Understanding Spontaneous Symbolism in Psychotherapy Using Embodied Thought.

Spontaneous, unwilled subjective imagery and symbols (including dreams) often emerge in psychotherapy that can appear baffling and confound interpretation. Early psychoanalytic theories seemed to diverge as often as they agreed on the meaning of such content. Nevertheless, after reviewing key findings in the empirical science of spontaneous thought as well as insights gleaned from neuroscience and especially embodied cognition, it is now possible to construct a more coherent theory of interpretation that is clinically useful. Given that thought is so thoroughly embodied, it is possible to demonstrate that universalities in human physiology yield universalities in thought. Such universalities can then be demonstrated to form a kind of biologically directed universal "code" for understanding spontaneous symbolic expressions that emerge in psychotherapy. An example is given that illustrates how this can be applied to clinical encounters.

Uncovering the determinants of brain functioning, behavior and their interplay in the light of context.

Notwithstanding the huge progress in molecular and cellular neuroscience, our ability to understand the brain and develop effective treatments promoting mental health is still limited. This can be partially ascribed to the reductionist, deterministic and mechanistic approaches in neuroscience that struggle with the complexity of the central nervous system. Here, I introduce the Context theory of constrained systems proposing a novel role of contextual factors and genetic, molecular and neural substrates in determining brain functioning and behavior. This theory entails key conceptual implications. First, context is the main driver of behavior and mental states. Second, substrates, from genes to brain areas, have no direct causal link to complex behavioral responses as they can be combined in multiple ways to produce the same response and different responses can impinge on the same substrates. Third, context and biological substrates play distinct roles in determining behavior: context drives behavior, substrates constrain the behavioral repertoire that can be implemented. Fourth, since behavior is the interface between the central nervous system and the environment, it is a privileged level of control and orchestration of brain functioning. Such implications are illustrated through the Kitchen metaphor of the brain. This theoretical framework calls for the revision of key concepts in neuroscience and psychiatry, including causality, specificity and individuality. Moreover, at the clinical level, it proposes treatments inducing behavioral changes through contextual interventions as having the highest impact to reorganize the complexity of the human mind and to achieve a long-lasting improvement in mental health.

The concrete processing of Chinese action metaphors: an ERP study.

The present research adopts ERP (Event-Related Potentials) technology to investigate whether there exists a concreteness effect in the processing of Chinese action verbs within metaphorical context. The mean amplitudes of N400 activated by action metaphors were compared with those activated by literal verbs and abstract verbs. The findings indicated that the Met verbs evoked a significantly larger N400 response at frontal brain region compared to the Abs verbs at a time window 200-500 ms, while the Met verbs elicited a notably greater N400 amplitude specifically at the posterior brain region in comparison to the Lit verbs at 300-500 ms time window. These results may be interpreted as indicating that the comprehension of the Met verbs is based on the concrete action semantics.

Is metaphor a natural kind?

In Metaphor Studies, metaphor is considered as a "form of understanding one thing in terms of something else." It is assumed that, despite their differences, metaphors share many properties and that a theory of metaphor should capture these essential properties. In short, it is assumed that metaphor is a natural kind. We call this view the Natural Kind Assumption. In this paper, we will challenge it and show that metaphor is not a natural kind. Finally, we will discuss the main philosophical consequences of this view.

Patient perspectives about multiple sclerosis: A metaphor study.

