Read Clinical Handbook of Mindfulness Online
Authors: Fabrizio Didonna,Jon Kabat-Zinn
Tags: #Science, #Physics, #Crystallography, #Chemistry, #Inorganic
two machines and some read-out shows up on both screens. Suppose what
comes up is, “Deep down, there’s something wrong with me.” Now imagine
two different situations. In situation #1, the operator is totally lost in the opera-
tion of the computer. It’s like being lost in a movie; you’re not watching, you are
in that movie, so when someone jumps out from behind a door, you jump. It is
like that. The operator is sitting right in front of the monitor, nose touching the
screen, lost in the read out and unable to distinguish between the machine and
the person operating the machine. The operator has forgotten that there’s any
distinction. So the screen shows “Deep down there’s something wrong with
me.” Now, from that place—with the operator indistinct from the machine—
the operator’s only choice is to try to reprogram the machine. Who’s going to
accept that deep down inside there’s something wrong with them? That’s like
saying it would be OK to be eaten by the tiger. Situation #2: Same computer,
same programming, everything is the same. The same readout comes up, “Deep
down there’s something wrong with me.” But this person is sitting back a little,
and is real clear that there is a distinction between the machine and the person.
He’s the operator of the machine, he’s working on the machine, but he is not
the machine. The operator can still see the read out very clearly, but because
there’s a distinction between himself and the machine, the read-out doesn’t
necessarily have to change. He could call over his friends and say “Look at this
thing. I type in x and looks what comes out on the screen. Interesting, huh.”
It’s like that. Your mind has been programmed by all kinds of people. So at one
point, Mom comes over and works on the keyboard for a while; a little later Dad
comes over. At various times, your husband (or wife), your teachers, your kids,
your friends, your coworkers—they all spend a little time at the computer. And
in certain situations—given the right input—you’ll get a certain read-out. You
might even believe it to be true. For example, it says on the screen, “Boy, I really
need to use heroin!” It may or may not be accurate. The issue isn’t whether the
readout is true or false. The issue is whether there is any distinction between
the person and the mental machinery. Is there any distinction between you and
the stuff that is in your life?
This metaphor is designed to weaken literal functions of language on multi-
ple levels. First, it equates thought and the associated language as computer
120
Alethea A. Varra, Claudia Drossel, and Steven C. Hayes
output rather than actual truth. Second, it introduces the idea that these
thoughts and language may be highly influenced by the “input” of other
people, rather than the clients own experience. Third, it emphasizes the
distinction between the person and their verbal products, increasing a sense
of choice even in the presence of particular verbal formulations.
Provide a Commonsense Model of Paradoxical Processes
Many ACT concepts do not make logical sense even though they make good
psychological sense. It is not that ACT is illogical; it is that the usefulness
of ACT concepts is dependent more on experience than analysis. Metaphors
provide a commonsense model that can reassure and guide the client when
dealing with paradoxical concepts. Consider the following example:
The Feedback Screech Metaphor
You know that horrible feedback screech that a public address system some-
times makes? It happens when a microphone is positioned too close to a
speaker. Then, when a person on stage makes the least little noise, it goes
into the microphone, the sound comes out of the speakers amplified and then
back into the mic, a little bit louder than it was the first time it went in, and
at the speed of sound and electricity, it gets louder and louder until, in split
seconds, it’s unbearably loud. Your struggles with your thoughts and emotions
are like being caught in the middle of a feedback screech. So what do you
do? You do what anyone would. You try to live your life [whispering]
very
quietly
, always whispering, always tip-toeing around. You can’t really live with-
out making noise. But notice that in this metaphor, it isn’t how much noise
you make that is the problem. It’s the amplifier that’s the problem. Our job in
here is not to help you live your life quietly, free of all emotional discomfort
and disturbing thoughts. Our job is to find the amplifier and to take it out of
the loop.
This metaphor is used to describe the complex implications of experiential
avoidance while, at the same time, to introduce the idea of acceptance. The
commonsense model of a feedback screech is more clear than an in-depth
description of how rules can interact with direct experiences to produce
self-amplifying loops of emotions and thoughts.
Providing Evidence Without Argument
This allows the client to experience a concept without having to convince
the person. An example in ACT is discussing our limits at achieving internal,
emotional control.
The Polygraph Metaphor
Suppose I had you hooked up to the best polygraph machine that’s ever been
built. This is a perfect machine, the most sensitive ever made. When you are
all wired up to it, there is no way you can be aroused or anxious without
the machine knowing it. So I tell you that you have a very simple task here:
all you have to do is stay relaxed. If you get the least bit anxious, however,
I will know it. I know you want to try hard, but I want to give you an extra
Chapter 7 The Use of Metaphor to Establish Acceptance and Mindfulness
121
incentive, so I also have a .44 Magnum which I’ll hold to your head. If you just
stay relaxed, I won’t blow your brains out, but if you get nervous (and I’ll know
it because you’re wired up to this perfect machine), I’m going to have to kill
you. Your brains will be all over the walls. So, just relax!
. . .
What do you think
would happen? Guess what you’d get? Bam! How could it work otherwise? The
tiniest bit of anxiety would be terrifying. You’d be going “Oh, my God! I’m
getting anxious! Here it comes!” BAM! You’re dead meat. How could it work
otherwise?
(Hayes et al., 1999,
pp. 123–124).
In this example, it is easy for the individual client to imagine being anxious,
despite their best efforts to control their anxiety. The extreme nature of the
metaphor allows the clinician to reliably demonstrate the concept without
having to convince the client of the outcome logically or argue that it fits the
client’s actual situation.
