Clinical Handbook of Mindfulness (35 page)

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Authors: Fabrizio Didonna,Jon Kabat-Zinn

Tags: #Science, #Physics, #Crystallography, #Chemistry, #Inorganic

described,

between another object

the left hand could be

approached,

and some attribute or

equally matched

manipulated, or

circumstance pertaining to

were they equally

“bought,” so can

Analogies

it” (OED online)

trained” (p. 276)

thoughts and feelings

Metaphors

Transfer a name or a descriptive word or phrase to

an object or action different from [
. . .
] that to which

it is literally applicable (OED online)

Pervasive in vernacular

discourse; ACT stresses

metaphorical or word

Metaphorical origins go

“Hold your tongue”

origin (e.g., discussion

Conventional

unnoticed (Kittay, 1987)

(p. 51)

of “responsibility”)

Human affect, behavior,

Concepts are applied to a

and cognition are

variety of expressions

nested, historical, and

pertaining to the same

ongoing events (Hayes,

topic (Lackoff & Johnson,

“Love is a physical

Wilson, & Strosahl,

Conceptual

1980)

force” (p. 90)

1999, pp. 18–26)

Emotions, thoughts, and

impulses are the cargo

of trains running on

Similarity is generated and

parallel tracks in one’s

not preexisting (Black,

“The garden was a slum

mind (Hayes & Smith,

Creative

1962)

of bloom.” (p. 17)

2005, p. 66)

The story of the person

in the hole (Hayes

“Extended metaphors” (OED

Plato’s
Allegory of the

et al., 1999,

Allegories

online)

Cave

pp. 101–102)

If you aren’t willing to

Express “a general truth

have it, you got it

drawn from science or

(Hayes et al., 1999,

Maxims

experience” (OED online)

pp. 121)

116

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

direct instruction or detailed rule giving. A body of research in the 1980s

(e.g.,
Barrett, Deitz, Gaydos, & Quinn, 1987; Catania, Matthews, & Shimoff
,

1982; Hayes, Brownstein, Zettle, Rosenfarb, & Korn
,
1986)
demonstrated that people are less likely to meet the changing demands of situations after

having received explicit instructions. In essence, excessive rule-following

may be repertoire narrowing, decreasing the flexibility necessary to mas-

ter life’s challenges. Conversely, more strategic or less-detailed verbal rules

may preserve flexible coping. The Buddhist allegory of
the finger and the

moon
(Watts, 2003)
provides an example: Meticulous instruction following (i.e., attending to the other person’s pointing finger) may prevent contact

with the actually prevailing conditions (seeing what is there to be seen).

Experiential exercises combined with the figurative speech in ACT are

explicitly designed to minimize the role of instruction and to maximize per-

sonal engagement with subtle and complex social situations. They downplay

the therapist’s expert (and potentially coercive) role, amplify the importance

of individual experience, and create a space where the client may begin to

experience events “freely and without defense”
(Hayes et al., 1999,
p. 77).

Flexible approach, rather than rigid avoidance, characterizes the engagement

in life that ACT aims to promote. In line with this understanding, regardless

of ACT’s evidence base and the demonstrated usefulness of the approach,

therapists have to assess whether the use of figurative speech has the desired

impact on the client.

Theories of Figurative Speech

Modern theorists characterize figurative speech as the “constitutive form” of

language and its “omnipresent principle”
(Richards, 1936,
p. 93). While similes and analogies explicitly extend comparative relations and proportions to

other subject matters and were rather uninteresting to linguists, metaphors

have always received more scholarly attention because they seemed to arise

out of a random, creative process that involved an intentional, “degener-

ative, incidental, or non-conforming”
(Ritchie, 2006,
p. 3) misuse of language. After Lakoff and his colleagues pointed to the ubiquity of conceptual

metaphors in language process
(Lakoff & Johnson, 1980, 1999),
linguistic scholars began to distinguish “conventional metaphors”—firmly engrained

in vernacular use, sharing nonverbal experience or a conceptual basis—from

the “creative metaphors” of extraordinary rhetorical construction in speech,

poetry, and literature
(Knowles & Moon, 2006; Rozik, 2007).

RFT
(Hayes et al., 2001)
reconciles these seemingly divergent views (Stewart & Barnes-Holmes,
2001).
RFT shows (1) how correlations between different types of nonverbal or verbal experiences may influence descriptions and

(2) how novel references to nonexisting events may emerge out of purely

verbally constructed relationships. To illustrate, a child commenting that car-

bonated water tastes like “my foot’s asleep” would be an example of the

first type of metaphorical extension
(Skinner, 1957,
p. 92), Shakespeare’s

“O, beware, my lord, of jealousy. It is the green-eyed monster which doth

mock the meat it feeds on” (3.3, 189–192) is an example of the second.

RFT integrates nonverbal events with verbal ones and provides an account

of how never-before-experienced events (e.g., a green-eyed monster) come

Chapter 7 The Use of Metaphor to Establish Acceptance and Mindfulness

117

to exert cognitive meaning as well as emotional effects. Unlike the current

compartmentalized and discontinuous theories of figurative speech, RFT ren-

ders a consistent and comprehensive account of language and cognition that

systematically spans all types of literal and figurative speech, from descrip-

tions over similes to creative metaphors.