AIM: Determining patients' perceptions of multiple sclerosis, a disease with varying symptoms and prognosis for each individual, can significantly contribute to directing care and treatment. Metaphors may be an opportunity to determine perceptions of this unique illness experience. The aim of this study was to reveal the perceptions of patients with multiple sclerosis about "multiple sclerosis" through metaphors. METHODS: This study was conducted with metaphor analysis technique based on phenomenological method. The sample included 184 patients with multiple sclerosis. Data was collected face-to-face between July 2022 and January 2023. Each participant was interviewed individually and was asked to fill in the blanks in the sentence, "multiple sclerosis is like… because…". Content analysis was performed for metaphors. RESULTS: The study revealed five main themes and twelve subthemes that provided insight into the participants' multiple sclerosis perceptions. The themes address (i) Manipulator multiple sclerosis; ambiguous multiple sclerosis, attritive multiple sclerosis, controller multiple sclerosis, demander multiple sclerosis, and conditional multiple sclerosis (ii) Temporal multiple sclerosis; cyclical multiple sclerosis and perpetual multiple sclerosis (iii) Follower multiple sclerosis; unaccepted multiple sclerosis, partner multiple sclerosis and ambusher multiple sclerosis (iv) Different multiple sclerosis; bittersweet multiple sclerosis and unique multiple sclerosis (v) Restorative multiple sclerosis. CONCLUSION: This study demonstrated that patients with multiple sclerosis mostly had negative perceptions regarding their relationship with multiple sclerosis. The results place a responsibility on healthcare professionals to improve how patients adapt to multiple sclerosis. This study's results can bridge theoretical knowledge and practice.

Making the Unseen Seen: The Role of Signaling and Novelty in Rating Metaphors.

Comprehension of metaphorical expressions differs with their degree of novelty. Conventional metaphors are typically comprehended as easily as literal sentences, while novel metaphors are responded to less quickly than their conventional counterparts. However, the influence of metaphor signals on the interpretability and acceptability of sentences with metaphors, especially their potential interaction with novelty, remains an open question. We conducted six online experiments among 1,694 native speakers of American English to examine how interpretability and acceptability ratings of individually presented sentences were affected by metaphor novelty and different types of metaphor signals. Across all six experiments, we consistently found that novel metaphors decreased the interpretability and acceptability of sentences compared to both conventional metaphors and literal controls. Signals, on the contrary, did not impact the interpretability or acceptability of the sentences. Moreover, only in experiment 3b did we find an interaction between metaphor type and signals. Specifically, when a metaphor was marked by double signals (i.e., both lexical signals and a typographical signal were added around the metaphorical keywords) vs. no signals, acceptability of novel metaphors increased, but acceptability of conventional metaphors decreased. We hypothesize that the double signaling of novel metaphors marks their novelty, making them more acceptable. By contrast, the double signaling of conventional metaphors may have been perceived as redundant, leading to a lower acceptability.

Language as social action: Gertrude Buck, the "Michigan School" of rhetoric, and pragmatist philosophy.

In the late 19th and early 20th centuries, Gertrude Buck and collaborators developed a sociologically and pragmatist-informed approach to language that has been neglected in later scholarship. Buck approached the study of language from the standpoint of pragmatist functional psychology, which is indebted to John Dewey's pragmatism at the University of Michigan, and which views language as a normal, dynamic action of human organisms engaged in necessary cooperative relations with one another. Her approach overcomes the small-minded pragmatism that would criticize figurative or poetic language as impractical, and instead shows how figuration is essential to the particular ways in which language is action that conveys meaning to others and serves broader social functions. Buck's forgotten work helps overcome criticisms of the application of pragmatic action theory to language and literature, sketching how language structure may be explained on the basis of language as a natural social-communicative act, how figurative language is inherent in the normal act of communicating situated bodily experiences to others, and how rhetorical speech and writing contributes to participation in democratic social processes. This paper also indicates how Buck's work has been partially rediscovered in Composition Studies, as well as prefigures later reader-response esthetics and feminist analyses of language.

SEEING IS NOT UNDERSTANDING: Vygotsky, Halliday and Metaphor in Forming and Forgetting Middle School Science Concepts.

