Metaphor, meaning and psychiatry.

OBJECTIVE: The aim of this paper is to examine the scientific and cognitive role of metaphor and the use of metaphor in the conceptualization of depression as an example of mental illness.

CONCLUSIONS: Metaphors from the creative arts have been used to support existing psychiatric diagnostic concepts. The existing concepts are themselves built on embedded metaphors now treated as literal facts. The choice of metaphor dictates not only the description of the condition but also its treatment and research. The use of unacknowledged and unchanging metaphors in current diagnostic practice affects progress in knowledge and practice. Some alternative borrowings of basic metaphors are provided.