Ever since I began managing the translation and adaptation of neuropsychological tests, I have been fascinated by proverbs.
While employed by its then-publisher, my first substantial encounter with them came through the Positive and Negative Syndrome Scale, better known as the PANSS. Although it is not a neuropsychological test, the PANSS has long been one of the standard instruments for measuring the severity of symptoms associated with schizophrenia.
One of its subscales, Difficulty in Abstract Thinking, uses two neuropsychological tasks. The similarities task measures a patient’s ability to identify a common concept shared by two different objects or ideas, such as table and chair and painting and poem. The other one is a series of proverbs arranged from relatively easy to increasingly difficult to help the clinician assess a patient’s capacity for abstract thought.
During a conference sometime in the late ’90s, one of the instrument’s co-authors—and the only one from the original three I had the pleasure of meeting—the late Dr. Lewis “Lou” Opler, invited me to join him for an afternoon walk around the San Diego Zoo.
I was new to the clinical assessment industry, having come from a genetics research laboratory, and I was on a steep learning curve. Lou was kind, thoughtful and an engaging storyteller. That day, I attended his annual PANSS training workshop, and afterwards he was particularly determined to see the pandas. We took the city bus, and the conversation began.
By the time we reached the panda house, we were talking about the PANSS. The PANSS was one of Lou’s babies, alongside his actual children. As we watched two very cute pandas interact, he explained how impaired abstract thinking is one of the core cognitive features of schizophrenia, especially in people with prominent negative symptoms.
I asked how he, with his colleagues Dr. Stanley Kay, Dr. Abraham Fiszbein, and Dr. J. P. Lindenmayer, had selected those particular proverbs and arranged them in the order they appear.
His answer was practical: a mixture of professional intuition and whatever published research they could find on the relationship between a proverb’s abstractness and the intellectual ability needed to interpret it.
I thought to myself, “Oh (mild expletive)… I don’t know how to do that…, especially in other languages…”
I needed a method. But, based on what rationale? Along what benchmarks? If the English-language research was already skimpy, then this subject may be even skimpier in other languages. And who was qualified to decide whether one proverb was cognitively easier than another in a different cultural setting?
Lou must have read the expression on my face. Smiling, he shrugged and said, “You’ll have to test it.”
Understanding a proverb goes way beyond knowing the meanings of its individual words. The reader, or listener, must be able to step back from the literal image, identify the broader principle underlying it and correlate the circumstances in which that principle applies.
And because proverbs emerge from mother languages, histories and ways of life, the path from the literal image to the abstract lesson is always connected to local culture.
What Makes a Proverb a Proverb?
Almost every culture has proverbs.
Some are only a few words long. Others are complete sentences. Sometimes they are humorous, other times cynical or poetic, but they all compress experience into memorable language.
Unlike ordinary individual experiences, proverbs convey generations of retelling of common experiences. Repeated by parents, teachers, grandparents and community elders until they became part of cultures’ collective memories. Unlike quotations, proverbs were not formulated by single individuals, but the lessons remain and belong to everyone within their society.
Most proverbs are also metaphorical. They rarely say exactly what they mean. Instead, they invite us to connect the concrete image with the intended idea. They present a small puzzle that we must solve. Processing the solution in our brains makes us remember it, along with the lesson.
This ability to communicate complex ideas through metaphors and simple imagery also fascinated generations of linguists, anthropologists, psychologists and educators.
Why Every Culture Has Proverbs
Long before books could be written, people told stories. And long before knowledge could be stored in libraries, it had to be stored in memory. So, every society passed experience from one generation to the next through storytelling and turned practical wisdom into something memorable.
Some cultures rely on proverbial speech more than others. In cultures where proverbs play an important role in everyday conversation, storytelling or ceremony, native speakers are typically familiar with a much larger repertoire of proverbs than speakers from cultures where they are used less frequently.
A good proverb is almost impossible to improve upon. It is short enough to remember, vivid enough to visualize and broad enough to apply to countless situations. The more often it proved useful and the longer it remained relevant, the more it was used, and the more people across generations knew its meaning. That is why even very old and unattributable proverbs are found in every known culture, regardless of geography, religion or language family.
Unlike laws, proverbs do not tell us what to do, or not to do. Instead, they offer observations about how life tends to work. Some encourage patience. Others reward persistence or caution against pride, greed or overconfidence. They do not guarantee outcomes, but they reflect patterns that generations believed were worth remembering for fostering a cohesive society.
Many of these sayings are centuries old. Some are even older than the languages in which we know them today, having evolved alongside cultures that had blended with others but continued to carry them forward. Depending on their age and language used to convey the idea, some are more abstract than others.
