultural cities and neighborhoods. We hope this journal helps you face that reality a bit more informed, confident and positively.

1 James A. Lipton and Joseph Marbach, Ethnicity and the Pain Experience, Social Science Medicine, Vol. 19, No. 12, pp. 1279-1298, 1984.

The body of SFA’s Continuum Reports/Work resides online at:

Continuum Program, Introduction, Dr. Maribel Alvarez

Leave a Comment

Skip to content