How-To Tips

Health Literacy

Metaphors, Similes, and Analogies

Aug 1, 2021

Metaphors, similes, and analogies are figures of speech used to help people understand unfamiliar words and concepts. They do so by comparing new information to that which people already know. While there are important distinctions among the three forms of speech, for sake of simplicity I’ll use the overall term “metaphor.”

Here are some how-to ways for putting metaphors into practice:

  • Determine when to use a metaphor. Some healthcare concepts are straightforward and a simple explanation is sufficient. Save metaphors for those times when you are teaching something that is unfamiliar or hard to understand. For example, you might use a metaphor to explain a new diagnosis like congestive heart failure but not for a well-understood condition like the common cold.
  • Use words, terms, and examples that people know. To be effective, the person you are speaking with needs to know what your analog (example) means. For instance, saying “getting a vaccination is like installing antivirus software” may have meaning to someone familiar with computers. But if the person prefers camping to computing, you might instead say, “getting a vaccine is like putting on bug spray before going in the woods.”
  • Explain the metaphor. Metaphors by themselves are seldom sufficient. After you use one, follow up with a fuller explanation. If you say “an aneurysm is like a bulge in a garden hose,” explain how these concepts are alike by saying, “The bigger the bulge, the thinner the wall and the more likely it will burst.” Acknowledge limitations of your metaphor, as well. In this instance you might say how aneurysms happen only in certain parts of the body, while garden hoses can get bulges almost everywhere.
  • Move beyond the metaphor. After you confirm that a patient understands the metaphor, transition to the correct medical terminology. In the example above about an aneurysm, this means teaching important terms like “aortic aneurysm” and “cerebral aneurysm.”
  • Confirm understanding. Metaphors aren’t always obvious, nor are they necessarily understood in the way you intend. Sometimes they add to confusion. A physician was explaining to his patient that her heart is “like a pump.” He assumed that since the patient lived in a rural area, she would certainly understand the metaphor. While the patient smiled and nodded politely, it wasn’t until several visits later that she told her doctor that she had no idea how pumps work. Knowing this, the physician explained her cardiac condition in another way. As with all forms of health communication, make sure that patients truly understand.

This how-to tip builds on the “Metaphors” chapter in Helen’s book, Health Literacy from A to Z: Practical Ways to Communicate Your Health Message, Second Edition (Updated 2018).

You can learn more on a related topic by listening to the Health Literacy Out Loud podcast, “Visual Metaphors: When Words Alone Are Not Enough (HLOL #178).”