When Metaphors Hurt or Heal: The Effects of Metaphor Use and Protagonist-Reader Similarity in Mental Illness Narratives on Stigma.

Drawing on narrative persuasion theories and Conceptual Metaphor Theory, this study investigates how different metaphors in mental illness (MI) narratives influence cognition, emotion, and anti-stigma behaviors among individuals without personal MI experience. Using a 4 (metaphor use: war, journey, conversation, literal) × 2 (protagonist-reader similarity: high vs. low) between-subjects experimental design (N = 522), the study finds that metaphor effectiveness highly depends on protagonist-reader similarity. Compared with literal narratives, war and journey metaphors increased hope and subsequently MI social interaction and MI help-seeking intentions, but only when protagonist-reader similarity was high. When similarity was low, these metaphors reduced identification and discouraged both behavioral outcomes. In contrast, the conversation metaphor demonstrated desirable effects across similarity conditions: Under high similarity, it increased hope, which predicted stronger anti-stigma behavioral intentions. Under low similarity, it enhanced MI help-seeking through greater cognitive elaboration or directly increased MI social interaction intention. Together, these findings suggest that incorporating self-talk and inward conversation may be particularly valuable in metaphorical MI narratives, while also providing preliminary evidence that metaphorical MI narratives can produce stigma-reduction effects when aligned with audience characteristics.