The Language of Pain: Is There a Relationship Between Metaphor Use and Adjustment to Chronic Pain?

OBJECTIVE: Metaphor, frequently used in chronic pain, can function as a communicative tool, facilitating understanding and empathy from others. Previous research has demonstrated that specific linguistic markers exist for areas such as pain catastrophizing, mood, as well as diagnostic categories. The current study sought to examine potential associations between the types of pain metaphors used and diagnostic category, disability, and mood. DESIGN: Online cross-sectional survey in Sydney, Australia. SUBJECTS: People with chronic pain (n = 247, age 19-78 years, M = 43.69). METHODS: The data collected included demographics, pain metaphors, the Brief Pain Inventory (BPI) and the Depression, Anxiety, and Stress Scales (DASS-21). Associations between metaphor source domains, obtained via Systematic Metaphor Analysis, and scores on the BPI, DASS-21, as well as diagnostic group were considered using binary logistic analysis. RESULTS: Use of different pain metaphors was not associated with pain intensity, however the extent to which pain interfered with daily life did have a relationship with use of metaphorical language. Preliminary support was found for an association between the use of certain pain metaphors and self-reported diagnostic categories, notably Endometriosis, Complex Regional Pain Syndrome, and Neuropathic pain. CONCLUSIONS: There may be specific linguistic metaphorical markers to indicate pain interference and for particular diagnoses. Appreciation of pain metaphors has potential to facilitate communication and enhance understanding in interactions between clinicians and people with chronic pain.

Conceptual metaphors influence memory automatically: Evidence from a divided attention false memory task.

Previous research has found that reading a list of ostensibly unrelated expressions based on the same underlying conceptual metaphor can evoke false recognition on a memory task for new expressions that use the same metaphor, the so-called conceptual metaphor false memory effect. We examined the automaticity of this effect by dividing participants' attention with a concurrent task. In Study 1, attention was manipulated while participants read the lists of expressions, whereas in Study 2, attention was manipulated both when they read the lists and when they were engaged in the later recognition memory test. Across both studies, the conceptual metaphor false memory effect was observed when conscious processing was limited by dividing attention. These data support the argument that conceptual metaphors are automatically activated when metaphorical expressions are read.

Time to Throw in the Towel? No Evidence for Automatic Conceptual Metaphor Access in Idiom Processing.

The goal of the current research was to determine if conceptual metaphors are activated when people read idioms within a text. Participants read passages that included idioms that were consistent (blow your top) or inconsistent (bite his head off) with an underlying conceptual metaphor (ANGER IS HEATED FLUID IN A CONTAINER) followed by target words that were related (heat) or unrelated (lead) to the conceptual metaphor. Reading time (Experiment 1) or lexical decision time (Experiment 2) for the target words were measured. We found no evidence supporting conceptual metaphor activation. Target word reading times were unaffected by whether they were related or unrelated to underlying conceptual metaphors. Lexical decision times were facilitated for related target words in both the consistent and inconsistent idiom conditions. We suggest that the conceptual (target) domain, not a specific underlying conceptual metaphor, facilitates processing of related target words.

Bibliometric assessment of world scholars' international publications related to conceptual metaphor.

Research on metaphor has gained increasing attention of world's scholars since the publication of Lakoff and Johnson's collaborated book Metaphors We Live By in 1980. The present study comprises a pioneering review of publications on Conceptual Metaphor Theory (CMT). It aimed to use the CiteSpace software to provide a clear overview of international research in relation to CMT. In total, 4,458 bibliometric recordings ranging from 1980 to 2022 were collected from the Web of Science (WOS) Core Collection. The descriptive analysis presents the trend of annual publications, the top 10 most prolific journals and the top 10 most productive authors. A document co-citation analysis was conducted via CiteSpace to navigate the key documents in this field. A visualization of keywords and its cluster analysis were conducted to show the research fields and dominant topics. The top 5 keywords with high frequency were language, comprehension, conceptual metaphor, discourse, and figurative language. The most prominent 5 clusters are labeled as right hemisphere, self, time, teacher education, and corpus linguistics. The present review through CiteSpace flags the need for more investigations of CMT from more aspects or interdisciplinary studies, such as metaphor translation, metaphor in literature, metaphor and corpus linguistics, etc.

