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Therapeutic Care

Therapeutic Analogy: When Anger Is Like Ketchup

This is a published article by our Director of Therapeutic Services and Systemic Practice, Michelle Newman-Brown. Michelle has been dedicated to work within the Therapeutic Care Sector for over 30 years, beginning as a Residential Support Worker.

As a Tavistock, MSc qualified Systemic Psychotherapist with an MA is SW and Diploma in Therapeutic Play she now promotes the importance of understanding the links between Attachment, Developmental trauma, Belonging and Trust. With this understanding, Michelle believes passionately that all children are able to heal and flourish from their negative experiences.

Therapeutic thinking and understanding is central to the ethos of Compass, which is why we do not simply provide therapy for the child but an on-going wrap-around service to ensure they progress successfully on their therapeutic journey.

The work that Michelle and her wider team do is incredibly important. The therapy provisions our children and young people receive is individualised for them. Read below how Michelle managed to create a therapeutic analogy with Harry about his anger.

Playing with words is one of my favourite pastimes! Some people like Monopoly and others like Lego but I like words! They’re free and easy to store; you can keep acquiring more, adapting, adding, moving, reconnecting, bending, and moulding, so this ‘word playing’ could catch on with even more people.

Sometimes I feel I am the luckiest therapist because I see a young man on a weekly basis who enjoys playing with words as much as I do. We have managed to explore and develop a significant level of change in his world as a result of this talking playfulness. Even in writing this, I am wondering about his descriptions of word play!

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Henry is a chosen pseudonym for a nearly-fifteen-year-old, white, English boy who has been living in a therapeutic care home for several years. Unlike many young people in care, he does not want to move into foster care and does not yearn to return home. As a result, he is not riddled in quite the same way with the complicated emotions of permanent effort to prove to professionals he is worthy of ‘progress’.

Instead, he can concentrate fully on choices he wants to make and how he feels in the here-and- now as well as to think about and discuss his experiences in his past.

It has been through discussion about this past that we have been able to become very playful with our language. It is difficult to say now how our use of metaphors or analogies began, as there is an experience of rolling between them together in a seamless and effortless manner, a genuine evolution of therapist and client co-construction at work.

The one I am presenting today is our discussion over time about his ‘cupboard of anger’.

‘Cupboard of Anger’

Henry had been talking about how he has had so many experiences throughout his life that have contributed to strong feelings of anger and acknowledged a sense of pride that he has predominantly managed them well. However, every so often, traumatic memories resurface and, as his relationship with them intensifies, he feels heightened levels of anger about them.

He recently explained to me he now believes he has not resolved his anger but, because he rarely vents it, he is frightened he has the potential for it to erupt, resulting in him being so violent he would end up killing someone.

Having listened to the language Henry used, such as “not losing”, “letting go” and “storing” his various memories that increase his anger, I began discussing this as a “store of anger”. When working with young people, one strategy I employ with them is to try to identify which episode in their wealth of traumatic experiences particularly stands out; which one resurfaces the most to try and formulate some hierarchy and to begin work with some specifics to reduce the overwhelming feelings that trauma and abuse can invoke.

However, when we attempted to talk about Henry’s experiences, he could not identify any as the least or most difficult. He just maintained there were so many things in his ‘anger store’ that they had all interconnected. He was clear that, whilst he was able to name many episodes of abuse, neglect, sadness, and abandonment, talking in depth about any of the memories was painfully difficult.

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This created a contradiction for Henry who ordinarily was highly articulate and had a desire to free himself from feeling angry about so much and so many people and yet facing the events through his usual means of direct discussion was leading him to feel highly vulnerable.

Below are some of the repeating narratives Henry returned to but found intolerable to elaborate on, as he feared the outcome of his angst.

In Henry's words:

“My mum went out and my dad shut me out in the rain. I remember trying to crawl in through the cat flap.”
“My dad didn’t care who he hurt as long as he had his drink.”

“I used to think it was funny that I ran out the house down the road in my nappy and people had to take me home. Now I just want to know why my dad didn’t know I was gone.”

“A lady found me once in the street and took me to the wrong school ‘cos I had an old school uniform jumper on. No one knew what to do with me or where I was from.”

”I can’t get over that I was the only one in my family who didn’t know we were going into care.”

“I can remember the social worker asking me what pizza I wanted; like that was gonna make it OK that I left my mum and was waiting in some room to be split up from my brothers and sister.”

“My mum was allowed to choose one of us to go back home. It wasn’t me.”

We began talking about his memory being like a kitchen cupboard that has been filled with many jars, tins and sauces, each one representing a component of his anger.

I suggested we just open the door and take one sauce out at a time. In this way, we could look at the sauce, see how old it was, whether there was still a use for it, whether it could be thrown away or stored elsewhere. Sometimes, we do not realise we have food in our cupboards we no longer want or have a need for. It sits on a shelf, impacting negatively on the space and organisation, out of date and unwanted.

However, Henry was initially dubious. He was concerned he was so saturated with anger that there was the potential for the bottles to tumble out if we opened the cupboard too wide; so we tentatively imagined us opening it a small amount and peering in. I repeatedly told him we were opening it together and I could support the door and catch anything that fell out.

Identifying the Ketchup

I was excited by this approach! In my thought processing, Henry could approach individual issues and discuss them in a more playful and less intense manner.

Likening ketchup to his anger about physical abuse he experienced from his father he told me that, if he opened the cupboard, the biggest thing to fall would be the ketchup. He believed it might spill everywhere, ruining and damaging everything around. He thought that perhaps this ketchup was the largest bottle possible and there was more than one in the cupboard because extra had been repurchased over the years.

Henry was able to work within the metaphor of ketchup representing all the negative experiences he remembered about his dad. We explored how he could physically hold the ketchup, when he thought he would be able to not only take a bottle out of his ‘cupboard of anger’ but also control how much he squeezed out. We anticipated in detail the dilemmas of the screw top lids in which you shake the ketchup out and at times it is harder to manage, potentially spoiling parts of a meal!

Henry grasped this concept with enthusiasm; Instead of telling me it was safer not to talk about his abusive father, he tackled the concept of the impact of his abuse in detail, multi-layering his thinking and anguish when the focus was connected to ketchup.


At Compass, we will always provide you with the support you require.