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HUM9997 - SECTION 11: SPECIAL CONSIDERATIONS: AFTER THE LAUGHTER

Understanding and Evaluating the Process and Effectiveness of the Humor Therapy

Understanding and Evaluating the Process and Effectiveness of the Humor Therapy

After employing almost any form of intervention, the professional will seek to gauge its success. It is, therefore, important for the clinician to evaluate the effects of the use of humor subsequent to its use, particularly if the technique seems not to have produced the desired effect upon the client.

This evaluation can be accomplished by debriefing or asking the client a number of questions related to the intervention. These might include “I’d like to know what your reaction to my use of humor? Do you think what I have just told you is related to your concerns? Did you feel supported, or not supported, by bringing this into our work?"

It is important that the clinician have established a fair amount of therapeutic trust and rapport so that the client will be reasonably comfortable providing honest feedback about whether or not the intervention was useful.

Even where verbal feedback is given, however, the clinician should carefully examine the client’s verbal and non-verbal behaviors following the use of humor. In the client’s facial expression or body language, there may be important indications that the intervention was helpful - or harmful - to the therapeutic process.

The clinician who keeps careful watch of these factors will be better prepared to respond to the client’s reaction immediately. Where the client expresses - directly or indirectly - discomfort or dissatisfaction with the intervention, the clinician can then spend some time in a debriefing process, helping to repair any possible damage to the therapeutic relationship.

This debriefing process should include 1) an affirmation of the client’s discomfort and his/her right to make known this discomfort, 2) some discussion of the intended goals and purposes for the use of humor, and 3) some honest, humble and non-defensive acknowledgement that the goals and purposes did not get served in the manner that was intended.

This approach supports and re-affirms the therapeutic relationship, while protecting the professional authority of the clinician. (Some clients may also benefit by an open and honest discussion of the limitations and imperfections all clinicians bring to this difficult and complex field, but this issue must be evaluated in the context of the entire therapeutic relationship.)

Continuous critical assessment of clients’ reactions to your use of humor can also serve as a tool for professional growth and improved competence. Through assessment, you can gradually become more adept at identifying your own strengths and weaknesses in the use of this intervention.

In the event that you find yourself using this technique inappropriately or too often, there are several questions that can serve as a guide in the critical self-assessment effort:

Do I have unresolved issues that I need to work-out with a supervisor, therapist, or other person?

Am I anxious with silence in therapy so that I fill the gaps with humor or other interventions that do not serve the primary goals of the treatment?

Am I trying to be liked, or do I have some need to have the client to identify with me?

Am I anxious about the power of the therapeutic process and use humor to calm myself?

Am I using humor to fill gaps in my knowledge and skills?

Honest answers to these questions can only result in increased competence and expertise for the clinician. Where it is clear that the clinician's own personal agenda is being inserted into the therapeutic relationship in ways that are detrimental to the client, it becomes the ethical obligation of the clinician to search for and implement solutions this problem.


Gauging the Results of the Use of Humor

Apart from asking the client directly, the conscientious clinician will also be alert for other cues that the use of humor did not serve its intended purposes. During this portion of the course, we will explore different methods to determine the success of the particular strategy using informally within the therapeutic relationship and through more objective means.

More importantly, we will provide some methods to respond less than optimal interventions appropriately. The conclusion of this segment will examine explore therapist self-care which helps bolster the ability to remain enthusiastic, inquisitive, and flexible with regards to developing fresh interventions and avoiding “compassion fatigue.”

Let’s discuss the different stages of client reactions’ in utilizing provocation in therapy. Farrelly and Brandsma (1974) describe several distinct stages clients typically experience. Understanding these will help the therapist then determine how to proceed in the therapy – whether to abort or continue the current approach.

Stage One – The beginning stages are marked by a client verbally or non-verbally expressing surprise, shock, anger, confusion, and uncertainty. The following descriptions explain why many clients tend to be attracted to humor in therapy and return for future sessions.

- The client may respond with a sense of injustice, stating that the intervention from the therapist was “unfair” or manipulative.
- Clients tend to feel a greater sense of security in the therapist being more transparent versus opaque. The therapist is seen as multidimensional and the client feels less anxious in wondering about the therapist’s impressions.
- The client feels a sense of safety and accountability in the approach. This sense of being able to give up some control is freeing.
- Clients tend to experience an unparalleled sense of validation because of the therapist’s honesty.

