Défi verbal et auto-analgésie : une étude psychophysiologique chez les Quichuas

Pain is among the most universal yet culturally diverse human experience.  Nevertheless, there is a dearth of research on pain in general and particularly among the Indigenous Peoples in the Americas. Little is known about the pain experience and suffering of the 28 million Indigenous peoples of the Andes in South America, mainly Quichuas (Inca).  The aim of this integrative cultural and psychobiological study is twofold:  (1) To examine the analgesic effects of culturally meaningful daring words among the Quichuas; and (2) To explore how Quichua adults perceive, describe, and cope with pain. For the psychophysiological component, a controlled, experimental study was conducted with a total of 40 healthy adult men, distributed alternately in an experimental and control group with 20 participants on each group.  They received a pressure pain stimulation using an algometer applied to the right temporal area.  The pain threshold and pain tolerance threshold were measured in all participants.  In addition, the experimental group received culturally meaningful daring Quichua words while their encouraged pain tolerance threshold was measured.  After each threshold measurement, a visual analog scale was administered.  The algometer and visual analog scale scores were analyzed using t-tests. For the anthropological component, an exploratory qualitative/descriptive survey was conducted with a convenience sample of 40 Quichua adults, including 15 women and 25 men, in the Northern Highlands of Ecuador.  We administered verbally structured interviews using a Quichua questionnaire called “The Nature of Pain” [Nanay Jahua Tapuicuna].  The interviews covered the notions of causation of pain, vulnerability to pain, responses to pain, aggravating factors, frequent locations of pain, types of pain, duration, characteristics of pain, control of pain, pathways to care, and preventive measures. Participants receiving culturally meaningful daring words had statistically significant higher algometer values than those who did not receive them.  Those who received daring words had higher VAS scores than those who did not receive them, reflecting their increased awareness of pain.  The Quichuas’ pain experience is complex and their strategies to cope with it are sophisticated.  According to the Quichuas, emotions, life events, co-morbid conditions, and supernatural forces play an important role in the cause, diagnosis and treatment of pain.  They embrace biomedicine as well as Quichua traditional medicine.  In their view family members and neighbors are valuable sources of health care and pain control. The pathway to pain care that the Quichua people favor is inclusive and pluralistic. Culturally meaningful daring words appear to increase tolerance to pain among the Quichua.  This is a pioneering study that reveals the analgesic effects of daring words.  It highlights the remarkable biological effects of language in humans. Knowledge of the “emic” details of the Quichuas’ belief system and coping strategies to control pain could be useful for the culturally competent health practitioner who is making efforts to provide high-quality medical care in the Andes.

Keyphrases: Quichua, pain, analgesia, pain thresholds, daring words, stoicism, Amerindian, traditional medicine, Ecuador