When teachers explain science concepts-for example, the solar wind, or plasma waves-some methods seem to be quick-acting and others long-lasting. Still others pose as many problems as they seem to solve. How, for example, does a parent explain how there can be solar wind without any air in space? How does a teacher explain how there can be plasma waves without any water? Locating metaphor between thinking and speech rather than within one or the other, we work out a single scheme to analyze two conversations with adult Koreans. These suggest that a text studied some ten years ago in middle school science class, replete with striking visual images, has left little more than everyday concepts. Instead of trying to use the striking visual images to refill gaps in the memory, however, the questions asked by a skilled science teacher suggest ways in which thinking could be freed from the middle school dogma of only three matter phases (solid, liquid, gas). To understand a metaphor like "solar wind", we need to replace fixed matters of fact with some more elusive facts of matter.

Metaphoric perceptions of individuals with diabetes in Turkey: A content analysis.

Background: The diagnosis of diabetes mellitus adversely impacts the quality of life due to treatment, changes in daily life, functional disability, and emerging complications. Using metaphors to convey perceptions of diseases and life experiences is crucial for understanding healthcare behaviors. Objective: This study aimed to explore the metaphorical perceptions of "diabetes" and "being a person with diabetes" within a sample group of individuals with diabetes in Turkey. Methods: A qualitative design was employed to investigate the metaphoric perceptions of 72 people with diabetes. Data were collected face-to-face between 15 May and June 2023 using a semi-structured questionnaire. Data were analyzed using content analysis. Results: From the statements of the individuals with diabetes in the sample, seven metaphoric themes related to diabetes - "pain and distress, helplessness and hopelessness, instability, attention and sensitivity, captivity, positive outlook and acceptance, deprivation" - and six metaphoric themes concerning being a person with diabetes - "suffocation and distress, helplessness, powerlessness and disappointment, captivity, attention and sensitivity, guilt, and being worn out" - were identified. Commonly recurring sub-themes with negative connotations included "darkness, well, convict, prison, captivity, microbe, infectious disease, a hot flush, guilt, clouding life, and being ruined." Some positively framed statements included "friend, traffic sign, and driving a car." Conclusion: The majority of patients in the study used negative metaphors, with fewer expressing positive sentiments regarding the necessity of accepting and paying attention to the disease. Defining individuals' metaphorical perceptions of their disease may enable the provision of better quality and holistic care. Nurses, in particular, play a crucial role in facilitating behavioral changes for patients with diabetes to achieve self-management.

Illustration of self-perceived knowledge, skills, and interests in undergraduate dental students using a visual metaphor- results of a monocentric cross-sectional study.

BACKGROUND: Self-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM). METHODS: Seventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman's Rho was used to reveal correlations between knowledge, skills, and interests in the cohort. RESULTS: Perceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p < 0.05). However, students' interests did not significantly vary between groups (p > 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p < 0.01), and weak to moderate positive correlations were found between interests and knowledge (p < 0.05). Regarding the relationship between perceived interests and skills, only restorative dentistry, endodontology and periodontology were significant and only moderate to weak correlations were found (p < 0.05). CONCLUSION: PRISM revealed differences in perceived knowledge and skills between third-, fourth-, and fifth-year dental students. Correlations were found between perceived knowledge and skills, as well as between interests and knowledge. PRISM may be a promising tool to support students and teachers in dental education.

Brain responses to a lab-evolved artificial language with space-time metaphors.

What is the connection between the cultural evolution of a language and the rapid processing response to that language in the brains of individual learners? In an iterated communication study that was conducted previously, participants were asked to communicate temporal concepts such as "tomorrow," "day after," "year," and "past" using vertical movements recorded on a touch screen. Over time, participants developed simple artificial 'languages' that used space metaphorically to communicate in nuanced ways about time. Some conventions appeared rapidly and universally (e.g., using larger vertical movements to convey greater temporal durations). Other conventions required extensive social interaction and exhibited idiosyncratic variation (e.g., using vertical location to convey past or future). Here we investigate whether the brain's response during acquisition of such a language reflects the process by which the language's conventions originally evolved. We recorded participants' EEG as they learned one of these artificial space-time languages. Overall, the brain response to this artificial communication system was language-like, with, for instance, violations to the system's conventions eliciting an N400-like component. Over the course of learning, participants' brain responses developed in ways that paralleled the process by which the language had originally evolved, with early neural sensitivity to violations of a rapidly-evolving universal convention, and slowly developing neural sensitivity to an idiosyncratic convention that required slow social negotiation to emerge. This study opens up exciting avenues of future work to disentangle how neural biases influence learning and transmission in the emergence of structure in language.

