Therapeutic humor

from Wikipedia, the free encyclopedia

Under therapeutic humor is understood the strategic use of humor in therapy. Through humorous comments by the therapist and the practice of such comments by the client, fear-inducing situations and events are reevaluated and thus the client has a greater degree of control over his situation.

It was not until the end of the 20th century that scientific studies appeared in which the importance of humor for psychotherapy was specifically emphasized (cf. literature references). Up until then there had been a lot of anecdotal evidence that laughter is healthy or “the best medicine”, but it wasn't until the spectacular report by Norman Cousins (1981) about his successful attempt to overcome a treacherous disease through targeted laughter that it did the professional world sit up and take notice.

In the therapeutic context, thought is therefore given both to the psychological mechanisms that generally trigger laughter and to the specific circumstances in which they are used in therapy.

Origins of laughter from a therapeutic perspective

According to the relevant literature, three basic theoretical approaches can be distinguished:

The cathartic theory of humor goes back to Sigmund Freud , who understood "laughter (as) a phenomenon of the discharge of emotional excitement". Findings of modern gelotology confirm that the humor reaction leads to a strengthening of the immune system, contributes to pain reduction and is conducive to reducing stress.

  • Theories of superiority and aggression

Laughing at others can temporarily stabilize your self-esteem. Arthur Koestler pointed out that there were already twenty-nine references to different laughs in the Old Testament : thirteen of them were associated with disdain, scorn, ridicule or contempt and only two “come from a really happy heart”. According to the ancient theory of degradation, which is traced back to Aristotle , the perception of defects, deformations or even just ugliness in a fellow human being stimulates aggressive laughter. Sigmund Freud also saw in the joke a "saving of pity" and a "momentary anesthesia of the heart".

These derogatory, aggressive inhuman parts of laughter in the forms of irony , sarcasm and cynicism are rejected by some of the therapists as unacceptable.

  • Incongruence theories

Humor reactions (amusement, smile, laughter) are also triggered by the interaction of certain logical-cognitive processes that run counter to the laws of normal thinking or Aristotelian logic and are referred to as "incongruence" or "inconsistency" of the environment and thinking. In their structure they correspond to the mechanism of jokes .

The communication theorists of the Palo Alto group (Bateson, Jackson, Haley, Weakland 1969) pointed out in one of their first research reports that humor arises when different levels of abstraction are combined. Paul Watzlawick defines the paradoxical effect of humor as "the deliberate confusion of element and class": this unexpected connection produces the comic effect. Therapy could therefore incorporate paradoxical strategies such as exaggerations, understatements, logical contradictions and distortions, play on words, absurd (“crazy”) interpretations of reality, equating the concrete with the abstract (metaphorical), reversing (ridiculing) the sublime, etc. in therapeutic communication .

Dimensions of the therapeutic effect of humor

  • The emotional effect: humor is therapeutically effective from an emotional point of view, in that it can release inhibitions and stimulate the release of repressed affects. When therapist and client laugh together, there is an immediate, spontaneous exchange of human emotions in the experience of revealing equality.
  • The cognitive effect: Humor is therapeutically effective from a cognitive point of view in that it stimulates the client's creative potential, activates his ability to solve problems, so that new connections can be established, assessments can be put into perspective and decision-making processes can be set in motion. In this way, humor promotes an exploratory attitude towards apparently irrevocable, normatively fixed sequences of action. Rigid, defensive behavior patterns can thereby be dissolved and replaced by more flexible ones.
  • The communicative effect: From a communicative point of view, humor has the meaning of a refreshing, relaxing, original and stimulating contact medium. If the therapist uses humor in an appropriate (!) Manner, the result is an informal, friendly, constructive tone, which contributes to the creation of a positive working alliance and which prevents an impersonal or even cramped atmosphere characterized by professional claims to sublimity. Rather, humor promotes modes of interaction that are characterized by openness and equality.
  • The practical effect: A humorous comment acknowledged with a laugh triggers the therapeutically desired change in perspective and behavior . As the client manages to decode the humorous message on their own, a feeling of self-affirmation arises. This feeling is usually accompanied by an aha reaction - as an expression of the feeling that you have found a new kind of solution to an old problem.

Forms of therapeutic use of humor

Dealing with humor requires great care and caution in order to rule out potential destructive effects. The following overview provides a description of those forms of humor that are not indicated in psychotherapy and those that are therapeutically effective.

Destructive humor

When a therapist uses sarcastic and pejorative humor, feelings of hurt and suspicion are usually evoked on the client's side. This is always the case when the therapist ventilates his own affects of anger or annoyance and is insensitive and unscrupulous about the corresponding effects on the client. This can permanently poison the therapeutic atmosphere, and a typical "bitter aftertaste" arises. This usually compromises the therapeutic relationship and the therapeutic process.

Clinical anecdote: A therapist to the client who complained about feelings of inferiority in connection with irrational self-esteem problems: “Obviously you must be in a pretty bad mood! With the look on your face, you could sink an entire fleet. You should also have the IQ of a dwarf pine. On the other hand, there can also be benefits in being stupid. Then you can qualify for regular payments from the pension office! "

Harmful humor

The therapist mixes the trivial with inappropriate ironic and sometimes sarcastic remarks. If he becomes aware of the inappropriateness of his approach, he tries to defuse the harmful effects by means of additional communication. Nevertheless, this form of use of humor is unsuitable for promoting the therapeutic process: Mockery and ridicule cannot be reconciled with the concern of therapeutic use of humor.

