Choosing to be Amusing;
Assessing an Individual's Receptivity to Therapeutic Humor

By Steven M. Sultanoff, Ph.D.

Originally Published in the
Journal of Nursing Jocularity, Winter, 1994
Vol. 4, No.4, p. 34-35.

While the use of humor in therapeutic settings continues to gain respect, and we are becoming more serious about humor, skeptics continue to express concerns about "negative uses of humor." These negative types of humor include sarcasm, put- downs, humor which is insensitive to the emotional experience of the receiver, and humor which is used to create distance from emotional experience. In order to avoid 'negative' humor, it is essential for the helping professional to learn how to differentiate between potentially therapeutic and potentially harmful humor. Also, to use humor in therapeutic ways, it is important to determine the appropriate time when another person will be receptive to a specific type of humor. To use humor therapeutically one must examine: 1) the target of humor (humor aimed at self, situations, and/or others); 2) the environmental conditions in which humor is presented (with whom, at what time, and in what setting); and 3) the specific individual's receptivity to humor.


In general, the target of humor tends to be oneself, another person, or a situation. If healthy humor (that which brings people together, reduces stress, provides perspective, and feels good) and harmful humor (that which alienates others, increases hostility, and ultimately feels bad) were endpoints of a humor continuum, then humor aimed at oneself and humor aimed at another person would anchor those endpoints. That is, humor aimed at oneself is more likely to be healthful while humor aimed at others is more likely to be harmful. Humor aimed at situations falls in between these two extremes.

For example, when we use humor directed at ourselves we learn to laugh at ourselves. Furthermore, others around us feel safe as they are not the target of the humor. When we laugh at situations the humor is once again directed away from others. Conversely, humor that is directed at others is the most dangerous and potentially harmful type of humor. For example, humor that insults or mocks specific individuals or groups of people has greater harm potential. Even when the giver of the humor is a member of the target group, others in the group may reject the humor and feel insulted or put down. Therefore, as a rule of thumb humor directed at oneself as an individual is safest, while humor directed at situations is still relatively safe, and humor directed at others is most risky and, therefore, is located at the negative end of the humor continuum.

Also, there are interrelationships between humor aimed at oneself, situations, and at others. For example, jokes about earthquake victims in California, flood victims in the midwest, or freeze victims in the northeast may help many deal with the crisis, but for those emersed in the crisis such humor may be experienced as insensitive. In these particular situations, humor is experienced by the individual in crisis as directed at him/herself. This occurs because during crisis individuals find it difficult to perceive the crisis as separate from themselves, and, therefore, the humor aimed at the crisis is experienced as directed at the individual. Once one is able to generate distance from the traumatic experience, the humor about the trauma is experienced as separate from the individual and can be perceived humorously. We are all familiar with the phrase, "It wasn't funny at the time," which implies that at some later time the situation was experienced humorously.


As noted above, humor ranges from therapeutic to harmful based on the target of the humor. Receptivity to therapeutic humor is also based on environmental conditions such as the nature and bond the relationship, the timing and circumstance when humor is shared, and the setting in which humor is presented. For example, we may have a strong bond with a loved one, but humor about death in close proximity to a significant death may be poorly timed. In addition, as medical professionals, we have a responsibility to be sensitive not only to the intended receiver of our humor but to others who might intentionally or unintentionally experience our humor.

All professions use humor to cope with stressors. This is particularly evident in the medical professions where humor is a powerful coping mechanism. However, the humor we share as medical professionals is often not appropriate for our patients or clients to overhear. We must be sensitive to others and the environment to be sure that our humor is experienced only by those for whom the humor was intended.


Beyond the target and environment surrounding humor, we must consider "humor factors" that are idiosyncratic. That is, each individual's receptivity will be at least partially determined by his/her own "humor quotient." An individual's humor quotient is the extent to which he/she experiences humor. There are four methods to assess an individual's humor quotient. These are: 1) observing current uses of humor; 2) soliciting the role of humor in the individual's life; 3) observing the individual's ability to laugh at him/herself; and 4) observing the individual's response to the humor of others.

Observing Current Uses of Humor

The first and easiest way to assess another's receptivity to humor is to observe his/her own presentation of humor with you and with others. The more an individual uses humor in healthful ways the more receptive he/she will be to humor interventions. However, if the individual uses distancing humor such as sarcasm and put downs then he/she is less likely to be receptive to therapeutic humor.

Soliciting the Role of Humor in the Individual's Life

The second way to assess an individual's humor is to ask him/her what role humor plays in his/her life. This can be done in a direct self-report fashion such as simply asking what role humor plays, or it can be assessed more playfully by asking questions about an individual's favorite cartoon, comedian, humorous movie, television comedy, joke, humorous story, etc. The quickness of another's response, along with the energy level of the response and extent of the response, indicate the importance of humor in the person's life.

Observing the Individual's Ability to Laugh at Him/herself

The third method to assess humor receptivity is observation of the individual's ability to laugh at him/herself. The more an individual is able to laugh at him/herself the higher his/her self esteem, and the more receptive he will be to humor interventions. Being able to laugh at oneself requires a solid level of self esteem and a strong self concept.

Observing the Individual's Response to the Humor of Others

The fourth humor assessor involves presenting humor to the person and observing his/her reaction. As the presenter of humor you may share a joke, story, cartoon, prop, or other element of humor. As you present humor, you observe the other's reaction. Laughter, smiles, an increase in energy, a willingness to share his/her own humor, etc. are all indicators of the other's receptivity to humor.

Therapeutic humor can be a powerful tool to facilitate emotional, cognitive, behavioral, and physiological well being. Like many other forms of therapeutic interventions, it is not neutral--it can be healthful or harmful. As health professionals it is our responsibility to assess and evaluate our use of therapeutic humor so that we increase the probability that our humor interventions will be healthful.

The preceding article has explored how to assess an individual's receptivity to therapeutic humor. Future exploration is also needed to assess the individual health professional's motivation to use humor. That is, what is it that prompts an individual to respond with a humorous intervention. It is also important that we, as helping professionals employing therapeutic humor, ask ourselves, "Why am I using this humor at this moment?" and "How will this humor intervention be beneficial to my patient/clients?

copyright, 1994

Humor Matters™

Steven M. Sultanoff, Ph.D.
Mirthologist and Clinical Psychologist
3972 Barranca Pkwy. Suite J-221
Irvine, CA 92606