Diagnosing learning and teaching potentials - a cognitive linguistic analysis of conceptions of heart excitation.

Purpose: The analysis of difficulties in understanding the information content of an electrocardiogram revealed indications that these are also caused by misconceptions about cardiac excitation phenomena. Therefore, a re-analysis of these research data is intended to deepen the understanding that medical students have of cardiac excitation. Furthermore, the concept of excitation represented in academic textbooks will be examined from an educational perspective. Methods: In order to diagnose learning potentials, a previous study on ECG comprehension collected statements from students using problem-centred, guideline-based interviews. These data were subjected to a re-analysis. The evaluation was based on a qualitative content analysis. Ideas of heart excitation and the underlying basal cognitions were analysed in the light of the Conceptual Metaphor theory using systematic metaphor analysis. Conceptual metaphors, which structure the understanding of this abstract fact, were identified. In a similar procedure, scientific ideas from textbooks were examined, too. The model of educational reconstruction served as the research framework. Results: On the basis of the data from exemplary cases, it will be shown which subject-related inappropriate ideas students of human medicine can construct when dealing with the phenomenon of excitation in a cardiological context. For example, excitation can be misinterpreted synonymously with the extracellular potential differences responsible for the development of an ECG. Sometimes, excitation is even understood as the tone of the myocardium. Analyzing the educational potential of academic textbooks reveals possible barriers to understanding in that excitation is not clearly defined in terms of the de- and repolarization of heart muscle cells. Moreover, both students and textbooks show an inappropriate idea of repolarization. Conclusion: The presented analysis of learning and teaching potentials offers the opportunity to identify difficulties in understanding with regard to an appropriate concept of cardiac excitation. It also helps to develop conclusions for educational interventions.

A Three-Dimensional Spatial Metaphorical Representation of Generation Implied in Han Kin Terms.

concepts can be represented in the brain by means of metaphors. Generation refers to seniority in the family or clan, implies the implementation of different attitudes required by kinship, and contains profound psychological, emotional, and social factors. Generation as an abstract concept is related to concepts such as power, social status, importance, and time. The conceptual metaphor theory based on the embodied theory proposes that abstract concepts are represented by actual sensorimotor experiences. Generation implied in Han kin terms is often represented by multiple spatial terms. According to conceptual metaphor theory, the current study predicted that generation could be represented by multiple spatial metaphors. We designed six experiments to investigate this issue. The results showed that (1) the up-down and left-right positions in which kinship words were presented affected the processing of the concept of generation; (2) the processing of kinship words also affected up-down and left-right spatial information perception; and (3) the processing of the concept of generation could also automatically activate the front-back spatial operation and induce the embodied simulation of body movement. In sum, the results suggested that generation might be represented by the three-dimensional spatial metaphor of vertical, horizontal, and sagittal axes, which are influenced by the sensorimotor system.

Rights Metaphors Across Hybrid Legal Languages, Such as Euro English and Legal Chinese.

This paper focuses on two legal languages such as the legal English developed by the European Union institutions (Euro English) and the legal Chinese of Mainland China, to study whether the mental representations and the embodied simulation created by the conceptual metaphors for the same Western concept, right, differ in any significant ways. By analysing the data contained in two large corpora, this study has found that, despite the common origin of the concept right in the two legal languages, they conceptualise it in a significantly different fashion. Finally, the findings of this study are read through the theoretical framework proposed for this special issue-hybridity and the Third Space. While it is somewhat straightforward to conceive of Euro English as a hybrid language, owing to the multilingual and supranational setting where it is used, this study has found that the Chinese legal language, too, is a hybrid language exhibiting linguistic features that intersect different belief systems.

