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Therapeutic Metaphors & Clinical Hypnosis
By David Puchol Esparza licensed psychologist & clinical hypnotherapist

A university professor went to visit a famous Zen master. While the master quietly served tea, the professor talked about Zen. The master poured the professor's cup to the brim, and then kept pouring. The professor watched the overflowing cup until he could no longer restrain himself. "It's overfull! No more will go in!" the professor blurted. "You are like this cup," the master replied, "How can I show you Zen unless you first empty your cup."

The term “metaphor” comes from the greek word metapherein,meaning “to carry over or transfer” ( meta=”beyond,between,over” + pherein=”to bring or to bear” ).
In greek, a “metaphor” is something that moves other things between places. A moving van or baggage cart, for example, would literally be a “metaphor” in Greece. When applied to deeper levels of experience, what becomes “transferred” or “carried over” by a metaphor are relationships, placement of attention, feelings, beliefs, thoughts, limiting values, wrong presuppositions, etc.....

According to Webster’s Dictionary, a metaphor is “a figure of speech in which a word or phrase denoting one kind of object or action is used in place of another to suggest a likeness or analogy between them” and involves “the transference of the relation between one set of objects to another set for the purpose of brief explanation”.

In the innovative and mind-expanding book 'Metaphors We Live By', linguist George Lakoff and philosopher Mark Johnson say: “The essence of metaphor is understanding and experiencing one kind of thing in terms of another” and "We understand experience metaphorically when we use a gestalt from one domain of experience to structure experience in another domain."  

A symbol is the smallest unit of metaphor, consisting of a single object, image, or word representing the essence of the quality or an attribute it stands for.
The following is a Jung's definition of a symbol: "A word or an image is symbolic when it implies something more than its obvious and immediate meaning. It has a wider 'unconscious' aspect that is never precisely defined or fully explained. Nor can one hope to define or explain it. As the mind explores the symbol, it is led to ideas that lie beyond the grasp of reason."

The following quotes about metaphor illustrate its importance:

  1. From Karl Pribram, 'Metaphors to Models: the use of analogy in neuropsychology' in Metaphors in the History of Psychology, edited by David E. Leary (1990) Cambridge University Press [page 79]:  
    "Brain scientists have, in fact, repeatedly and fruitfully used metaphors, analogies, and models in their attempts to understand their data. The theme of this essay is that only by the proper use of analogical reasoning can current limits of understanding be transcended. Furthermore, the major metaphors used in the brain sciences during this century have been provided by inventions that, in turn, were produced by brains. Thus, the proper use of analogical reasoning sets in motion a self-reflective process by which, metaphorically speaking, brains come to understand themselves."  
  2. From Dedre Gentner and Michael Jeziorski, 'The shift from metaphor to analogy in Western science' in Metaphor and Thought, edited by Andrew Ortony (1993, Second Edition) Cambridge University Press [page 447 and 478]:  
    "Analogy and metaphor are central to scientific thought. They figure in discovery, as in Rutherford's analogy of the solar system for the atom or Faraday's use of lines of magnetized iron filings to reason about electric fields. They are also used in teaching: novices are told to think of electricity as analogous to water flowing through pipes or of a chemical process as analogous to a ball rolling down a hill. Yet for all its usefulness, analogical thinking is never formally taught to us. We seem to think of it as a natural human skill, and of its use in science as a straightforward extension of its use in commonsense reasoning. For example, William James believed that 'men, taken historically, reason by analogy long before they have learned to reason by abstract characters'. All this points to an appealing intuition: that a faculty for analogical reasoning is an innate part of human cognition”  

Therapeutic metaphor is one of the most elegant tools available for assisting people in the process of personal transformation, healing and growth.The major purpose of therapeutic metaphor is to pace and lead an individual’s experience through the telling of a story which helps that individual access resources necessary for change.

In a therapeutic context metaphors are used as tools for transformation facilitating new patterns of thoughts, feelings and behavior. If constructed properly, they are very successful and powerful in fostering the change because they communicate directly with the subconscious mind, bypassing the critical faculty of the conscious mind.  