Structure Experiential Processes
From an ACT perspective, mindfulness involves acceptance, defusion, a
focus on the present moment, and a transcendent sense of self. Experien-
tial mindfulness exercises are used regularly in ACT. Metaphors can be used
to help guide the client to use these mindfulness exercises in a way that is
focused on these four ACT processes. The following metaphor is designed to
help the client observe their thoughts mindfully.
Leaves on a Stream Metaphor
Imagine yourself sitting on the bank of gurgling stream. You are sitting, enjoy-
ing the beautiful day, and relaxing under a large oak tree. It is fall and as you
sit you notice many leaves falling from the tree into the stream, and floating
by. As you imagine this, I want you to pay attention to any thoughts that you
may be having in each moment. Notice the thoughts coming and going as the
leaves come and go, and imagine your thoughts are written on the leaves as
they float by. One leave may say, “Am I doing this right,” and another might
say, “I feel tired today.” Whatever thought you having—just picture it on one
of the leaves and watch it as it goes by, without pushing it or pulling it. At
some point you may have the sense that you are no longer doing the exercise,
that you are caught up in the thoughts rather than just watching them go by.
When that happens, I want you to back up a few seconds and see if you can
catch what you were doing right before the leaves stopped. Then go ahead and
sit under that tree and start putting your thoughts on the leaves again. I’ll be
quiet now while you engage in this process [several minutes of silence follow]
(Hayes et al., 1999,
pp. 158–162).
In this exercise, all four ACT processes that are thought to define mind-
fulness are put into a figurative image. The “person under the tree” repre-
sents a transcendent sense of self; looking at a thought like one looks at a
leaf encourages defusion; neither pushing nor pulling the leaf is a metaphor
for acceptance; and watching for thoughts as they arise is a focus on the
present moment. The silence that follows allows the actual exercise, but the
metaphor structures it so that it is likely to be successful in ACT terms.
122
Alethea A. Varra, Claudia Drossel, and Steven C. Hayes
Summary
We have reviewed the importance of metaphor in ACT, from the model
underlying its philosophy of science to the use of figurative language to
encourage ACT processes. We have argued that metaphor is a useful clini-
cal tool in acceptance- and mindfulness-based practice in general because it
is uniquely suited to address the concerns that contextual therapies hope to
address. Metaphor is heavily used in ACT therapy and addresses the impact
of language on human suffering by undermining or at least avoiding reason
giving and pliance, weakening the literal functions of language, providing
commonsense models of paradoxical processes, experientially demonstrat-
ing concepts, and helping to properly structure and guide more experiential
processes.
References
Barrett, D. M., Deitz, S. M., Gaydos, G. R., & Quinn, P. C. (1987). The effects of pro-
grammed contingencies and social conditions on response stereotypy with human
subjects.
Psychological Record, 37
, 489–505.
Blenkiron, P. (2005). Stories and analogies in cognitive behaviour therapy: A clinical
review.
Behavioural and Cognitive Psychotherapy, 33
, 45–59.
Catania, A. C., Matthews, B. A., & Shimoff, E. (1982). Instructed versus shaped human
verbal behavior: Interactions with nonverbal responding.
Journal of the Experi-
mental Analysis of Behavior, 38
(3), 233–248.
Chödrön, P. (1997).
When things fall apart: Heart advice for difficult times
. Boston:
Shambala.
Drossel, C., Waltz, T., & Hayes, S. C. (in press). An introduction to principles of behav-
ior. In D. Woods & J. Kanter (Eds.),
Understanding behavior disorders: A contem-
porary behavioral perspective
. Reno, NV: Context Press.
Eynon, T. (2002). Cognitive linguistics.
Advances in Psychiatric Treatment, 8
,
399–407.
Harmon, T. M., Nelson, R. O., & Hayes, S. C. (1980). Self-monitoring of mood ver-
sus activity by depressed clients.
Journal of Consulting and Clinical Psychology,
48
(1), 30–38.
Hayes, S. C., Barnes-Holmes, D., & Roche, B. (Eds.) (2001).
Relational Frame The-
ory: A post-Skinnerian account of human language and cognition
. NY: Kluwer
Academic/Plenum Publishers.
Hayes, S. C., Brownstein, A. J., Zettle, R. D., Rosenfarb, I. & Korn, Z. (1986). Rule-
governed behavior and sensitivity to changing consequences of responding.
Jour-
nal of Experimental Analysis of Behavior, 45
, 237–256.
Hayes, S. C., Hayes, L. J., & Reese, H. W. (1988). Finding the philosophical core: A
review of Stephen C. Pepper’s “World hypotheses: A study in evidence.”
Journal of
the Experimental Analysis of Behavior, 50
(1), 97–111.
Hayes, S. C., Hayes, L. J., Reese, H. W., & Sarbin, T. R. (Eds.). (1993).
Varieties of
scientific contextualism
. Reno, NV: Context Press.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999).
Acceptance and Commitment
Therapy: An experiential approach to behavior change
. NY: The Guilford Press.
Hayes, S. C., Wilson, K. W., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Expe-
riential avoidance and behavioral disorders: A functional dimensional approach
to diagnosis and treatment.
Journal of Consulting and Clinical Psychology, 64
,
1152–1168.
Chapter 7 The Use of Metaphor to Establish Acceptance and Mindfulness
123
Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K.,
Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral
treatment for depression.
Journal of Consulting and Clinical Psychology, 64
(2),
295–304.
Knowles, M. & Moon, R. (2006).
Introducing metaphor
. New York: Routlege.
Lakoff, G., & Johnson, M. (1980).
Metaphors we live by
. Chicago: The University of
Chicago Press.
Lakoff, G. & Johnson, M. (1999).
Philosophy in the Flesh: The embodied mind and