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Humor
as a Healing Tool
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Last Monday,
March 11, 2002, marked the sixth month anniversary of the
events of 9/11, and I am certain your local newspapers and
news programs were full of human-interest stories. In
a Washington Post interview with colleagues from an
office in the Pentagon that lost almost 50 % of its small
team, the group shared a laugh about that horrific day.
Three or four of the survivors escaped by crawling under the
increasingly heavy smoke, until one of them found a hole in
a wall. Somehow, one of the women managed to grab her
rather large purse and to also drag it to safety.
A story beginning
on the front page of the March 19, 2002 Washington Post
looks at how local teenagers are using new slang terms
from the event of 9/11 to ease tension. Here are some
examples the author, Emily Wax, cites. Messy bedrooms are
"ground zero". A petty concern is "so September 10".
The word "hottie", once used to describe an attractive teenage
male, has been replaced by "firefighter cute". There
is a fine line between comedy and insult, and the teachers
and students interviewed appear to be sensitive to this.
Academics call
this "terror humor". This summer in Forli, Italy, a
Boston College professor, Paul Lewis, is planning a panel
to discuss "terror
humor" at a conference of the International Society for Humor
Studies (ISHS) . The official journal of ISHS is
Humor: International Journal of Humor Research.
Poking fun at something frightening helps the teens to deal
with the event and using this special language makes them
feel more connected to one another.
If humor in children
and adolescents interests you, these articles may as well:
1.Dews, S., Winner,
E., Kaplan, J., Rosenblatt, E., Hunt, M., Lim, K., McGovern,
A., Qualter, A. & Smarsh, B. (1996). Children's
understanding of the meaning and functions of verbal irony.
Child Development, 67(6), 3071-85.
ABSTRACT: We investigated
children's understanding of irony and sensitivity to irony's
meanness and humor. In Study 1, 89 participants (5-6-year-olds,
8-9-year-olds, and adults) heard ironic and literal criticisms,
and literal compliments. Comprehension of irony emerged between
5 and 6 years of age. Ratings of humor increased with age;
ratings of meanness did not (showing that all ages perceived
irony as more muted than literal criticism). In Study 2, results
from 135 participants (6-7-year-olds, 8-9-year-olds, and adults)
replicated these findings and revealed the role of form and
intonation. Thus, comprehension of irony emerges between 5
and 6 years of age, and sensitivity to the muting function
develops prior to sensitivity to the humor function.
2.Schimel, J.L.
(1992). The role of humor as an integrating factor in adolescent
development. Adolescent Psychiatry, 18:118-26.
3.Schwartz, E.A.
(1999). Humor development in children from infancy to eighth
grade. Research for Nursing Practice, 1(2): 6p,
Abstract: Our appreciation
of humor starts in childhood. As we age, our understanding
and appreciation of humor changes (McGhee, 1989). Investigation
reveals very little recent research in this area. The purpose
of this paper is to present what is known about humor development
and to encourage nurse researchers to think about this area
for potential study. This paper reviews the research literature
concerning the development of humor in children from infancy
to eighth grade. Smiling and laughter start in infancy and
many changes occur as children go through the developmental
process. This information can help nurses and other health
care professionals design methods to make illness and hospitalization
more bearable. The inclusion of age-appropropriate humor can
also enliven educational presentations for children and parents.
4.Warm, T.R.
(1997). The role of teasing in development and vice
versa. Journal of Developmental & Behavioral
Pediatrics, 18(2), 97-101.
ABSTRACT: This
study was undertaken because there are almost no reports in
the scientific literature on the subject of teasing. Teasing
changes as it expresses developmental issues from playing
peek-a-boo in infancy to expressing personal issues, such
as boy/girl relationships, in adolescence. The form also changes
as the cognitive capacity of the child changes. Two hundred
fifty children from 1st, 3rd, 6th, 8th, and 11th grades were
asked to describe teasing, its motive, and the reaction of
the victim. The form of teasing was organized into hurtful
(hitting or spitting), mean (calling a burn victim ugly) and
symbolic, which allows the victim to realize that the provocation
is "just words." The forms correlated with age and
suggest that progression through these forms can be understood
in terms of the theories of psychological stages drawn from
Piagetian and psycholinguistic studies. The dominant motivation
for the child doing the teasing seemed at every age to be
sadistic pleasure in the discomfort of the child being teased,
although one sees some playful, benign teasing by late adolescence.
