ISSN 1671-3710
CN 11-4766/R

Advances in Psychological Science ›› 2022, Vol. 30 ›› Issue (7): 1546-1560.doi: 10.3724/SP.J.1042.2022.01546

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Therapeutic metaphors: Theories, empirical efficacy and underlying mechanisms

YU Guanlin, LIU Ruixuan, ZHANG Wencai()   

  1. CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
    Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
  • Received:2021-05-18 Online:2022-07-15 Published:2022-05-17
  • Contact: ZHANG Wencai


Metaphor is a unique form of language and way of cognition, with which people use concrete or familiar concepts to express and understand abstract or unfamiliar ones. As metaphors usually work effectively in transmitting therapeutic information, they are extensively used in psychotherapy. Fundamental theories of linguistics and psychology state that metaphors possess cognitive processing superiority because they are high in creativity and has memory retention functions. Though different schools of psychotherapy have varied emphasis on using metaphors generated by either the client or the therapist, they all agree that metaphors can help with effectively processing, transmitting and preserving therapeutic information through highly creative content, better long-term memory and high cognitive involvement, with psychoanalysis focusing on unconscious meaning exchanges, CBT on schema restructuring, and ACT on intuition experiences. For empirical research, a majority of studies focused on whether adding metaphors to a certain therapy (mostly CBT) could improve the effects of treatment, and as a result, some studies found that therapies with metaphors have greater intervention effects compared with conventional ones, while some others found that the two kinds of therapies are equally efficient. These studies generally demonstrate that metaphor use in psychotherapy is overall efficient, as the potential mechanisms proposed in theories had also been observed. Studies have shown that metaphor-triggered creative insight (with significant activation of amygdala, hippocampus and fusiform gyrus), enhanced long-term memory, and greater cognitive involvement could play important roles between metaphor use and therapeutic effects. In conclusion, therapeutic metaphor is an effective tool with unique advantages in cognitive processing and transmitting therapeutic information on both theoretical empirical perspectives. Future research should examine the advantages of metaphor use by setting more rigorous control groups, using metaphor-related measurements of treatment effects and exploring mechanisms further. Finally, practical applications on applying metaphors in psychotherapy practices and developing cost-efficient public mental health service programs with therapeutic metaphors are suggested.

Key words: metaphor, psychotherapy, psychological intervention

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