Should Psychologists Include Humor in Their Practice?

Humor is part of the universal human experience and can be a key resource in psychotherapy. A recent systematic review found that “humorous interventions can have significant positive effects on symptoms of depression and anxiety” (Sarink and García-Montes, 2023).

The potential upside: Humor is an often underappreciated component of mental health care, but it holds significant potential within the therapeutic context. In psychotherapy, humor can build rapport, reduce anxiety, enhance insight, promote emotional release, improve mood, foster resilience, facilitate cognitive shifts, humanize the therapist, enhance engagement, and communicate difficult messages.

The potential downside: Humor carries inherent risks that can undermine the therapeutic process. These risks include misinterpretation, reinforcing negative behaviors, trivializing client concerns, damaging the therapeutic alliance, cultural insensitivity, and the risk of humor becoming a defense mechanism.

In this post, we will explore both potential benefits and risks.

Therapy and humor in therapy can be tricky! Proceed with caution but leverage laughter to gain important benefits in therapy.

Source: Bigstock/Used with permission

Build Rapport, Build Positivity

Establishing a strong therapeutic alliance is crucial for effective psychotherapy. Humor can facilitate this process by helping break the ice and creating camaraderie between therapist and client. Studies have shown that shared laughter can foster a sense of connection and trust, essential components of a positive therapeutic relationship (Martin, 2007).

Humor can make therapy sessions more engaging and enjoyable, increasing clients' motivation to participate. Engaged clients are more likely to adhere to therapeutic interventions and achieve better outcomes. Humor can also make the therapeutic process less daunting and more manageable (Reik, 1948).

Humor has been shown to elevate mood and increase positive affect. For clients dealing with depression or other mood disorders, humor can provide a temporary respite from negative emotions and contribute to a more positive outlook. This positive effect can enhance motivation and engagement in the therapeutic process (Overholser, 1992).

Damaging the Therapeutic Alliance

Inappropriate or poorly timed humor can damage the therapeutic alliance, creating distance between the therapist and the client. Clients may feel disrespected or belittled, which can lead to a breakdown in communication and reduced engagement in therapy (Freud, 1928).

Reduce Anxiety and Tension

Therapy often involves discussing distressing and anxiety-provoking topics. Humor can alleviate these feelings by creating a more relaxed and open atmosphere. Neuroscientific research indicates that laughter can reduce stress hormones and increase the release of endorphins, promoting a sense of well-being and relaxation (Berk, Tan, and Fry, 1989).

Trivializing Client Concerns

Humor has the potential to trivialize or dismiss the client's concerns. Clients come to therapy seeking validation and support for their struggles. Humor, if perceived as dismissive or minimizing, can make clients feel unheard or misunderstood, which can erode trust and hinder progress (Salameh, 1987). A client who has experienced repeated traumatic events (complex trauma) might feel that the therapist lacks empathy or understanding.

Enhance Insight and Perspective

Humor can offer new perspectives on problems and situations, enabling clients to view their issues in a different light. This shift in perspective can lead to greater insight and cognitive flexibility, facilitating problem-solving and coping strategies (Kuhlman, 1984). Humor can challenge rigid thinking patterns and help clients reframe their experiences more constructively.

Open to Misinterpretation

Humor is inherently subjective, and therapy needs to be sensitive to the client's culture. What one person finds funny, another may find offensive or confusing. In a therapeutic setting, misinterpretation of humor can lead to misunderstandings and may negatively impact the therapeutic relationship. Studies have shown that humor can be particularly risky when dealing with clients who have cognitive distortions or who are in a heightened emotional state (Franzini, 2001).

Humor Essential Reads

Don't Laugh at Me; Laugh With Me

The Psychology Behind Humor

Promote Emotional Release

Laughter can be a powerful emotional release, helping clients express and process pent-up emotions. Emotional release through humor can be cathartic, relieving psychological distress and enhancing emotional regulation (Freud, 1928).

Cultural Insensitivity

Humor is deeply rooted in cultural norms and can vary widely across different cultural contexts. What is humorous in one culture may be offensive or incomprehensible in another. Therapists must be acutely aware of cultural differences and exercise cultural sensitivity when using humor in therapy. Failure to do so can result in the alienation of the client (Apte, 1985).

Foster Resilience

Humor can build resilience by helping clients to see the lighter side of their struggles. This can promote a sense of mastery and control, empowering clients to cope more effectively with life's challenges. Humor can serve as a coping mechanism, enabling clients to navigate adversity with greater ease (Vaillant, 1977).

Reinforcing Negative Behaviors

Humor can inadvertently reinforce negative behaviors or maladaptive thought patterns if not used carefully. For example, making light of a client's harmful behavior or minimizing the severity of symptoms through humor can undermine the therapeutic goals. This risk is particularly pronounced in clients with self-destructive tendencies or those who struggle with addiction (Martin, 2007).

Facilitate Cognitive Shifts and Communicate Difficult Messages

Humor can disrupt maladaptive thought patterns and encourage more flexible thinking. By introducing incongruity and surprise, humor can challenge clients' cognitive distortions and promote more adaptive thinking (Nezu, Nezu, and Blissett, 1988). This can be particularly useful in cognitive behavioral therapy, where modifying dysfunctional thoughts is a central goal.

Humor can be an effective way to convey difficult feedback or truths. By softening the impact of challenging topics, humor can make them easier to discuss and accept. This can facilitate honest and open communication, which is essential for addressing core issues in therapy (Salameh, 1987).

Risk of Humor as a Defense Mechanism

Clients and therapists may use humor as a defense mechanism to avoid dealing with uncomfortable emotions or topics. This can impede the therapeutic process by preventing the exploration of deeper issues. Therapists need to be mindful of when humor is used defensively and address it appropriately (Kubie, 1971).

Humanize the Therapist

Appropriate use of humor by therapists can humanize them, making them appear more relatable and approachable. This can reduce power differentials and create a more egalitarian therapeutic relationship. Clients seeing their therapists as genuine and approachable can enhance the therapeutic alliance and foster greater openness (Franzini, 2001).

Ethical Considerations

There are ethical considerations regarding the use of humor in therapy. The therapist holds a position of power, and humor can be misused to assert dominance or control over the client. Additionally, humor should never be used to mock or ridicule clients (American Psychological Association, 2017).

Conclusion - How Should Practitioners Proceed?

Humor can be a valuable therapeutic tool when used thoughtfully and appropriately. Humor in the therapeutic process also carries significant risks that must be carefully managed. Therapists should be alert to possible misinterpretation, reinforcement of negative behaviors, trivialization of client concerns, damage to the therapeutic alliance, cultural insensitivity, and the use of humor as a defense mechanism.

By approaching humor with caution and mindfulness, therapists can mitigate these risks and use humor to enhance, rather than hinder, the therapeutic process. Practitioners should consider using humor in psychotherapeutic practice while proceeding cautiously and mindfully.

© 2024 Dr. Fabiana Franco. All rights reserved.