An innovative psychotherapeutic approach to the treatment of abuse utilizing the laughter catharsis

Though my whole family was bruised and tested, it had found solace in the healing unctions of laughter. This dark humor had preserved us from both sanctimony and despair. ~ Pat Conroy, Beach Music

In our hurried intensity which we refer to as our daily lives, professionals allow themselves to be swept up in the frenzy of managed care and the pressure for symptom relief only. Literature abounds with new, brief therapies for everything, including sexual abuse. The ability to function is being insinuated as a synonym for healing. In this increasingly robotic environment, the treatment of sexual abuse needs every humanizing element possible. The cathartic processes of crying and anger are already commonly recognized as necessary for healing. Laughter, however, which is an entirely human, equally vital part of the healing process is generally overlooked, merely tolerated, or shunned completely by clinicians. Helping clients use cathartic laughter is a needed addition to the specialized treatment offered to survivors.

Culturally and professionally there is a major misconception about laughter. It is most often connected to happiness and to frivolity and silliness, with an assumption that it has no connection to the important, serious things of life. The fact that laughter springs from pain as a natural coping and survival mechanism simply doesn’t occur to the majority of the mental health community because we generally utilize a more intellectual form of psychotherapy. The mere suggestion that laughter has an important place in the treatment of something as serious as abuse is commonly dismissed out of hand. Psychologist and literary editor. Max Eastman tells us that, “the only reason why…so many earnest investigators…have sought to explain laughter away as a by product of the other impulses is that the laugh impulse and its emotions are not serious.” (Eastman, 1937, p. 348) He is absolutely correct. Laughter isn’t serious, but it is terribly important. It is a primary cathartic release of emotions and a necessary part of any healing process. The treatment of abuse which is so intense and painful for the client, desperately needs the balance and relief that laughter provides. If we as clinicians understand this and gain the appropriate training and information, we can facilitate the laughter catharsis for our abuse clients.

As the circle of time again revolves, we are coming to know once more what those before us have known. We are re-learning the importance of laughter in the lives of human beings. Please do not mistake humor for laughter. Although laughter is related to humor, it is not the same thing and they should not be automatically interchanged. Laughter is a physiological process which heals the body and the emotions and it may or may not be triggered by humor. As we slowly grasp laughter’s newfound importance, we are quickest to embrace the more measurable results of its physical healing. Nevertheless, laughter’s release of emotional pain is just as powerful and also inseparable from our total well-being.

Human beings are able to laugh soon after birth in order to deal with emotional and physical pain. Babies do not do humor. They are laughers. Physically, laughter provides us with relaxation, easing tired minds and bodies, and providing renewed energy. It stimulates our immune system which helps ward off disease. It also massages our internal organs, works out our respiratory system, and lowers blood pressure. It can ease biological pain and is the most effective ongoing means of reducing stress. Laughter is essential to good physical health.

For the purposes of abuse treatment, however, the primary focus is the powerful role laughter plays in the healing of deeply repressed emotion. Laughter is one of the processes which powers out emotional pain. It is specific to the primary painful emotions of fear, anger, and boredom. When people laugh, if uncomplicated by medications which may interfere with the physical catharsis, they are releasing painful feeling which is gone for all time. The exact amount of pain is immeasurable but the body will keep discharging pain cathartically until there is no longer a need. The only thwarting influences are the controls artfully imposed in childhood. Human beings are taught the value of control from an early age. The loss of control cathartically through laughter, crying, or anger makes us uncomfortable to say the least. What we don’t realize is that when we lose control of our feelings cathartically, we actually gain “control of our lives in flexible, intelligent, creative, and caring ways.” (Goodheart, 1994, p. 36)

Our cultural preference for processing feelings cognitively instead of feeling them in our bodies tends to contribute to the terrible numbing pain of survivors. They have little or no idea as to how to release the emotions so shrouded in secrecy and buried in the most intimate recesses of their bodies. Nevertheless, some part of them instinctively knows that pain is driving them unconsciously. Sooner of later, the innate drive toward health carries them toward the help they need. Often from families where feelings are not allowed, survivors may have squelched their ability to laugh, cry, and get angry. As clinicians, we can offer assistance in regaining these cathartic processes. This will enable our clients to release emotions deeply held and wrapped around early traumatic incidents.