Stage Two – As the first stage transitions, the client tends to react in a humble, irritated, or sulky way. “Darn you, you’re right about me.” Desired behavioral changes in the session may be encountered. Defense mechanisms begin to dissolve or become more adaptive.

Stage Three – The client often begins to clarify, make decisions, and change. The client tends to more strongly protest the therapist by asserting themselves and exhibiting the desired behavior without necessarily being conscious of it.

Stage Four – The final stage involves the client experiencing the benefits both in and outside of the sessions. He or she tends to be more focused on behavioral and character change, and believes they are developing an improved and more stable self-concept. References to old patterns will begin to be viewed as “the old me” or “the old you." (Farrelly & Brandsma, 1974, 131-138)

Given the typical progression of humor therapy, let’s examine how we might be able to conceptualize and evaluate the efficacy of an intervention. Salameh (1983) developed his “Humor Rating Scale” towards these ends. (Buckman, 1994, pg. 22-23) These classifications are described below.

Destructive Humor – This has no therapeutic value and intentionally or unintentionally is designed to emotionally wound the client – and is never appropriate.

Harmful Humor – This is used when the therapist feels disconnected from or unsure of the client’s needs. This is an inappropriate attempt to regain a sense of direction and connection by helping the therapist attempt to derive a sense of comfort and control when feeling lost.

Minimally Helpful Humor – This is a socially appropriate or safe humorous response. It may serve to validate something that is obvious in a humorous way. It is pleasant but only mildly therapeutic or interpretive for the client.

Very Helpful Humor – This demonstrates therapist keen discernment of the client needs, encourages introspection, and phasing out of inappropriate, or rehearsing positive behavior through interpretation.

Outstandingly Helpful Humor – This is similar to the previous category. But intangible qualities such as timing of the intervention and tone of voice make this extremely poignant. It is reassuring at times, but more importantly pushes the client to move beyond their defenses in a seemingly effortless way.

Especially when first experimenting with humor therapy as an approach, it is extremely important to role play interventions with colleagues before using them. Start with clients where you have less counter-transference. Also, after trying an intervention rate it yourself and compare it to a colleague’s rating after reviewing it with them (without telling them you’re rating first, of course!).

Taking this one step further, you might consider asking your colleagues to help you brainstorm other examples of humor that may have ranked higher in the particular situation. Always be willing to generate alternative interventions at one time.

The following discussion provides some different questions to consider individually and in supervision, based on some of the concepts that have been gleamed thus far.

When an intervention falls flat or yields an undesirable result, try to get a sense of whether it was the content or the tone of the conversation. Revisit the 4 different tones (i.e., giggling state, friendly banter, wise person, or objective observer) mentioned earlier. Were you able to approach the situation from one of these positions? If not, what kept you from doing so? If you were, how could you have done it differently?

To what extent were you disconnected with the client’s current socio-emotional space or needs? Did your language attempt to connect with the client by genuinely trying to reflect their conversational modes of communication? (e.g., street / locker room, moral) Or, were you expecting them to decipher your clinical or formal style?

It is paramount to reflect to yourself honestly about whether the therapist or client needs are being serviced by the particular intervention and to what degree. An intervention that produces a positive feeling for the therapist needs to be a byproduct of – and not a primary objective of the intervention.

As we have discussed ad nauseam, there exists no substitute for clinical judgment in evaluating the efficacy of your work. Paying attention to the client’s response will help you determine which avenue to venture down in your follow-up.

Responding Therapeutically to the Client’s Reaction

As per the four stages of therapy mentioned earlier in this section, what one may intuitively consider an “unhelpful” response such as being baffled or irritated, is likely a natural response that is to be expected. The therapist must work to be comfortable and desensitize themselves.

However, with extreme or consistently negative reactions such as rage, withdrawal, or missing sessions, the therapist may need to review their approach. This is best dealt with by being direct and asking the client how they have felt about the therapy thus far.