Temporal Gestures in Different Temporal Perspectives.

Temporal perspectives allow us to place ourselves and temporal events on a timeline, making it easier to conceptualize time. This study investigates how we take different temporal perspectives in our temporal gestures. We asked participants (n = 36) to retell temporal scenarios written in the Moving-Ego, Moving-Time, and Time-Reference-Point perspectives in spontaneous and encouraged gesture conditions. Participants took temporal perspectives mostly in similar ways regardless of the gesture condition. Perspective comparisons showed that temporal gestures of our participants resonated better with the Ego- (i.e., Moving-Ego and Moving-Time) versus Time-Reference-Point distinction instead of the classical Moving-Ego versus Moving-Time contrast. Specifically, participants mostly produced more Moving-Ego and Time-Reference-Point gestures for the corresponding scenarios and speech; however, the Moving-Time perspective was not adopted more than the others in any condition. Similarly, the Moving-Time gestures did not favor an axis over the others, whereas Moving-Ego gestures were mostly sagittal and Time-Reference-Point gestures were mostly lateral. These findings suggest that we incorporate temporal perspectives into our temporal gestures to a considerable extent; however, the classical Moving-Ego and Moving-Time classification may not hold for temporal gestures.

The Role of Metaphor in Hermeneutic Research.

The identification and interpretation of metaphor is useful to hermeneutic research. Metaphor is a way of conceiving one concept in terms of another and serves as a function of understanding. The author explores the rise of hermeneutics research and its relevance to nurse artsciencing. Metaphors are a creative strategy hermeneutic researchers can use to analyze and interpret data, and serve as a powerful strategy to represent complex realities, illuminate unnoticed aspects of a phenomenon, and provide depth of meaning to the understanding of human experiences.

"No man is an island": How Chinese netizens use deliberate metaphors to provide "depression sufferers" with social support.

Objective: Online social support provides a way to positively influence depression sufferers. In the present study, we aim to analyze how social support in Chinese online depression communities is communicated through the lens of deliberate metaphor theory (DMT) to deepen the understanding of the under-researched complicated, emotionally laden, and culture-related concepts of this experience. Methods: We collected data (n = 3546 comments) from the Warm Supporting section of the Depression Super Topic, a major Chinese online depression community on Weibo. The data were analyzed using a metaphorical analysis with the Metaphor Identification Procedure Vrije Universiteit and a thematic analysis. Results: Our findings identify two themes: deliberate metaphors (DMs) of depression and DMs of social environment for depression sufferers. The former conceptualizes future expectations without depression (as rosy images; victorious battles; the beaten black dog); disorder (as subtle objects; subjective initiative events); depression sufferers (as valuable objects; important roles); and present life with depression (as optional events; spiritual practices; fragile objects). The latter conceptualizes social connection (as solid objects; nonessentials); individuals in the social environment (as energetic objects; vicious roles); and prejudice (as colored objects). Conclusions: The findings suggest that DMs as important online social support resources, helping to express empathy and normalize depression with more common-sense, and non-judgmental concepts. Additionally, in DMs, Chinese netizens navigate the intricate intersection of medical and moral perspectives on depression and its recovery, leveraging both aspects to offer comprehensive social support. "Confucian-based" elements are embedded in culture-related social support expressions in DMs. In practice, our findings contribute to tailored and appropriate health interventions for depression.

Perceptions of the Agency and Responsibility of the NHS COVID-19 App on Twitter: Critical Discourse Analysis.