In terms of new
slang, Geoffrey Nunberg, a senior researcher at the Stanford
University Center for the Study of Language and Information,
says new slang words often appear during crises. Remember
"going postal'? Teens are more iconoclastic than adults
are, and they communicate with one another with more dynamic
and picturesque words. Sometimes, I am disturbed by
overheard conversations between teens, say during my metro
ride. Givers and receivers of what I consider coarse
or unkind remarks appear to not be confused or offended but
to quickly grasp the meaning under the words.
In MEDLINE/PubMed,
I found this article on the use of humor and fear:
Ventis, W.L., Higbee, G. & Murdock, S.A. (2001). Using
humor in systematic desensitization to reduce fear.
Journal of General Psychology, 128(2), 241-53.
ABSTRACT: Effectiveness of systematic desensitization for
fear reduction, using humorous hierarchy scenes without relaxation,
was tested. Participants were 40 students highly fearful of
spiders. Using a 24-item behavioral approach test with an
American tarantula, participants were matched on fear level
and randomly assigned to 1 of 3 treatment groups: (a) systematic
desensitization, (b) humor desensitization, and (c) untreated
controls. Each participant was seen for 6 sessions, including
pretest and posttest. Analyses of covariance of posttest scores
revealed that the 2 treatment groups showed greater reduction
in fear than the controls on 3 measures but did not differ
from each other. Therefore, humor in systematic desensitization
reduced fear as effectively as more traditional desensitization.
This finding may have therapeutic applications; however, it
may also be applicable in advertising to desensitize fear
of a dangerous product, such as cigarettes.
All of us use laughter
to ease a tense situation, and we know we feel better after
a good laugh. Health professionals, including occupational
therapy practitioners, believe that laughter assists them
in treating their patients. Norman Cousins in his 1980
book, Anatomy of an illness as perceived by the patient:
Reflections on healing and regeneration, talks about the
value of humor and laughter in his battle with ankylosing
spondylitis. Two years ago, Patch Adams was the
keynote speaker at the opening of the Annual Conference of
the American Occupational Therapy Association. Now,
you may not agree with Patch about everything he says on the
health care system, but you have to admit that he is funny,
and that he did have a good idea when he thought humor had
a big place in the NIH hospital. Robin Williams
plays the part of Patch Adams in the movie of the same name,
and you can read more about Patch in: Adams, P. & Mylander,
M. (1993). Gesundheit: Bringing good health to you,
the medical system, and society through physician service,
complementary therapies, humor, and joy. Rochester,
VT: Healing Arts Press.
A paper, "Laughter
and medicine: How humor can help you heal" is posted on the
Mayo
Clinic Information Center, and includes Cousins
and Adams in its discussion of this subject.
The following citations
are from OT SEARCH, under the subject heading WIT AND HUMOR,
the same term used in MEDLINE/PubMed and CINAHL. The
databases, PsychInfo and EMBASE, use the subject heading HUMOR.
References:
1.Banning, M.R.
& Nelson, D.L. (1987). The effects
of activity-elicited humor and group structure on group
cohesion and affective responses. The American
Journal of Occupational Therapy, 41(8), 510-514.
2.Dodge, J. (1998
Apr). The therapeutic use of humor in occupational
Therapy. The Journal of Occupational Therapy Students,
4-7.
ABSTRACT:
For the past several decades, the topic of humor and its place
in health care has been increasingly debated. Various
studies examining the physiological, social, psychological,
and cognitive benefits of laughter and humor have been conducted,
and the advantages of using mirth in health care delivery
have been weighed. In this article, a sample of these
studies and opinions is presented and applied to the field
of occupational therapy. Numerous studies are cited
regarding the specific benefits or detriments of the use of
humor in medicine, care of elderly persons, and psychology.
The physiological and psychological benefits of laughter are
given more attention than are the cognitive or social effects
due to the larger body of scientific evidence regarding those
benefits; the latter topics are approached more subjectively.