The Application of Metaphor

ACT is a theory-driven and contextually based therapy in which the appropri-

ate intervention differs greatly, given the individual client and the presenting

problem. In discussing common ACT metaphors, we encourage therapists to

identify the purpose of the metaphor and adapt the story or technique to

their individual client’s experience. This is congruent with research that sug-

gests that clinical effectiveness of metaphors is increased when metaphors

are produced in collaboration with client, are frequently repeated, and are

apt to the situation
(Martin, Cummings, & Hallberg, 1992).
Thus, while each of the following metaphors is commonly used by ACT therapists, therapists

are encouraged to create their own, similar metaphors in conjunction with

their clients.

Undermine or Avoid Reason Giving

The ACT approach to understanding human suffering postulates that lan-

guage is the basis for a great deal of emotional pain and inflexible behav-

ior. One of the common impediments to behavioral change is reason giving.

Individuals find it difficult to do something new because they have a well-

developed story about why they are doing something old. A classic example

is discussing why a person continues to use a particular coping strategy that

is clearly not working. One approach would be to identify the strategy and

identify reasons the person should do something else. From the ACT perspec-

tive, this simply strengthens reason giving as an appropriate coping strategy

and leaves clients further entrenched in their original suffering. Consider the

following metaphor:

The Person in the Hole Metaphor

The situation you are in seems a bit like this. Imagine that you’re placed in a

field, wearing a blindfold, and you’re given a little bag of tools. You’re told that

your job is to run around this field, blindfolded. That is how you are supposed

to live life. And so you do what you are told. Now unbeknownst to you, in this

field there are a number of widely spaced, fairly deep holes. You don’t know

that at first—you’re naive. So you start running around and sooner or later you

fall into this large hole. You feel around and sure enough you can’t climb out

and there are no escape routes you can find. Probably what you would do in

such a predicament is take the bag of tools you were given and see what is

in there: Maybe there is something you can use to get out of the hole. Now

suppose that there is a tool in that bag but what you’ve been given is a shovel.

It’s seemingly all you’ve got. So you dutifully start digging, but pretty soon you

notice that you’re not out of the hole. So you try digging faster, and faster. But

you’re still in the hole. So you try big shovelfuls, or little ones, or throwing the

dirt far away or not. But still you are in the hole. All this effort and all this work

118

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

and oddly enough the hole has just gotten bigger and bigger and bigger. Hasn’t

it? So you come in to see me thinking “maybe he has a really huge shovel—

a gold-plated steam shovel.” Well, I don’t. And even if I did I wouldn’t use it

because digging is not a way out of the hole—digging is what makes holes. So

maybe the whole agenda is hopeless—you can’t dig your way out, that just digs

you in.

(Hayes et al., 1999,
pp. 101–102)

One function of this metaphor is to undermine reason giving. The

metaphor acknowledges that the person may have reasons and that those

reasons make quite logical sense. However, the metaphor puts at the fore-

front the question of whether or not what the person is doing is working.

Reasons are undermined in that they are less important than the measure

of workability. The therapist need not debate the individual’s reasons nor

convince their clients of the supremacy of other reasons.

Undermine or Avoid Pliance

As discussed above, while rule-following may decrease the flexibility neces-

sary to master life’s challenges, sufficiently vague rules may preserve flexi-

ble coping. Metaphors are particularly useful in undermining pliance in part

for this reason. There is often no correct response or answer following a

metaphor. In ACT, this is sometimes addressed directly in discussion of the

therapeutic relationship. This is an example:

Two Mountains Metaphor

It’s like you’re in the process of climbing up a big mountain that has lots of

dangerous places on it. My job is to watch out for you and shout out directions

if I can see places you might slip or hurt yourself. The question is how do I best

do that? If I am at the top of your mountain, then I can’t really see you very well.

If I am leading you up the mountain, then I have the same view as you and that

isn’t much help either. I see it like I am actually on my own mountain, just the

one across the valley. From there I have a good view of your path. I don’t have

to know anything about exactly what it feels like to climb your mountain to see

where you are about to step. You are the expert on your mountain and what it

feels like to be there. I have the advantage of being able to see from a different

perspective. Together we might be able to figure out a way to climb.

At other times, the metaphor is used to give a specific message, but the

expected change in behavior is not articulated by the therapist

The Rubber Hammer Metaphor

It would be as if you were to go to the doctor and say that you have a terrible

headache, and the doctor looks at you and you’re hitting yourself in the head

with a rubber hammer. You may not know that you’re hitting yourself, or you

might have a very good reason for doing so. However, the first thing the doctor

is likely to tell you is “you are hitting yourself over the head with a hammer,

and your head is likely to continue to hurt until that stops.”

In this situation, the patient must decide what the hammer is and what

it means to stop hitting oneself over the head with it. Pliance is reduced

Chapter 7 The Use of Metaphor to Establish Acceptance and Mindfulness

119

because the therapist does not explicitly define the rule. The resulting effect

more closely resembles contingency shaping than a direct rule because a

very wide variety of actions could be relevant to the metaphor.

Weaken Literal Functions of Language

Because of the emphasis on language in ACT, there are many metaphors that

specifically target the literal functions of language. These metaphors are used

to highlight the pitfalls of taking our thoughts and the associated language

literally, and seek to establish contexts in which that is less likely. This is an

example.

Two Computers Metaphor

Imagine two computers, sitting side by side, each with an operator in front of

them. These are identical machines, and they have the same programs and the

same data in them. Now, the way computers work is that if you give them a par-

ticular input, they give a particular output. So suppose we push a key on these

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