Clinical anecdote: A client reports that they are confused about their goals in life and unable to understand themselves. The therapist replies: “So you are moving to the end of the flagpole!” The client (nervously giggling): “I assume you want me to be perfect?” The therapist (now self-critical): “Well, uh, sometimes I am the same Sometimes I can't think straight ahead either. ”The therapist now tells examples from his own life, which are supposed to prove that he too can be imperfect.

Minimal helpful humor

Overall, the use of humor with regard to the needs of the client is suitable to give the client an opportunity to assess his problems from a less serious point of view. The therapist's humor is, of course, limited to mere reactions to the client's communications without expressing an active and targeted intervention.

Clinical anecdote: A married couple reports to the therapist that spontaneous sexual encounters are increasingly fading. Sexual intercourse would only take place on special occasions. Therapist: “Your sex life is apparently comparable to the good old Christmas tree: it is quite tedious to choose, buy and decorate it. When the candles are then lit, that's nice: But that only happens once a year ... "

Very helpful sense of humor

The therapist's humor is essentially in line with the client's needs. This makes it possible for them to find new decision-making perspectives. Specific forms of maladjustment can be uncovered in this context without losing respect for the personal dignity of the client. In addition to the consistent promotion of the client's ability to understand, he also experiences suggestions to recognize and change self-damaging readiness to act or behavioral patterns. At the same time, the quality of a therapeutic relationship that is characterized by openness and frankness is guaranteed.

Clinical anecdote: A compulsive patient consistently rejects the therapist's offers of interpretation with the remark: "No, this is not my beer!" To which the therapist replies: "What is your beer - or what kind of champagne do you prefer?"

Especially helpful humor

The therapist's humor demonstrates profound empathy towards the client. He is also characterized by repartee, spontaneity and precise timing. This form of therapeutic humor represents a constant challenge for the client to fully utilize his or her effective and intellectual potential. This can initiate a comprehensive cognitive restructuring.

The process of self-knowledge of the client is stimulated in a playful way by humorously defining problems and presenting them in a condensed way; Therapeutically significant material is clad in unusual symbols, while new life goals and methods for their realization appear almost casually. The creativity of therapeutic humor released in this context can bring crucial existential insights to light on the part of the client. Last but not least, the client finds the opportunity to discover his own sense of humor and - in accordance with other attitude changes - to practice.

Clinical anecdote: During group therapy, a manipulative client speaks repeatedly about his unsuccessful attempts to establish a non-manipulative way of communicating with his fellow human beings. Although he honestly tried to do this, the others would not buy it from him and would not go into his authentic self-revelation either. The therapist explained: “Your situation reminds me of a corrida with torero and bull. But we don't know whether you are the bull whose slaughter we regret or the torero whose courage we should admire! ”A group member replied:“ He's not a bull at all. It is he who turns other people into beasts! ”The manipulative client (laughing):“ In the end I have to remain the torero. I'm going to give a coup de grace and wait for the Olé of my audience! "To which everyone shouted in unison:" Olé! "

Quote

“Because this laugh, all humor, creates distance, lets the patient distance himself from his neurosis. And nothing can repair a person to such an extent, create distance between something and himself, as humor does. "

literature

  • Juan Andres Bernhardt: Humor in Psychotherapy. Beltz, Weinheim 1985, ISBN 3-621-54664-2 .
  • Norman Cousins : The doctor in ourselves. Rowohlt, Reinbek near Hamburg 1996, ISBN 3-499-19307-8 .
  • William F. Fry : Medical Perspectives on Humor. Humor & Health Letter 2 (1), 1-4, 1993.
  • Henri Rubinstein: The healing power of laughter. Hallwag, Bern 1985, ISBN 3-444-10313-1 .
  • Waleed A. Salameh: Humor in Short Term Psychotherapy. Klett-Cotta, Stuttgart 2007
  • Michael Titze , Christof T. Eschenröder: Therapeutic humor. Basics and Applications. Fischer, Frankfurt am Main 1998, ISBN 3-596-12650-9 .
  • Michael Titze: The healing power of laughter. Healing early shame with therapeutic humor. Kösel, Munich 2007, ISBN 3-466-30390-7 .

See also

Web links

Individual evidence

  1. ↑ Michael Titze , Christof T. Eschenröder: Therapeutic humor. Basics and Applications. Fischer, Frankfurt am Main 1998.
  2. ^ Waleed A. Salameh: Humor in short-term psychotherapy. Klett-Cotta, Stuttgart 2007.
  3. ^ Viktor Frankl : Medical pastoral care. Basics of logotherapy and existential analysis. Last edition. Status: 2005. In: Viktor Frankl : Gesammelte Werke. Volume 4. Böhlau Verlag, Vienna, Cologne, Weimar 2011, ISBN 978-3-205-78619-1 , p. 311 (496)