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Woman using metaphorical associative cards for anxiety relief in a calming five-minute self-reflection practice.

September 29, 2026

When You Can't Find the Words: Metaphorical Cards for Anxiety

"How are you feeling?"
"Fine."
"And really?"
"...Like a washing machine full of bricks." 🧱

That second answer is a metaphor, the same trick metaphorical cards use. And it says far more than "fine" ever could.

Why anxiety struggles with words

Anxiety lives in the body: a tight chest, restless legs, a head full of static. Turning that into words can be surprisingly hard, especially if you grew up in a home where feelings weren't discussed.

Some people find it especially difficult to identify and describe emotions, a trait psychologists call alexithymia. In one large Finnish study, about 13% of adults showed it. So if feelings seem to arrive without subtitles, you're not "bad at emotions." You may simply never have been given the vocabulary.

This is where images can help.

What are metaphorical associative cards?

Metaphorical associative cards (MAC) are decks of images, such as scenes, people, objects, and abstract shapes, used to spark associations, memories, and feelings. They have no fixed meanings.

The card doesn't tell you anything. You tell the card. That's the main difference from tarot: these cards don't predict. They reflect.

One of the best-known decks, OH Cards, was developed by Canadian artist and art history professor Ely Raman in the 1970s. It was first published in 1981 and later brought to Europe by German psychotherapist Moritz Egetmeyer. Cards like these draw on a long tradition of projective methods, such as the Rorschach inkblots (1921) and the Thematic Apperception Test (1935), which invite people to project their inner world onto ambiguous images.

For a deeper introduction, read our post Metaphorical Cards in Therapy.

How cards help with anxiety 🃏

  1. They give feelings a shape. Anxiety feels formless. A card makes it visible: "It's this storm. No, wait, it's this tiny boat in the storm."
  2. Naming calms the alarm. In a 2007 study at UCLA, Matthew Lieberman and colleagues found that putting feelings into words, called affect labeling, reduced activity in the amygdala, the brain's alarm center. A card can be a shortcut to the right word.
  3. Distance feels safer. It's easier to talk about "the person in the picture" than about yourself. And then, slowly, you realize who you've been talking about.
  4. They invite curiosity instead of panic. "What's happening here?" is a much kinder question than "What's wrong with me?"

Try it: a 5-minute card practice 🌿

You can use a MAC deck, postcards, magazine pictures, or even photos on your phone.

  1. Breathe. Take three slow breaths, with the exhale longer than the inhale.
  2. Choose a card. Pick one face down and let chance decide, or face up and take the one that pulls you.
  3. Describe only what you see. Colors, objects, people. Facts first.
  4. Then ask the card: What's happening here? How does it feel in this place? What does this place need?
  5. Connect gently. Does anything here remind you of today?
  6. Choose one more card for "what would help." Just look at it for a while.

There are no right answers. If five minutes turn into tears, that's not failure. That's information. Be gentle with yourself.

What cards can and can't do

Honesty time: research on metaphorical associative cards specifically is still limited, mostly small studies and no large randomized trials yet. Cards are not a diagnostic test and not a treatment on their own.

They're a tool for reflection and conversation, and they're most powerful with a trained professional. Think of them as a flashlight, not a map. 🔦

Quick FAQ

Are metaphorical cards the same as tarot cards?
No. Tarot has fixed symbolic meanings and is often used for prediction. Metaphorical cards have no fixed meanings and are used for self-reflection.

Can I use metaphorical cards on my own?
Yes, for gentle self-reflection. For deeper or painful topics, it's best to work with a therapist.

Do metaphorical cards work for anxiety?
They can help you notice and name feelings, and naming emotions is linked to calmer brain activity. Research on the cards themselves is still growing.

Sources

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