Painful Bodies at Work: Stress and Culture?

Abstract

This paper presents data on significant cultural influences on pain related psychosocial work place conditions, one of the core issues of psycho-somatic medicine, and discusses consequences for a cultural neuroscience of pain. Chronic pain encompasses the experience of the pain sensation itself and a whole universe of related emotions, thoughts, behaviors and suffering, whilst tissue damage is no necessary precondition for it. A biopsychosocial view on risk factors typically concentrates on the intra-individual level and includes genetic dispositions or injuries, e.g., whilst an embodied approach emphasizing the “body being in the world”, integrating cultural perspectives seems more appropriate. However, recent epidemiological work demonstrated the relevance of group level psychosocial risk factors for chronic pain. Lack of social support at work, injustice, high job strain and effort-reward imbalance are important here. Nevertheless, even these perspectives do not capture all relevant differences: Studies in different societies reveal significant cultural influences, both in an “etic” and in an “emic” perspective. The link between culture and pain involves different aspects. Culturally shaped ways of world-making influence interpretation, labeling and treatment of distress. Now, additional knowledge on the relational biology of pain reveals, how culture determines differences in neural processes underlying emotion and pain experience.