Intentional Choices of Metaphors for Psychedelic-Assisted Therapy
Cognitive and Behavioral Practice April 1, 2025 M. Earleywine, Henry A MacConnel, Joseph A. de Leo
Metaphors used in psychedelic-assisted therapy (PAT) shape client expectations and outcomes, yet few publications address their deliberate use within a cognitive-behavioral framework. Common metaphors like journeys, brain rewiring, and medicines may not suit all clients or align with learning-focused interventions. This paper introduces baseball's "batting practice" as an alternative metaphor, emphasizing autonomy, agency, responsibility, and the incremental skill-building nature of PAT. Depicting the therapist as a coach reimagines therapy as active engagement, ongoing effort, gradual improvements, and periods of progress and stagnation, paralleling integration processes. The metaphor highlights process over outcomes, persistence, patience, mindfulness, and teamwork. Potential shortcomings are noted to encourage flexibility and collaborative metaphor selection for optimizing outcomes in psychedelic-assisted CBT.