Counseling tips for Doctors around using metaphors to explain fusion and defusion relevant for mental health

In counseling/Acceptance Commitment Therapy, one of the most important thing is to educate our patients around the concept of fusion and defusion, or in other words, zoomed-in (+hook onto thoughts) or zoomed-out (+unhook from thoughts) perspectives.

It’s like when you zoom into a forest.  You can see a dead tree, but when you zoom out, you may see a beautiful lushed tropical forest. Nothing has changed but your perspective has. 

Many folks we see have a very zoomed-in or “fused” perspective to life eg. folks with depression, anxiety, or personality disorders. 

Some folks we see have a very zoomed-out or “detached” perspective to life. But it is so zoomed-out, that it is out of focus. Think dissociative disorders or even ASD when in “extreme”. 

Of course, life is very dynamic and requires us to zoom in and zoom out all the time depending on context. The problem is when this zoom function malfunctions.  Imagine having a camera without the ability to zoom in and zoom out in order for us to focus.  It would be quite frustrating. 

Part of counseling is to help folks to zoom in and zoom out in various context through active listening, reflection, validation, and “gentle” challenge.  

Using metaphors like these can help us explain abstract concepts to our patients in more digestible ways.

Of course, learning to zoom in and zoom out ourselves will help us with our own selfcare/mental health, and help our patients in the long term. 

The more zoomed-in folks may have to learn how to zoom out more through meditation, mindfulness etc, and the zoomed-out folks may have to zoom in more to gain more empathy, passion, and connection in life perhaps.