The role of metaphorical language in the context of mental illness
DOI:
https://doi.org/10.4396/20250310Keywords:
artfulness, epistemic injustice, mental illness, metaphorical language, schizophreniaAbstract
Within the framework of epistemic injustice observed in illness experiences (Fricker 2007; Kidd, Carel 2017), this paper highlights the beneficial role of metaphorical language in communicating inner states that cannot be expressed in literal language (Mould et al. 2017; Ervas 2024). This is apparent in the context of a complex disorder such as schizophrenia, where speakers have difficulty expressing their experience and suffer from a lack of credibility as patients and as people. Furthermore, disorders affecting the perception of the body can hinder the ability to relate to others (Gallese et al. 2024). While schizophrenic individuals exhibit pragmatic deficits (Bambini et al. 2016), evidence suggests their use of creative metaphors (Nichini et al. 2025). If metaphorical language can be a strategic expressive resource, then artistic creation, as a pre-reflective, embodied dimension of experience (Merleau-Ponty 1952), can also become an epistemic “bridge” between speaker and interpreter. This study therefore aims to demonstrate how, in the context of art-based therapeutic experiences (Attard et al. 2017; Mitchell, Meehan 2022), metaphorical inventiveness can reactivate sensorimotor circuits, enabling individuals to “feel at home” despite their illness.
Downloads
References
Adamczyk, Przemysław, Daren, Artur, Sułecka, Aleksandra, Błądziński, Piotr, Cichocki, Łukasz, Kalisz, Aneta, Gawęda, Łukasz, Cechnicki, Andrzej (2016), «Do better communication skills promote sheltered employment in schizophrenia?», in Schizophrenia Research, vol. 176, issues 2-3, pp. 331-339.
American Psychiatric Association (2013 5th ed.), Diagnostic and statistical manual of mental disorders, American Psychiatric Publishing, Arlington (Manuale diagnostico e statistico dei disturbi mentali, Raffaello Cortina, Milano 2023).
Amir, Dana (2016), «When Language Meets Traumatic Lacuna: The Metaphoric, the Metonymic, and the Psychotic Modes of Testimony», in Psychoanalytic Inquiry, vol. 36, Issue 8, pp. 620-632.
Attard, Angelica, Larkin, Michael, Boden, Zoë, Jackson, Christopher (2017), «Understanding Adaptation to First Episode Psychosis Through the Creation of Images», in Journal of Psychosocial Rehabilitatio Mental Health, vol. 4, pp. 73-88.
Bambini, Valentina, Arcara, Giorgio, Bechi, Margherita, Buonocore, Mariachiara, Cavallaro, Roberto, Bosia, Marta (2016), «The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life», in Comprehensive Psychiatry, vol. 71, pp. 106-120.
Boden, Zoë and Eatough, Virginia (2014), «Understanding More Fully: A Multimodal Hermeneutic-Phenomenological Approach», in Qualitative Research in Psychology, vol. 11, issue 2, pp. 160-177.
Bowdle, Brian F., Gentner, Dedre (2005), «The career of metaphor», in Psychological Review, vol. 112, n. 1, pp. 193-216.
Carel, Havi (2013), «Bodily doubt», in Journal of Consciousness Studies, vol. 20, n. 7-8, pp. 178-197.
Casey, Edward S. (2001), «Between geography and philosophy: What does it mean to be in the place-world?», in Annals of the Association of American Geographer, vol. 91, issue 4, pp. 683-693.
Crichton, Paul, Carel, Havi, Kidd, Ian J. (2017), «Epistemic injustice in psychiatry», in British Journal of Psychiatry, vol. 41, n. 2, pp. 65-70.
Cutting, John (1985), The Psychology of Schizophrenia, Churchill Livingston, Edinburgh.
Despot, Kristina Š., Sekulić Sović, Martina, Vilibić, Maja and Mímica, Ninoslav (2021), «Metaphor Production by Patients with Schizophrenia – A Case Analysis», in Metaphor and Symbol, vol. 36, issue 3, pp. 119-40.
