Metaphor gone wrong

Mental health professionals love to compare mental illness to diabetes.  The idea is: both diabetes and mental illness are chronic conditions, and you need to manage them for the rest of your life.  If you go off your meds, bad things will happen.

I’ve seen this go well.  I had a young client who heard this metaphor for the first time and immediately said, “That was helpful.”  To her, it lessened stigma and made taking medication seem like a more normal thing to do.

I’ve also seen it go badly.  One man insisted, “I cured myself of diabetes.”  Which may have been more or less true, if he had type 2 diabetes.  In any case, he was firmly convinced this also meant he would not need to continue psych meds either, which was not what his doctor had in mind when introducing the diabetes metaphor.

I also saw this go wrong with a client who had very little concept of what diabetes was.  The worker kept asking him, “Tell me what you know about diabetes.  You know, sugar.  Azucar.” And the client kept shrugging, puzzled about why she was going on about this, until the worker finally gave up.

(Now that I look into it, someone with schizoaffective disorder already wrote a good essay on the failures of this metaphor.)


1 thought on “Metaphor gone wrong

  1. Assistant Village Idiot

    Your site recommended by a reader who reads both my blog and yours. I have taken a lighter hand in the last few months, writing less about serious subjects. But you may like it. There is topic overlap. I have been a social worker at a state psychiatric hospital for 36 years, have five grown sons, am an evangelical Christian, have a librarian wife, and dabble in linguistics. Dance – eh, not so much anymore.

    As to the linked essay: yes it is socially much harder to have mental illness, because it is a behavioral disease, and causes one to do things that society frowns on. But that doesn’t make diabetes a bad analogy.



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