Remember that the client may experience ambivalence about sharing their reaction (e.g., confused but afraid to be seen as incompetent, or angry but really is afraid to upset the therapist), and this will mainly manifest in non-verbal behaviors.

Instead of feeling the need to commit to an interpretation, sometimes taking responsibility for the situation is a huge part of reconnecting. If a client denies an obvious reaction, softly restating the therapist’s subjective experience and objective observation of the client’s response may normalize this for discussion.

As many clients would be reluctant to share this, ask if they would be comfortable being honest with the therapist and under what conditions. Or, inquire as to how the therapist might know they are upset (i.e., based on the client’s own self-awareness of their external signs).

When a client has non-verbally acknowledges being hurt, and the therapist believes the intervention may have been inappropriate, clarifying this is crucial. An apology may serve to rebuild client trust and role model conflict resolution, humility and taking responsibility. Also, this may allow the client to be more comfortable being vulnerable and admit making mistakes in session, or even considering forgiveness with others.

However, be careful of shifting the focus to the therapist or expressing excessive guilt triggered by the need to constantly pacify the client. Be curious of what counter-transference transpired in the dialogue that interfered with the specific intent of the intervention. Then, reflect the situation with a trusted peer.

If a therapist feels guilty about a client feeling betrayed by an intervention (e.g., accusations of manipulation, trivializing, or misrepresentation), refrain from apologizing before you understand what is triggering that response. “Maybe I was…Hmmm…” might be an initial response. Then, asking them to talk about other impressions about what the intervention may have implied for them might be helpful.

If the client appears too distraught to process the intervention, giving them permission to take some time before talking about it may be necessary. The therapist should refrain from trying to gloss over these feelings afterwards, but need not pressure the client to discuss this before they feel prepared to do so. Normalizing communication challenges, the discomfort they create, and the benefits of working through them might be appropriate, especially as this may apply to the client’s presenting problem.

When revisiting the situation with the client, it may also be useful to consider a psychodynamic approach in wondering what was triggered for the client from past or present relationships, and perhaps normalizing this. Only consider this if there appears to be ample evidence that a client has something to gain from the interaction and if it reflects a possible pattern in their life. Again, This is not the forum to explore the therapist’s response in detail.

The therapist could also use this opportunity to empathize with the client’s social system (family, work, or relationships) and expressing how others might be feeling in the client’s life. Be clear on expressing wonderment with the client rather than justifying the therapist behavior or shifting blame to the client.

Then, reframe the experience as at least a partial success in that the client and therapist engaged in successful conflict resolution, which is a form of intimacy. Continue to check-in with the client about how they are experiencing the situation.

If a client continues to resist exploration, use your clinical judgment as to whether to probe deeper or give permission of the client to revisit any past issues at any point. Then, refocus on where the client consciously feels the need to venture in the session.

Responding with continuous humor may be appropriate as the therapist becomes more experienced. If the therapist is conflicted, it might be advised to explore ways of responding outside of the session in supervision. The better the relationship, insight into the client, and timing of the intervention, the more favorable the results of sticking with humor will likely prove.

The Therapist’s Ongoing Learning Process and Educational Needs

Whether the therapist intends to adopt the style of “provocative therapy” or integrate this more conservatively, the following description by Farrelly and Brandsma (1974, 139-142) highlight the typical progression of changes they experience in their responses.

- Shock and disbelief – I am supposed to say what?
- Curiosity and fascination – I would love to see or hear more about that.
- Tentative experimentation – Even though I am afraid to scare the client away, I am willing to try with some guidance from my supervisor. I need some concrete direction and help from those more experienced to know how to proceed.
- Renewed Enthusiasm – I feel excited by the fact that therapy need not be solely clinical. I have a sense of confidence in beginning to integrate how myself and therapy with the client. I begin to realize that the pain I feared causing will mainly come from the fear and discomfort of consequences of past actions and needing to change. But, it can be presented in a more efficient and “down-to-earth” way.
- Generalization and Integration – I begin to see boundless opportunities for using a humorous frame both in and outside of therapy. Trial and error feels more natural – and it’s a good thing, I do make mistakes. This seems less like a technique and more like a facet of my being.
- Discernment and Revision – I feel more adept at knowing when I am using humor to meet my own needs or in extreme ways. I can have parallel conversations with myself and the client which reflect the nuances of the dialogue.
- Autonomous internalization and commitment – I am less dependent on my supervisor and have developed an internal gauge that guides me. I am excited and awed by the endlessness opportunities for growth this framework provides.

