RFT for clinical use: The example of metaphor
Introduction
Contextual Behavioral Science (CBS) is a broad church that encompasses three core areas of knowledge. First, functional contextualism provides clear and pragmatic assumptions about the scientific agenda such that behavior can be understood, predicted, and influenced with precision, scope, and depth (Gifford & Hayes, 1999). Second, Relational Frame Theory (RFT) identifies basic contextual elements (i.e., relating stimuli) that permit the prediction and influence of complex verbal behavior (Hayes, Barnes-Holmes, & Roche, 2001). Third, Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) facilitates an empirically effective approach to psychological health and well-being, thus directly addressing the “challenge of the human condition” (Hayes, Barnes-Holmes, & Wilson, 2012). The challenge now faced by the CBS community is to draw these three strands into a broad, scientific, and coherent agenda. This is not an easy feat, and has rarely, if ever, been successfully achieved in the history of psychology. But as a starting point, Hayes et al. (2012) suggested the following:
“…a reticulated (that is, web-like) model of scientific and practical development, in which theoretical and technological progress occurs at multiple levels but in an interconnected way, with differing standards of progress appropriate to the particular level of the work” (p. 6).
Section snippets
Integrating RFT and ACT
The integration of RFT and ACT is central to the CBS reticulated model and the program of research it promotes and relies upon. Accordingly, RFT scholars are often asked by ACT clinicians for RFT-based definitions of fusion, for example. Because the concept of cognitive fusion is pivotal to ACT assumptions and practices, and RFT is after all, an account of language and cognition, it might seem straightforward to be able to provide this. However, an RFT translation of fusion is still a long way
An RFT account of analogy
Naturally, the RFT approach to analogy has the core concept of arbitrarily applicable relational responding (AARR) at its root. But what broadens AARR out and makes it specifically applicable to analogy is the more complex or higher order concept of relating relations. The first detailed analysis of this was provided by Barnes, Hegarty, and Smeets (1997). An example illustrating their basic account is provided in Fig. 1.
Consider the simple analogy in Fig. 1 that might be described as ‘peach is
Distinguishing between analogies and metaphors
The terms ‘analogy’ and ‘metaphor’ are often used interchangeably, and it is difficult to find distinct or concise definitions that separate one term from the other in the language of RFT. Critically, the current paper does not adhere to the traditional English language distinctions between metaphor and analogy (easily distinguished from each other by the use of “like” or “as”) because this is not a working distinction for RFT. To clarify, in terms of RFT, we would define analogy as a
The role of metaphor in ACT
Metaphors have a long-established history as therapeutic tools (for a review see McCurry and Hayes (1992)). Their common purpose in clinical settings appears to be two-fold. First, they are designed to validate the client׳s experience. Second, they aim to enhance the client׳s awareness of her situation. For example, in Cognitive Behavioral Therapy (CBT) metaphors are used to link different areas of thought and thus challenge unhelpful styles of thinking (Blenkiron, 2005, Stott et al., 2010).
Using RFT to enhance metaphor in ACT
From the outset, we acknowledge that the therapeutic pieces outlined subsequently appear, in some ways, to be out of context. For example, we do not focus on the client–therapist relationship, although we believe that this is central to all therapeutic change. Similarly, the client validation that invariably occurs within a good client–therapist relationship clearly impacts on the potential utility of individual techniques, including metaphor.
Perhaps the simplest place to start in an attempt to
Perspective-taking (deictic relations)
For RFT, perspective-taking comprises three types of deictic relations: I–YOU; HERE–THERE; and NOW–THEN.1
Using RFT to construct clinical metaphors
From the perspectives of both RFT and ACT, metaphors should be used to identify and change functional processes. For example, clinical metaphors are used in part to create changes in the deictic relations and particularly the coordination between the I and the client׳s behavior. If metaphors do not achieve this, they are not maximally effective and may need to be modified or replaced. Put another way, the verbal behavior of the therapist, such as in providing a metaphor, changes the context in
Can RFT enhance the use of metaphors in ACT?
There is an on-going debate within the CBS community about whether ACT therapists ‘need’ to learn RFT to better support their clinical work. For example, one might argue that ACT is a functional therapy based on core components (e.g., the hexaflex) and all therapists using this model are going to follow the model (i.e., do some defusion, acceptance, values, etc.) with practically all clients. Addressing this debate is an empirical issue. For example, you would need to compare outcomes and
Future research
There is a great deal of research that is needed to make tracks into the fourth generation of RFT work, and thus to articulate more fully the functional overlap between it and ACT, where this is possible. We have created a short list below of topics that emanate directly from the issues discussed within the current paper. This is not a definitive list even of the issues encountered here, but is simply offered as a guide to those who may be struggling to see exactly what implications RFT has for
Concluding comments
Psychological content and its hold on behavior is an ultimately verbal and uniquely human experience. So too, are our metaphorical and analogical reasoning skills. But there appears to be little empirical study of how these two matters overlap. For the community of CBS, it will become increasingly important to establish functional links between our approach to psychological suffering and our approach to its alleviation. It is thus imperative that fourth generation explorations in RFT begin to
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2021, Journal of Contextual Behavioral ScienceCitation Excerpt :The process of situating ourselves in a certain perspective, and the ability to shift to others, has been previously explicated through the framework of RFT. Notably, RFT accounts of metaphorical reasoning have pointed to the role of deictic relations in explaining how metaphors derive their effect through perspective taking (Foody et al., 2014). Deictic relations specify the perspective from which we experience the world, and are comprised of the relations I—YOU, HERE—THERE, and NOW—THEN.
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2020, Journal of Contextual Behavioral ScienceAppetitive augmental functions and common physical properties in a pain-tolerance metaphor: An extended replication
2020, Journal of Contextual Behavioral ScienceCitation Excerpt :In the therapeutic setting, it has been suggested that metaphors help to convey and formulate ideas as to the source of a client's issues in cognitive behavioural therapies (Stott, Mansell, Salkovskis, Lavender, & Cartwright-Hatton, 2010), particularly to challenge maladaptive thinking styles and address biases or behaviour (Blenkiron, 2005). In “third wave” behavioural therapies, such as Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999), metaphors are used not least to deliteralise psychological content that might perhaps be problematic (Foody et al., 2014). Given their clinical utility and widespread use, it is important that we develop a clearer idea of how metaphors are understood by the listener, and especially, how and when metaphors used properly in the intervention setting can lead to behaviour change.