METAPHORS

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METAPHORS

• Their Utility in Therapy
• By Robert M. Tansley

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Robert M. Tansley

• Father of Four
• Happily Married
• Therapist in Private Practice
• Masters Degree in Social Work from the University
  of Toronto 1987
• Undergraduate Degree in Social Work 1982
• Internship with Jay Haley Cloe Madanes

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Assumptions for Today

• You agree that we are in the change business
  this is about therapy
• People come to us because they have thoughts,
  feelings, behaviours, relationships that they are
  unhappy with, or someone else is unhappy with and
  they desire change
• Typically they have done everything in their own
  power to bring about that change before they come
  to us and the change they desire has not yet
  happened

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CONTEXT

• We are key in the change equation (stop blaming
  the clients)
• We play an active role in change (MI or
  Motivational Interviewing - CBT or Cognitive
  Behavioural Therapy)

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WHAT WE BRING TO THE DANCE

• We bring ourselves self use of self
• We bring our skills engagement skills,
  interviewing skills, assessment skills, verbal
  skills, intervention skills
• We bring theory problem theory and solution
  theory ok probably more problem than solution

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WHAT WE BRING TO THE DANCE

• We also bring bias, blind spots, faulty
  assumptions and our own baggage

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TOOLS

• One of our key tools in therapy is language
  (the other key tool is relationship)
• If we want to influence someone we need to be
  good at language

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TOOLS

• Speaking
• Articulating
• Meanings
• Definitions
• we use them to join, to show we understand, to
  gain influence, to cause reflection, to set a
  stage for someone to make another choice, a new
  behaviour

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LANGUAGE

• This is a two way street we are listening, we
  are processing, we are rearranging but we are
  also preparing to speak to intervene
• Everything we do is an intervention to the
  client EVERYTHING

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LANGUAGE

• Once I open my mouth I am guiding a
  conversation, choosing what needs attention
  influencing intervening
• Narrative Therapy Therapeutic Conversations

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LANGUAGE

• Embedded in our language the English language
  are metaphors todays presentation focuses on
  these metaphors their power their utility
  their beauty .

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METAPHORS

• As a way to engage a client, to show that you
  understand their story to gain a position of
  influence to begin to alter both thinking and
  behaviour . We use metaphors

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What is a Metaphor?

• Metaphors are comparisons that show how two
  things that are not alike in most ways are
  similar in one important way. Metaphors are a way
  to describe something.

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Two Types of Metaphors

• 1. The Metaphors our clients give us.
• 2. The Metaphors we use, collect, for therapeutic
  use.

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Why Metaphors?

• The English language is pretty linear.
• It lacks depth - texture
• Metaphors create meaning
• Metaphors enhance description

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Common Metaphors

• The whole nine yards
• this is a war reference not football
• For the Birds
• before cars, horses, birds ate the oats from
  the poop means its horse crap
• Fit to be tied
• a reference to a straight jacket !!
• Feather in your cap
• 1800s tradition to count how many people you
  killed in battle

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Common Metaphors

• I paid an arm and a leg
• Keep your shirt on
• Kick the bucket
• He spilled the beans
• Fit as a Fiddle
• He really hit the roof
• Hes pulling your leg
• Do these ring a bell

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Common Metaphors

• I am in a rut a quicky
• whats the difference between a rut and a
  grave?
• A loose cannon
• maritime war reference, loose cannons on a
  deck, sank ships
• Its time to face the music
• from British, court marshal execution

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Common Metaphors

• The Grass is Always Greener on the other side of
  the fence
• I like to stew about my problems

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Addiction Metaphors

• Wasted
• Falling off the Wagon water was delivered by
  wagon on the wagon means I am drinking only
  water, not alcohol
• High
• Slaying the Dragon
• Battling the Demon

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Metaphors are Gifts

• When we listen to clients, they give us gifts.
• Metaphors are gifts, often hidden, embedded in
  common language, phrases. (I heard a client say
  recently I am being used as an escape goat).
• Metaphors are gateways to a clients soul.
• They are entry points to connect, to understand,
  to create change.

