Avoidance Is Heroin: Metaphors in and out of Therapy

Metaphors help us see old problems with new eyes.

Posted Oct 27, 2017

Human language is largely metaphorical. When you say, “I’m buried under a mountain of work. My boss is breathing down my neck. Let’s touch base this weekend,” you don’t mean any of it literally. There is, in fact, no actual grave, no actual mountain, no stream of hot air at the neck, and no baseball involved. The actual meaning you’re trying to convey is delivered via metaphor, rather than literally. A good metaphor is useful shorthand for lengthy didactics. It also surprises and delights the senses. When Picasso says, “Art washes away from the soul the dust of everyday life,” we know instantly what he means, and we also feel the pleasure of discovery.

Therapists also often use metaphors to clarify concepts, help clients imagine novel solutions, see old problems with new eyes. Below is a short list of therapeutic metaphors that may prove useful even beyond the clinic’s walls:

Change is a Dial, Not a Switch

A common obstacle to sound mental health is the habit of thinking about life’s tasks and challenges in all-or-nothing, black-and-white terms. This kind of thinking is appealing in part because it’s simple. It is also bolstered by our culture’s love affair with the “vs.” narrative structure (loser vs. winner; good vs. evil, etc.). Sound mental health, however, requires a more nuanced view that matches the complexities of the actual world and acknowledges that there are levels and degrees to most of our efforts and outcomes. This idea finds useful embodiment in the comparison between a switch and a dial. We know both technologies from our life experience. And we recognize the difference between them readily. The dial is a more sophisticated mechanism than the switch, providing better control and better choices. And the metaphor conveys well the useful notion that, while certain problems can’t be turned off entirely, they can be dialed down significantly.

The Mind Is a Society

Psychologists who study and try to explain the mind often make use of available metaphors to guide, inform, and explain their inquiries. The mind has been likened in the past to a hydraulic system, a steam engine, a phone switchboard and, more recently, a computer. But I find that Marvin Minsky’s formulation of the mind as a society often works best in getting people to reflect deeply and understand more fully their own experiences. Society, after all, is made of many related yet distinctive parts. It includes diverse, often conflicting, agendas and constituencies vying for influence. It is dynamic; it both solves and creates its own unique problems; it is necessary for survival, but has a dark, dangerous side. It can contain dysfunctions without being defined or doomed by them. It changes over time, and sometimes abruptly. And to speak about it intelligently is to acknowledge that all these elements do not contradict or negate the existence of a meaningful whole.  

Progress Is a Rebuilding Team

The process of change is often long and hard. And clients may get frustrated when they continue to struggle for a while with the same obstacles, often without attaining their desired goals. Too many of the client's loved ones wonder why they are not seeing the therapy working. In these situations, it is sometimes useful to employ a sports metaphor. A team may struggle for a while even after getting a new coach and some better players on the roster, implementing a new system, and creating a new culture. The team may continue to lose. And some uninformed fans may argue that "losing is losing." But those in the know, know that it isn’t. A team that was losing its games by an average margin of 20 points last year, but is losing its games by an average of 2 points this year is still a losing team, but it is not the same team. This year’s team is on its way to winning. The players can sense it in the locker room far sooner than the fans see results on the field.

Thoughts Are Highway Traffic

One of the skills that prove useful in mental health management is the ability to observe one’s mind in action without jumping into the action. This is the essence of all the trendy mindfulness training going on. You can acknowledge a thought, and name an emotion, without doing anything about them other than that. One useful (metaphorical) way to think about this process is by imagining yourself watching the highway traffic from a pedestrian overpass. You can acknowledge the traffic, sensing its power and volume, direction, and noise without running onto the highway, trying to hitch a ride, or deciding to buy a car.

Your Thoughts Are Mind Events, Not World Events

Mental events are defined in part by the fact that, while internal, they are directed toward some external reality. After all, our internal processes have evolved to help us manage our commerce with the world. We use our minds to navigate the external world and to dialogue with it. Thus we believe that our fear corresponds well to external danger; that the size of our rage corresponds well to the size of the insult, etc. While this may at times be true, it is not always or inherently true. In fact, like any bureaucracy, the mind over time may accumulate all manner of gunk gumming up the system, undermining its original purpose. Therefore, our psychic experience can become quite untethered from, and distortive of, the facts of external reality.