The use of humor in therapy, not to mention a therapist’s personal life could also be helpful in terms of preventing burnout. There are many ways to enhance one’s use of humor to maintain or renew your personal and professional enthusiasm.

- See the references at the end to read more in-depth about the topic.
- Associate with various colleagues who excel at using humor.
- Join a professional organization such as the ones listed below keep abreast of specific opportunities for professional growth in that area.
- The Association for Applied and Therapeutic Humor (online @ http://aath.org/)
- The World Laughter Tour (http://www.worldlaughtertour.com/) about laughter classes or becoming a Certified Laughter Leader
- Salameh (1993) references a systemic program to increase humor skills; “Humor Immersion Training” or “HIT,” developed in 1987.
- McGhee (1999) has developed a workbook to help the layperson and professional enhance their humor skills; “Health, Healing, and the Amuse
System: Humor as Survival Training.”
- Keep a daily log of humorous one-liners or ironic experiences that are amusing.
- Go to comedy shows, watch sitcoms, and try some of the exercises in this course…plan time for humor…but practice being spontaneous also.

Gallows humor is the raw, unedited, and “inside” humor used by people that share a common experience. Therapists, among other professionals, can use this in moderation to diffuse stressful and horrific situations – especially when one can ill afford to experience their full range of emotions (e.g., in the middle of a stressful day) (Salameh & Fry, 1993). Over time, if one fails to use other forms of expression and coping, this can translate to cynicism and burnout.

 

Ethics and the Uses of Humor

When evaluating whether it is ethical to use an intervention, there are a number of factors to consider. For starters, it is helpful to understand whether that intervention is considered part of best practices. There are several levels of intervention that are concerned with this particular issue. These are shown below.

 

Level of Intervention

Evidence-based Interventions
Interventions that have undergone rigorous evaluation based on the positive findings of several empirically conducted research studies.

Evidence-based practice, (as noted in the approved policy of the American Psychological Association (APA) in 2005),

“is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences.”

Research-based Interventions
Include interventions that are evidence-based and also others that have a somewhat less rigorous or extensive research foundation.

Promising Interventions
Have the potential to effectively address the client issue(s). They are often interventions that have worked elsewhere with similar client issues. Others are based on a solid theory or your past professional experience.

Innovative Interventions (Thinking Outside the Box)
Are often considered an intermediary step between clinical care and formal research. They are usually initiated with a limited number of clients in unusual clinical situations.

The use of humor, as noted in earlier sections, has some reasonably well-established research results to support bringing it into the treatment. While humor is such a complex phenomenon, occurring in an equally complex context, it is somewhat difficult to establish the parameters of what would constitute an evidence based level of intervention within which contexts. It may be more appropriate to view the use of humor as research-based provided that the clinician who is using it is using it appropriately. 

 

Degree of Competence

When codes of ethics weigh in on whether a clinician is able to utilize a technique or an approach in an ethical manner, they note that clinicians must operate within one's area of competence. So it is with the use of humor. It is a somewhat high risk - high reward intervention. Like the use of metaphor, which is able to convey multiple layers of meaning, humor will succeed because it will reveal flexible aspects of situations that people often have difficulties seeing in flexible ways. 

When used in the right ways, it can be very powerful and can achieve things that are not able to be easily accomplished through other means. However, not everyone is able to be competent using humor within a therapeutic relationship. Simply being funny in your personal relationships does not mean that you will be able to use humor in an effective and appropriate way as an intervention in clinical work. 

The use of humor, in therapy, in real time, requires a high degree of expert intuition. It is a skill, but a skill at a very high level, as much an art as a cognitive process. It is a skill for which you must have an instinct and a feel, particularly with regard to timing and context. 

The art of clinical intervention requires a different kind of cognitive process: the capacity of the individual professional to access and apply his/her database of knowledge in a creative, insightful and purposeful way, adapting it to the individual and emerging needs of his/her clients.