Embodied Songs: Insights Into the Nature of Cross-Modal Meaning-Making Within Sign Language Informed, Embodied Interpretations of Vocal Music.

Embodied song practices involve the transformation of songs from the acoustic modality into an embodied-visual form, to increase meaningful access for d/Deaf audiences. This goes beyond the translation of lyrics, by combining poetic sign language with other bodily movements to embody the para-linguistic expressive and musical features that enhance the message of a song. To date, the limited research into this phenomenon has focussed on linguistic features and interactions with rhythm. The relationship between bodily actions and music has not been probed beyond an assumed implication of conformance. However, as the primary objective is to communicate equivalent meanings, the ways that the acoustic and embodied-visual signals relate to each other should reveal something about underlying conceptual agreement. This paper draws together a range of pertinent theories from within a grounded cognition framework including semiotics, analogy mapping and cross-modal correspondences. These theories are applied to embodiment strategies used by prominent d/Deaf and hearing Dutch practitioners, to unpack the relationship between acoustic songs, their embodied representations, and their broader conceptual and affective meanings. This leads to the proposition that meaning primarily arises through shared patterns of internal relations across a range of amodal and cross-modal features with an emphasis on dynamic qualities. These analogous patterns can inform metaphorical interpretations and trigger shared emotional responses. This exploratory survey offers insights into the nature of cross-modal and embodied meaning-making, as a jumping-off point for further research.

'Barbed wire wrapped around my feet': Metaphor use in chronic pain.

OBJECTIVES: As there is no objective test for pain, sufferers rely on language to communicate their pain experience. Pain description frequently takes the form of metaphor; however, there has been limited research in this area. This study thus sought to extend previous findings on metaphor use in specific pain subgroups to a larger, heterogeneous chronic pain sample, utilizing a systematic method of metaphor analysis. DESIGN: Conceptual metaphor theory was utilized to explore the metaphors used by those with chronic pain via qualitative methodology. METHODS: An anonymous online survey was conducted which asked for the descriptions and metaphors people use to describe their pain. Systematic metaphor analysis was used to classify and analyse the metaphors used into specific metaphor source domains. RESULTS: Participants who reported chronic pain completed the survey (N = 247, age 19-78, M = 43.69). Seven overarching metaphor source domains were found. These were coded as Causes of Physical Damage, Common Pain Experiences, Electricity, Insects, Rigidity, Bodily Misperception, and Death and Mortality. CONCLUSIONS: Participants utilized a wide variety of metaphors to describe their pain. The most common descriptions couched chronic pain in terms of physical damage. A better understanding of pain metaphors may have implications for improved health care communication and provide targets for clinical interventions.

Metaphor Analysis as a Window into How Japanese Entry-level Medical Students Conceptualize Their Future Profession as Physicians.

Metaphor analysis is a useful tool for uncovering tacit assumptions and beliefs. In education, metaphor analysis of students' attitudes and motivations can provide useful insights for educational discourse and curriculum development. The current metaphor analysis of Japanese entry-level medical students' conceptualizations of their future profession of physician was conducted to determine what insights might be derived therefrom for medical educational discourse and curriculum development. For the analysis, the students filled in the blanks of a metaphorical statement, A physician is like _____ because _____, and the metaphors thus collected were coded using content analysis procedures. Ninety-one metaphorical statements were included for analysis. Two generic-level conceptual metaphors were identified: the physician as deeply caring figure (49/91, 53.8%), in which metaphors relating to family members were predominant (25/49, 51.0%), and the physician as specially able and skillful figure, in which just over half of the metaphors related to a super being (22/42, 52.3%). The predominantly positive metaphors elicited by this study reflect high levels of idealism in this group of students about to embark on their medical studies. However, the high number of metaphors relating the physician to a super being emphasizes the need for space in the medical curriculum devoted to discussion of the realities of uncertainty and fallibility in medical care. Extrapolating more broadly, metaphor analysis may be used in other areas of the medical profession, such as for exploring values and beliefs about medical practice and for comparing cross-cultural perspectives in medical teams composed of members from different countries.

