Psychiatric playfulness

Humor as a strategy in dealing with stressful situations.

March 17, 2019 13:47
Psychiatric playfulness

Humor as a strategy in dealing with stressful situations. (photo credit: TNS)


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Therapeutic humor, as defined by the Association for Applied and Therapeutic Humor, is “any intervention that promotes health and wellness by stimulating a playful discovery, expression or appreciation of the absurdity or incongruity of life’s situations.”
Killinger points out that humor appears to release patients from a narrow, ego-centered focus while loosening rigid, circular thinking. Thought processes that had become ruminatively stale and closed are interrupted through humor and a new fresh perspective emerges. “The shift in focus facilitated by humor may then serve to unlock or loosen the rigid repetitive view that individuals often hold regarding their particular situations.” 
Below are described several personal examples of the use of humor as an adjunctive strategy in decreasing stress and anxiety of psychotherapy patients (and people in general). 

1. In my first year as an intern in clinical psychology, my distraught patient announced that after the session she was going to commit suicide because of her unbearable situation. After several futile attempts at dissuading her regarding her plans, I excused myself for several minutes and ran to my supervisor in a heightened state of panic and informed him regarding my patient’s intentions. Noticing my heightened state of anxiety, my supervisor told me not to worry and calmly reassured me that if my patient should carry out her threat, he will provide me with another patient. His thoroughly “inappropriate” response stunned me at first and then I started laughing. After my anxiety level dropped considerably, we were able to discuss appropriate therapeutic interventions.
2. Years later, I was able to utilize this intervention with a very dependent patient who suddenly had to terminate therapy because she was forced to relocate to another city because of a job transfer. In the last session, she was in a heightened state of anxiety and began ruminating about what she was going to do as this was her last meeting and that next week she was moving to another city. The question, “Doctor, what should I do, I am moving next week?” was repeated over and over again. The therapist calmly suggested to the patient to immediately make arrangements with a moving company. This unexpected response had the effect of short-circuiting the patient’s anxiety and enabled her to discuss her separation anxieties in a more controlled and effective manner.
3. An obsessive-compulsive (OCD) patient of mine with a severe hand-washing compulsion, upon returning from the bathroom, began washing her hands for several minutes. This behavior prompted me to remark, “Now I understand why the water level of the Kinneret (Sea of Galilee – the largest reservoir in Israel) is at its lowest level in many years.” This humorous comment evoked unrestrained laughter in the patient and immediate cessation of her activity.


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