Getting Clients To Buy Into Treatment Through Metaphor and Analogy

Last week, while putting together a proposal for a potential new client, I found myself concerned about whether my approach was too much or too risky, even though I understood the importance of standing out to get their attention. So I met with a trusted mentor to obtain some feedback on my plan. After reviewing what I was intending to do, she looked up and responded, “Why not, Joe? They’re already not hiring you.”

You recognize I was doing a bit of catastrophizing. You recognize as well that what she was doing was desensitizing — by adroitly pointing out that I can’t lose what I didn’t have in the first place, as well as the potential advantages of being the different one. And I recognize how I would have done a similar thing with a patient of mine, while acknowledging how difficult it is to do for myself at times.

The decision for someone to enter into therapy is often accompanied by its own catastrophizing elements — with thinking such as “something must be really wrong with me because I’ve been unable to figure this out for myself.” As such, some people enter counseling taking their situation so seriously, they fear treatment, which obviously is intended to provide relief from their woes. I’ve found this to particularly be the case with certain anxiety disorders.

Take panic disorder, for example. Evidence-based therapeutic interventions for panic entail some type of exposure to the anxiety-producing factors driving it in the first place. So since the idea of exposing oneself to an anxiety trigger frequently makes clients nervous, I will, where appropriate, help them buy into the treatment by using an analogy. Here’s one I like: Allergies. I’ll explain that allergies develop because some people’s immune systems are highly vulnerable to certain environmental triggers. So instead of having little or no reaction when exposed to allergens such as pollen, the allergy sufferer’s immune system kicks into overdrive — producing an allergy attack.

With anxiety, the central nervous system overreacts, so those prone to panic respond disproportionately to an “emotional allergen” (threat, danger) and their nervous system’s response leads to the distress of a panic attack. But just as an allergy sufferer can be desensitized by exposure to gradually increasing doses of allergens, those with panic can be desensitized through gradual but consistent subjection to the very stimuli kindling the anxiety fueling the panic. In time, the panic-prone person’s nervous system then backs down from what ignited it in the first place.

The bottom line: This allergy metaphor helps deflate fear, making treatment more attractive, thus vitalizing clients and positioning them for success.

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Attribution Statement:
Joe Wegmann is a licensed pharmacist & clinical social worker has presented psychopharmacology seminars to over 10,000 healthcare professionals in 46 states, and maintains an active psychotherapy practice specializing in the treatment of depression and anxiety. He is the author of Psychopharmacology: Straight Talk on Mental Health Medications, published by PESI, Inc.

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