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The Theory of Metaphors

• Using Metaphors create momentum for change judo
• Metaphors are not random !!!
• They are part of our cognition
• Dare we say, unconscious
• They exist in layers, like an onion

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Case Example

• Male 25
• Married employed at an investment bank
• No children
• Living with his in-laws
• Moved from Toronto, sold their home and put
  60,000 in the bank
• They were shopping for their dream home
• Ready to sign a contract with a builder he tells
  his wife he lost the 60,000 gambling, borrowed a
  further 20,000 and lost that

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Case Example

• As part of his story he says,
• my life is a dead end.
• What does this mean in this context?

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Example Layers - Onions

• A dead end
• It seems innocuous, benign, maybe even irrelevant
  this is the first layer
• However lets consider the dead end

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What do you notice about the Dead End?
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The Dead End Another Layer

• Dead Ends are relatively arbitrary
• You dont fall off the face of the earth at a
  dead end like the old joke, I am from
  Brantford, its not the end of the earth, but you
  can see it from there .
• It really means that the constructed road has
  come to an end
• Its quite easy to move past a dead end

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THERAPY

• What have we done we have taken the initial
  meaning, presented by the client its over, I
  cant go on, and begun to soften that meaning
  up we have used their term, their language
  their rhythm with the world and massaged it
  not accepted the meaning begun to create hope,
  options peeled the onion

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The Utility of the Dead End

• Send a client to find a dead end old school
  Strategic Therapy
• Discuss the alternative meaning of dead end old
  school Structural Family Therapy (reframing)
• And yes to all the mental health folk in the
  crowd here is depression, suicidal thoughts
  etc. etc. - dont be scared we can change this

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Where is the Therapy?

• CBT change the way someone thinks and you
  change their behaviour
• Therapy is about possibilities, about getting
  people unstuck
• Therapy is about finding faulty thinking and
  changing the thought sequences

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Another Example

• Couple
• Early 30s
• 2 young children
• Arguing a great deal
• Cycle of intense arguing then reconciliation
• In telling their story they say, We need more
  balance in our life. Its all too extreme.

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Where is the Metaphor?

• Do you own a balance? drugs
• Can you bring in a balance?
• Can you make a balance?
• What is in the balance that makes the extreme?
• What needs to be in the other side of the balance
  to make it balance?

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SOLUTION

• I asked the couple to put their balance in an
  obvious place in their home.
• If there were an issue to discuss, either one
  could put a penny on one side of the balance
• Each was to check the balance daily
• If it was unbalanced they were to ask the other
  why
• This changed the sequence of suppressing feelings
  until they exploded

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SOLUTION

• This changed to tone in the house
• It brought in a playfulness
• It created an early warning system
• It allowed issues to be addressed at an earlier,
  less volatile stage

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This is a Balance
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You get the Idea

• If we are to influence people, their thinking,
  their behaviour, their healing
• We need tools
• Language in therapy is one of our most important
  tools
• We need to get good at it
• The Metaphors clients give us are a gateway a
  way in a way to connect in their language,
  their rhythm their own words

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The Second Type of Metaphor The Canned Metaphor

• I collect metaphors
• They are embedded in stories
• They have a utility to create meaning,
  understanding change
• Jay Haley said that all therapy is hypnosis, its
  about levels of trance telling a story creates
  trance

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The Monkey Trap
The Case of the Orderly
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The Orderly

• 37 years of age
• Separated father of an 8 year old daughter
• Worked at the hospital for 10 years
• Sent by his employer for Anger Management
  because of incidents at work

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The Confusion

• Job description says you must help control all
  unruly patients
• The Clint Eastwood of it all

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Rewarded Behaviour is Repeated Behaviour

• Doctors loved me, complimented me
• Two nurses disagreed, wrote to HR to complain

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The Intervention The Theory

• Problems are embedded in sequences Jay Haley
• The sequences are both behavioural and cognitive
• Interrupting these sequences - change the
  sequence change the outcome change the
  behaviour

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Do You Know How to Catch a Monkey? The
Intervention

• Creates a brain scan
• Interrupts sequence of cognition
• Creates a focus, a level of trance
• This is a skill

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The Coconut

• In order to catch a monkey its quite simple
• You take a coconut
• Cut the top off so its shaped like a sphere
• Put some rice or banana in the coconut
• Tie the coconut to a tree
• And wait

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The Coconut

• A monkey will come along
• Stick their hand in the coconut
• Grab what is in there
• And now they are trapped

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The Coconut

• Here is the trap
• The monkey, convinced what they are holding on to
  is important
• They will not let go
• They are trapped

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The Coconut

• You can now untie the coconut and lead the monkey
  away
• Now the connection the comparison the metaphor

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The Coconut

• This is what people are like
• They are holding onto things they believe are
  important, thoughts, feelings, beliefs,
  behaviours, relationships ...
• But they are trapped, being lead away to a place
  they may not want to go

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The Coconut

• Places like, unemployment, jail, divorce court,
  victimization, crack houses (MI)

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Whats In Your Coconut?