Only now has research begun to validate the belief that emotions are stored in the body, not the mind. Cathartic techniques allow clinicians to help clients access their stored emotions and release them. The more catharsis the client experiences, the faster she moves through the healing process. Laughter, which is the most powerful cathartic process and the least threatening in many respects, leads the way in easing controls on emotion and often opens the door to crying and deep anger.

What causes the mental health community to be so slow in accepting laughter as a healing tool? It’s not comfortable. “Like any expression of the true self, laughter is radical and revolutionary, and it upsets conformity.” (Steinem, 1992, p. 175) In order to offer clients the power of laughter, clinicians must be willing to break loose from traditional therapeutic constraints, regain their own laughter, and learn the techniques to facilitate laughter in their clients.

The repression of emotion which protects abused children from death (Miller,1991, p. 82) is no longer necessary in adulthood. The adult can allow herself to feel the pain, thereby healing deeply buried trauma. Adults have many available options for dealing with pain while children do not. According to Alice Miller, “in the absence of love, respect, and protection an abused child has no choice but to suppress every kind of natural reflex such as anger or even laughter. It also had to practice constant obedience. Only thus could it hope to keep the threat posed by its father within bearable limits.” (Miller,1991, p. 90) The adult can reaccess the natural processes which release the pain the child found unbearable. Unfortunately, laughter, often suppressed during childhood, is viewed with suspicion in adulthood as silly, inappropriate, and trivializing. Unless these ideas are challenged by clinicians, many survivors will turn away from the healing power of their laughter, fearful that others will see them as minimizing a very important problem as well as potentially devaluing their own importance. Only the irrepressible few will laugh, hurling conventional behavior to the winds.

Traditionally, mental health practitioners have viewed laughter as hiding painful emotion. In contrast, cathartic psychotherapy believes that laughter is releasing emotion. It is the physical process which powers out certain kinds of pain. Psychiatrist Raymond Moody believes that through laughter, people’s feelings and emotions erupt from inside them into the outside world. (Moody,1978, p. 10) Therefore, if one curtails or quenches laughter as inappropriate, the release of pain is quenched as well. In struggling to release the great hurt of childhood sexual abuse, survivors need their laughter. Sexual abuse is both deeply painful and important, but it doesn’t have to be locked down in seriousness which is synonymous with control.

Growing up in the web of dysfunction created by abuse, survivors commonly deny their emotions. As they resist feeling, they become increasingly rigid and less able to change their patterns of behavior. They become more re-active than active and tend to repeat behaviors that are increasingly unsuccessful. If, however, they are able to release their feelings cathartically, they will automatically rethink situations. The clearer thinking made possible by catharsis enables them to take sensible, more appropriate action. (Goodheart,1994, p.97) They are no longer locked in a self destructive cycle which prevents the experience of a quality life.

The laughter catharsis does not change the facts, but it does change the way one relates to the facts. It allows a person to see things from a bird’s-eye view where horrendous misfortune seems much more bearable. This allows survivors to remember, to feel, and to explore without fearing that they will once more be trapped by circumstances beyond their control. Life’s most tragic and bizarre occurrences contain things which may strike one as personally absurd if one is able to look for them and the absurd is often a trigger point for laughter. Underneath the layers of unresolved pain, there is the child who possesses a strong biological drive toward joy and with the capacity for it , even with the capacity to generate it for itself. (Montagu, 1989, p.153) All that prevents the survivor from being joyful once again is the release of the pain layered on top. Laughter provides that release in a pleasurable way. Partnered with crying and rage release, laughter peels away the pain, allowing one to feel the joy beneath.

Emotionally, laughter takes care of several painful feelings. It releases fear which is a major emotion for many survivors. They find they are always afraid. For one thing, they are anxious about the possibility of losing their families. They worry about whether or not they are making the abuse up. Their memories terrify them. In fact, much of life in general is intimidating. Fear, however, which motivates people to protect themselves from danger, is only a liability if not heeded and released.

Survivors, struggling to function under a heavy psychological burden of fear, often shut down. Paralyzed with emotion, they isolate themselves and are often unable to relate to other people with any degree of warmth or empathy. It is their fear which prevents their empathy for other people even when they don’t realize they’re scared and perhaps think they’re angry instead. (Napier, 1990, p. 35) Turned inward, they are only able to instinctively focus on “fight or flight,” and it is the fight part of fear that is often mislabeled anger.