Metaphors and stories,in a therapeutic context, may be usefull

• To provide a key mechanism for changing our modes of representing the world.
• To cause something to be remembered.
• To make, demonstrate,explain or illustrate a point.
• To create generative realities.
• To open up possibilities and strategies.
• To normalize or otherwise re-contextualize a particular position or content.
• To carry multiple levels of information.
• To facilitate new patterns of thoughts,behavior and feelings.
• To stimulate lateral thinking and creativity.
• To reframe or redefine a problem or situation.
• To introduce doubt into a position that holds that there is only "one" way.
• To provide or guide associations and thinking along certain lines.
• To allow the client to form a choice or find his own direction.
• To bypass normal ego defenses.
• To allow the client to process directly at a subconscious level (indirect suggestions).
• To shift the subject or redirect the discussion.
• To suggest solutions and new options.
• To provide a gateway between the conscious and the unconscious.
• To pass suggestions to the subconscious mind.
• To increase rapport and communication.
• To facilitate retrieval of resource experiences.
• To lighten up the mood.

Metaphors (imaginative, but not literal, descriptions of objects, events, processes etc.) can enrich, and accelerate, the emergence and sharing of ideas and models. If the process is used properly, it greatly reduces the likelihood that people are operating on assumption or misinterpretation and all the problems that this can cause. A metaphorical story in a therapeutic context consists of elements that symbolically represent the client's problem and offers a solution to the client's problem in an indirect manner.

According to Robert Dilts,a metaphor is essentially a fantasy which places the “reality” of the listener at some level.The meaning of a story or metaphor is typically not in the specific events that make up its content (its ‘surface structure’), but rather in the underlying patterns or principles it conveys (its ‘deep structure’).

The value of metaphor is that it can bypass conscious resistances, and serves to stimulate creativity and lateral thinking in relation to a problem. Metaphorical thinking provides a gateway between the conscious and the unconscious and between ‘left brain’ and ‘right brain’ processing.  

Therapeutic metaphors encourage people to focus on the deeper structure relationships between their reality and that of the story.The therapeutic value of the metaphor lies in the similarity of its deep structure to the deep structure of the problem (formal properties), even though the surface level characters and details (the content) are very different.

The fact that stories and metaphors are non-literal also makes it possible for them to provide a way of thinking that is different from the way of thinking that is creating the problem.
One of the main characteristics of therapeutic metaphors is that they are open ended, thereby allowing listeners to draw on their own resources for a solution.

Like all other forms of communication, a great deal of the influence of a therapeutic metaphor comes from the non-verbal ‘meta messages’ that accompany the oral presentation.
Voice inflection, gestures and facial expression are used to convey a large portion of the metaphor’s meaning. Key words and phrases may be marked out by shifts in voice tone and tempo. Embedded messages, analogic markings and other linguistic and non-linguistic may also be employed within the context of a metaphor to enhance and increase the effectiveness of its outcome.

There are two major components in creating a therapeutic metaphor: symbolism and isomorphism.

1.-Symbolism involves the substitution of one ‘referential index’ for another. Metaphor is defined as “a figure of speech in which something is spoken of as if it were another”.
In the case of therapeutic metaphors, the client and his circumstances are spoken of ‘as if’ they were the characters in a story. A symbol is a character, situation or object that stands for some aspect of the client’s reality.

2.-Isomorphism involves establishing similarities between the behaviors, relationships and situations of different individuals (e.g.the client and the symbolic character).

In general, symbols will identify the structural aspects of the metaphors, while isomorphism will deal with the relational or syntactic components.

The use of analogies or metaphors in Hypnotherapy is common and important, and indeed in all learning. They involve relating the new to something already known, so that the new may be understood by analogy with the known. Metaphors are used widely in hypnotherapy to pass suggestions to the subconscious mind while bypassing or occupying critical faculties. Typically a short phrase or story that has more than one meaning and at least one of the inherent meanings carries a hypnotic suggestion. A hypnotic metaphor is like a Trojan Horse.  

Dr. Erickson's work was the inspiration for using metaphors in a therapeutic context. Milton H. Erickson has done more than any other individual this century to change the way in which Hypnotherapy is practised. Many of Erickson's methods for communicating with the Unconscious using sophisticated language patterns and metaphor are recognised now as desirable and essential for effective change.