Ervas, Francesca, Guerrieri, Alice (2025), «Metafora e affettività nella malattia mentale: il caso dell’ingiustizia epistemica», in Cipriani Letizia, Del Sordo Caterina, a cura di, Azimuth. Philosophical coordinates in modern and contemporary age. Vol. 25: Multifaceted Embodiment. A (meta-)Philosophical Assessment, Inschibboleth, Roma, pp. 15-32.
Ervas, Francesca (2024), «“It was the illness talking”: Self-Illness Ambiguity and Metaphors’ Functions in Mental Health Narrative», in Philosophical Explorations, vol. 28, issue 2, pp. 123-141.
Ferrari, Federica (2020), «The ‘transformative’ power of ‘integrated metaphor’ in counselling. Applying and measuring its implemented potential», in Metaphor and the Social World, vol. 10, issue 2, pp. 292-319.
Fricker, Miranda (2007), Epistemic Injustice: Power and the Ethics of Knowing, Oxford University Press, Oxford.
Fuchs, Thomas (2012), The phenomenology of body memory, in Koch Sabine C., Fuchs Thomas, Summa M., Müller C., edited by, Body Memory, Metaphor and Movement, John Benjamins, Amsterdam, pp. 9-22.
Gallagher, Shaun (2000), «Philosophical conceptions of the self: implications for cognitive science», in Trends in Cognitive Sciences, vol. 4, issue 1, pp. 14-21.
Gallese, Vittorio, Ardizzi, Martina, Ferroni, Francesca (2024), «Schizophrenia and the bodily self», in Schizophrenia Research, vol. 269, pp. 152-162.
Galvin, Kathleen T., Todres, Les (2011), «Kinds of well-being: A conceptual framework that provides direction for caring», in International Journal of Qualitative Studies on Health and Well-Being, vol. 6, issue 4, pp. 1-13.
Gibbs, Raymond W. Jr. (1994), The poetics of mind: Figurative thought, language, and understanding, Cambridge University Press, Cambridge.
Guerrieri, Alice (2025), Metafore artistiche. Come si vedono e cosa raccontano, Meltemi editore, Milano.
Iakimova, Galina, Christine, Passerieux, Marie Christine, Hardy-Baylé (2006), «La compréhension des métaphores dans la schizophrénie et la dépression. Une approche expérimentale», in L’Encéphale, vol. 32, issue 6, part 1, pp. 995-1002.
Jablensky, Assen (2010), «The diagnostic concept of schizophrenia: its history, evolution, and future prospects», in Dialogues in clinical neuroscience, vol. 12, issue 3, pp. 271-287.
Jaspers, Karl (1963), General psychopathology, Manchester University Press, Manchester.
Karp, David A. (1992), «Illness ambiguity and the search for meaning: A case study of a self-help group for affective disorders», in Journal of Contemporary Ethnography, vol. 21, issue 2, pp. 139-170.
Kidd, Ian J., Carel, Havi (2017), «Epistemic Injustice and Illness», in Journal of Applied Philosophy, vol. 34, n. 2, pp. 172-90.
Kopp, Richard R. (1995), Metaphor therapy. Using client-generated metaphors in psychotherapy, Routledge, New York (Le metafore nel colloquio clinico. L’uso delle immagini mentali del cliente, trad. di, R. Mazzeo, A. Gasperi, Centro Studi Erickson, Trento 1998).
Lakoff, George, Johnson, Mark (1980), Metaphors We Live By, University of Chicago Press, Chicago.
Littlemore, Jeanette (2019), Metaphors in the mind: Sources of variation in embodied metaphor, Cambridge University Press, Cambridge.
Littlemore, Jeanette, Turner, Sarah (2019), «What can metaphor tell us about experiences of pregnancy loss and how are these experiences reflected in midwife practice?», in Frontiers in Communication, vol. 4, pp. 1-17.
Maiese, Michelle (2014), «How can emotions be both cognitive and bodily?», in Phenomenology and the Cognitive Sciences, vol. 13, pp. 513-531.
