Is there a middle ground between individualism and collectivism?

Pediatricians providing anticipatory guidance to parents from diverse cultural backgrounds need to understand the different value systems operating in individualistic and collectivist societies. Questions about child behavior, development and parenting are central to well-child visits, and pediatricians will encounter a range of parenting styles and beliefs that may be at odds with their personal beliefs as well as recommendations by the AAP. Though most doctors today receive some “cultural competency” training during medical school, the focus is typically on how different cultures interpret and treat illness.

There is far less training on how culture drives family dynamics and informs essential differences in child rearing practices. (Johnson, Radesky, & Zuckerman 2013). Two Fundamental Patterns in Child Rearing Based on attitudes towards autonomy vs. interdependence, most all cultures in the world can be divided into two basic patterns of child rearing (though notable differences between cultures that share the same pattern do occur).

There can be considerable disapproval across two such fundamentally different value systems, and this disapproval often surfaces in childcare and health care settings. Individualistic Cultures Ties between individuals are loose: everyone is expected to look after him/herself and her/his immediate family only.” The United States is the most highly individualistic culture in the world, followed closely by Australia, Great Britain, and Canada.

(Hofstede, 225) In study after study, cultural anthropologists have found that the overriding goal of American parents is to make a child independent and self-reliant. (Small 2002) Every culture has its ideal smart, well-functioning child. The ideal is so ingrained in the culture that few question its validity.

In America, that ideal is a highly verbal, independent, emotionally controlled, and self-reliant child. These social skills are seen as essential to success in an individualistic society. (Small 2002) Most American parents believe a child has an inborn temperament, a set of personality traits that can be molded by parenting and society.

Babies are bundles of potential and a good parent is one who can uncover the latent abilities and talents in their child, encourage the good while discouraging the bad (Small 1998). American parents are concerned about the self-esteem of their children; the word self-esteem can’t be easily translated into other languages because the trait is not part of the value system in many cultures. Of course American mothers are acutely aware that success in society depends on having good people skills.

Being individualistic to the point of overt selfishness is problematic. Successful children achieve a balance between self-maximization and consideration of others. Collectivist Cultures Collectivism stands for a society in which people from birth onwards are integrated into strong, cohesive in-groups, which throughout people’s lifetime continue to protect them in exchange for unquestioning loyalty.

Members of “we”-group societies make a clear distinction between themselves and those who are not in their group – or clan. (Hofstede, 225) In the majority of cultures in the world children learn to think of themselves as part of a “we”-group or in-group. Collectivist cultures actually downplay independence and promote dependence on a core group of people.

This strengthens the relationships that hold the fabric of a collectivist society together. Reciprocity of responsibility and favors between members of an in-group allows people in an extended family to get things done – in other words, it allows them to negotiate cooperation. Families in some collectivist cultures actually train children in dependent behaviors.

The idea is to teach children to engage in appropriate levels of relatedness – to have an obedient, calm, polite and respectful demeanor. One has to learn to both give and receive graciously. A person has to feel responsible for his behavior and avoid, at all costs, shaming not only himself but also the family, tribe, and community.

The worst thing that can happen to a person is to be left alone. Rejection by the in-group is a terrible punishment. Compare this to the American icon the cowboy – he is usually depicted as being a loner by choice.

He rides the range on his most faithful companion – his horse. He is a model of self-sufficiency. Individualism vs. Collectivism in Three Child Rearing Practices Sleeping, feeding, and toilet training issues make great examples of autonomy vs. interdependence in the earliest stages of parenting.

Sleeping Solitary vs. Co-sleeping At well-child visits with pediatric doctors in the U.S., questions about the schedule of both feeding and sleeping are used as markers of the child’s development and well-being. Parents from other cultures may not understand these questions and may not agree with the concepts being emphasized by health care providers. In an individualistic culture that promotes autonomy, an infant sleeps in his or her own crib or room, which requires the infant to self-regulate and self-soothe.

American babies tend to sleep solitary and, in general, spend much more of their time alone than babies do in more collectivist cultures. They spend considerable time sitting in playpens or play seats with their toys. Many parents feel that social time is stressful for babies and that infants need “downtime” to rest and recover.

Babies very quickly learn that social interaction is spaced between times of solitude. (Small 1998) Though some American parents do sleep with their babies for “pragmatic” reasons (presumably for breast-feeding and comforting a fretful baby), many express the concern that co-sleeping fosters attachment. Many move their babies out of the parental room as soon as possible, usually by six months; They express the need to guide the child down a path of independence as well as a desire for their own privacy (Small 1998).

Mothers in collectivist cultures rarely raise concerns about children having attachment issues. In many cultures, putting the infant in another room is considered unacceptable, and due to traditional practices or physical constraints the infant shares a bed with the mother or parents. ( Johnson, Radesky, & Zuckerman 2013) In fact, for the overwhelming majority of mothers and babies around the globe today, co-sleeping is an unquestioned practice – in much of southern Europe, Asia, Africa and Central and South America. Mothers from these cultures believe co-sleeping to be the best and most natural practice because the mother is more tuned into their baby’s arousal during the night.

For U.S. pediatricians working with immigrant and refugee populations it is important to know that infant sleep patterns are one of the last traditions to change under pressure from the adopted country. (Farooqi 1991) Tips on communicating in a culturally responsive way about co-sleeping: Explore sleeping practices with immigrant and refugee families especially. Ask parents and grandparents about their cultural preferences for putting babies to sleep.

Expect some parents to politely listen to concerns about co-sleeping safety without any intention of actually changing the practice.

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