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2021-04-23

Use of Metaphors in the Therapy office 🕵️‍♂️

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The problem runs as deep as what practitioners face when practicing psychotherapy
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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 the university level and have been a family therapist for a decade. I can say that this overemphasis on utilizing metaphors to communicate, illustrate points, and evoke our clients’ imagination can be troublesome, if not very problematic. But this problem is also existent in the profession. We rely on too many over-generalizations, platitudes, simplifications, and always run the risk of being so reductive in our work. In doing so, we sometimes can trigger our clients or upset them in 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 he is experiencing or how he can change his situation. In doing so, you conjure up a metaphysical analogy or a metaphor. From there, the client is lost, misunderstands your point 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 is lost altogether in the imaginary realm.

 

 

 

I read family therapy textbooks all the time. I also read journal articles and attend the latest conferences on family therapy. Participating in professional development in my own discipline of social work, and with others, marriage and family therapists, psychologists, and mental health counselors. My experience and knowledge fund are 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 analogies, studied English in undergraduate school, and wanted to be a 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. The metaphor continues to be heavily relied upon to educate therapists and utilized in the session. Thus, calling upon clients’ imagination and creativity to visualize the solutions to their problems. But this literary technique and clinical skill, 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, results 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 practicing psychotherapy. Knowing when to use what skill and when to best treat the patient is the therapist’s job. Well, this problem is rooted in the very construction and execution of the clinical practice. Perhaps because the 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 are 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 problematic for both therapists and clients.

About the Author

J. Peters

Max Guttman '08, MSW '12, is the owner of Recovery Now, a private mental health practice. Through his work as a Licensed Clinical Social Worker, therapist and disability rights advocate, Max fights for those without a voice in various New York City care systems. He received a 2020 Bearcats of the Last Decade 10 Under 10 award from the Binghamton University Alumni Association.

Guttman treats clients with anxiety and depression, but specializes in issues related to psychosis or schizoaffective spectrum disorders. He frequently writes on his lived experiences with schizophrenia.

"I knew my illness was so complex that I’d need a professional understanding of its treatment to gain any real momentum in recovery," Guttman says. "After undergraduate school and the onset of my illness, I evaluated different graduate programs that could serve as a career and mechanism to guide and direct my self-care. After experiencing the helping hand of my social worker and therapist right after my 'break,' I chose social work education because of its robust skill set and foundation of knowledge I needed to heal and help others."

"In a world of increasing tragedy, we should help people learn from our lived experiences. My experience brings humility, authenticity and candidness to my practice. People genuinely appreciate candidness when it comes to their health and recovery. Humility provides space for mistakes and appraisal of progress. I thank my lived experience for contributing to a more egalitarian therapeutic experience for my clients."

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