Merleau-Ponty, Maurice (1945), Phénoménologie de la perception, Gallimard, Paris (Fenomenologia della percezione, trad. di, A. Bonomi, Bompiani, Milano 2003).
Merleau-Ponty, Maurice (1952), «Le langage indirect et les voix du silence», in Les Temps Modernes, voll. 7-8, n. 80-81.
Mitchell, Julia, Meehan, Trudy (2022), «How art-as-therapy supports participants with a diagnosis of schizophrenia: A phenomenological lifeworld investigation», in The Arts in Psychotherapy, vol. 80, pp. 1-13.
Mould, Tracy J., Oades, Lindsay G., Crowe, Trevor P. (2010), «The use of metaphor for understanding and managing psychotic experiences: A systematic review», in Journal of mental health, vol. 19, issue 3, pp. 282-293.
Nelson, Barnaby, Sass, Louis A. (2009), «Medusa’s stare: A case study of working with self-disturbance in the early phase of schizophrenia», in Clinical Case Studies, vol. 8, issue 6, pp. 489-504.
Newbigging, Karen, Ridley, Julie (2018), «Epistemic struggles: The role of advocacy in promoting epistemic justice and rights in mental health», in Social Science & Medicine, vol. 219, pp. 36-44.
Nichini, Cristiano, Barattieri di San Pietro, Chiara, Scalingi, Biagio, Alecci, Eleonora, Toschi, Luca, Cavallotti, Simone, Cigognini, Anna Chiara, Durbano, Federico, Ferraris, Silvia, Santinon, Patrizia, Pompei, Chiara, Frau, Federico, Mangiaterra, Veronica, Bischetti, Luca, Bosia, Marta, Peschi, Gianluca, Politi, Pierluigi, Bambini, Valentina (2025), «Characterizing the patient experience of physical restraint in psychiatric settings via a linguistic, sentiment, and metaphor analysis», in Scientific Reports, 15(1):2111.
Phillips, Denise (1986), «Photography’s use as a metaphor of self with stabilized schizophrenic patients», in The Arts in Psychotherapy, vol. 13, issue 1, pp. 9-16.
Rossetti, Ilenia, Brambilla, Paolo, Papagno, Costanza (2018), «Metaphor comprehension in schizophrenic patients», in Frontiers in Psychology, vol. 9, pp. 1-15.
Saks, Elyn R. (2007), The Center Cannot Hold: My Journey Through Madness, Hyperion, New York (Un castello di Sabbia. Storie della mia vita e della mia schizofrenia, trad. di, P. A. Corsini, Franco Angeli, Milano 2012).
Sass, Louis A., Parnas, Josef (2003), «Schizophrenia, Consciousness, and the Self», in Schizophrenia Bulletin, vol. 29, issue 3, pp. 427-444.
Semino, Elena, Demjén, Zsófia, Demmen, Jane, Koller, Veronika, Payne, Sheila, Hardie, Andrew and Rayson, Paul (2017), «The online use of Violence and Journey metaphors by patients with cancer, as compared with health professionals: a mixed methods study», in BMJ Supportive & Palliative Care, vol. 7, issue 1, pp. 60-66.
Siegel, L. (1988), «The use of mural and metaphor with a schizophrenic population for recovery in a trauma situation», in Pratt Institute Creative Arts Therapy Review, 9, pp. 40-53.
Stanghellini, Giovanni (2009), «Embodiment and schizophrenia», in World Psychiatry, vol. 8, issue 1, pp. 56-59.
Steen, Gerard (2008), «The paradox of metaphor: Why we need a three dimensional model for metaphor», in Metaphor and Symbol, vol. 23, issue 4, pp. 213-241.
Tay, Dennis (2016), «A Variational Approach to deliberate metaphors», in Cognitive Linguistic Studies, vol. 3, issue 2, pp. 277-298.
Zahavi, Dan, Kriegel, Uriah (2015), For-me-ness: What it is and what it is not, in Dahlstrom Daniel O., Elpidorou Andreas, Hopp W., edited by, Philosophy of mind and phenomenology, Routledge, New York, pp. 36-53.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Works published in RIFL are released under Creative Commons Licence:Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
