In a groundbreaking study published in Social Cognitive and Affective Neuroscience, scientists have found evidence that bilingual individuals perceive pain differently depending on the language they are using. The study, involving Spanish-English bilingual adults, found that participants rated pain more intensely when using Spanish compared to English, suggesting a profound connection between language, culture, and sensory experience.
Previous research has long hinted at the intricate ways in which our cultural and linguistic backgrounds shape our experiences and perceptions. The concept of ‘linguistic relativity’ suggests that the language we use can influence our thought processes and perceptions. Studies in cultural psychology have shown that bilingual individuals often ‘switch’ between cultural mindsets based on the language they are using, a phenomenon known as ‘cultural frame switching’. This intriguing interplay of language and culture has been observed to affect various psychological and neural processes.
Pain is known to be influenced by various psychological and social factors. Recognizing the importance of understanding pain in a multicultural context, especially given the healthcare disparities faced by Hispanic communities in the United States, researchers at the University of Miami set out to explore how bilingual individuals experience pain in different language contexts.
“My personal interest in this topic first emerged through learning Spanish (and later Portuguese) as a foreign language,” said study author Morgan Gianola, a T32 Postdoctoral Scholar for Behavioral Medicine Research in Cardiovascular Diseases. “There are numerous ways in which different languages encode similar situations and experiences in very distinct ways, and from a subjective perspective they have different ‘feelings’ to them.
“I was interested in showing experimentally that this might actually be the case. The potential link to pain was particularly exciting as pain is highly clinically relevant (most major medical complaints involve pain in some way) and is often thought about in terms of being an ‘objective’ response to external events but has a strong subjective component. It’s easier to see how having different feeling words in one language vs another might influence our emotions, but to have language alter the way our bodies and minds respond to a physically painful experience would really show the power of language in perceptual processing.
How the Study Was Conducted
The study’s participants were a group of 39 bilingual adults, all fluent in both English and Spanish. They were drawn from the University of Miami and the surrounding Miami-Dade County area. Their ages ranged from 18 to 44 years, offering a broad perspective on the bilingual experience across different stages of adult life.
The core of the study involved a series of pain assessments conducted in both English and Spanish sessions. Participants were exposed to heat stimuli, a universally recognized form of physical discomfort, and asked to rate the intensity of the pain they experienced. These ratings were made on a scale from 0 to 10, providing a quantifiable measure of their pain perception. This approach was designed to tease out any differences in pain perception that might arise from the language context in which the experience was framed.
But the study went beyond just these subjective ratings. The researchers employed functional Magnetic Resonance Imaging (fMRI) as they processed the pain stimuli. This cutting-edge imaging technique allowed the team to observe and record brain activity in real-time, particularly focusing on areas known to be involved in processing pain and language.
Findings of the Study
Participants consistently rated the pain as more intense when they were in the Spanish language sessions compared to the English ones. This language effect was not just limited to subjective ratings; it was also reflected in the brain’s activity. The fMRI scans revealed that certain brain regions associated with pain processing showed increased activity during the Spanish sessions.
Moreover, the researchers discovered that the brain’s responses in areas associated with sensory and affective processing of pain mediated the effect of language on pain intensity ratings.
Interestingly, a participant’s cultural orientation – whether they identified more with Hispanic or US-American culture – played a significant role in how language influenced their pain perception. The pain response was stronger in the language that matched the participant’s stronger cultural orientation. This suggests that cultural identity can modulate the way language impacts our sensory experiences, including pain.
“We looked at a few different brain systems that we thought might explain differences in pain across languages,” Gianola told PsyPost. “I was surprised that the somatosensory processing areas (those regions that directly process tactile/feeling sensations) showed the largest language effects and had the largest effect on the pain reports people ultimately gave.”
“I had expected that people might just be paying more attention to the pain in one language vs the other, and while we saw some evidence for that, it really seems that differences in the sensory experience of the pain across languages are driving changes in pain ratings, particularly for individuals who identify more strongly with the Hispanic side of their culture.”
These findings shed new light on the complex interplay between language, culture, and the human sensory experience, revealing that these aspects of our identity can profoundly shape our perception of physical sensations.
“Overall, it seems to be the case that the language in which a bilingual person experiences/processes a physically painful event can affect not only the level of pain they report but also the way that physical sensation is processed in the brain,” Gianola explained. “Specifically, the sensory qualities of the experience are highlighted to different degrees in different languages. However, it’s not simply ‘more pain in Spanish for everyone.’ Rather, it seems to be that the pain is felt more strongly when it is processed in the language that the person feels a stronger cultural connection to.”
“This means 1) that the effect of pain in a different language doesn’t necessarily have the same effect on everyone (if I feel similarly connected to both cultures, the language doesn’t seems to affect my pain reporting much) and 2) some people (those identifying more strongly with US-American culture) appear to experience stimuli as more painful in English while more Hispanic-identified bilinguals show signs of more intense pain in Spanish.”
Limitations and Future Directions
While the study offers significant insights, it also has its limitations. The sample size was relatively small, limiting the ability to detect weaker language or cultural effects. Additionally, the study’s design combined language with cultural priming, making it challenging to isolate the effects of each factor independently.
Future research could explore different bilingual groups, vary experimental conditions, or focus on chronic pain patients to provide a broader understanding of how language and culture intertwine in shaping our perception of pain. Such studies could further elucidate the neural mechanisms underlying the connections between language, culture, and pain.
“There are several major caveats to this research,” Gianola told PsyPost. “First, to our knowledge, we are the first researchers to address this question (how language affects pain processing among bilinguals) and this is a small sample of individuals, so these results need to be replicated multiple times among larger groups of people before we can say with high certainty that they are real.”
“Second, we were studying healthy individuals being exposed to brief induced thermal pain (like holding a cup of hot coffee against your forearm for a few seconds). We hope these results generalize to people suffering acute pain in medical contexts and/or sufferers of chronic pain, but that is follow-up research that needs to be conducted.”
“Third, we only tested Spanish-English bilinguals, so it is not clear if a similar pattern would emerge amongst bilinguals who speak different languages,” Gianola said. “Finally, our sample represented people of diverse cultural backgrounds and national origins (about half immigrated to the United States from Latin American countries while the other half were children of immigrants). This is a strength in some regards as many studies focus only on Mexican American individuals, but it does leave questions as to whether the effects are consistent across people of different national origins.”
Nevertheless, the new study adds a new dimension to our understanding of pain perception and also underscores the importance of considering linguistic and cultural contexts in healthcare, particularly in pain management.
“Hispanic/Latino populations in the United States still face consistent disparities in health care access, pain assessment, and treatment,” Gianola explained. “It is our hope that this research can be leveraged to build more effective treatment approaches for these and other culturally diverse communities. However, it is essential that the underlying systemic issues leading to these disparities are addressed in tandem with refining treatment approaches. That is, we can develop more effective pain assessment techniques, but that won’t do anything for patients that never have their pain assessed in the first place.”
The study, “Does pain hurt more in Spanish? The neurobiology of pain among Spanish–English bilingual adults“, was authored by Morgan Gianola, Maria M. Llabre, and Elizabeth A. Reynolds Losin.
