Metaphor as a diagnostic tool

A case study is reported wherein the patient's frequent use of metaphors was used as presumptive evidence that the patient had been misdiagnosed ten years earlier as having central nervous system disease. The ability to produce metaphors depends upon the capacity to condense several meanings into a word or two, and this in turn implies a rather active associative process. Concretism, not associative richness, characterizes central nervous system disease. The presumption as regards diagnosis was supported by subsequent data including the patient's response to psychotherapy.