Metaphors and emotions in therapy

Clinicians are encouraged to use metaphors in Acceptance and Commitment Therapy (ACT). This study aimed to investigate the types of metaphors that occurred within an ACT therapy group and how they were used within on-going dialogue.

Naturally occurring data was gathered from an ACT therapy group. Therapy sessions were audio-recorded across the course of the therapy group and discourse analysis was applied to the transcriptions.

Various systematic metaphors were identified in relation to the therapeutic discourse of managing emotions. These included protective containers, handling objects, moving passed impediments, and emotions as fellow travellers. Between the group members and the facilitators various power dynamics were identified that influenced how the metaphors were negotiated and appropriated.
These findings highlight differences between traditional metaphors of therapy and ACT-specific metaphors, differences between metaphor use by clinicians and clients, and some of the challenges associated with more directive approaches to therapy.

Practitioner points
• A number of different metaphors can be used to conceptualise how emotions can be managed.
• Awareness of the metaphors that occur implicitly within therapy can inform how ACT-specific extended metaphors are used.
• Appropriation of metaphors introduced by clinicians can be a potential therapy outcome, and clinicians may need to consider how they are negotiated.