• Where does this walk around wait for the guy to
  say something then jump him come from?
• I live by a rule If you are man enough to
  mouth off, you better be man enough to back it
  up

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Rules

• I dont live by that rule
• Where did you get the rule?

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Fathers

• Growing up poor
• Bullies to bikers

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Letting Go Grocery Shopping

• I did it with tears
• It aint safe in the vegetables
• I have a confession to make
• The client teaches me

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Confessions

• I have been making monkey traps .

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Replacement Behaviours

• How do you get your hand out of a coconut?
• Change is a two step process ....
• There is what is being let go of ... A rule, a
  belief, a behaviour ...
• And there is what is being grabbed onto ... New
  rules, new beliefs, new behaviours

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Good Endings

• Practice makes perfect
• Sparring with safety
• Success is the attainment of goals with favour

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The Vase Metaphor

• VICTIMIZATION
• And
• RELATIONSHIPS
• And
• SELF ESTEEM

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VICTIMIZATION

• Many people struggling with addictions have been
  victimized many times
• Child abuse, sexual abuse, adult children of
  alcoholics, neglect, domestic violence, rape,
  abandonment, emotional abuse, placements in
  multiple foster homes, etc.
• Victimization is about being in a situation or
  position of powerlessness

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VICTIMIZATION

• We often hear metaphors from clients like
• My life is shattered
• I feel broken
• Im a mess

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VICTIMIZATION

• When I hear one of these references I think about
  using the metaphor of the VASE

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VICTIMIZATION

• A vase is designed to hold water
• Water that is pure, transparent, healthy
• Good parenting and strong life experiences fill
  the vase up, abundantly, over flowing we will
  get to self esteem

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VICTIMIZATION

• Some life experiences no matter how full the vase
  is, crack the vase
• And things begin to leak out
• Things like good judgement, confidence, self
  esteem leak out

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VICTIMIZATION

• We have all met these people they have heard
  messages like youre worthless, useless,
  stupid, you will never amount to anything, you
  are a waste of my time, I wish I never had
  children, I wish you were dead or there has
  been physical abuse, sexual abuse or neglect
  acts of ommission and commission CRACK

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VICTIMIZATION

• They are leaking and vulnerable to feeling empty
  
• These are the people that leave your office
  looking better, but by the next day, what has
  been said or done, has leaked out of them
• And sometimes when people feel empty they fill
  themselves up with things that are not good for
  them, substance, drugs,

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VICTIMIZATION

• What do we do ?
• How would you repair the vase ?
• Putting glue on the outside will not hold
• Putting glue on the inside will not hold

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VICTIMIZATION

• The only repair that is going to hold is to
  finish the crack . So you can pull the vase
  apart
• Then on the edge surfaces you put epoxy glue

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EPOXY GLUE

• Two tubes
• One Safety
• The other - Identity

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HEALING

• When we combine safety and identity healing
  occurs
• Living a safe life
• A strong positive identity this must be built

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SAFE LIFE

• Victims live very risky lives, they go to risky
  places, they hang out with risky people, they are
  involved in risky behaviours

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IDENTITY

• WHO AM I AND WHO AM I NOT
• This is a shield

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THE VASE RELATIONSHIPS

• When relationships begin they are like a vase
  of pure water, transparent, healthy, clean
• We are in love, pouring good things into the vase
  to over flowing

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RELATIONSHIPS

• Eventually some dirt gets thrown in
• But because we are committed, pouring in good
  water, it may get cloudy but it soon becomes
  clear
• This is self filtering

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RELATIONSHIPS

• However, sometimes, something really bad happens,
  and a big chunk of dirt gets thrown in
• It sinks to the bottom and sits there,
  distracting us from anything good
• We focus on the chunk of dirt, stop pouring in
  good water

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RELATIONSHIPS

• Soon, all we can see is the dirt, our good water
  is evaporating
• Our tendency is to pound on the chunk of dirt .
• Then we brake the vase and it holds nothing

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RELATIONSHIPS

• When a big chunk of dirt is dumped in our vase,
  we must do something really difficult, continue
  to pour in good water
• It is the only thing that will soften up the
  chunk of dirt .

