Clinical Handbook of Mindfulness (34 page)

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Authors: Fabrizio Didonna,Jon Kabat-Zinn

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everyday problems and create a comfortable world, while simultaneously

permitting us to bring our painful past to the present, to view the emotional

echoes of our history as a problem to be solved, to compare ourselves to an

unrealistic ideal, and to project fearful futures.

Metaphor as the Scientist-Practitioner’s Conceptual

Framework

While it is important to understand specific metaphors useful in therapy, it is

also important to acknowledge the root metaphors underlying a given prac-

titioner’s conceptual framework. This is especially important in acceptance-

and mindfulness-based practice because the fundamental assumptions are

often different than those that predominate a great deal of medical and psy-

chiatric practice.

111

112

Alethea A. Varra, Claudia
Drossel, and Steven C. Hayes

Pepper
(1970)
identifies four “root metaphors” describing prevalent views of human affect, behavior, and cognition and their relation to other events.

All scientific questions, subsequent research programs, and interventions

mirror can be characterized according to these metaphors (Rosnow &

Georgoudi,
1986;
Hayes, Hayes, Reese, & Sarbin, 1993).
Two of these metaphors are of special interest for clinical psychology. The metaphor

of the
machine
views human beings and their problems as one would a

complex clock. It prompts an examination of how components and forces

work together to culminate in a perceived explanatory chain of events. This

metaphor is the basis for the medical model and provides guidance to inter-

vention as finding the broken part and fixing it.

A contextualistic metaphor, conversely, views all human events as one

would a historically situated, purposive action, like going to the store or

making love. This metaphor emphasizes the
nested, historical, and ongo-

ing
nature of human action and introduces a focus on context and workabil-

ity within that context. In a contextualistic metaphor, there is not something

that is necessarily broken that needs to be fixed, but rather an interest in how

a particular action functions, given the person’s history and current situation.

In contrast to other metaphors, the metaphor of ongoing purposive, histori-

cal actions assumes neither a final or complete analysis nor a “right way” to

go about such an analysis. Instead, as illuminated by the root metaphor itself,

analysis itself is just another ongoing action, embedded in uncountable layers

of context and history:

[The analysis itself] is categorically an event [
. . .
.] In the extended analysis of

any event we presently find ourselves in the context of that event, and so on,

from event to event as long as we wish to go, which would be forever or until

we got tired [
. . .
] there are many equally revealing ways to analyze an event

(Pepper, 1942,
p. 249–250).

ACT specifically and contextual psychology more broadly have explicitly

adopted this latter metaphor
(Hayes, Hayes, & Reese, 1988).
They represent an approach to human behavior within its context, as interconnected,

nested, historical, and ongoing events. We are writing this chapter largely

from within the assumptions of a contextual approach.

The concept of mindfulness tends readily toward contextualistic perspec-

tive, for its focus at each moment is on the fundamentally interrelated nature

of human experience. This contextual understanding resembles the teach-

ings of many eastern philosophical schools that cultivate an intuitive, almost

nonverbal knowledge of the interrelated quality the person experiences in

the world through meditation and mindfulness practice. Contextual psychol-

ogy avoids overlaying mindfulness practices from eastern traditions onto an

essentially mechanistic root metaphor. Instead, mindfulness is a nature exten-

sion of the tenets of contextual psychology that have emerged from the basic

and applied study of human affect, cognition, and behavior (Drossel, Waltz,

& Hayes, in press).

It seems important to explicitly acknowledge the influence of root

metaphors on scientific and clinical activities, because otherwise these

assumptions present themselves, falsely, as data on the success of an

approach. Root metaphors are the ground of analysis, not the result of

analysis, and they need to be owned and stated, not thrust forward as an

Chapter 7 The Use of Metaphor to Establish Acceptance and Mindfulness

113

intellectual weapon in the battle with other views. The use of figurative

speech for clinical change is thus itself embedded in the even deeper

metaphors of clinical and scientific work. When we consider the value of

mindfulness in clinical work, we need to do so within the set of assump-

tions we adopt that allows value itself to be known and to be a useful guide

to intellectual activity; these assumptions themselves need to be grasped. In

creatures as cognitively limited as human beings, there seems to be no bet-

ter way to do that than to embrace our assumptions as embedded in a root

metaphor.

Understanding Figurative Speech in ACT

ACT attempts to alter the normal, culturally, and linguistically established

relationships among affect, cognition, and behavior so as to weaken barriers

to change. While the
machine
metaphor of human behavior assumes a causal

chain leading from sensation to perception, then to emotion and cognition,

and finally to behavior, contextualists hold that behavior change is possible

without a prerequisite alteration of the form or frequency of thoughts, feel-

ings, or memories (e.g.,
Harmon, Nelson, & Hayes, 1980;
Jacobson et al.,

1996).
The form or frequency does not need to change because the impact

of the experience is embedded in context. With a change in context, the

impact of the experience can change even when the form of the thought of

felling remains the same.

