Therapy is generally serious and for a good reason. People come to treatment because they want relief. They need professional support for their mental health, and they deserve to work with someone who can competently treat their symptoms.
With that in mind, the idea of laughing together in therapy may seem counterintuitive. But therapy laughter can have cathartic benefits, including building rapport, strengthening connection, and reframing certain life circumstances.
Understanding the Therapeutic Benefits of Laughter
People are naturally driven to seek humor and laughter. There's nothing quite like sharing a moment of genuine laughter with someone you care about. Not only does it emotionally feel good, but your body benefits from it as well.
Releases endorphins: Research shows that the body releases endorphins (which are sometimes dubbed as 'natural painkillers') during spontaneous laughter. Endorphins help promote blood flow and can increase your overall well-being.
Puts anger into perspective: Anger is a necessary emotion, but laughter is creatively associated with relieving stress, which can help reduce some emotional sharpness.
Strengthens the immune system: Research shows that laughter reduces stress hormones and strengthens immune cells, which can bolster your overall physical resilience.
Builds closeness with others: Social laughter is an expression of positive emotions, and sharing that experience together can promote a sense of emotional intimacy.
The Role of Mirroring and Connecting
The relationship sets the foundation where the change in therapy occurs. Regardless of why a client seeks treatment, they need to feel safe, and they should ideally trust their therapist.
Mirroring refers to reflecting a client's behaviors, emotions, and words back to them. When done well, mirroring reflects a high level of attunement. It demonstrates a therapist's ability to actively listen and relate to a client's specific needs. Mirroring is both verbal and nonverbal, and research shows that highly-effective clinicians engage in this skill during the majority of their sessions.
Mirroring is invaluable when it comes to building and maintaining rapport. From this approach, laughter can be a form of mirroring, particularly when moments of lightness occur. Sharing a good laugh- when the moment calls for it- can act as a form of connective support.
Laughter Interventions in Psychotherapy
Most of the time, laughter in therapy isn't achieved via specific laughter exercises or laughter-inducing exercises. It's more spontaneous and reactive to what's happening in the session. Family therapist, Carl Whitaker, emphasized the benefits of "embracing" playfulness and craziness within psychotherapy. Laughter can break up emotion and heighten introspection.
Prescribing the symptom: This intervention entails a therapist asking the client to worsen the symptom, rather than improve it. For example, if a client wants to set better boundaries with their partner, the therapist would encourage them to act even more passively during their conversations. This, in turn, often empowers the client to focus on their achievable goals toward change.
Worry time: Cognitive-behavioral therapists sometimes recommend worry time as a homework assignment. Worry time encourages clients to set specific times to focus on their worries. And while this recommendation may sound good in theory, the idea of structuring designated worry times often seems so silly that it makes a client laugh, which offers a point for self-reflection.
Externalizing: Narrative therapists may instruct clients to externalize themselves from their own problems. Externalization refers to distinguishing problems as separate entities. For example, instead of identifying as "being anxious," a client will identify their anxiety as having its own identity, voice, and needs. This makes the anxiety feel less intense, which can be empowering (and, at times, humorous) for clients.
Funny stories: Inviting the client to bring their sense of humor into therapy can be important in building rapport. Clients who show high levels of resistance or uncertainty may benefit from this strategy. Sharing stories is also effective for building safety and connection within group dynamics.
When Laughter Isn't Appropriate in Therapy
Laughing in therapy certainly has its role. But, like with most things, overdoing it (or relying on a good joke at the wrong time) can adversely affect the therapeutic process. In most cases, laughter isn't appropriate during the following situations:
Attempting to diffuse or distract emotion: It's essential that clients have unrestricted access to tap into their emotional states within therapy. Jokes may break up some of the awkwardness of therapy, but it's a therapist's job to model being comfortable with uncomfortable material.
Meeting your own satisfaction/desires: Therapists need to be mindful of their own countertransference reactions when working with clients. Some clients use their sense of humor as a way to cope with pain, and therapists may have similar patterns in their own lives. Therapists need to always consider if and how laughter benefits their clients.
Engaging in fake laughter: Authentic reactions are important in therapy, and there's such a nuanced difference between the expression of real and fake laughter. Incongruent behavior can cause ruptures within the therapeutic process, which can worsen clinical outcomes
Avoiding important topics: Humor can be a form of avoidance, and therapists need to be careful of playing into enactments or inadvertently enabling withdrawal patterns.
Final Thoughts
Therapeutic laughter often helps facilitate therapeutic breakthroughs and can deepen the connection between therapist and client. Therapists are, of course, humans, and showing this human side may offer a transformative experience within clinical work.