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> Which of course is a lot less polite and causes a lot of friction.

Most cultures have this, but it goes mostly unnoticed from the inside because one can read between the lines. "How are you?" can be asked just to be polite, and can cause friction when answered truthfully (rather than just politely, as the cultural dance requires). An Eastern European may not appreciate the insincerity of such a question.

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Great example.

I work in a radiology practice and greet patients regularly.

99% of them say the are good/great etc.

It’s quite a striking response when they are limping, bandaged and on crutches.

That’s not really an example of cultural lying- that’s an example of a fixed answer to a fixed question.

When somebody sneezes and you say “bless you” you’re not expressing your belief in god, and you’re not lying about one either.

They're called phatic expressions.

> that’s an example of a fixed answer to a fixed question.

That's my whole point! The expected answer seems pretty obvious to you, given the context, doesn't it? Why then are you surprised that a different culture has an equally obvious (to them) fixed answer ("Yes") to any question asked by someone with power/authority to their lesser? Both depend on mutual learned cultural awareness, and can fail spectacularly in cross-cultural contexts.

Edit: my regional favorite is "We should meet for lunch some time" which just means "I'm heading out now", but you have to decode the meaning from the nature of the relationship, passive voice usage, and the lack of temporal specificity.

I sometimes answer “each day better then the next”, no one seems to notice.

I use "about the same", thanks to a friend. I love the reactions (from Americans, where everyone is expected is to say "Great" or "Good" or something similarly positive).

That's good as well.

I think I actually gave my line in a 1:1 to my manager at a job, they did not pick up on it. I was gone not long after.

Is that just a reflex response though? I would expect people to be more deliberate in their interactions with medical professionals, but I can easily imagine hearing “How are you?” and my brain goes on autopilot.

The greeting is generally in the waiting room. I’d do exactly the same if I was them.

Yeah, this is something I had to learn over my teenage/early 20s years. "How are you?" Is often not a question but just a generic greeting like "Hello" or "Nice to meet you". Sometimes it is though, but that's just one of the many examples of unwritten rules about how to tell whether someone literally means what they're saying or if there's a better way to interpret it.

Having only lived in the US, I don't have nearly enough firsthand experience with other cultures for me to be the one to comment on them, but I suspect that every culture has some things like this where the actual intent of the communication isn't direct. I suspect that if people in tech were asked to identify which cultures they considered to be the most direct in their communication, American culture probably wouldn't be ranked first. Generally the stereotypes of other cultures that are perceived as more direct get described in more pejorative terms like "blunt" though.

These days I do a 'eh' and shrug when someone asks a random 'how are you'?

I’ve always interpreted that question to mean emotionally. Yes, clearly I’m physically injured, but I still have a positive outlook.

When I do hear people respond in the negative it tends to be an opening up about stress.

At the yearly colonoscopy I say "you can tell me after how I am".

similarly, in the west, when your boss takes you to HR for an honest and open discussion, it's not really an honest and open discussion. normies know this instinctively. I didn't.

No, most cultures don’t have this, unless you measure by biomass.

Some cultures are better than others, where “better” might mean better at doing stuff (no comment on morally/socially)

A fairly common conversation starter for eastern europeans is "how are you doing?", "it sucks", "yeah it does, doesn't it?". The American style of being all flowers and butterflies can indeed be perceived as lying.

It is fine if it is not lying but so often you ask how are you and get the flowers and butterflies response but when you sit 10 min more they start explaining how miserable they are: as a Dutchman, I do tend to ask why they said how great and excellent they were just minutes ago. And no, it is not just something you do out of politeness: if you just canned response to one thing, how do I know you don't have canned responses to many more things which are in fact lies at this point in time? I don't want to talk with Zendesk, I want to chat with someone I just met in the pub.

It isn’t lying, it is what we consider an appropriate level of sharing. We don’t tend to want to put our burdens on people who may not be interested in hearing it.

After talking to many folks from US I appreciate that. It's like going through the original `SYN ; SYN ACK ; ACK` flow. You are just establishing the conversation, but then the content can start flowing after if there's interest.

To be fair we Americans also poke fun at this. Here in the South I usually say, “Can’t complain,” and most people will finish the adage, “and it wouldn’t do any good if you did.”

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