Morphological Metaphor Mapping of Moral Concepts in Chinese Culture.

According to conceptual metaphor theory, individuals are thought to understand or express abstract concepts by using referents in the physical world-right and left for moral and immoral, for example. In this research, we used a modified Stroop paradigm to explore how abstract moral concepts are metaphorically translated onto physical referents in Chinese culture using the Chinese language. We presented Chinese characters related to moral and immoral abstract concepts in either non-distorted or distorted positions (Study 1) or rotated to the right or to the left (Study 2). When we asked participants to identify the Chinese characters, they more quickly and accurately identified morally positive characters if they were oriented upright or turned to the right and more quickly and accurately identified immoral characters when the characters were distorted or rotated left. These results support the idea that physical cues are used in metaphorically encoding social abstractions and moral norms and provided cross-cultural validation for conceptual metaphor theory, which would predict our results.

A qualitative study on the development and rectification of advanced medical students' misconceptions about the physiological electrocardiogram (ECG).

Purpose: The study takes a qualitative and explorative approach to capture the concepts that German medical students have of the physiological electrocardiogram (ECG) which they acquired during their preclinical training. These concepts are then considered for possible misconceptions. Afterwards a theory-based intervention which allows subjects to see the connection of the curve progression with the spatial spreading of excitation (animated vector loop) is put to the test. Methods: In the course of a diagnosis of learning potentials, individual students participated in problem-centred, guided interviews. The developed intervention was tested in separately conducted teaching experiments using thinking aloud protocols. The data evaluation was done through qualitative content analysis. Based on the conceptual metaphor theory, conceptions and their underlying embodied cognition were analysed. Results: One of the subjects' typical misinterpretations is taking the progression of the ECG tracing for a mere increase and decrease of the myocardium's electrical activity, rather than connecting it with its spatial and temporal aspects. The data evaluation has shown that the newly developed theory-based intervention can lead to re-learning. Reconstructed metaphorical concepts illustrate this process of understanding. It is exemplarily shown how, through the course of the interviews, students are enabled to appropriately explain ECGs as the two-dimensional representation of the spatial excitation propagation in the heart. Conclusion: By capturing typical misconceptions of the physiological electrocardiogram and demonstrating interventions that support learning, the study provides a contribution to comprehensive learning which can be used in the basic education of medical students.

Why Smoggy Days Suppress Our Mood: Automatic Association Between Clarity and Valence.

The intuition of clarity-valence association seems to be pervasive in daily life, however, whether there exists a potential association between clarity (i.e., operationalized as visual resolution) and affect in human cognition remains unknown. The present study conducted five experiments, and demonstrated the clarity-valence congruency effect, that is, the evaluations showed performance advantage in the congruent conditions (clear-positive, blurry-negative). Experiments 1 through 3 demonstrated the influence of the perception of clarity on the conceptualization of affective valence, while Experiments 4 and 5 verified the absence of the influence of conceptualization on perception, thus the unidirectionality of clarity-valence association in cognition is confirmed. The findings extend the affective perceptual-conceptual associations into the dimension of clarity, thus providing support for the ideas of embodied cognition as well as implications for our preference for clarity and aversion to blur.

Time Is Not More Abstract Than Space in Sound.

