Chances are good that you or someone you know has experienced a traumatic event at least once in your lifetime. Many individuals who experience trauma will develop a psychological condition known as post-traumatic stress disorder (PTSD). Evidence indicates that communication plays a critical role in helping individuals recover from PTSD. Due to emotional sensitivities, traumatized individuals will often (unwittingly) choose metaphors in place of literal language to describe their traumatic experiences. We can help individuals recover from traumatic events by learning to communicate with them using metaphorical language.

Trauma is the word we use to describe the emotional distress which results from experiencing extreme personal injury or witnessing it. The PTSD Alliance (no date) estimates that 70% of adult Americans have experienced at least one traumatic event, and of these, 20% will develop PTSD. The PTSD Alliance goes on to estimate that 13 million Americans have PTSD at any given time. According to the National Center for Post-Traumatic Stress Disorder (NCPTSD), PTSD “can occur following the experience or witnessing of life-threatening events such as military combat, natural disasters, terrorist incidents, serious accidents, or violent personal assaults like rape” (2006).

It may take days, weeks, months or years for an individual to develop symptoms of PTSD following the traumatic event (NCPTSD, 2006). PTSD manifests itself by means of a variety of symptoms, including panic attacks, nightmares, insomnia, flashbacks, hallucinations, hypervigilance, emotional numbing, avoidance and more (Jaffe & Segal, 2005). Brant (2005) makes note of the particular difficulty that many war veterans have in acknowledging their PTSD symptoms due to the stigmas attached to mental health problems and their own fears of appearing weak.

Nonetheless, communication is an important key to recovery. Butler (1997) reports that “Research suggests that trauma survivors can head off long-lasting symptoms by letting friends know what they're going through and by confronting traumatic memories early on”. “Talk to a lot of other people," says Edna Foa, a cognitive-behavioral psychologist and PTSD expert (Butler, 1997). Another trauma researcher, Rachel Yehuda, also stresses the importance of communicating to others and not withdrawing. She goes on to say that "The really devastating effect of trauma comes about when you damage your ability to relate to your social support system" (Butler, 1997).

What is metaphor? In simplest terms, a metaphor is a form of expression in which one thing is likened to something else with similar properties. A metaphor is one of many kinds of trope, which is a “rhetorical figure of speech that consists of a play on words, i.e. using a word in a way other than what is considered its literal or normal form” (Wikipedia, 2006). “Metaphors are common in language because they are so useful,” says Burns (2004). “Every new experience is at first understood in terms of what we already know. Metaphors can convey so much with few words, yet often are evocative and easily remembered” (Burns, 2004).

For example, in the famous play “Romeo & Juliet” by William Shakespeare, Romeo exclaims that “Juliet is the sun!” In so doing, Romeo is using a metaphor in order to liken the brightness, warmth and power of the sun to how he feels about Juliet. As the audience, we understand intuitively from this expression that Romeo does not mean to say that Juliet is literally the sun. Another example of a metaphorical expression can be found in the movie “Serenity”. When Serenity’s spaceship pilot Hoban Washburne says, “I am a leaf on the wind”, he is likening his own remarkable piloting abilities to the agile movement of a leaf on the wind. Again, it does not need to be explained to the audience that he does not believe he is an actual leaf.

It’s common for individuals who suffer from PTSD to use metaphors to express the experiences of traumatic events. According to Amendiola (1998), “Metaphor provides an altered frame of reference that allows the client to entertain novel experience without physiological hyperarousal and attending negative affect.” In layman’s terms, this means that speaking in metaphor allows a traumatized individual to talk about what happened without being re-traumatized by the memory of the event.

Winslow (2004) describes traumatic memory as creating a separate world which is very different from and initially irreconcilable with the ordinary world that most people know. “But,” she says, “the situation is more complicated still; changes in physical and psychological states shift the experiencer into an altered state of consciousness characterized by heightened imaging and interference with reasoning” (Winslow, 2004). Metaphor helps to create a bridge between the “ordinary” world and the trauma world.

As one might imagine, some difficulty may arise when it’s not properly understood that an individual is speaking metaphorically. Due to the highly sensitive nature of the subject matter, a traumatized individual who is using metaphors is not likely to be able to acknowledge that this is what he or she is doing. For example, imagine that a trauma victim expresses to a loved one that “Lois Lane” was in distress but that “Superman” didn’t come to save her. For the listener to insist on immediately translating the metaphors into what they may represent will likely provoke further emotional upset for the narrator, considering that the reason metaphors were chosen to begin with was that they were less emotionally threatening terms of expression. Furthermore, to automatically write off what the individual is trying to express as being false, or delusional, is counter-productive to the individual’s recovery process because it acts as an obstacle to communication.

