Got Anxiety: Therapeutic metaphors: riding the wave of anxiety
Mary B. Barmann, MFT
This is the first in a three-part series of columns from the Barmanns concerning the use of clinical metaphors in the treatment of anxiety disorders. Look to SierraSun.com next week for Part Two.
Metaphor refers to a “figure of speech in which an expression is used to refer to something that it does not literally signify, in order to suggest a similarity between the two.”
For example, “I’m drowning in a sea of worry.” Metaphors serve as a bridge between our concrete world, and more abstract constructs, such as anxiety.
A person we treated in the past metaphorically once stated that she often feels like she has spent her life running as fast as she can up an escalator which is, unfortunately, going “down.” Her statement suggests an abstract sense of struggle and a loss of hope.
We responded by asking if it were possible she may be viewing her life through too small a lens; one that is often malfunctioning. It was our hope this question would trigger the idea that one solution to this problem would be to “change lenses,” for the purpose of seeing her dilemma in a different light; implying that her situation is not permanent, and could be managed by shifting her perspective.
COGNITIVE THEORY OF EMOTIONS
Most people believe that emotions are determined by the situation we find ourselves in. It is more accurate to state it is the MEANING we assign to our moment-by-moment experiences that triggers our emotional reactions.
The same event may elicit different emotions in different people, or even different emotions in the same person, based on one’s mood, context in which the event occurred, etc. Anxious individuals are typically stuck in faulty thinking patterns, believing that THEIR interpretation is the ONLY correct way of appraising a situation.
Metaphors related to being “stuck” in a way of thinking, can prove to be an effective means for helping people to generate alternative ways of looking at things, particularly when these habitual thinking patterns result in negative emotional states.
METAPHORS IN COGNITIVE THERAPY
The use of metaphors when conducting cognitive therapy is designed to encourage people to “think about how they think,” for the purpose of better understanding the unhelpful manner in which they tend to interpret life events, followed by learning methods for constructing alternative, more helpful interpretations of the problems they are experiencing.
The following, are two examples:
1. The “Bully” Metaphor: Regarding anxiety disorders, we often use the metaphor of asking the individual we are working with to “personify” their anxiety. That is, if their anxiety condition were a person, describe his or her personality traits.
Inevitably, anxiety is described as a metaphorical “bully,” telling the person what they are NOT capable of doing, where they may or may not go, and insisting on following specific rules for the purpose of maintaining their anxiety (e.g., “If you stop worrying, you will let your guard down and become vulnerable to threat. So, always worry, it keeps you safe”).
2. The “Best Friend” Metaphor: This metaphor involves asking a husband (or wife) to imagine sitting at home alone, while his spouse’s cell phone receives a text from his best male friend stating, “Can you meet me at 7 p.m. tomorrow?”
The husband discovers there are several previous texts asking to meet his wife at various evening times throughout the week. One of the texts states, “Are you sure your husband doesn’t know we are meeting”?, and “Will he be away from home long enough”?
The husband is then asked, “If this person were you, how would you interpret these texts?” Most often, the interpretation is the wife is having an affair. The metaphor continues … “The husband confronts his wife about these texts, and she responds by stating there is nothing to worry about, and is upset he would even entertain such an idea”.
Although the husband has been reassured by his spouse, her response is not good enough. Frequent reassurance for those with anxiety can be compared to “digging to get out of a hole.”
Being told there is nothing to worry about provides no explanation regarding what IS really going on. What’s needed is something that allows the person to generate alternative explanations for their concern.
The metaphor concludes … “One week later you arrive home from work to discover your house is packed with many of your best friends, including the friend who sent those texts to your wife. It’s your birthday, and your spouse has been secretly arranging a surprise party for you!”
This metaphor not only indicates that reassurance-seeking is ineffective, but also demonstrates the need to encourage frequent questioning of one’s initial interpretations; the necessity to generate other possible explanations for an encountered event; and the need to think beyond one’s original assumptions — assumptions which often result in feelings of anger, anxiety and/or depression.
Barry C. Barmann, Ph.D., is a Licensed Clinical Psychologist in Nevada and California. His wife, Mary B. Barmann, MFT, is a licensed Marriage and Family Therapist in California. Visit anxietytreatmentinclinevillage.com to learn more.