The art of clinical intervention happens on the fly, in real time, where actions that are undertaken in the immediate act of intervention can have effects that can’t always be undone. It requires a fluidity and proficiency in accessing and applying the most important and relevant information from our stored knowledge base very quickly, under conditions where we can’t just stop the intervention and return to our textbooks and research resources to review or prepare.

The kinds of skills that occur with the art of clinical intervention come from information that is stored diffusely in our long-term memory and less – for the lack of a better word – consciously known and understood until we access it. Ideas about how to proceed with a client, what to say in a given situation, when to act and when to hold back, this information surfaces from the deep storage of our long term memory when we need it, more based upon a feel for a situation – a kind of intuition, if you will - than upon logic.

Skilled professionals trust this process of accessing information. However, we trust by verifying. The information that rises up from deep storage can‘t be brought into the intervention process unfiltered. It has to be processed through our critical thinking equipment. Our deep storage equipment doesn’t just contain information about our client’s circumstances. It also contains our own emotional concerns, our biases, our misperceptions and our blind spots. Before we do something that we feel might be a good idea, we have to check to make sure we also think it is a good idea.

Our critical thinking equipment also serves as the arbiter when ideas are not clear or certain. The knowledge contained in our deep storage will not always be perfectly formed. It will sometimes consist of information that is incomplete, or that competes or conflicts with other things we know.

The narrative of clinical intervention – deciding what to do in a given situation - is a process of both testing things out and engaging in a kind of complex conversation and conflict resolution within our own knowledge base. Where conflicts and disagreements occur between different things we know, the process is to work them out very quickly at several levels, shuttling back and forth between our critical thinking skills and the less conscious parts of our cognitive equipment.

In the final part of that conversation, the ideas that arise from our deep knowledge are winnowed down to a single choice of action, with our critical thinking skills making the final determination of the worth and validity of our choice. It is a complex process, one that takes some time to master.

This is something for which you must have some baseline aptitude, and a willingness to develop increase competence over time. If you are not able to develop this kind of artful use of humor, then it will not be ethical for you to attempt to use humor as a technique. You will run into some of the contraindications for the use of this technique before you even get started. 

However, if you do wish to use this technique in the course of your clinical practice, then it is important to build your knowledge base adequately before you begin to apply humor in a therapeutic way with actual clients.  The quality of the information that arises out of our deep knowledge base is dependent upon the quality of the information that is placed into our deep knowledge. 

The greater the amount of knowledge about any subject area that is placed into our deep knowledge base, the more possibilities there are for integrating and using that knowledge in creative ways. It is not always possible to predict what elements of a course such as this will combine with other stored knowledge to produce the capacity to use an intervention like humor, but the more of this course you have been able to absorb, the greater the likelihood that you will be able to formulate the uses that are helpful to you.

 

Humor and Moral Authority

No matter which model or approach the practitioner chooses, and which techniques applied within that model, it will be applied from a role as an expert or leader. This role of a facilitator or leader of change is one which must be built on a foundation of well-constructed and well-utilized professional authority. This means that practitioners must understand the nature and uses of professional authority. The ability to use professional authority competently, like other aspects of maintaining a good therapeutic relationship, is durable and transferable across different modality of intervention and different choices of techniques.

Understanding the uses of professional authority also carries with it another important purpose. Clinicians are also people who teach and train others in how to manage interpersonal relationships. We work with parents, with supervisors, with other people in leadership roles. Knowing what is involved in professional authority allows us to pass this information forward in ways that instruct others and serve the purposes of the people whom we are teaching.

The four pillars of authority is a model that is clear, concise, and easy to grasp – for both clinicians and clients. It explains very well what people need to focus on in order to generate authority in relationships with other people.

The first important thing to know about professional authority is that the client retains the right to grant it to the practitioner or to withhold it from the practitioner. The client has a choice of whether to trust the capabilities of the professional and allow the professional to lead or facilitate the change efforts, or reject the efforts of the professional. The practitioner can optimize his or her actions in an attempt to secure the trust of the client, but even the most skilled professional does not have the ability to create professional authority without the permission of the client. If the client does not wish for the clinician to use humor within the context of that professional relationship, then the clinician must respect the wishes of the client.

