Chapter 2 explores the developmental psychology of metaphor and its significance for illness experience. While semiotics of medicine implies a simple link between physiological processes and symptom reports, illness experience is articulated through metaphors that are grounded in bodily experience, social interaction, discourse, and cultural practices. Bodily grounding of metaphor is based on sensorimotor equivalences, as seen early in development in synesthesia and cross-modal analogies. Social grounding resides in the pragmatics of language in which context and goals depend on social roles, norms, and cultural meaning. Despite this, metaphors allow for creative play by requiring only piecemeal correspondences to the world through ostension. The meaning of metaphors is then found not in representation but in presentation. Clinical examples illustrate a patient on dialysis refusing a blood transfusion and a woman with medically unexplained floating sensations, showing how a semantics of metaphor can clarify the tensions between the essential irrationality of illness experience and the biomedical presumption of rationality in normative accounts of illness cognition and behavior.