Time is talked about in terms of space more frequently than the other way around. Some have suggested that this asymmetry runs deeper than language. The idea that we think about abstract domains (like time) in terms of relatively more concrete domains (like space) but not vice versa can be traced to Conceptual Metaphor Theory. This theoretical account has some empirical support. Previous experiments suggest an embodied basis for space-time asymmetries that runs deeper than language. However, these studies frequently involve verbal and/or visual stimuli. Because vision makes a privileged contribution to spatial processing it is unclear whether these results speak to a general asymmetry between time and space based on each domain's general level of relative abstractness, or reflect modality-specific effects. The present study was motivated by this uncertainty and what appears to be audition's privileged contribution to temporal processing. In Experiment 1, using an auditory perceptual task, temporal duration and spatial displacement were shown to be mutually contagious. Irrelevant temporal information influenced spatial judgments and vice versa with a larger effect of time on space. Experiment 2 examined the mutual effects of space, time, and pitch. Pitch was investigated because it is a fundamental characteristic of sound perception. It was reasoned that if space is indeed less relevant to audition than time, then spatial distance judgments should be more easily contaminated by variations in auditory frequency, while variations in distance should be less effective in contaminating pitch perception. While time and pitch were shown to be mutually contagious in Experiment 2, irrelevant variation in auditory frequency affected estimates of spatial distance while variations in spatial distance did not affect pitch judgments. Results overall suggest that the perceptual asymmetry between spatial and temporal domains does not necessarily generalize across modalities, and that time is not generally more abstract than space.

Spatializing Emotion: No Evidence for a Domain-General Magnitude System.

People implicitly associate different emotions with different locations in left-right space. Which aspects of emotion do they spatialize, and why? Across many studies people spatialize emotional valence, mapping positive emotions onto their dominant side of space and negative emotions onto their non-dominant side, consistent with theories of metaphorical mental representation. Yet other results suggest a conflicting mapping of emotional intensity (a.k.a., emotional magnitude), according to which people associate more intense emotions with the right and less intense emotions with the left - regardless of their valence; this pattern has been interpreted as support for a domain-general system for representing magnitudes. To resolve the apparent contradiction between these mappings, we first tested whether people implicitly map either valence or intensity onto left-right space, depending on which dimension of emotion they attend to (Experiments 1a, b). When asked to judge emotional valence, participants showed the predicted valence mapping. However, when asked to judge emotional intensity, participants showed no systematic intensity mapping. We then tested an alternative explanation of findings previously interpreted as evidence for an intensity mapping (Experiments 2a, b). These results suggest that previous findings may reflect a left-right mapping of spatial magnitude (i.e., the size of a salient feature of the stimuli) rather than emotion. People implicitly spatialize emotional valence, but, at present, there is no clear evidence for an implicit lateral mapping of emotional intensity. These findings support metaphor theory and challenge the proposal that mental magnitudes are represented by a domain-general metric that extends to the domain of emotion.

Interrelations Between Temporal and Spatial Cognition: The Role of Modality-Specific Processing.

Temporal and spatial representations are not independent of each other. Two conflicting theories provide alternative hypotheses concerning the specific interrelations between temporal and spatial representations. The asymmetry hypothesis (based on the conceptual metaphor theory, Lakoff and Johnson, 1980) predicts that temporal and spatial representations are asymmetrically interrelated such that spatial representations have a stronger impact on temporal representations than vice versa. In contrast, the symmetry hypothesis (based on a theory of magnitude, Walsh, 2003) predicts that temporal and spatial representations are symmetrically interrelated. Both theoretical approaches have received empirical support. From an embodied cognition perspective, we argue that taking sensorimotor processes into account may be a promising steppingstone to explain the contradictory findings. Notably, different modalities are differently sensitive to the processing of time and space. For instance, auditory information processing is more sensitive to temporal than spatial information, whereas visual information processing is more sensitive to spatial than temporal information. Consequently, we hypothesized that different sensorimotor tasks addressing different modalities may account for the contradictory findings. To test this, we critically reviewed relevant literature to examine which modalities were addressed in time-space mapping studies. Results indicate that the majority of the studies supporting the asymmetry hypothesis applied visual tasks for both temporal and spatial representations. Studies supporting the symmetry hypothesis applied mainly auditory tasks for the temporal domain, but visual tasks for the spatial domain. We conclude that the use of different tasks addressing different modalities may be the primary reason for (a)symmetric effects of space on time, instead of a genuine (a)symmetric mapping.