Humor is discussed from the perspective of occupational therapy.
Each area (physiological, cognitive, social, and psychological)
is related to occupational therapy practice, and the specific
relevance for the use of humor by occupational therapy practitioners
is shown. It is concluded that, used responsibly and
in appropriate situations, humor can be a beneficial tool
in occupational therapy.
3.Harvey, L.C.
(1998). Humor for healing. San Antonio,
TX: Therapy Skill Builders.
4.Hilton, C.
(1994). Humor: "When things get heavy...lighten
up!" OT Week, 8(5), 20-21.
NOTE: This
is the advice of Gene Mitchner, a man who prefers to share
laughter rather than complaints with the thousands of people
he speaks to across the country.
5.Leber, D.A.
& Vanoli, E.G. (2001). Therapeutic use of humor:
occupational therapy clinicians' perceptions and practices.
The American Journal of Occupational Therapy, 55(2),
221-6.
6.Miller, L.D.
(1970). Humor as a projective technique in occupational
therapy. The American Journal of Occupational Therapy,
24(3), 201-4.
7.Robinson, V.M.
(1991). Humor & the health professions:
The therapeutic use of humor in health care. 2nd
ed. Thorofare, NJ: SLACK, Inc.
8.Saltz, D.L.
(1991). Therapist's sense of humor enhances therapy
sessions. OT Week, 5(27), 15.
9.Saltz, D.L.
(1991). Laughter can be serious business. OT
Week, 5(19), 28-29.
10.Southam, M.
& Cummings, M. (1990). The use of humor
as a technique for modulating pain. Occupational
Therapy Practice, 1(3), 77-84.
11.Sullivan,
J.L. (2001). Hand therapy: the healing touch
with a touch of humor! Journal of Hand Therapy, 14(1),
3-9.
12.Tooper, V.
(1986). Laughter is the best medicine. Occupational
Therapy News, 40(5), 4.
13.Tooper, V.O.
(1984). The role of laughter in physical disabilities.
Physical Disabilities Special Interest Section Newsletter,
7(1), 1-2.
14.Tooper, V.O.
(1984). Humor as an adjunct to occupational therapy
interactions. Occupational Therapy in Health Care,
1(1), 49-57.
ABSTRACT:
Although humor and laughter have been a natural part of human
life in all cultures as far back as recorded history can determine,
the conscious use of humor as a therapeutic technique is comparatively
recent. This article suggests that health specialists
have been slow to adopt the ideas of some of the better known
and cultural attitudes toward humor as a "frivolous"
subject. As more information on the positive benefits
of humor and laughter is being disseminated in books and workshops,
previous myths regarding humor are being dispelled and attitudes
are changing. A brief history of the state of the art
over the past decade is included along with a few ideas from
seminars and workshops on the use of humor as a planned activity
in health and educational settings.
15.Vergeer, G.
& MacRae, A. (1993). Therapeutic use of
humor in occupational therapy. The American Journal of
Occupational Therapy, 47(8), 678-83.
ABSTRACT: Interviews
with five occupational therapists who use humor therapeutically
in their practice were conducted and analyzed with a phenomenological
method so that the lived experience of therapeutic humor use
in occupational therapy could be examined. Sixteen themes
were identified through data analysis: The Concept of Therapeutic
Use of Humor; Spontaneous Versus Deliberate Humor; Humor,
the Great Equalizer; Humor and Professionalism; Contraindications
of Humor; Humor Among Co-Workers; Humor and Play; Humor and
the Environment; Humor Providing Balance; The Intrinsic Quality
of Humor; The Transformative Power of Humor; The Effects of
Humor on the Subjects Themselves; Humor as an Evaluation and
Treatment Tool; Humor as Therapeutic Use of Self; Humor as
a Coping Mechanism; and Other Uses of Humor With Patients.
This study revealed that the use of therapeutic humor in occupational
therapy is a multifaceted phenomenon, much richer than had
been previously presented in the literature.
Compiled by Mary
Binderman, MLS
Director
of Information Resources
American Occupational
Therapy Foundation
March 20, 2002
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