Use of Figurative Language in Successful and Unsuccessful Cases of Psychotherapy: three Comparisons

The purpose of the present study was to extend the scant empirical literature on figurative language in psychotherapy by analyzing its use over time by clients and therapists in cases differing in outcome. Instances of figurative language related to major therapy themes were selected from all available and audible sessions (N = 95) of six cases of psychotherapy—one successful and one unsuccessful case from each of three therapists—gleaned from the Vanderbilt I Psychotherapy Project. Descriptive analyses revealed features of clients' figurative language that were more consistently present in the successful than in the unsuccessful cases, namely, the elaboration of major therapy themes via bursts of figurative language or development of a metaphor over time, the existence of a central metaphor(s) as evidenced by the use of several conceptually related figures that fit the metaphor(s), and the expression of some positive personal change in figurative language. The analyses also cast doubt on certain prevailing notions in the area. Some implications for psychotherapy practice and suggestions for future research are presented.