BACKGROUND: Since September 2020, the National Health Service (NHS) COVID-19 contact-tracing app has been used to mitigate the spread of COVID-19 in the United Kingdom. Since its launch, this app has been a part of the discussion regarding the perceived social agency of decision-making algorithms. On the social media website Twitter, a plethora of views about the app have been found but only analyzed for sentiment and topic trajectories thus far, leaving the perceived social agency of the app underexplored. OBJECTIVE: We aimed to examine the discussion of social agency in social media public discourse regarding algorithm-operated decisions, particularly when the artificial intelligence agency responsible for specific information systems is not openly disclosed in an example such as the COVID-19 contact-tracing app. To do this, we analyzed the presentation of the NHS COVID-19 App on Twitter, focusing on the portrayal of social agency and the impact of its deployment on society. We also aimed to discover what the presentation of social agents communicates about the perceived responsibility of the app. METHODS: Using corpus linguistics and critical discourse analysis, underpinned by social actor representation, we used the link between grammatical and social agency and analyzed a corpus of 118,316 tweets from September 2020 to July 2021 to see whether the app was portrayed as a social actor. RESULTS: We found that active presentations of the app-seen mainly through personalization and agency metaphor-dominated the discourse. The app was presented as a social actor in 96% of the cases considered and grew in proportion to passive presentations over time. These active presentations showed the app to be a social actor in 5 main ways: informing, instructing, providing permission, disrupting, and functioning. We found a small number of occasions on which the app was presented passively through backgrounding and exclusion. CONCLUSIONS: Twitter users presented the NHS COVID-19 App as an active social actor with a clear sense of social agency. The study also revealed that Twitter users perceived the app as responsible for their welfare, particularly when it provided instructions or permission, and this perception remained consistent throughout the discourse, particularly during significant events. Overall, this study contributes to understanding how social agency is discussed in social media discourse related to algorithmic-operated decisions This research offers valuable insights into public perceptions of decision-making digital contact-tracing health care technologies and their perceptions on the web, which, even in a postpandemic world, may shed light on how the public might respond to forthcoming interventions.

Nursing students' metaphors of first clinical experiences of encountering patients with mental disorders.

BACKGROUND: Psychiatric wards are one of the most stressful medical centers. Apprenticeship in mental health can cause feelings of stress and anxiety among nursing students. Investigating nursing students' beliefs about mental illnesses is very important to improve nursing education. The present study aimed to identify nursing students' metaphors for their first clinical experiences of encountering patients with mental disorders. METHODS: This descriptive qualitative study was conducted on 18 undergraduate nursing students studying in two nursing colleges at Guilan University of Medical Sciences, in the north of Iran, in 2022. The data were collected through semi-structured interviews and analyzed using Critical Metaphor Analysis by the MAXQDA 2007 software. RESULTS: The analysis of nursing students' metaphors led to the emergence of 36 metaphors and 5 categories. These categories were "experience of dealing with a mental patient is similar to fear mixed with excitement", " patient is similar to an errant human", " psychiatric hospital is similar to a prison", "nurse is similar to a prison guard", and "clinical instructor is similar to a supporter, sympathetic and knowledgeable friend". CONCLUSIONS: The results showed their negative attitude towards the psychiatric hospital and health care providers. It is suggested that the findings of this study be taken into consideration in the planning of clinical education of nursing students.

The journey within: mental navigation as a novel framework for understanding psychotherapeutic transformation.

