Metaphor in illness and nursing: a two-edged sword. A discussion of the social use of metaphor in everyday language, and implications of nursing and nursing education.

Study of the use of language, and in particular metaphor, is a valuable approach to an understanding of the experiential, lived world of the patient. There is an emerging focus on the need for nursing care to be informed by an appreciation of the experience of the phenomena of illness and patienthood. Related nursing epistemological issues are discussed as background. The anatomy and social use of metaphor in language in general are described. The metaphors surrounding cancer are examined to illustrate the two main functions of metaphor; the instrumental and the expressive. Illness metaphors may have negative consequences, imbibing myth, fear and stigma. However, the author concludes that awareness of the expressive function of metaphor provides a valuable focus for listening to and understanding the experience of the patient. Finally, some of the implications of both functions of metaphor in nurse education are outlined.