That said, the degree to which the practitioner operates in a way that commands professional authority, the more likely it is that the client will allow the clinician to lead the change efforts.

Professional authority is different from personal authority in that it does not exclusively emanate from any personal characteristic of the practitioner. Professional authority is not dependent upon the provider being of a particular age, gender, ethnicity, personality type, or any other personal characteristic. It comes from knowing how to generate it and use it wisely.

Good clinicians both exhibit authority as a characteristic and use authority as a tool for persuading clients to operate in accordance with the shared purposes defined as the change work. Professional authority, properly used, generates both trust and positive pressure for clients to face their fears and resistances to engaging in change work.

In the literature, it is postulated that there are four different kinds of authority, each one of which is generated by different factors. These are the four pillars of authority, and they are shown below:

- Structural authority
- Sapiential authority
- Moral authority
- Personal or charismatic authority

Structural authority is the kind of authority that is created by rank or position within a hierarchy. This is to say that a person’s position within some kind of organized and structured entity allows them to issue guidelines, directives, or even commands to people at a lower point in the hierarchical structure. For instance, within the military, generals have structural authority over majors, who have structural authority over captains, who have authority over lieutenants, and so forth.

The structured system usually allows leaders higher on the ladder to give rewards and apply consequences to people lower on the ladder as a method of directing followers towards preferred behaviors and away from unwelcomed behaviors. Unlike any of the other kinds of authority, where authority is dependent upon the skills demonstrated by the person, the persuasive power of structural authority comes solely from the structure itself and the hierarchy’s ability to dole out rewards and punishments.

The practicing professional is granted structural authority through his/her licensure, in which case the state grants that authority through legal means and the state and the practitioner’s whole profession support and sanction that authority. That authority allows the clinician to practice, take insurance payments, and any other rights accorded by the law.

Structural authority, however, also brings with it responsibilities that limit the rights of the clinician to operate in unsanctioned ways. Any practitioner who violates practice or ethical guidelines runs the risk of forfeiting this structural authority – and incurs the possibility of consequences from the professional and/or licensure bodies supervising practice.

Violations of practice by any professional fundamentally weaken the structural authority of all other practitioners by decreasing overall trust for the profession. In business and marketing terms, violations “cheapen the brand.”

The practitioner can also hold structural authority through his/her position within an organization. The head of a unit or department will carry decision making rights and responsibilities that professionals lower on the hierarchical structure will not possess. Clients will sometimes seek out the professionals higher up the ladder in acknowledgement of this reality.

Parents, in their relationship with their children, possess structural authority, supported not only by culture and tradition, but also supported by the legal system that gives parents rights to make decisions for their children. Parents’ ability to control the resources of a family supports this structural authority, allowing the parents to shape behavior through the application of rewards and consequences.

Structural authority is the only kind of authority that incorporates coercive modes of interaction: rewards and punishments. All of the other kinds of authority work through persuasive modes of interaction. Structural authority can be given to a person without that person having earned it. All of the other kinds of authority need to be earned.

This is important in terms of utilizing authority in an empowered way. A person who attempts to utilize structural authority – without having earned the other kinds of authority through well-considered action – will usually generate resistance and pushback from his/her followers.

Sapiential authority (from sapiens, the Latin word for wise or knowledgeable) generates its persuasive capacity from the degree of knowledge or wisdom held by a person. The greater the degree of knowledge, the greater the amount of sapiential authority created. People are often promoted to positions of leadership because of their greater degree of knowledge or experience, factors which should allow them to direct others to better results.

In situations where the most important consideration is who knows how to do something in the right way or the best way, sapiential authority can be more important than structural authority. Even the president of a company will generally follow the lead and instructions of a technician lower on the organizational ladder if the technician knows how to do something that the president doesn’t know how to do.

When a person in a position of authority lacks the wisdom or knowledge to handle the responsibilities of his/her leadership role, that person’s authority very quickly begins to erode. This can lead to a leadership void and an increased risk that followers will rebel against or reject the leader’s defined goals and purposes.

A deficiency in sapiential authority can create problems in relationships between parents and their children. Parents who do not possess adequate knowledge and skills to lead their families can lose the trust and buy-in of their children, creating a dangerous leadership void. Parents who have a clear understanding of the importance of sapiential authority are often more willing to be open to instruction in better parenting skills.

