Introducing the Metaphorical Anchor Model: A Mixed-Methods Study of Cognitive Metaphor Use in Palliative Care

This study introduces and provides an initial validation of the Metaphorical Anchor Model, a framework in which metaphors function as cognitive tools that transform affective overload into structured professional meaning in the context of death and end-of-life care. A mixed-methods design was used to test whether professional background moderates the anchoring process. Study 1 involved a qualitative analysis of 61 metaphorical expressions produced by 14 multidisciplinary professionals, using thematic analysis within a discourse-based interpretative framework grounded in cognitive linguistics. Study 2 provided quantitative validation through Fisher's Exact Test to examine whether professional training influences the selection of metaphor types. Qualitative findings identified six cognitive domains grouped into two macro-clusters: Symbolic & Relational Anchors (symbolic, affective, relational) and Functional & Cognitive Analogies (embodied, spatial, cognitive). Quantitative results supported the model, showing professional role as a significant moderator (p = 0.008): science-based professionals predominantly used Functional & Cognitive Analogies (54.3%), whereas humanistic-psychosocial professionals relied mainly on Symbolic & Relational Metaphor Anchors (80.8%). These findings suggest that metaphor use offers insight into how professional roles shape representations of death and care and may represent a relevant resource for emotional processing. Beyond its theoretical contribution, the model has potential implications for clinical communication training, supporting healthcare professionals in managing emotionally demanding interactions and improving reflective practice in end-of-life care.