Robert M. Gordon,Ph.D., ABPP, LLC

The appreciation of both humor and interpretations requires high symbolic reasoning. Some psychologists are not good at humor or interpretations because they are too concrete in their thinking. This reminds me of a psychologist who hollered at a child for putting his footprints in the psychologist's recently paved walkway. The boy's father said, "Didn't you tell me not to scold my child in anger?" The psychologist replied, "That was in the abstract. This is the concrete."

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What I just did was to use humor to diffuse my unkind statement about the concreteness of some psychologists. If I did something like this in therapy, the patient would feel my aggression and my attempt to disguise it with humor. Any treatment that depended on empathy would suffer. On the other hand, this same behavior would encourage short-term, symptom-focused treatment.

Being clever can give one status, and it is a socially acceptable way to vent otherwise uncivilized feelings. One of the earliest scholarly works on wit and humor is Freud's "Wit and Its Relation to the Unconscious" (1916).  Freud wrote, "Wit is the best safety valve modern man has evolved; the more civilization, the more repression, the more need there is for wit."  

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Freud loved to tell jokes. In fact, Ernest Jones (1963) wrote, "A Gentile would have said that Freud had few overt Jewish characteristics, a fondness for relating Jewish jokes and anecdotes being the most prominent one." Yes, Freud among his friends was a George Burns ("Sometimes a cigar is a great schtick"). However, Freud did not encourage joking in treatment. He feared that it might decrease tensions when they needed to be tolerated and explored. He also feared that the patient might feel hurt by the joking. There is also the risk of telling a joke badly. No self-respecting patient would stay with a therapist who cannot tell a joke well. Unfortunately, many physicians took Freud's concerns as a rule and psychiatry was born.

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A humorless therapist robs the therapeutic relationship of playfulness, desensitization and mastery. Albert Ellis (1977) was one of the earliest advocates for humor in psychotherapy. He stated that Rational Emotive Therapy puts the locus of psychopathology at taking one's self and life too seriously. He believed that humor could be a powerful therapeutic force. I sought out Ellis' help soon after graduate school. When I told him about my problems, he laughed at me and called me an "ass-hole." I felt much better.

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After my work with Ellis, I went on to psychoanalysis. My analyst laughed and asked questions. It was always the same question. "You did WHAT?!!"   After my analysis, I was much more confident in telling jokes.

Something occurs within the analytic holding environment. There between our boundaries, is a space where there can be acting out or a sublimating area of mastery. In that symbolic area, we play with children and teach them about feelings, thoughts and actions. With adults, we can use interpretation. It is in that relational area, where we can also use mature humor.

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Humor at one level fosters stress reduction, creativity and mastery. At a deeper level, humor can have a self-reflective and interpretive function.  Warren Poland (1986) tells of a patient who presented a dream which expressed a wish that the patient preferred to disown. The patient, after reporting the dream stated, "Of course I would never do anything so outrageous as the dream suggests!" To this Poland replied, "You wouldn't even dream of such a thing."   (pp.246-247).

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I (Gordon, 2006b) gave an example of the interpretive function of humor in my work with a defensive patient, "Karen". Karen was complaining about her boyfriend who had justifiably criticized her.

"...He dared to say that I was self-centered, inconsiderate and defensive.”

“Karen, I know how sensitive you are to criticism, but it’s important to learn to take constructive feedback if you wish to have a healthy relationship.”

“I told him that he was not my psychologist.”

“Being your psychologist hasn’t made it any easier for me.”

My humor allowed Karen to see that there was a pattern to her defensive behavior. Karen laughed and then was able to appreciate that her defensiveness hurt her relationships and interfered with her learning from her mistakes.

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In preparation for this article, I asked members of the PPA listserv how they used humor to help their patients. They also shared how humor helped them avoid burn out and metabolize the stress of work (Cohen, 2004). Some bravely shared stories of embarrassing slips. "I can see you next Wednesday" to an attractive patient became, "I can do you next Wednesday." "You can end treatment when ever you wish," became to an unpleasant patient, "I can terminate you when ever you wish." These countertransference slips are common. How the therapist honestly handles these slips, may determine the quality of the therapeutic relationship.  The therapist's defensiveness or narcissistic confessions do not help the patient.

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In conclusion, the therapist's use of humor is inappropriate if it: 1. is used as a defense for the therapists' anxiety, 2. demeans the patient or the patient's problems, or is unempathic to the patient's degree of pain, 3. is seductive, and 4. narcissistically diverts the therapy.

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The therapist's use of humor is valuable if it: 1. makes the patient feel more at ease in the relationship, reduces stress and defensiveness, 2. desensitizes the patient to areas of conflict, fear or trauma, 3. encourages creativity, mastery and play, 4. disrupts the patient's destructive tendencies, 5. helps to develop sublimation and humor as healthy coping mechanisms,  and 6. acts as an interpretation and fosters insight.

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References

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Cohen, P. F. (2004). The Care and Feeding of the Therapist in Times of Trauma. Psychoanalysis & Psychotherapy, 21(1), 99.

 

Ellis, A. (1977). Fun as psychotherapy. Rational Living, 12(1), 6.

 

Freud, S. (1916). Wit and its relation to the unconscious. trans. by Brill, A. A. Moffat.

 

Gordon, R. M. (2006b). I Love You Madly! On Passion, Personality and Personal Growth. Charleston, S.C.: BookSurge,LLC.

 

Jones, E. (1963). The life and work of Sigmund Freud. Oxford, England: Doubleday.

 

Poland, W. S. (1986). The analyst's words. Psychoanalytic Quarterly, 55(2), 272.