Metaphors in Interaction: Reusing, developing and resisting metaphors of illness, the body and medical treatment in chronic pain consultations

This paper analyses the interactional dynamics of reusing and resisting metaphors of the body, illness and medical treatment in consultations between doctors and chronic pain patients in a pain clinic. Research has evidenced the general importance of metaphors in talk, and in health care settings specifically. Metaphors serve as a way of structuring our reasoning and understanding, including of illness experiences. This is particularly relevant in the case of chronic pain, as these patients are usually expert patients with particular assumptions on their illness, due to the chronic nature of their condition. However, we know less about how metaphors are taken up and potentially resisted in interaction. We study this by combining conceptual metaphor theory, MIPVU and interactional analysis. We found that metaphors are reused in many different ways, ranging from exact repetitions or very similar rewordings, to extensive metaphorical and literal elaborations, and are sometimes met with different forms of resistance. In our data, how metaphors are taken up is not tied to the metaphors’ characteristics, but can mostly be explained by interactional dynamics, often specific to clinical consultations. This shows that not only which metaphors, but when and how they are used, matters when communicating with patients in health care contexts.