BACKGROUND: Despite the demonstrated efficacy of psychotherapy, the precise mechanisms that drive therapeutic transformations have posed a challenge and still remain unresolved. Here, we suggest a potential solution to this problem by introducing a framework based on the concept of mental navigation. It refers to our ability to navigate our cognitive space of thoughts, ideas, concepts, and memories, similar to how we navigate physical space. We start by analyzing the neural, cognitive, and experiential constituents intrinsic to mental navigation. Subsequently, we posit that the metaphoric spatial language we employ to articulate introspective experiences (e.g., "unexplored territory" or "going in circles") serves as a robust marker of mental navigation. METHODS: Using large text corpora, we compared the utilization of spatial language between transcripts of psychotherapy sessions (≈ 12 M. words), casual everyday conversations (≈ 12 M. words), and fictional dialogues in movies (≈ 14 M. words). We also examined 110 psychotherapy transcripts qualitatively to discern patterns and dynamics associated with mental navigation. RESULTS: We found a notable increase in the utilization of spatial metaphors during psychotherapy compared to casual everyday dialogues (U = 192.0, p = .001, d = 0.549) and fictional conversations (U = 211, p < .001, d = 0.792). In turn, analyzing the usage of non-spatial metaphors, we did not find significant differences between the three datasets (H = 0.682, p = 0.710). The qualitative analysis highlighted specific examples of mental navigation at play. CONCLUSION: Mental navigation might underlie the psychotherapy process and serve as a robust framework for understanding the transformative changes it brings about.

Can metaphors help us better remember wines? The effect of wine evaluation style on short-term recognition of red wines.

People are generally poor at remembering complex food stimuli, such as wine. While writing a description has been shown to improve memory performance, talking about wine is generally a difficult task for novices. However, giving novices a framework in which to evaluate the wine may help with the memory process. Using a short-term recognition task, this experiment compared different forms of wine evaluation on the to-be-remembered wine sample, using either 1) a classic smell and taste evaluation, 2) a multisensory metaphor selection task with visual, auditory, and tactile metaphors, or 3) a control condition with no writing. Results from 153 participants revealed that recognition performance between the three groups was not significantly different. Secondary analysis revealed that recognition accuracy was correlated with wine liking for the control group, suggesting that in the absence of explicitly evaluating the wine, participants relied on wine liking as a cue for memory. Implications for theory development and applications in wine education are discussed.

[Understanding and explaining functional movement disorders]. / Funktionelle Bewegungsstörungen verstehen und verständlich machen.

Functional movement disorders are not uncommon in neurological consultations, hospitals and emergency departments. Although the disorder can usually be recognized clinically, the communication of the diagnosis is often unsatisfactory. Those affected are indirectly accused of a lack of insight or openness but it is often the doctors who fail to formulate a coherent and comprehensible explanation of the underlying disorder. In this review an integrative model for the development of functional movement disorders is presented, which places the motor (and nonmotor) symptoms in a neuroscientific light. In addition, explanations and metaphors are presented that have proven helpful in conveying an understanding of the disorder.

'We are all in the same boat': a qualitative cross-sectional analysis of COVID-19 pandemic imagery in scientific literature and its use for people working in the German healthcare sector.

Background: The COVID-19 pandemic presents a significant challenge to professional responders in healthcare settings. This is reflected in the language used to describe the pandemic in the professional literature of the respective professions. The aim of this multidisciplinary study was to analyze the linguistic imagery in the relevant professional literature and to determine the identification of different professional groups with it and its emotional effects. Method: A list of 14 typical, widespread and differing imageries for COVID-19 in form of single sentences (e.g., "Until the pandemic is over, we can only run on sight.") were presented to 1,795 healthcare professionals in an online survey. The imageries had been extracted from a qualitative search in more than 3,500 international professional journals in medicine, psychology and theology. Ratings of agreement with these imageries and feelings about them were subjected to factor analysis. Results: Based on the list of imageries presented, it was possible to identify three factors for high/low agreement by experiences, and two factors for high/low induced feelings. Broad agreement emerged for imageries on "fight against the crisis" and "lessons learned from the crisis", while imageries on "acceptance of uncontrollability" tended to be rejected. Imageries of "challenges" tended to lead to a sense of empowerment among subjects, while imageries of "humility" tended to lead to a sense of helplessness. Conclusion: Based on the qualitative and subsequential quantitative analysis, several factors for imageries for the COVID-19 pandemic were identified that have been used in the literature. Agreement with imageries is mixed, as is the assessment of how helpful they are.