Obviously, sapiential authority is extremely important for practitioners of the helping professions. Our clients are continuously assessing our level of skill in helping them improve their circumstances. If we do not possess the necessary knowledge and skills to help them, then they will ultimately withdraw their trust.

If we are not able to use humor with skill, getting the timing wrong, or using it in contexts where it is not helpful for appropriate, we immediately weaken our sapiential authority. This has implications for the strength of the therapeutic relationship.

Moral authority derives its persuasive capacity from the respect given a person who is willing to do the right things for the right reasons even in situations where doing the right things places personal burdens upon that person. The integrity of the person exercising moral authority models and champions a willingness to put mission ahead of self, placing moral pressure on others to do the same.

Within organizations, moral authority is more powerful and more effective: 1) when the positions taken by the person exercising moral authority align well with the mission of the organization and 2) when the mission itself is seen as right and correct, both within the organization and outside of the organization. Conflicts over the “rightness” of decisions that are made serve to weaken moral authority.

In parent-child relationships, moral authority is created by the parent’s willingness to pursue the mission of raising a healthy child, one who develops the capacity to be well integrated into the adult world, even when the pursuit of that mission requires considerable work and sacrifice on the part of the parent.

Moral authority can be the most complicated part of authority to address, as it raises questions of what is the “right” mission. Parents who were themselves raised with a particular style of parenting will often view the “right” mission as raising their children in the same manner that they were raised – even if that style of parenting doesn’t produce what clinicians would consider particularly good results in terms of healthy, well-adjusted children.

In such instances, moral authority can be diminished because the parent is seen as placing their need to hold onto what is comfortable for them above the child’s need for a parenting style that gets the job done. The mission can be seen as preserving the parent’s comfort, not forwarding the well-being of their child.

If you recall the idea of deep knowledge from earlier in this course, a parent’s ideas of what constitutes good parenting is part of their deep knowledge, deeply embedded in their knowledge base of how to act in the world. Sometimes that deep knowledge - with our help and guidance - must be re-examined by the parent, using his/her critical thinking skills, much in the same way that we professionals have to examine each idea, belief and value that bubbles up from our deep knowledge.

As helping professionals, our job is not to dictate to the client what the mission should be. Our job is rather collaborating with the client in a process of clarification, making sure that the mission that they are choosing is one that they would consciously choose.

For both professionals and parents, moral authority is created through a willingness to engage in this critical re-appraisal process, working to make a bridge between what they feel about a given situation and what they think about a given situation. This will connect deeply with the next section of this training program, concerned with the idea of adaptive work.

Within professional relationships where change work is the mission, moral authority is enhanced when the client perceives the mission as the “right” one, and when the client sees the professional as being willing to take on the personal and professional burdens of pursuing that mission passionately.

Within this context, if we are using humor in a manner that seeks to serve the mission, to propel change forward, then we can use humor and still retain our moral authority - even if the humor doesn't quite hit the mark. On the other hand, if we use humor because we enjoy using humor, even when it is not effective for the client, then we risk sacrificing our moral authority, and weakening our therapeutic relationship.

Personal or charismatic authority is based on the capacity of the person in charge to rally others to his/her cause based upon charisma, personal presence or other personal characteristics, such as confidence, certainty or, in some cases, aggressiveness. Personal authority occurs when the charismatic presence of the person in charge is sufficient to persuade followers to pursue whatever mission that the leader defines as right, whether or not the leader is working with wisdom or folly, good moral intentions or bad.

While many successful leaders and clinicians possess personal authority – and use it for positive purposes - there are clearly instances in which unscrupulous leaders and unethical practitioners have misused personal authority. In the absence of wisdom to understand how to proceed correctly and/or a vision - as well as a mission - that is “right” in a moral sense, personal authority can be and has been used to lead followers or clients in the direction that serves the personal purposes of the person in the leadership role.

If we are not prepared to use humor effectively and confidently, if we are not able to project charismatic authority while using humor, then we again run the risk of harming our professional authority and the therapeutic relationship. We must accurately assess both the appropriateness of the intervention and our own competence to use the intervention, including our confidence about using the humor effectively. 