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SELF ESTEEM

• Self Esteem is something that is built
• It is built through praise compliments and
  encouragement

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SELF ESTEEM

• I am raising a child
• I am offering, praise, compliments,
  encouragement, affection
• I am filling the vase up, over flowing, building
  self esteem, confidence
• Then someone nasty, hurtful comes along and calls
  my child a name that puts some dirt in my vase
  
• The child comes home and we discuss the insult
  I can put more good water in and make it clean
  again

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SELF ESTEEM

• If the child has no good, pure water in their
  vase there is nothing to absorb the insult
  there is no resiliency no bounce no shield
  there has not been sufficient praise,
  compliments, encouragement, affection
• Now when something is thrown in the vase, there
  is no capacity for absorption, no resiliency,
  everything hits, sticks and hurts

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SELF ESTEEM

• Self esteem is built first, from the outside in
  
• Children initially cannot build their own self
  esteem
• We build it for them through praise compliments
  and encouragement

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SELF ESTEEM

• As a child grows they begin to build their own
  self esteem
• They can do something and say, I feel good about
  that.

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• LONELINESS
• Vs
• HUNGER

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LONELINESS

• Addicts can be incredibly lonely people
• They have few real close friends
• They are often estranged from their family of
  origin
• They are often distant in their own families,
  fearing intimacy with everyone angry at them
  
• Therapeutically its only a matter of time
  before this comes up as an issue, loneliness

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Loneliness a quick metaphor

• So they are in your office somewhat lucid and
  they say, I feel so lonely.
• This INTERVENTION is a body blow a quick
  metaphor to connect with a client and soften them
  up to prepare them for other possibilities we
  dont go from unhealthy to healthy in one step
  its a process we rarely hit a home run
  straight up (how many metaphors are in this
  little rant?)

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LONELINESS - METAPHOR

• Loneliness is the hunger for a relationship
• and when we are starving we will eat anything
• This statement alone usually gets a head nodding
  you have permission now to intervene people
  get that statement I am connecting loneliness
  with hunger as a comparison

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LONELINESS

• So we carry on with the metaphor
• usually when we do this, we eat something that is
  not good for us This is often true in
  relationships we know the person we are with is
  not good for us, or the people we hang out with
  are not good for us but we continue because it
  fills us up
• We are looking for head nodding

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LONELINESS

• How many times has it happened to you when you
  get up at night, you are hungry and you go to the
  fridge
• Its got food in it but you cant see anything
  that is good for you
• Its right there an apple or yogurt but somehow
  they disappear as options
• So you take out something you know is not good
  for you and you eat it just to fill yourself up
  to feel full

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LONELINESS

• You are now eating something that is not good for
  you and rationalizing Ill work out tomorrow
  It wont kill me not today anyway
• These are the rationalizations of an addict
  Ill just do one 40 thats all and then they
  wake up in a Crack House a week later . Their
  family cant find them, they have not been to
  work, they have Hep C or worse

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POSSIBILITIES

• Now you are in very rich fertile ground you
  have taken loneliness and used it to propel you
  to some fairly fundamental issues in the area of
  addictions choices, rationalizations, risky
  behaviours, the logic model, the sequence of
  thoughts you have connected with the client,
  developed some influence by showing you
  understand

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THE JUDO OF THERAPY

• IF IF you have observed the client nodding in
  agreement through all this they get it you
  have an opportunity to intervene this person is
  in Insoos words, a customer or in the Stages of
  Change, an Action Stage you have created a yes
  set.
• So here I go, I say something like Loneliness
  is such a common problem, its like that old
  Beatles song, all the lonely people where do
  they all come from

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THE JUDO OF THERAPY

• I continue, I have used that story countless
  times and inevitably someone says, Rob, where
  are the good refrigerators in life. Everyone I
  know does drugs, there is no escaping it
• I disagree This involves faulty thinking, false
  rationalizations NOT EVERYONE DOES DRUGS AND
  YES YOU CAN ESCAPE IT if I am instructing
  someone on where to go and how to find new
  friends here is what I recommend

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THE JUDO OF THERAPY

• Go somewhere for another reason not to meet
  people for another reason knowing that the
  reason alone is good for you just being there
  will be good for you and then you are with
  other people, there for a good reason not there
  for a relationship this list is endless it
  can also be cost free .