Development of Metaphorical Thought before Language: the Pragmatic Construction of Metaphors in Action.

In this article, we set out, first, a general overview of metaphor and metaphorical thought research within cognitive psychology and developmental psychology. We claim that, although research efforts broadened perspectives that considered metaphors to be ornaments of poetic language, certain predominance of a linguistic point of view within investigations led to relatively little attention paid to (i) non-verbal and non-written metaphorical instantiations, and (ii) the pre-linguistic and cultural origins of metaphorical thought. Next, we attempt to delve into, and model, the ontogenetic origins of metaphor, taking into consideration social and cultural elements. To that end, we consider the Vygotskian perspective and contemporary research from the pragmatics of the object. We propose that metaphorical thought is an emerging result of a complex web of dynamic relationships between pre-linguistic and socioculturally regulated semiotic systems. The analysis undertaken shows the need for a research programme with a developmental orientation that considers metaphor to be a product of the intertwining between the individual and social dimensions of cognitive development. We suggest this programme should find its roots in the analysis of the semiotic skills that precede the acquisition of metaphorical language.

A Heavy Heart: The Association between Weight and Emotional Words.

People often express emotion in language using weight (e.g., a heavy heart, light-hearted, light humor, or heavy-handed), but the question remains whether these expressions of emotion are rooted in the body. Six experiments used a priming paradigm to explore the metaphoric relation between weight perception and emotional words. Experiments 1 and 2 investigated the influence of weight perception on judgments of emotional words and the influence of emotional words on judgments of weight, respectively. A significant difference between the consistent condition (e.g., lightness corresponds to positive words and heaviness corresponds to negative words) and the inconsistent condition (e.g., lightness corresponds to negative words and heaviness corresponds to positive words) was found in Experiment 1 but not in Experiment 2. Experiments 3, 4, and 5 were conducted to exclude potential confounds. Experiment 6 was a repeated-measures study that was conducted to verify the weight-emotion effect. The study confirmed that weight perception affected judgments of emotional words. The results contribute to the growing literature on conceptual metaphor theory and embodied cognition theory.

Affective valence facilitates spatial detection on vertical axis: shorter time strengthens effect.

Affective concepts can be described in terms of space, which is known as the valence-space metaphor. Previous studies have not investigated either the specifics of this metaphor on the transverse and vertical axes or the time course of this metaphoric association. With Chinese participants, we used a spatial cue task to study the valence-space metaphor on the transverse (left-and-right; Experiment 1A) and vertical (upper-and-lower; Experiment 1B) axes. After being shown an affective word and asked to keep it in mind, the participants were given a spatial target detection task. The results revealed that the metaphoric association was only found on the vertical axis. More specifically, keeping a positive word in mind facilitated the detection of the upper target, but no such effect was found in the detection of the lower target. Furthermore, in Experiment 2, we manipulated the duration of time (100, 500, and 1000 ms) between the offset of the affective word and the onset of the spatial target (i.e., interstimulus intervals, ISI), to test the dynamic time course of the valence-space metaphor on the vertical axis. The results showed that when ISI was 100 ms, keeping a positive word in mind facilitated the detection of the upper target and keeping a negative word in mind facilitated the detection of the lower target. However, when the ISI was 500 or 1000 ms, keeping a positive word in mind facilitated the detection of the upper target and no such effect was found in the detection of the lower target, indicating that ISI might be important in the valence-space metaphoric association. In sum, we found that the processing of affective valence activated the vertical spatial axis but not the transverse axis. Further, the association might be modulated by ISI, indicating that it may be related to attention allocation.

Mapping the brain's metaphor circuitry: metaphorical thought in everyday reason.

An overview of the basics of metaphorical thought and language from the perspective of Neurocognition, the integrated interdisciplinary study of how conceptual thought and language work in the brain. The paper outlines a theory of metaphor circuitry and discusses how everyday reason makes use of embodied metaphor circuitry.