An extreme example is the unmoored delusional ramblings of a schizophrenic. Yet we all live with some degree of confusion about what’s in our minds and what’s actually out there in the world. In this context, it is useful to note that our thoughts and feelings are mind events, not world events. This is not exactly a metaphor, but what the hell. The distinction is true and also potent. World events and mind events call for different responses. Worrying about being in a fire is not the same as being in a fire. Only the latter calls for running out of the house.

Avoidance Is Heroin

Much mental anguish is caused by the attempt to avoid mental anguish. This concept—that avoidance of problems becomes over time a bigger problem than whatever you’re avoiding—is not easy to comprehend in the abstract, in part because our brain is designed to favor the short-term and avoidance is such an effective short-term solution. One way to vividly illustrate the problem with avoidance is by likening it to heroin. Like avoidance, heroin presents itself to new users as a quick and effective solution, not a problem. And it works well in the short term. But, like avoidance, it becomes a bigger problem in the long run than the problem that made you use it in the first place. Both avoidance and heroin promise to liberate and end up enslaving those who embrace them. The OCD client who performs rituals is shooting heroin, as is the travel phobic who avoids travel, etc. When presented in these stark terms, the right choice (face your issues, don’t avoid them) becomes more obvious.

Emotion Is a Company Consultant, Not the CEO

When dealing with difficult emotions, people often make one of two mistakes. They either deny the emotion or obey it. Denial doesn’t work because it amounts to avoidance and lying. If you’re anxious, it makes no sense to tell yourself you are not, or cannot be, anxious. (And it will also make you more anxious, because now you’re also anxious about being anxious). Obedience doesn’t work because it begets reckless and unwise behavioral choices. If you feel angry with someone, hitting them upside the head with a brick is not usually advisable. (If you don’t see why, their lawyer will explain).

The correct way to deal with difficult emotions is to accept the experience for what it is, while at the same time bringing additional resources to the decision-making task. In this situation, thinking of oneself as the executive of one’s life, and thinking of one’s emotions as consultants may clarify the needed process. The executive listens to the consultants, but the decision is not in the consultant’s hands. Moreover, emotions are not the only consultants around the table. A wise executive will also want to hear from others, such as history, experience, logic, goals, and values before making a decision.

Unpack the Problem

The "unpacking" metaphor is an old therapeutic trope. Many therapists speak of "unpacking an issue," by which they mean looking into the contents of the metaphorical "baggage." Yet an important extension of this metaphor takes into account the location of the baggage as well. I often speak to my clients about unpacking a large box that sits in the middle of their living room causing everyone to trip over it, taking up useful space, and just being an eyesore. The unpacking in this scenario involves identifying and inspecting the contents, but also taking the contents out of the box, placing each of the contents in its rightful place around the house (books on the bookshelf, cloths in the closet, etc.) and then disposing of the box (in an environmentally friendly way, naturally…). This way, nothing is lost, and order and safety are gained.

We Are All Used Cars

To paraphrase Tolstoy, new cars are all alike; every used car is used in its own way.

Unlike new cars, in which things usually work as they are designed to work, uniformly, and according to factory specifications, used cars are quirky. They have dents, broken parts, and strange tendencies none of which are described in the owner’s manual. Owners of those cars need to learn their idiosyncratic language. They must learn to correct left if the car tends to pull right; they learn that the car heats up if driven at 70 mph. They must learn that the gasoline gauge is stuck on empty even when the tank is full. We are all used cars—quirky, idiosyncratic, modified and dented by life experience. It’s not enough to know how the gasoline gauge functions in cars. You need to learn how it functions in this car. Things do what they do, not what they were designed to do.

