Myocardial infarction patients' use of metaphors to share meaning and communicate underlying frames of experience

The onset of a myocardial infarction (MI) is frequently associated with distinct sensations that may shape the personal meaning of the MI illness experience. Although highly important, patients may have difficulty communicating the personal meaning of the MI illness experience because of lack of congruence between the clinician's and patient's frames of experience. The frame of experience defines the context and agenda for encounters from each participant's perspective. This secondary analysis of data explored MI patients' use of metaphorical language to convey aspects of their underlying frame of experience. Specifically, this paper addressed (a) the structural and linguistic features of metaphorical language used by patients to describe MI pain, (b) the content and structure of associated patient metaphors, and (c) the similarities and differences between the content of patient metaphors and descriptions of MI pain. Our findings confirm that even in encounters characterized by clinician imposition of an organizing framework upon the patient encounter, patients use metaphors to reveal their underlying frame of experience and aspects of the personal meaning of the MI illness experience. Furthermore, although non-metaphorical descriptions provide insights into the patients' cognitive understanding of events associated with the MI, metaphorical descriptions are particularly helpful in eliciting aspects of the affective response to the MI.