Lawley & Tompkins (2001) point out that “Because metaphors describe one experience in terms of another, they specify and constrain our ways of thinking about the original experience. This influences the meaning and importance we attach to the original experience, the way it fits with other experiences, and the actions we take as a result”. In other words, communicating with a traumatized individual using the specific metaphors chosen by that individual can influence the future actions taken by that individual, and has the potential to empower the individual to positive action.

The question then arises of how to respond to a traumatized individual who is speaking metaphorically. David Grove, a renowned psychotherapist and PTSD expert from New Zealand, developed a special methodology which would allow therapists to communicate comfortably with their clients while preserving the metaphors chosen by their clients to represent traumatic events (Lawley & Tompkins, 2001). He calls this methodology “Clean Language”, and it is also known as “Grovian Metaphor Therapy”. The way “Clean Language” works, basically, is that the therapist responds to the metaphor with questions that continue to respect the client’s mode of expression. For example, if the client expresses that she is a bird who is trapped inside a hole, then the therapist may respond by asking questions about the nature of the bird (by saying, for instance, “And what kind of bird is it?”), or about the nature of the hole (“And what kind of hole is it?”), or about what happens next (“And then what happens?”). Note that when using “Clean Language”, each response is prefaced with the conjunction “And”. The purpose of these questions and this particular phrasing is simply to perpetuate communication. To insist that the client is not a bird or that there is no hole would prove to be counter-productive to the client’s recovery process as it would ultimately act as an obstacle to communication and thereby impede recovery.

Even though many therapists recognize and appreciate the important role that metaphor plays in trauma therapy, metaphors along with opportunities to discuss them are still often missed during the recovery process. Why? Burns (2004) gives three main reasons. One is that metaphors are so common in our every-day language. “We are so used to metaphorical language that we are like fish in an ocean of metaphors,” he says (Burns, 2004). As a result, metaphorical language may pass by unnoticed. Secondly, it may happen that the therapist assumes a universal interpretation of a metaphor and fails to recognize the more subjective meaning intended by the client. Thirdly, the therapist may be reluctant to use metaphorical language for fear of being misunderstood.

In spite of these obstacles, the effort to understand metaphorical language remains a valuable opportunity to open up lines of communication and help to build the social support which is so critical to the trauma victim’s recovery process. In reference to written trauma narratives, Winslow writes:

Although Winslow is speaking of being an audience to written trauma narratives, her sentiment still holds true for spoken narratives as well. As one might imagine, a little validation goes a long way.

While hallucinations and/or delusions may in some cases be an indicator of PTSD, they may in other cases be an indicator of schizophrenia or some form of psychosis. Regardless of which psychological condition is triggering the hallucinations, the same principle of recovery through communication applies. In his book, Phenomenology & Lacan on Schizophrenia, After the Decade of the Brain, Alphonse De Waelhens asserts that “hallucinations cannot simply be explained as nothing more than false perceptions” (Johnston, 2002). De Waelhens felt that hallucinations represented unconscious and spontaneous attempts at recovery from psychological pain by the individual who experienced them. Amendiola (1998) supports this idea when she states that individuals “are usually attempting to problem-solve, even in a dissociative date”. Bruce Fink, a scientist who continued research along the lines of De Waelhens’ school of thought, reiterated the importance of using communication via metaphor to establish what he calls a “stable delusional system” which would allow the individual experiencing hallucinations to be able to interface with society’s objective reality in spite of varying perceptions (Johnston, 2002).

If a person says that he is a fish, it could mean many different things. It could mean that he is hallucinating. It could mean that he is delusional. It could mean that he is simply speaking poetically. Or, it could mean that he is attempting to express the nature of some trauma that he has suffered. There is a certain old-fashioned school of thought which dictates that any person expressing “false” perceptions should be “corrected” and made aware that their perception differs from the norm (Sidis, 1914). The reality is that it may be more helpful to him to attempt to understand what he is trying to communicate than it will be to insist that he is wrong.

This does not mean that one is being dishonest by electing to communicate with an individual using his choice of metaphor. It does not mean that others have to agree that they perceive him to be a fish. It only means that they are trying to understand why he perceives himself that way. Asking questions such as “What kind of fish?” will reveal more about his train of thought and thus serve to perpetuate communication along with healing.

Trauma makes a tremendous impact on the human psyche, the effects of which may last for years. Even though sufferers of PTSD may benefit from the assistance of a professional psychotherapist, we as friends and loved ones can also make a powerful difference in an individual’s recovery process by simply listening and making an effort to understand what the individual is trying to express. The fact that trauma victims often use metaphorical language means that sometimes we have to put in a little more effort in order to interpret what is being communicated. This effort goes a long way.