When paired with trembling which releases deep fear, laughter takes care of anxiety which untended, often becomes disabling panic attacks or all consuming phobias. The frame of mind created by laughter is one of safety and clear thinking. It allows one to reframe a specific threat or stress, so that it becomes less overwhelming. As people laugh at things which threaten their safety and well-being, they release their anxiety and their discomfort decreases. For example, one particular client was constantly anxious and fretful about going crazy. When she was able to play with the fear and describe her fearful picture of being crazy with delightful irony, she laughed. Because she was able to laugh, she could cope. In coping, she was not likely to become psychotic.

Laughter also releases the fear which prevents survivors form taking risks, facing things directly, or embracing life. When fear is released by laughter, they relate more fully, think more clearly, and bond more with others. Laughter fights isolation. As survivors “lighten up,” they resist and ease their shame and find themselves much better able to balance the nagging depression. The fear of “knowing” shrinks as survivors shift to the power in lightness. They are no longer victims.

In addition to fear, laughter releases light anger. It also works to release deeper anger indirectly. It does so by allowing one to shed the lighter aspects of fear and anger which can then open access to deep rage. Laughter is often a more acceptable way to approach one’s angry feelings. So much anger has been repressed by fear, that laughter actually serves the dual purpose of first releasing the fear of anger and then the anger itself.

Anger, which is the emotional response to the invasion of one’s boundaries, is not allowed for the sexually abused child. Boundaries are ignored and discouraged both by the abuse itself and by the environment in which it flourishes. Instinctive angry responses are brutally snuffed out by powerful adults or squelched at great cost by the terrified child. That anger destroys is a strong, unyielding message pounded home over and over. To access their anger, survivors must breach the iron defenses of their own survival. Laughter allows this. With encouragement by a therapist, a survivor might be able to say “I feel angry” with a smile, the incongruity of which allows her to laugh. For many abuse survivors, laughter is a much more gentle way to address anger. It is less threatening than a direct expression of anger. They can laugh their way into their rage, the release of which is so necessary for healing.

Finally, laughter releases boredom, the emotion related to changing the amount of stimulus in our environment. Boredom ranges from the simple type which is acutely distressing until the cause is removed, to hyperboredom which is comparable to an agonizing, chronically painful disease which in some cases ends in death. (Healy, 1984, p. 28) When we have too much or too little of something (and what survivor doesn’t), we get bored, and we to take action. Failing that, we need to laugh. Survivors who have been struggling with the healing process for a while, may certainly experience boredom with their abuse and feel trapped by it at the same time.

Boredom does not stop the internal drive to heal, nor does it indicate the release of the sadness and anger which so dominate survivors lives. It is a numbing, demoralizing emotion, undermining one’s sense of purpose. Psychologist Harvey Mindess offers this on boredom. Although we often fail to recognize the extent to which our unique self has been stifled, “we sense it dumbly, dimly in the deadening monotony of our days. The predictable routine brings sterility, lassitude, a restless mood of unfulfillment. We feel only half alive.” (Mindess, 1971, p.39) Obviously, boredom is pain and its release through laughter is important to the healing process.

Clinicians may facilitate their clients’ laughter by helping them play with their pain. According to Max Eastman, “…We come into the world endowed with an instinctive tendency to laugh and have this feeling in response to pains presented playfully. (Eastman, 1937, p. 45) Psychologist Annette Goodheart presents this concept as a formula—Pain + Play = Laughter. (Goodheart, 1994) Although laughter is often triggered by things that are funny, it is not about “funny.” Laughter is about pain and therefore highly appropriate for all the things in life which are not in the least amusing, including sexual abuse. When a sexual abuse survivor can play with her pain, the result is laughter. It is essential that clinicians understand that they are not to play with the client’s pain for them nor give free rein to their own sense of humor. Doing so can result in a feeling of ridicule by the client and do her harm. The therapist’s role is to help the client find ways to play with her pain that work for her and to assist her in keeping the process moving.

