“Man alone suffers so excruciatingly in the world that he was compelled to invent laughter.” 

- Nietzche

Now that we have presented some basic definitions concerning the concept of humor, let us very briefly discuss its historical and theoretical roots. Ideas about the importance of humor in treating patients go very far back in time.

“Let the surgeon take care to regulate the whole regimen of the patient’s life for joy and happiness, allowing his relatives and special friends to cheer him, and by having someone tell him jokes.”

Earliest known historical reference to humor in the helping professions, by French Surgeon Henri de Mondeville in the 14th century

As highlighted in the previous quote, the use of humor in treating patients is hardly a new concept. Several centuries later, Martin Luther – not usually considered the most playful and jovial of spirits - documented the use of telling jokes in his pastoral counseling and writing letters that were riddled with playful remarks.

The philosopher Kierkegaard understands humor as a method of indirectly communicating to others, which downplays the authoritative role of the teacher. This is useful in that the target of the humor will likely accept or reject the truth in the lesson on the basis of its legitimacy, not solely on the basis of being idealized or devalued as an authority figure. This allows the student to take more responsibility for their discovery of the truth. (Heuscher In Fry and Salameh, 1993, 214)

In the 1930’s, clowns were brought into the hospital to entertain children suffering from polio. The belief was that laughter had some recuperative effects. In 1979, Dr. Norman Cousins, a physician, published a serious book discussing the use of laughter in the management of his own chronic pain due to rheumatoid arthritis.

The most recent and memorable depiction of humor in the medical field is portrayed in the movie, “Patch Adams.” In this 1998 film, Robin Williams played the doctor Hunter “Patch” Adams – based on the real story of Dr. Adams treating the poor in rural West Virginia, originally told in the 1983 autobiography “Gesundheit!”

While the aforementioned examples speak to the field of medicine, Sigmund Freud – also not generally considered the most joyous of persons - brought the formal use of humor in to the psychotherapy arena. He even wrote an entire book on the subject of humor, including a fairly substantial collection of jokes from his day.

He viewed humor in many cases as a high-level defense which allowed people to broach difficult issues more easily. Also, this allowed access to a more one’s unconscious drives (e.g., often related to libido) in “slips of the tongue”. He mentioned that humor could provide access to the superego and represent a playful or nurturing internalized parent.

Though the use of sarcasm from therapist to client is obviously damaging and needs to be avoided, the reverse is not necessarily true. According to Freud, sarcasm or jokes delivered from the client to the therapist may provide information about transference issues.

Other 20th century writers also advocate for the use of humor. Grotjahn (1957) shared a vignette of a patient who amusingly shared a cartoon, which later led to a revelation of his “homosexual longings.” Winnicott (1975) used humor with children and families to provide a level of comfort and to allow them to discuss difficult subject matters.

Well-known therapists such as Albert Ellis (1977), the founder of the Rational-Emotive school of thought, have used humor as a formidable intervention to combat exaggerations and over-seriousness.

Corey (1986) states that cognitive, behavioral, systems, Adlerian, Gestalt, and experiential therapists also utilize humor in their approaches regularly.

Lamb (1980) discusses an application of Minuchin’s strategic therapy in using “paradoxical intention,” where the client is encouraged to exaggerate their symptoms “to the point of absurdity." (Saper, 1988, 313-14) In contrast to humor therapy, this technique would be delivered in a serious, straightforward manner.

Lear (1998) believes that humor can help the patient and therapist create a mutually original relationship. Eckardt (2000) stresses the use of humor to create meaning and a coherent life story. Zeddies (2000) wrote that failure to incorporate humor may indicate the therapist is closed or detached from their emotional experience. (Encyclopedia of Alternative Medicine, 2006)

Therapeutic Riddle:

Question: How many therapists does it take to change a light bulb?

Answer: It takes only one therapist to change a light bulb, but the light bulb must “want” to change.