In that sense, proverbs are more than expressions. They are survivors of cultural sagas. Every proverb still in use today has outlived countless others that gradually disappeared, offering timeless, valid and reliable wisdom.
Life Lessons in Single Sentences
If you’ve ever learned another language, and even lived in the country where your learned language is spoken, you may have noticed that the further apart two cultures are, the less their proverbs resemble one another.
This is natural. People create metaphors from the things they know. The wisdom may be universal, but the imagery is local.
A farming community pays attention to birds, fields, seasons and harvests. Coastal communities talk about tides, storms and ships. Desert cultures speak of camels, wells and long journeys. Mountain communities draw lessons from steep climbs, narrow paths and unforgiving winters.
For example:
An English speaker knows that the early bird catches the worm.
An Arabic speaker knows to trust in God, but tie your camel.
A Czech child knows that Bez práce nejsou koláče — without work, there are no koláče (locally beloved open-top pastries with sweet toppings).
Each proverb reflects the ordinary world of its society, from childhood years to adult problems. Interestingly, many of these worlds no longer exist as they once did, yet they are still somehow relatable. Most people who use proverbs like Don’t count your chickens before they hatch have never raised chickens. Probably never held a live one. Many children have never seen a haystack, milked a cow or harvested wheat, yet they still understand proverbs centred on those experiences.
In addition to conveying wisdom, proverbs also provide a peek into everyday life from long ago, what earlier generations believed, and what they saw, valued, feared and depended on.
Proverbs as Cognitive Puzzles
So, Lou and his colleagues organized a series of English-language proverbs by level of cognitive difficulty–from relatively easy to increasingly difficult.
What makes one more difficult than another?
Here are some examples from their list, starting with the easier ones:
Plain as the nose on your face.
Too many cooks spoil the broth.
One man’s food is another man’s poison.
One swallow does not make a summer.
A stitch in time saves nine.
People who live in glass houses should not throw stones at others.
Many proverbs are constructed from frequently used words a young child understands perfectly well.
Take: People who live in glass houses should not throw stones at others.
There is nothing linguistically complex about people, glass, houses or stones. But there is a mental leap from the literal image in the sentence to its metaphorical meaning. Some proverbs require only a small leap from the literal image to the intended meaning. Others demand more layered inference, more life experience or greater familiarity with the cultural context in which they formed. These are all features of our cognition and intellectual abilities.
Neuropsychologists have long been interested in proverb interpretation. They use proverbs to explore how a person organizes ideas, recognizes analogies and navigates from concrete images to abstract concepts. This mental leap is what they mean by abstract thinking.
In my role, however, answers to other questions are also important.
Q: If proverbs differ in their level of abstract difficulty within one language, what happens to symptom measurement accuracy when they are not replaced with native proverbs and instead simply translated?
Q: What is the likelihood that they will still be equally familiar once they are translated?
Q: Does a culturally equivalent proverb require the same mental journey?
Q: How do we know that a native proverb is equivalent in this way?
Q: Or does the mental journey become shorter… or longer?
We just have to test it. Every time. Because in this context, language, culture and cognition are different expressions of the same human experience.
The PANSS is not the only clinical outcome assessment that contains proverbs. Multiple neuropsychological and psychoeducational assessments do.
Proverbs convey more than wisdom. They carry the imagery, assumptions and cultural familiarity that make the message inherently accessible to native members of its society. But finding a proverb with a similar meaning in another language does not automatically make it equivalent to the original one. And since some cultures employ proverbial speech more frequently than others, a proverb with similar meaning also does not automatically make it equally challenging.
In Part 2 of this article, I’ll look at what happens when two proverbs express the same idea but differ in how people process them, and why conceptual equivalence is not always functional equivalence.
Stay tuned, and thank you for staying with me to the end!
How Santium Contributes to This Space
Santium contributions to the Life Sciences industry are designed to support the global implementation of patient-centered endpoints and patient-facing research materials. We do this through multilingual patient and stakeholder interviewing, cross-cultural evidence gathering, local subject-matter expert engagement, and measurement-aware linguistic and cultural adaptation.
Drawing on expertise in psychometrics, thousands of linguistic validation projects, multilingual interviewing, and multinational study operations, Santium helps sponsors and researchers evaluate whether patient-facing concepts remain relevant, clinically meaningful, culturally appropriate, and operationally usable across languages, countries, and modes of administration.
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Monika Vance
Managing Director | SANTIUM
My work sits at the intersection of linguistics, scientific and medical translation, psychometric measurement, and multilingual operations, where terminology, usability, and regulatory context must align. I write about scientific and medical translations, psychometrics, languages, patient-centred research and the operational challenges that inevitably come with them. I also teach translators how to properly translate and validate complex psychometric instruments to hone their expertise in linguistic validation.