We understand this fully in everyday life, but its implications are usually

missed. A person on a roller coaster may be terrified, but the terror is not

harmful. A person having a panic attack may be terrified, but that terror as it

is carried forward may be life restricting. The difference is not so much the

terror itself as the psychological context in which it occurs.

From an ACT perspective, many of the most important functional contexts

for thoughts, feelings, memories, and sensations are those that are built into

human language itself. For example, language communities find it useful to

establish the social and practical functions of language to treat words largely

as if they are their referents. A person being told how to walk to a destination

is usually not harmed by treating the description and the images it evokes

almost as if it is the actual experience of walking to the destination. Words

and their referents are poured together, or “fused” (a word drawn from an

ancient root meaning “to pour”), without damage. But a person doing the

same thing while thinking “I’m bad” can be drawn into a lifelong struggle

with shame and self-blame, without even noticing the illusion of language

that demanded that this fight be fought. The person is having the thought

“I’m bad”—not experiencing being bad—but if that is missed the functions

of that thought are radically altered. From an ACT perspective, cognitions

and emotions function as barriers in life when we—therapists, clients, and

people in general—take them literally and treat them as static objects that

must be avoided or complied with, or that constitute “good reasons” for

engaging in some actions and withdrawing from others, or that prove further

judgments and evaluations of oneself or the world.

The avoidance, alteration, or termination of unwanted thoughts, feelings,

or memories are often futile and even counterproductive (Hayes, Wilson,

114

Alethea A. Varra, Claudia Drossel, and Steven
C. Hayes

Gifford, Follette, & Strosahl,
1996;
Wenzlaff & Wegner, 2000),
but because these effects are contextual, people often experience them as automatic, and

not a matter of behavioral choice. Western culture encourages such experien-

tial avoidance as a coping strategy, through the media and commercialism in

particular. Disengaging from particular experiences certainly provides some

short-term relief. However, in the long term, language processes assure the

more frequent or more influential occurrence of exactly those experiences

one seeks to avoid.

For example, the rule “I should not think x” contains a verbal event (“x”)

that will tend to evoke x, and thus following that rule is likely to work only

temporarily. As soon as the person following it checks to see if it is working,

it no longer will. A lack of flexibility and perceived vitality is the result of

such processes, and people feel “stuck”
(Ch¨

odr¨

on, 1997).

The reason figurative language is so frequently used in ACT is that it is a

challenge to alter the functions of normal verbal processes by engaging in

verbal processes. The theory on which ACT is based, Relational Frame The-

ory (RFT;
Hayes, Barnes-Holmes, & Roche, 2001),
provides a way out. RFT

divides language functions into those that establish the meaning of terms

based on their relations to other things (cf.,
Sidman, 1994)
and those that give terms behavioral impact. Most therapeutic approaches to cognition focus

on the relational context, that is, on methods that instigate different rela-

tions among terms and between terms of other events. Said in another way,

these methods try to change thinking patterns. ACT focuses instead on the

functional context, that is, on methods that alter the degree to which verbal

events evoke behavior. Said in another way, these methods try to change the

impact of thinking.

Some of these methods, such as defusion techniques, directly target func-

tional contexts. For example, saying a word repeatedly aloud quickly dimin-

ishes the believability and emotional arousal to the term
(Masuda et al.,

2004).
But it is also possible to use the relational context in a way that alters a functional context. Figurative language is an example. From an RFT point

of view, figurative language brings together two or more entire sets of ver-

bal relations. The number of derived relations that result are staggering, and

functions that are dominant in one relational network may now be available

with regard to another but often not in a way it is easy for the person influ-

enced by the metaphor to describe. For example, the metaphor “anxiety

is like quicksand” may bring functions that exist with regard to quicksand

(e.g., do not struggle with it; maximize your contact with it by laying out

flat) to bear on anxiety.

Interventions based on the “machine metaphor” assume that clients’ pre-

senting problems are due to atypical errors in the machinery and will subside

with error correction
(Mojtabai, 2000).
The processes targeted in ACT maintain the root metaphor of nested, historical, and ongoing events. Thus, figura-

tive speech in ACT is not so much designed to change think as it is designed

to change the context of thinking. Figurative speech is used to reframe think-

ing, evaluating, judging, remembering, and feeling as ongoing human activ-

ities, and to decouple the culturally established link between these experi-

ences and overt behavior, so that life transformation becomes possible even

if unwanted private experience persists.

Chapter 7 The Use of Metaphor to Establish Acceptance and Mindfulness

115

Figurative Speech Versus Direct Instruction

ACT employs a variety of figurative speech component as is shown in

Table
7.1.
In contrast to other therapies that may employ figurative speech as rhetorical tools to convince or persuade, figurative speech in ACT eschews

Table 7.1.
Types and examples of figurative language.

Figure of

Examples (from

speech

Definition

Kittay, 1987)

ACT examples

“A wolf is like a dog”

(literal simile) versus

Struggling with anxiety is

“Compare one thing with

“A man is like a wolf”