Using Metaphors as a Clinical Tool

Metaphors have been used in various forms of psychotherapy for decades and for good reason. They are a memorable and effective way of helping to solidify and make concrete the many facets of what it means to be human, and can help patients understand the meaning and consequences of their behavior.

Studies show that when metaphors are used in therapy, patients rate sessions both more memorable and more helpful. Metaphors were particularly effective when clients were asked to participate in developing and describing them in relation to their circumstances.

Here are a few of the reasons metaphors are such a useful clinical tool:

Metaphors Can Make Abstract Concepts Concrete.

A good metaphor offers a more concrete way of experiencing what might otherwise feel abstract. Whether a patient is in the midst of a break-up, having difficulty breaking addictive behaviors or unhealthy habits, buried in debt, grieving the loss of a loved one or simply feeling stuck—metaphor can help them view their challenges with a certain level of objectivity, which facilitates the ability to make sense of things.

Metaphors Remind Patients That There is No Experience, No Matter How Painful, That is Unique to Them Alone.

If you’ve worked with metaphors in clinical settings for long enough, you likely find yourself coming back to some of the same ones because the issues patients tend to present with in therapy are often symptoms of a set of common core human afflictions. Difficulty tolerating uncertainy, emotion regulation issues and fear of failure are just a few of those things that lead clients down the rabbit hole of avoidant and maladaptive coping behaviors.

The practice of working with metaphors is a subtle way of reminding patients that they are not alone. The fact that one particular metaphor is often used over and over again with a range of clients is itself a testament to the commonality of many human afflictions.

When using a particular metaphor, it may be clinically useful to remind clients that the metaphor presented has been used in therapy before and will likely be used again. This approach serves as a way of reminding the patient that they are not the first, nor will we they be the last, to experience this particular brand of hardship.

Be careful not to invalidate the clients here; this practice is not meant to take away from the weight of their suffering nor to tell them “this is normal, get over it.” It is simply to remind them that they are not alone.

The awareness that all humans suffer makes space for the client to approach her situation with awareness of the interconnectedness of all beings. When she does this, she shifts out of a painful, self-centered perspective in which her suffering is often compounded by judgments around unfairness, isolation, self-pity and shame.

Metaphors Have the Power to Prompt Feelings, Facilitating a Level of Emotional Contact That the Client May Otherwise Avoid. 

Metaphors are not just ideas; much of their clinical relevance is in the fact that they also have the power to invoke feelings that the client might otherwise choose to ignore or shy away from in a session.

Particularly when exploring an especially challenging life issue, metaphors can prompt intense emotional reactions. This presents a golden opportunity for the patient to learn new ways of dealing with or approaching difficult internal experiences. The clinician might guide the clients toward a more self-compassionate stance, for example, or remind them that, in this moment, they are safe to feel what they are feeling. A skilled clinician provides a safe space in which clients can either choose to move toward or back away from what comes up.

Metaphors Can Facilitate the Process of Learning to Shift Flexibly Between Perspectives.

Science has proven that being “psychologically flexible” is fundamental to well-being. One aspect of what this expression means is that we’re able to shift from one perspective to another; a core skill for qualities like compassion and empathy.

When we look at aspects of our lives through metaphor, we’re stepping back and seeing things from a new perspective. We are no longer caught up inside the content of our minds or lives, rather we are observers.

This ability to step back is one of the core skills of mindfulness, which has been increasingly supported through research in recent years and proven to provide a host of mental health benefits. It can be trained through practices like meditation, charitable behavior, lovingkindness meditation, compassionate mind training and more.

Metaphors are powerful tools but they take practice to utilize in sessions. They can be found in clinical texts, created in an improvisational fashion or generated through the appropriate use of cards, such as tarot.

Whichever approach you choose, remember to be flexible and willing to make mistakes. If a chosen metaphor does not resonate with a client, that’s okay. Finding effective metaphors—like therapy—is a collaborative process and creates an opportunity for the patient to learn more about her experience in the process.

Using Metaphors as a Clinical Tool

Jessica Dore

Jessica Dore is a behavioral science and spirituality writer with several years of experience in clinical psychology publishing. She blogs weekly about tarot cards and psychology on her website In her free time, she is a devoted ashtanga yoga practitioner, food enthusiast, and DJ. Follow her on twitter @realJessicaDore.


APA Reference
Dore, J. (2017). Using Metaphors as a Clinical Tool. Psych Central. Retrieved on October 29, 2020, from


Scientifically Reviewed
Last updated: 22 Jun 2017
Last reviewed: By John M. Grohol, Psy.D. on 22 Jun 2017
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