Progress: Chopping a Tree vs. Trimming a Tree

Some change processes progress along a gradual smooth slope, with noticeable changes at every stage along the way. Others involve a tipping point, where all the visible change happens at once, often after much seemingly fruitless labor. The former is trimming a tree. With every branch you saw off, the tree looks different. Progress is gradual and apparent throughout. The latter is chopping a tree. You chop at the trunk with your ax 50 times, and the tree still looks the same, standing up just as before. And then, at the 51st chop, the whole thing collapses at once.

Self Care is a Lit Candle

Many clients, particularly women who are often socialized to mind, care, and work for others, are ambivalent about self-care. A common mistake is to confuse self-care with selfishness. Selfishness is when you fail to share your abundant resources. Self-care is when you protect your resources from ruin, to make sure you’ll have something to share. Self-care is a foundation of mental health. Metaphorically, you can’t light a candle from an unlit candle. To spread your light, you must first protect it.

Emotions Are (internal) Weather

A fundamental skill of mental wellness is emotional acceptance. Much mental suffering is the result of people attempting to deny, push away, or fend off difficult emotional experiences. In general, these efforts not only fail but also make the problem worse. A tree that pushes against the wind is more likely to break than a tree that bends. One way to think about emotions in this context is the weather metaphor. This is, of course, a well worn—weathered, as it were—cliché. Yet it is both universal and intuitive, and surprisingly apt. Emotions, like weather, are facts of the world, the inner world in this case. Emotions can change wildly and abruptly, as can the weather. We like some emotions better than others, as we do weather. As with weather, it makes no sense, and isn’t useful in coping, to deny what is. If it’s snowing outside, I’m not going to say, ‘It can’t be snowing.’ Clearly, it can, since it is. Like weather, strong emotions usually pass. As with weather in different regions of the world, different individuals have different emotional climates and ranges. Emotion, like weather, requires some preparation and skill to manage well. If you don’t know how to handle snow, you’re more likely to get hurt during a snowstorm. Like weather, emotion, while always a part of your life, does not have to become the focus of it. Weather is something in which we live, not something for which we live. Like emotions, the weather may overwhelm us at times, or mess with our plans (mostly, recently, because we have been in denial about it). But no effective handling of the weather will ever include denying that it exists.

Consciousness Is the Front Page of the Newspaper

Our brain is biased in multiple ways at the evolutionary hardware level. Under evolutionary selection pressure, certain response tendencies are selected over others. Our heartbeat goes up when we encounter novelty. Our attention is drawn to movement. We like sweet stuff. One such feature is our brain’s tendency to focus hard and long on trouble, threat, and violence. This has to do with the fact that any detection system can make two errors: a miss or a false alarm. These two errors are linked in that a decision to avoid one invariably increases the other. A decision to avoid a miss at all costs will result in multiple false alarms, and vice versa. If we want to make sure that no innocent man is imprisoned (false alarm), we will have a lot of guilty men walking free (miss).

The evolutionary logic is clear. We can ill afford to miss on a danger or threat since even one such miss can spell our doom. Thus, our immediate attentional focus is calibrated to avoid a miss, and to accept many false alarms. As the psychologist Rick Hanson has said, “The brain is like Velcro for negative experiences, but Teflon for positive ones.” This system evolved at a time when life was indeed dangerous, and mere survival was our central challenge. But we are still using it now even though thriving, rather than survival, is the main challenge for most of us. In looking to keep us safe, our brain also keeps us on almost constant alert, which does not facilitate thriving.

In order to thrive, we need to correct for the biases that are built into the system. That is, we need to train ourselves to mind the positive and good. A metaphor that often works here is to view your brain as a daily newspaper. Your immediate attentional focus is the front page, which is usually full of crisis, alarm, and trouble. If you only read the front page, you’ll become convinced that all manner of doom is imminent. The front page will always yell "murder," even if the actual murder rate is way down. But if you read the inner sections, you get to the science section, where the statistics about the murder rate are presented; you also get to learn about uplifting art, interesting people, beautiful places, leisure, sports, and good food. If you read only the front page, you get a terribly skewed picture of the world. And you miss out on some great recipes.