There are many ways to play with the pain of abuse. Some people do so instinctively and come for therapy already laughing and crying. Others need a little help in finding ways to play with their abuse. For example, a ridiculous song title worked for one woman to playfully describe a body memory. This inspired another to write a playful hymn about her abuse. Both were highly effective because the laughter they created allowed the clients to feel the associated pain and move on.

Abuse, with its life damaging repercussions, is certainly anything but trivial, but it doesn’t have to be viewed as serious or as a sacred cow. People who are able to see the things they care about the most with an outrageous sense of freedom, can play with their pain. There are no rules. Everyone’s pain is her own. If she chooses to play with it, it’s not only okay, it’s healthy. A client who can laugh about pain is able to feel it and heal more quickly. Saying the unthinkable allows it to become thinkable. If the client laughs as she says it, it becomes manageable. As she begins to cope, she moves forward and in moving forward, life becomes worth living.

For those reluctant to let go of their “serious” view of abuse, it may be helpful to explore seriousness just a little. As adults, we are fairly obsessed with the idea that life must have meaning. As we superimpose meaning onto life, “we intellectualize it and distance ourselves from it….Distanced from life, we become isolated, alienated, and serious.” (Goodheart, 1994, p.25) Being serious about important things tends to lock us down in the pain. In order to stay serious, we have to maintain control. In maintaining control, we turn away from catharsis and the necessary release of emotion.

Upon entering adulthood and learning to distinguish importance from unimportance, we need to maintain our ability to take things playfully. Once we have learned to care about things, it is important to balance that concern in a way that eases the intensity. It isn’t terribly difficult to reverse our seriousness, once we understand the importance of doing so. It only requires reversing our early brainwashing and tapping into play which is “a socio-physiological state or posture of instinctive life. It is not only something that we do but something we are while we do it.” (Eastman, 1937, p. 16)

The nature of sexual abuse is such that it can be all consuming and can keep survivors pinned down, unable to put their abuse experiences in perspective. If instead they are somehow able to deal with at least some aspects of the abuse playfully, they will trigger their laughter and in that instant rise above it. Seriousness, which doesn’t laugh, cry, or release anger, is a very real problem. Staying locked in seriousness about one’s abuse can often prevent movement. The horror seems to be all there is. If a survivor can laugh, solutions present themselves. For example, one client who could not imagine being less than serious about her abuse, found herself able to write a silly poem about it and laugh. This opened the door to greater balance and new ways of coping.

Inviting and facilitating laughter in therapy is not the same as developing and using humor to make the client laugh. Although not always true, making others laugh can be an issue of control and often dangerous because it can translate into ridicule without that being the intent. Humor is not necessary to have laughter. Adults can laugh without it as do infants. The greater our inhibitions and restraint, the more we need release of some kind. Our spirits will so desperately crave relaxation, that even the weakest stimuli will trigger the laughter response. (Mindess, 1971, p.245) In other words, we laugh when we hurt if our controls are off. Humor, though not a requirement, can be a cause for laughter, but survivors must feel free to use it in their own way with their own abuse. It is a good rule of thumb to beware of using humor with someone else’s pain because the result can be hurtful to them. Help them do it themselves instead.

Laughter in therapy enables survivors to move closer to the core of their patterns of survival. Since these patterns developed in order to help the child survive, any attempt to alter them raises the client’s anxiety. The “child within,” whose feelings are protected by the pattern, fears that she will die if it is altered in any way. Laughter provides a means of changing things that feels safer while it releases the anger and fear associated both with change and with the abuse. When clients laugh, their total selves move with energy. They will not be stymied by their pain. Their thoughts, made more spontaneous by laughter, create greater flexibility. As they laugh more and more readily, they regain self confidence. (Goodheart, 1994, p.120) They fear change less. Eased by their laughter, clients are more willing to find out who they really are.

As therapist and client approach the client’s pain playfully together, they are actually engaged in what may seem like a kind of joint, playful regression. Depending on the level of a person’s withdrawal or emotional lock down, it is helpful to begin at her level and retrieve her through laughter. It’s somewhat similar to saying to the client, “If you cannot or will not come out of your numbed shell, then I will go into it with you and lead you back out.” (Moody, 1978, p. 111) In enabling clients to laugh at any aspect of their abuse, for that moment clinicians enable them to stand above it, acknowledge it, but treat it lightly in the awareness that they are touched but not contained by it. (Mindess,1971, p. 123) Clients are empowered by gaining perspective and find it easier to step out of the sense of victimization so long a part of their lives. Surprisingly, they find that their greatest place of power is in lightness.

