Definitions of Humor

Using Humor For Treatment and Diagnosis: 
A Shrinking Perspective

By Steven M. Sultanoff, Ph.D.

Originally published  in
Therapeutic Humor,
Publication of the American Association for Therapeutic Humor, 
January/February 2000, Vol. XIV
, (1), p. 5. ©2000

Therapy is a process where counselors create intervention strategies that are designed to influence a client’s emotions, behaviors, cognitions, and/or biochemistry. Each of these four aspects of the human system interacts with one another so that a change in one area (e.g., emotion) is likely to create change in another (e.g., behavior). The therapeutic power of humorous interventions rests in its ability to stimulate changes in all four areas.

There are numerous ways in which a counselor can use humor in the therapeutic relationship. Humor can be used to build the therapeutic alliance, to increase client energy, to treat emotional distress and cognitive distortion, and to diagnose the client’s ongoing progress. In this article, I will address the use of humorous stimuli as interventions for the purpose of treatment and diagnosis.

Humor as Treatment

One common usage of humor as a treatment modality occurs when the counselor creates humorous interventions which target the client’s emotional distress. For example, one of my clients who was dedicated to her depression, complained incessantly about wanting to feel less depressed. As part of her treatment I began offering her "humorous" interventions. After each of the first few interventions, she responded, "I hate when you do that (say something humorous)." She became increasingly annoyed with my humor until finally I inquired, "What is it about my use of humor that bothers you?" Instantly she replied, "When you make me laugh, I don’t feel depressed!" Suddenly, in a moment of insight, the light bulb came on! My humorous interventions were helping to lighten her depression (treatment) while, unconsciously, she continued to maintain her emotional distress.

Since humor directly changes our emotional states—humor and distressing emotions cannot occupy the same psychological space—it can be used as a treatment modality to alter these states. Clients can be taught to use humor to relieve anxiety, depression, and anger. The use of humor helps teach clients that they can not only relieve emotional distress but also be empowered to manage their emotional reactions.

Humor as Diagnosis

In addition to treatment, humor can be used to diagnose a client’s psychological state. A client’s ability to perceive humor is related to his/her interaction of thought and emotion. Perception of humor can indicate (diagnostically) progress in therapy (treatment).

For example, a former client explained on her first visit, that "bad things happened" to her because she was "stupid." On subsequent visits, I used a traditional cognitive therapy approach, helping her to change that belief system. On the tenth visit, she reported to me that another "bad thing had happened," but she could not explain why. I insisted that she knew why and we went back and forth for a while with her insisting that she did not. I finally looked directly at her and exclaimed, "It happened because you are stupid!"

After a brief moment of shock, she burst out laughing. Her ability to perceive the ludicrousness of a "bad event" being tied to her "being stupid" triggered her laughter. Diagnostically, I was able to assess her therapeutic progress from the first session (when she would have agreed with my statement) to the tenth session (where it seemed ridiculous).

Had she agreed with me that I was correct (and indeed this event happened because she was "stupid"), I would have diagnosed that she still had work to do on her faulty belief system, having not yet integrated corrective thinking targeting her emotional distress.

No matter whether her reaction was to perceive the ludicrousness or to agree with the absurd beliefs, her reaction to my humorous stimulus served to diagnose her progress in therapy.

The more we understand the process of using humor as a therapeutic intervention and the more we observe a client’s reaction to that process, the better equipped we will be to consciously present humorous interventions as a strategy for both treatment and diagnosis of emotional distress.

Humor Matters™

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