If you are a patient or psychotherapist, the odds are you have been encouraged to use metaphors in the therapy room. I teach family therapy at university level, and have been a family therapist for a decade. I can say that this overemphasis on using metaphors to communicate, illustrate points, and evoke the imagination of our clients can be troublesome, if not very problematic.
But this problem is also existent in profession. We rely on too many over-generalisations, platitudes, simplifications, and seems to always run the risk of being so reductive in our work. In doing so, we sometimes can trigger our clients, or upset them in the process of trying to help them.
I am sure you’ve encountered this before. Your client is speaking about something important to them, and you the therapist use a metaphor to either explain to the client what they are experiencing or how they can change his situation, feelings, or thoughts, based on this metaphysical manifestation you conjured up before the client was even done speaking.
From there, the client is lost, misunderstands your points altogether, or feels like your explanation wasn’t adequate. When we use metaphors and other reductive techniques, we will always run the risk of triggering our clients, or being so vague and indecipherable that the message lost altogether in the realm of the imaginary.
I read family therapy textbooks all the time. I also read journal articles and attend the latest conferences on family therapy. I also participating in professional development in my own discipline of social work, and with others, marriage and family therapists, psychologists and mental health counsellors.
My experience and fond of knowledge is as broad as it is complexly informed with the latest information and studies available.
And yet, I continue to read texts, articles and listen to other professionals using the same old metaphors to talk about the work. I love metaphors; I studied English at university and wanted to be writer but heed my warning: Beware of the dangers lurking underneath the metaphors’ thin metaphysical veneer.
Whether it is a ship or a car steering wheel to avoid disaster and its engine to drive therapy forward, the metaphor continues to be heavily relied upon to both educate therapists and instilled in therapists to utilise in session when calling upon the imagination and creativity of clients to visualise the solutions to their problems.
This literary technique and clinical skill that I am suggesting is much more reductive than it is expansive in its power to conjure positive outcomes in sessions consistently. I would also hazard to say that outcomes will be rarely reproducible. And when the therapist calls upon the metaphor to repeat an intervention, you may run the risk of failing.
The problem with metaphors and using them in therapy runs as deep as the litany of problems practitioners face when practising psychotherapy: knowing when to use what skill and when to best treat the patient and be as effective as possible as a therapist.
This problem is rooted in the very construction and execution of clinical practice.
Perhaps because clinical practice itself is an abstraction of a canon of discourses of knowledge in the allied fields of social work, medicine, psychology, and others that have built the profession with writing, research and practice.
Since abstractions exist in the metaphysical world, we aren’t just encouraged to use metaphors. In a sense, we are restricted to them The very expansiveness and creativity we think of when we use metaphors in the therapy room is truly more limited than we think. Since we therapists are restricted to using this intervention, instead of choosing it, I am again suggesting metaphors in the therapy room are truly reductive, often dangerous, and above all, problematic for both therapists and the clients served.
Image credit: Freepik
Max E. Guttman, LCSW is a psychotherapist and owner of Recovery Now, a mental health private practice in New York City.