There are many ways to help survivors play with their pain. First and foremost, however, it is important to have a firm understanding of cathartic theory as the springboard for leading clients into laughter. Doing so without knowledge can result in harm however well intentioned therapists may be. People have different degrees of willingness and different capacities for creating playful approaches to their memories and their feelings. It is important that the therapist follow their lead, approaching catharsis with the deep respect it deserves. With that in place, the following suggestions may provide a place to start. All a client needs is a desire to laugh and the internal permission to do so.

Suggestions for assisting clients into laughter regarding their abuse

Explore the client’s most outrageous angry fantasies with her. Encourage her to share them with others sympathetic to her anger. Encourage “no holds barred” creativity.
Suggest writing a light poem or piece of prose about the abuse, the more outrageous the better. The playfulness involved creates laughter and shifts one’s perspective, enabling movement.
Encourage your client to practice laughing. Have her put feeling into it. The idea is to fake laughter until she experiences the real thing and can laugh at will.
Have your client play with the opposite of reality, i.e., Someone with a great deal of abuse in their past might say, “I was a tiny bit abused as a child.”
Only with the client’s permission and understanding, one may role play abuse issues with major exaggerations. It is important to state clearly what you will do and explain why you will exaggerate a particular aspect of an issue. The more obviously overdone it is, the less threatening it is and the greater the laughter. This can allow the client to move into an issue instead of away from it. Use this technique with great care and respect for your client and her place in the treatment process.
Appreciate your client’s need to use gallows humor about her abuse. Suggest she share it with others who can appreciate it with her.
Help your client work with the opposite of what’s expected, i.e. Look at the “good things” about going crazy.
Help your client settle on a light phrase about her abuse which she can use for perspective and laughter when she needs it most, i.e., “I am a little bit sad about my abuse,” said with a shrug and a smile.
Look together for what the client may see as the absurdity in the abuse. It’s always there in some way and can trigger laughter while providing a different perspective.
When a client is swamped by self pity, suggest exaggerated moaning and whining, explaining that it lifts one out of victim thinking.

With increasing comfort with the laughter catharsis, therapist and client can enjoy wonderfully creative, healing therapy sessions together. Client and therapist both reap the benefits of their own laughter. For the therapist, this contributes incidentally to the prevention of burnout. Nonetheless, it is important to remember to laugh with the client, not sooner than she or more than she or you may hurt her inadvertently. Because of her preconceptions about laughter, she may feel laughed at, instead of laughed with.

Introducing laughter into the dark and painful world of sexual abuse is like introducing the sun in a rainstorm. It injects into the darkness, not only the power of its ability to heal, but also the light of hope for the future. Sexual abuse survivors need their laughter. Their pain demands it. Of all the tools they might use and all the options available to them, laughter is extremely healing and an affirmation of life itself.

References:

Bass, E. and Davis, L. (1994). The Courage to Heal. New York: Harper Perennial.
Blume, E. S. (1992). Secret Survivors. New York: Ballantine Books.
Briere, J. (1992). Child Abuse Trauma. Newbury Park: Sage Publications.
Briere, J. (1989). Therapy for Adults Molested as Children. New York: Springer Publishing Co.
Eastman, M. (1937). Enjoyment of Laughter. New York: Simon and Schuster.
Goodheart, A. (1994). Laughter Therapy. Santa Barbara: Less Stress Press.
Healy, S. D. (1984). Boredom, Self, and Culture. Cranbury, N. J.:Associated University Presses.
Herman, J. L. (1992). Trauma and Recovery. New York: Basic Books.
Montagu, A. (1989). Growing Young. New York: Bergin and Garvey Publishers.
Miller, A. (1991). Breaking Down The Wall of Silence. New York: Penguin Books.
Mindess, H. (1971). Laughter and Liberation. Los Angeles: Nash Publishing.
Moody, R. (1978). Laugh After Laugh. Jacksonville: Headwaters Press.
Napier, N. (1990). Recreating Yourself. New York: W.W. Norton and Co.
Steinem, G. (1992). Revolution From Within: A Book of Self Esteem. Boston: Little, Brown and Company.

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