Unorthodox psychiatrist, congenial family doctor, ingenious strategic psychotherapist and master hypnotherapist, Milton Erickson’s influence has revolutionised western psychotherapy. Thanks largely to Erickson the subject of hypnosis has shed its shackles of superstition and is now widely recognised as one of the most powerful tools for change.  

Erickson emphasized indirect communications to the so-called unconscious, the use of anecdotes and metaphors to shift the frame of experiential reference, embedded (unconsciously marked-out) language phrasings, the trance experience "itself" as a generalized metaphor to re-shape consciousness, and what might be called a meta-level regression psychology, in which one pointed not to the content of past experiences (to expose repressed traumatic material, for example)...but to the structure of certain typical childhood (or life-stage) experiences of growing up (what Ernest Rossi called "Early Learning Sets"), in order to utilize those structures as re-usable metaphors to re-shape one's current (problematic) experiencing. Naturalistic and conversational hypnosis as well as strategic interaction, metaphors, tasks, and his personal and creative qualities  were his major therapeutic tools.

The major elements of constructing a therapeutic metaphor, according to Robert Dilts, include:
  1. Transferring focus from the individual to some character in the story.
  2. Pacing the individual’s problem by establishing an isomorphism with respect to the behaviors,the events and the characters in the story that are parallel to those in the individual’s situation
  3. Accesing resources for the individual within the context of the story.
  4. Finishing the story such that a sequence of events occurs in wich the characters resolve the conflict and achieve the desired outcome.

Erickson told many stories and told them to a variety of clients. As he said of his treatment for a young, anorexic girl, "My treatment for Barbie was to tell her short stories, metaphors, suspenseful stories, intriguing stories, boring stories. I told her all kinds of stories, little stories" (Zeig, 1980). He illustrated the experiences he wanted his clients to retrieve as they fixated their attention upon the dramatic aspects of an unfolding story line about someone else. Clients were free to create their own meaning from the stimulus offered and even have learnings too painful for the conscious mind to tolerate. After all, it was "only a story."  
As such, metaphor can be considered an altered framework through which a client is free to entertain novel experiences.
Milton H.Erickson gives an account of how he used isomorphism while working with a couple having marital difficulties over their sexual behavior.Erickson talked to the couple about their eating habits.He found that their eating habits paralleled the individual sexual behaviors that were causing the difficulty.The husband was a ‘meat-and-potatoes” man and liked to head right for the main course, while the wife liked to linger over appetizers and delicacies.
For their therapy,Erickson had them plan a meal together ‘from soup to nuts’, in which they both were able to attain satisfaction.The couple, of course, had no idea of the significance of the event, but were pleasantly surprised to find that their sex life improved dramatically afterwards.

Any of the therapeutic goals illustrated with metaphor will be interpreted differently by each unique client who filters them through perceptions and experiences unique to his or her personal history. But still, the stories are constructed and delivered (emphasizing and detailing particular experiences with indirect suggestions and binds) based on specific therapy goals. These stories stimulate clients to do a good bit of focused thinking which facilitates retrieval of resource experiences not customarily available or associated to in particular problem contexts.

Milton H. Erikson has been called the most influential hypnotherapist of our time. Closely related to his therapy was his use of "teaching tales." Calling upon shock, surprise, confusion - with generous use of questions, puns, and playful humor - he seeded suggestions indirectly and positively with therapeutic metaphors.  

Reading his many case studies in such books as ‘Uncommon Therapy’ and the subtle metaphorical approaches of his storytelling in ‘My voice will go with you’ is like entering another dimension. Since it was first published, in 1982, ‘My voice will go with you’ has been one of the most popular and most readable introductions to the innovative psychotherapeutic and hypnotic approaches of Milton Erickson

Dr. Erickson's work was also the inspiration and foundation for such innovative therapies as Bandler and Grinder's Neuro-Linguistic Programming, Steve de Shazer's Solution Talk therapy, the interactionalist approach of Haley, Watzlawick, Fisch, et.al. at M.R.I., brief therapy, and the refined use of metaphor, paradox, confusion, therapeutic tasks, reframing, and many other advances.

Once there was a well known philosopher and scholar who devoted himself to the study of Zen for many years. On the day that he finally attained enlightenment, he took all of his books out into the yard, and burned them all.  

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