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THE JUDO OF THERAPY

• Once you are there, doing that thing that is good
  for you look around who else is there there
  is no pressure no one is there to meet people,
  to meet you they are there for the same reason
  you are to do that good thing this means they
  share that thing with you the interest in it,
  the value of it you have something in common

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THE JUDO OF THERAPY

• there is no pressure no hidden agenda no
  one is trying to take you home or get you to a
  crack house you are there because being there
  is good for you now you can begin a
  conversation with someone the content is built
  in its that thing that has you there its a
  neutral, no pressure beginning point now if
  your radar goes off, move away if you feel good
  keep talking

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THE JUDO OF THERAPY

• This is how healthy relationship begin, over
  time, quietly, with screening so you have been
  to this thing several times and you have talked
  with several people and someone strikes you as
  someone you could be friends with you take the
  relationship to another place do you have time
  for a coffee when this is over?

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THE JUDO OF THERAPY

• OK so where are those places, those refrigerators
  full of good food
• They are everywhere volunteer to coach soccer,
  join a Lions Club, take an interest course at
  College or elsewhere, volunteer for the Board at
  the Food Bank, join a hiking club, take up stain
  glass window making, join a gym, volunteer to
  tutor at a school, read to the elderly

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THE JUDO OF THERAPY

• We start with someone stuck their thinking,
  their behaviour we engage them we soften them
  up . We get them nodding, interested, invested
  we get momentum then we flip them to something
  healthy new ideas new possibilities Therapy
  is as much about what we are letting go of as it
  is what we are grabbing on to we need
  replacement behaviours, thoughts

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TRUST
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TRUST

• This is a fundamental issue, not only to therapy
  but to life
• developmental psychology stuff
• DTA dont trust anyone a common value among
  people struggling with addictions

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TRUST

• Addicts are often people that have experienced an
  incredible amount of betrayal
• it shatters ones ability and/or desire to trust
  
• they are often victims of child abuse, sexual
  abuse, domestic violence, crime

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TRUST

• Trust comes up in every therapeutic relationship
  either directly or indirectly
• When it does we need a way to address it
• I use the metaphor of a house

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TRUST

• It is almost cliché but I will say Trust is
  something you build
• I am looking to create that brain scan, that
  sequence interruption
• This typically gets me a head nod agreement
  Insoos Yes Set !

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TRUST

• I will then push this belief further and say It
  is naïve to grant trust, but people often do
  they trust people until they are screwed over but
  then it is too late
• To further punctuate my point I will say,
  trust is the fulfillment of commitment.

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TRUST

• I have a rule dont trust untrustworthy people
  
• At this point I usually have my permission to
  proceed head nodding, active listening if I
  dont I dont proceed

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TRUST

• note to self dont waste good interventions on
  people that are not ready to benefit from them

105
TRUST

• Building TRUST is like building a house
• We start with a foundation
• In this case our foundation is made out of cinder
  blocks, bricks
• One brick is one commitment ..
• Early in a relationship, the brick is something
  simple like I will call you on Saturday

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TRUST

• This seems small, insignificant, but it is a
  commitment
• Trust is the fulfillment of commitment
• So someone commits to call you on Saturday that
  puts the brick down in our foundation
• Fulfilling the commitment is the mortar or cement
  that goes around the brick so I can add or lay
  another brick down beside it

107
TRUST

• So lets say they call on Saturday and they make
  another commitment I will meet you tomorrow at
  1100 and we will have coffee at Starbucks
  another brick 1100 comes and they are there
  more mortar at this point we do not have a
  foundation they are two for two but more needs
  to happen a lot more

108
TRUST

• The average foundation has 14,000 bricks in it
  and over time when you are with someone you see
  their ability to make and fulfill commitments
  not only with you but, work, their family, their
  friends when enough time has passed and 14,000
  commitments have been made and fulfilled you can
  say this is a trustworthy person

109
TRUST

• When you look at the foundation and you can see,
  it is a foundation you are ready to build
  bigger commitments until now the commitments
  have been relatively small, measurable things
• Lets try a bedroom commitment I will be
  sexually faithful to you
• Lets try a family room commitment We will
  raise children together
• Lets try a living room commitment I will love
  you forever

