As therapists, we frequently use well-studied psychotherapy techniques, such as cognitive reframing, validation of feelings, and unconditional positive regard. But one technique that may be underused and under appreciated, despite its potential benefits for clients, is humor.
Although this may seem strange, humor holds a special place in the history and development of psychotherapy, and several theories explicitly endorse it as a therapeutic technique. This article aims to explore the role of humor in psychotherapy across three therapeutic modalities (i.e., psychodynamic therapy, cognitive therapy, and logotherapy), including its theoretical underpinnings, empirical support, and practical implications.
Evidence Supporting Humor in Therapy
Overall, research supports the use of humor in psychotherapy. One study found a positive correlation between the therapist’s use of humor and the quality of the therapeutic relationship. Another review study found that humor was associated with higher stress tolerance levels, particularly in response to adverse life events, both during therapy and during crisis situations.
Researchers have theorized that the use of humor in psychotherapy can improve outcomes in three ways:
- Improving rapport between client and therapist
- Facilitating the client’s insight
- Lightening the client’s experience of therapy
Humor in Psychodynamic Therapy
Often underestimated in its therapeutic potential, humor is a dynamic force across various psychotherapeutic modalities, offering a unique avenue for exploration and transformation.
The purpose of psychodynamic therapy is to uncover the underlying processes, conflicts, and dramas that have been playing out in the client’s unconscious. This is done to improve the client’s self-understanding and help them grow out of negative patterns of thoughts and behaviors.
In the psychodynamic view, jokes made by the client may reveal repressed content and are therefore something to be interpreted by the therapist. They are moments of rebellion against the superego, when the client’s censors relax their hold, giving us a glimpse of their underlying processes. However, according to one author, the therapist’s humor could be considered “collusion with the patient’s avoidant striving” because jokes are considered defensive mechanisms.
In the course of psychodynamic therapy, the client and therapist can use levity and a playful attitude to shed more light on the client’s psychological processes. In Nancy McWilliam’s book Psychoanalytic Case Formulation, she tells us about how she uses humor to help her clients recognize oppressive superegos:
“It helps for the therapist to challenge the superego in a teasing way: “Oh. I forgot. You’re too nice to have hostile feelings towards someone who’s been nasty to you” … When someone has a perverse standard for feeling self-esteem, the therapist’s slightly sarcastic questioning of that standard, provided it occurs once there is a good working relationship, can be rather dramatically therapeutic” (McWilliams 175-176).
Note how this strategy aligns with the traditional psychoanalytic view of humor: as a rebellion against the superego. When the therapist joins with the client in tastefully poking fun against their rigid systems of thought, they can be helped to challenge them and become more free.
Humor in Cognitive Therapy
The purpose of cognitive therapy is to identify and challenge the distorted thoughts that are structuring the client’s experience of themselves, others, and the world. This allows the client to function more clearly and tackle their problems on a basis more firmly rooted in reality.
This lends itself inherently to humor: after all, these distortions, like the stretchings and compressions of fun-house mirrors, can be quite amusing. In short, if one definition of humor is the identification of the ‘absurdly incongruous’, we might say that this applies equally to cognitive distortions.
As one of the early proponents of cognitive therapy, Albert Ellis recommended using humor in his own therapy, Rational-Emotive Therapy (RET). He argues that many cognitive distortions are rooted in exaggerating the seriousness of things and “taking life too seriously.” Accordingly, the therapist can challenge this serious view by incorporating humor into the session.
Ellis accomplished this in many ways: puns, gentle teasing, and so on. He even went so far as to create songs that poked fun at some of his client’s irrational expectations. One of them ends:
“Life really owes me the things that I miss,
Fate has to grant me eternal bliss!
And since I must settle for less than this,
Whine, whine, whine!”
Of course, Ellis would advise discretion and tact when considering the use of this and similar comedic techniques.
Humor In Logotherapy
Logotherapy helps clients develop a clear purpose in life and ascribe meaning to life’s inevitable struggles. This makes adverse circumstances and problems more bearable because clients are guided to experience them as worthwhile.
In his book Man’s Search for Meaning, Frankl advocates for humor in logotherapy using a technique he calls paradoxical intention. Describing this technique, he says:
“Such a procedure … must make use of the specifically human capacity for self-detachment inherent in a sense of humor” (Frankl, 116).
For example, Frankl describes a client who suffered from terrible handwriting due to a cramp and became insecure about this. As a paradoxical intention, he was advised to challenge himself to write as sloppily as possible. As he reported back during therapy sessions, he and Frankl started to poke humor at his bad handwriting. By doing so, his handwriting improved: no longer a deadly serious task, he could relax and make gains in his penmanship (Frankl, 117).
The technique of paradoxical intention shows us how the lightness inherent in a humorous approach to ourselves can free us up to our natural processes of growth and adaptation, which are the bedrock of logotherapeutic treatment.
Guidelines for Using Humor in Psychotherapy
While humor in therapy has a long history and evidence for its effectiveness as a therapeutic tool, it is essential to adhere to the following guidelines that underscore the importance of restraint, positivity, and constructive purpose in using humor in therapy.
First, the use of humor should be, as one author writes:
- Restrained. Humor should not be the first course the therapist should take. A serious attitude should be the default setting, but humor can be used when it’s helpful to challenge therapeutic distance and humanize the therapist.
- Positive. Humor should be inherently supportive, and never deriding or ridiculing. The resulting laughter should be a laughing-with: not a laughing-at.
- Constructive. Humor should be used when it has a clear therapeutic purpose. Our previous examples showed how humor can be used in specific settings to help the client’s process.
As a final note, the use of humor should always be attended to by careful attunement to the client’s response. As the philosopher Henri Bergson wrote, “Laughter appears to stand in need of an echo.” If we don’t hear an echo of our use of humor, we should reconsider its efficacy.
Harnessing Humor: A Therapeutic Tool in Psychotherapy
Humor, in itself, is a form of therapy. It gives us some distance from adverse experiences, keeps our outlook bright, and gives us a sense of mastery over our circumstances. It’s no surprise, then, that humor has potential as a tool in the therapist’s arsenal and has been used and recommended in many theories of psychotherapy.
In conclusion, humor in psychotherapy offers therapists a powerful yet nuanced tool to enhance therapeutic outcomes. Through its use, therapists can foster rapport, facilitate insight, and alleviate the heaviness often associated with therapy. However, its application requires careful consideration of individual client needs, cultural sensitivities, and ethical boundaries. By integrating humor in a restrained, positive, and purposeful way, therapists can create a therapeutic environment conducive to growth and resilience.
