In multiple fields, there are evidence-based, theoretical premises and interventions - both established and emerging - that integrate traditional medical care with non-medical, humanistic, relational approaches borrowing from arts and literature. The common goal among them is the empowerment of individuals, the deepening of awareness and human connection, and the enabling of uniquely tailored and skillful action on the part of caregivers, with the fullest possible participation of patients on behalf of their own wellbeing.
Pursuing theoretical "why's" to explain the power and efficacy of Metaphoric Affect Processing has meant engaging concepts and research from many fields. Those below were the most significant to codifying Metaphoric Affect Processing as a teachable technique. They have offered neurological, psychological, and cognitive linguistic representations of key mechanisms of metaphor-based dialogue. Below is an incomplete role-call of thinkers and researchers, listed in the order in which I explored and used their work and insights to deepen and support my own:
Kahneman's model of separately operative, double tracks of thinking struck me as central to what I was doing from from the beginning. In his work on decision-making, he identified an intuitive system and a rational one. The Metaphor-based Interview seemed to be facilitating a metacognitive back-door approach to introspection, as if through activation of Kahneman's intuitive "System 1" thought-track, we were able to bypass the problematic (for our purposes) rational cognition of "System 2". This had the benefit of allowing a participant to identify, and then almost simultaneously verbalize, his emotions without triggering negative thought-modes commonly associated with states of anxiety and depression. My poetic interviewing technique was providing a way to gently nudge participants back onto the "safer", intuitive track of introspection inherent to the process.
Mindfulness, as defined by Kabat-Zinn: "paying attention in a particular way: on purpose in the present moment, and without judgement", and my practice of it, have introduced me experiences and concepts that continue to inform my understanding and teaching of Metaphoric Affect Processing. I have also been struck by the delicacy of mindfulness meditation, and how it isn't always an applicable instrument of wellbeing. Certain circumstances require interventions on the fly that leave sufferers with something to hold onto (like a revised metaphor-mirror). Though I've moved away from this thinking, early on I like the idea that Metaphoric Affect Processing was fast-food to the gourmet meal of mindfulness. to
George Miller's Magical Number Seven illuminated for me the function of metaphor as a fundamental denominator in our mental and verbal representation of the world as we engage others and ourselves. It helped me to think of metaphors as vessels carrying in discrete, manageable units of "5 plus or minus one" an infinity of shades, tones, sensations, flavors and scents that a listener didn't have to unpack in order to sensorily perceive.
The three necessary and sufficient conditions for helpful encounters toward positive change: a short phrase encompassing the heart and soul of an operator/scribe's emotional and attitudinal approach to his or her participant/poets.
The body is addressed in search of "felt sense", and the "all of that there". He developed a teachable technique we can use to close the gap between feelings and the words we use to bring them in for observation and change.
An operator can guide empathic dialogue to influence the nature of the language used by an interlocutor such that he or she will consequently engage in positive or negative self-expression and behavior.
Charon's work at Columbia University and the work of committed colleagues around the world is now an evidence-based celebration of literary/humanistic approaches to suffering. Narrative medicine has staked its rightful and elemental place in campuses and hospital corridors of conventional medicine. To quote Charon, "...to find words to contain the disorder and its attendant worries gives shape to and control over the chaos of illness." Her discussions of attention, representation and affiliation, and narrative medicine's core inclusion of "close reading" are the fundamental qualities of the Metaphor-based Interview and I believe among the principle sources of its measurable benefits. The metaphoric/poetic externalization of the participant's present-moment self is observed and commented upon by operator and attendant listeners as a literary work - textures, tones, rhythms, rhymes - the sound and feel of it - and especially the objective definitions of the words and language of the text. All of this goes to validate and embrace the individual in ways that have a profoundly positive effect, repeatedly demonstrated both qualitatively and quantitatively, as he or she narrates his present moment experience and emotion.