Professional authority is generated by the combined effects of all of these four kinds of authority. The very best professionals tend to be personally charismatic, operating with a great deal of both knowledge and wisdom, fiercely pursuing a mission that is both well defined and widely understood as right, within an structural and conceptual framework that arranges itself so that the professional is granted wide authority, but with good support and limits from other components of the organizational structure.

Professionals who do not possess all four kinds of authority in sufficient quantities can run into predictable difficulties. Professionals who possess ample amounts of charismatic, sapiential and structural authority, but who suffer from a deficiency in moral authority – because they do the wrong things for the wrong reasons - are liable to direct the mission towards wrongheaded, unethical or dysfunctional purposes.

Professionals who lack sapiential authority, because they apply the wrong knowledge bases to pursuing their task or mission, also weaken their moral authority. Doing the right thing involves gathering the right knowledge to support what you are doing.

Professionals who possess sapiential, structural and moral authority, but who lack personal or charismatic authority, can struggle in the leadership and directive elements of change work. There is a competition in change work between regressive goals and purposes coming from the client’s resistance to change versus the goals and purposes that lead the client towards positive change.

The practitioner must work not to be intimidated by resistance, and personal authority is the behavioral expression of that commitment to use one’s own personal resources for the right purposes. Personal or charismatic authority is often the most readily evident and visible kind of authority. For this reason, it is tremendously important for the practitioner to overcome his or her personal inhibitions to operating with assertiveness and confidence in the leadership role.

The directive and persuasive power of professional authority ultimately is derived from the mission. It is the mission - and not the personal beliefs, values, ideas and/or personal characteristics of the professional - that informs the professional’s actions and interventions. Those actions that best direct the clinician and client towards the optimal fulfillment of the mission, and its clearly defined goals and purposes, are the correct actions to be chosen by the professional in his or her leadership position.

Professional authority, in this sense, does not consist of a solitary and isolated practitioner being engaged in individual interaction with any client. In each individual action or intervention, the practitioner who is effectively utilizing professional authority will have the entire weight and backing of the state and his/her profession behind him or her.

Because professional authority emanates from the mission, it is deeply impersonal. It has no feelings. Professional authority does not become frightened, or angry, or frustrated. It is always organized and purposeful, engaged in a constant process of searching for the most successful action, approaches and solutions that can lead to the successful achievement of the mission.

Professional authority is also impersonal in the sense that it is not directed towards protecting or fulfilling in any way the personal needs, values and feelings of the practitioner who is engaged in its use. The use of professional authority makes demands upon the practitioner to ignore, suppress, and control his or her own feelings, needs, wants and values in ways that pose a personal burden to the clinician. Wherever the professional chooses to focus on his or her own agenda in a way that interferes with the fulfillment of the mission, he or she relinquishes some portion of the support of his/her state and profession. Hence his or her professional authority is diminished.

Successful use of professional authority requires several things of the practitioner, as well as his/her profession and the state who work together to define standards for practice. It requires that the practitioner be right when he or she acts. This is to say that his or her actions are purposeful and functional, and directed towards the clearly defined goals and tasks of the mission.

At a deeper level, it also requires that the mission be right. Where professional authority takes place within organizations, with a single and generally universally accepted organizational culture, this to say it requires that the mission be fully in line with the organization, its people and the deeply held values that direct the mission and purpose of the organization.

Now, feel free to breathe a well-deserved sigh of relief. You have completed the majority of the course. By way of reviewing the case studies presented initially, the final section provides an opportunity to compare your pre and post-course knowledge base in applying humor to therapy.


After completing Section X, participants will be able to answer the following questions:

How would you distinguish the phases of client responses to humor in therapy?

How can you informally and formally gauge the success of your interventions?

What are 3 appropriate therapist responses to the client’s reaction to the intervention, and in which contexts would you use them?

How might the therapist’s learning process be described in applying humor to therapy?

It is my sincere hope, that this course has allowed for educational and experiential exposure to help you become informed as to the depth and breadth of humor in psychotherapy. Moreover, I hope this provided some needed respite from the monotony routine all of us encounter of our daily professional lives, and reignited a natural curiosity and creativity in you that may have been lying partially dormant or unfulfilled.

 

 

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