110
TRUST

• Often today we see people making bedroom, living
  room, family room commitments without a
  foundation
• We cant be surprised when it collapses because
  there is no solid foundation
• DONT TRUST UNTRUSTWORTHY PEOPLE

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TRUST

• When your foundation is solid, you are a
  trustworthy person, a person of integrity, a
  person of your word you get some slack
• In a family with children it takes 6 to 12
  commitments a day to keep it moving forward
  Ill get milk, Ill stop and get a movie, Ill
  pick up pizza, dry cleaning or the children

112
TRUST

• If I come home and say I forgot the pizza I
  can repair that pretty quickly I go back out
  and get the pizza
• But If I come home and say I forgot to be
  faithful today thats a different message
• Which is why the foundation is so important

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TRUST

• The foundation commitments are pretty
  measureable, visible either I have the pizza or
  I dont
• It is far more difficult to measure, fidelity or
  love so I rely on the foundation to know the
  other commitments are safe

114
TRUST

• How often, in therapy, have you seen a couple say
  We are almost embarrassed to tell you what we
  fight about. They are such small petty things.
  But the theme that ties them all together is
  trust It is a lot easier to fight about the
  toothpaste or the garbage than to say, I dont
  trust you .

115
LEAVING HOME EAGLES
116
Children come into the world completely dependent

117
Its our job to raise them to be independent
self reliant
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Leaving home is often described as being like the
birthing process intermittently painful,
sometimes bloody but in the end they are out
119
Eagles know how to raise their young they mate
for life and build their nests in very high
places to keep their young safe from predators
their nests are huge, made of sticks so to make
them comfortable they line them with feathers.
120

• A baby eagles first experience of independence
  is witnessing it seeing their parents leave the
  nest this creates their first drive or desire
  to leave home

121

• A baby eagles next motivation to leave home is
  overcrowding as they grow there is less and
  less room in the nest

122

• The overcrowded nest sends eagles up the side of
  the nest to the top edge at this point they can
  stretch their wings but they are not ready to
  fly

123

• Now there are two motivations to leave home
  independence looks really attractive and this
  place aint big enough for all of us anymore

124

• Now that the babies are strong enough to climb to
  the edge of the nest they are almost ready to
  fly but the parent eagles perform a ritual
  they sit above the nest and wait for the babies
  to jump or fall

125

• Once the baby eagle jumps or falls from the nest,
  one of the parents will follow them down
  remember their nests are high so they have time
  they give the baby time to fly but after about
  half way they fly past the baby and catch them
  on their back to return them to the nest safe
  they will not allow their young to fall on their
  face !!!

126

• That attempt at independence they get for free
  but now that the baby eagles seem ready for
  independence the adult eagles perform a ritual
  they remove all the feather linings from the
  nest because the nest is made of large sticks
  it is now very uncomfortable it is prickly
  this creates the third and final motivation for
  the young to leave home

127

• Now all the ingredients or motivations to
  independence are in place
• Independence must be seen, witnessed
• Overcrowding forces us to seek independence
• At each stage of our childrens growth we must
  supervise their attempts at independence so they
  dont fall on their face
• In the final stages the nest must be made to be
  prickly

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• If we dont make our young adult childrens lives
  prickly they will grow up to be pricks

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Healing The Wound Metaphor

• At the core of Victimization is Betrayal
• Being betrayed is like being cut with a knife
• If we dont seek medical attention, when we are
  betrayed the wound bleeds and gets infected
• Now even if we stop the bleeding, ourselves, we
  still have an infection
• That infection in emotional terms is RESENTMENT

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VICTIMIZATION

• RESENTMENT

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The Rule of Threes for Resentment

• Rule 1 Resentment Prevents Intimacy
• Rule 2 Resentment Creates Dependency
• Rule 3 Resentment is like Acid in a Bottle
  It eats you from the inside out

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Healing cont

• The goal of healing is a scar you remember but
  there is no pain
• Repairing an infected wound takes both
  antibiotics and reopening the wound to clean it
  out
• Then the wound needs stitching creating a new
  story with who is responsible
• Then we can heal, create a scar we remember how
  we got it but it doesnt hurt us any more

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Love vs. Pyrite
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Getting in Your Car
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Gardening Pruning
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The Wheel Barrow Rut