9/9/2013

Therapeutic Metaphors:
What to say when there is nothing to say

Bridging to an Integrated Future

September 16 2013
Tom Moore, LMSW, LLP, CCS

Uniqueness of trauma
Defining metaphor
Purposes
Strategies
Techniques

Examples

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Client trauma
presentation

Counselor
presentation

Trauma is contagious...When a
(support person) experiences, to a
lesser degree, similar terror, rage and
despair as the victim, the phenomenon
of traumatic counter transference or
vicarious traumatization occurs.
Herman, Trauma and Recovery, 1992

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(Figley)

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Other Life
Demands
Exposure
to Suffering

Prolonged Exposure
to Suffering

Detachment

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1

Empathic
Ability

Empathic
Response

Residual
Compassion
Stress

Compassion
Fatigue

Sense of
Satisfaction

Concern

Traumatic
Memories

The Compassion
Fatigue Process-Figley,
2001

Belief

Personal
invulnerability

Perception
of world

Meaningful,
orderly

View of self Positive

(Janoff-Bulman, 1992)

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Inner
experience
negatively
transformed

Experience of
terror, grief and
grieving

Description of
events, reports of
cruelty, sadistic
abuse

Occurs through
empathic engagement
with traumatic
material

Witness to
trauma

(McCann & Pearlman, 1990)

Effects=
cumulative

Effects=

Effects=

modifiable

permanent

Common
factors

Effects=
emotionally
intense and
painful

Change core
beliefs

(Rosenbloom, Pratt, Pearlman)

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(VanWagoner, Gelso, Hayes, and Diemer, 1991)

Empathy key
factor

Experienced
personal
trauma

Activation of
unresolved
trauma

Childrens
trauma
especially
provocative

Become aware of
personal trauma
Traumatic events are
really and part of
society
Clients present
powerful emotional
needs and mistrust
Client-presented
trauma evokes
therapists own past

Therapist often
perceived as
perpetrator or assailant

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Intensity of issues
Transference issues
Assault on caregiver identity
Evocation of past trauma
Results in
Boundary violations

EXAMPLE

Failed therapeutic relationships

Increased shame

You are meeting with a

client . The client
experiences a flashback
and proceeds to disclose in
detail a traumatic event
from their life.

Have you
ever
experienced
this with a
client?

How have
you
responded
in the
moment of
the
disclosure?

Following
the event,
how did you
respond?

Collins Dictionary of the English Language

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Guru: Metaphors of a Psychotherapist,

Kopp, page 17

David Gordon

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Religious
writings
Fairy
tales
Song,
stage,
film

Intense impact

Varies
communication
forms

Implied
meaning about
subject

Decreased level
of threat or
confrontation

Flexible

Builds rapport

Used in own
way and
purpose

Impacts
unconscious &
attitudes

Models a
different form of
communication

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CLIENT
METAPHOR

Statements

CLIENT
METAPHOR

Statements

Interaction=
battle

Ill beat this guy Time is a

at his own
valuable
game
commodity

That decision
cost me a year
of my life

You approach
life with a
defeatist
attitude

I cant give you

any of my
precious time.

He defended
well against the
verbal assault

I spent hours
thinking about
this.

Weve got to
attack this
thing head on.

Ive got to
budget my time
better.

Everyones got
an Achilles
heel.

Ive
squandered
and wasted my
time.
Gilligan, 1987

What does
the state
or attitude
remind me
of?

How can I
elaborate
and
evoke?

When
have I
experience
d this state
or
attitude?

When has
someone
else ..
When
could
someone
experience

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George Santayana

They are
able to
because
they think
they are
able.
Virgil

Believe that
life is worth
living, and
your beliefs
will help
create the
fact.
William James

Christian Nestell Bovee

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What illustrates this idea?

What does the idea remind me of?
How can I elaborate.?
How do I know the idea is valid?
What convincing evidence exists?
What would evidence to others?
What will happen if others do not learn this?
How did I learn this?
How did others learn this?

Voice
tone

Repetition

Pauses

Quotes

Mindful
planning
Receiver finds
the meaning

Thoughtful use
of self stories

GUIDELINES
Integrate
within therapy

Multiple
stories
Combs and Freedman, 1990

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Study
recipient and
therapeutic
relationship

Be mindful of
non verbal
communication

Selective
decisions
about
subject
matter

List a dozen
emotional
states

Take
first
item
Picture
or
image
Physical
posture
or action

Sound
Add other
categories

Gilligan, 1987

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Emphasizes a model of the world

Individualized=exerts power over our behavior

Make sense of our experience

Albert Einstein

Select stories suggesting

specific ideas or resources

Refrain from explaining the

meaning or moral of a story

Find
personal
meaning

Exceptions:
1) Preparation for direct
suggestion;
2) Unhelpful
misinterpretation

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Actual
Situation
Significant persons

Client

Metaphor

Xc Story
Characters

BECOMES

Person 1

Xp1

Person 2
Progression of
problem

Zp2

Event 1

Incident e1 Story structure

Event 2

Incident e2

Event 3

Incident e3

EXAMPLE

Head of
household
father

Protective
mother

Adventurous
son

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Actual
Situation
Significant
person

Progression of
problem

Metaphor

Father

Captain Story

Mother

1st Mate

Characters

Son

Cabin Boy

Family

Boat crew

Father rarely
home

Captain shut up in cabin Story structure

Son gets in trouble

Cabin boy sets wrong sails

Mother covers for

son

1st mate corrects him and

attempts to reset sails before
captain sees them

Father finds out,

becomes furious
and leaves

Captain discovers sails, furious

he was not told, and retires to
cabin

No resolution,
problem recycles

No resolution, problem recycles

until

Watzlawick, 1982

motives, needs, desires, or intention

past and current behaviors
Establish
or identify Place positive labels, thus eliminating resistance

Discriminate
between

motive versus self-defeating behaviors

opens door for new/effective methods, satisfying actual
needs of client

Restructure
experience

permitting new learning and desirable behaviors to

emerge
replace problematic behaviors, feelings or thoughts
Lankton and Lankton, 1983

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My friend Joe
Personal experience=engrossing
and convincing
Humanize events, not all success
stories
Preferable when teller was in a
different phase of life

One short
story
invites
another

Small
steps

One story
rarely
decisive
element

Use more
than one
angle

Redundancy
may be
important

REFRAIN FROM MARKING OUT

Creates and artificial purpose and meaning

POSITIVE RAPPORT
Allows telling stories with widely different content from session

TYPICAL PHRASES
As you were talking, I thought of

This may not be exactly what you were

meaning, but

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CLIENT
METAPHOR

Client
Statements

Interaction= Ill beat this

battle
guy at his
own game

Counselor
Statements

CLIENT
METAPHOR

Client
Statements

Counselor
Statements

Were
interested
here in
mobilizing
your
internal
resources.

Time is a
valuable
commodity

That
decision
cost me a
year of my
life

Lets look at
the high
cost of
maintaining
this
problem

You
approach
life with a
defeatist
attitude

Lets tackle
this
problem

I cant give
you any of
my precious
time.

Youve
invested so
much time
in this, you
cant
abandon it
now

He
defended
well against
the verbal
assault

Win in the
game of life

I spent
hours
thinking
about this.

If you spend
a little time
practicing
this, itll
really pay
off with
some
valuable

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