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Anxiety: Behavioral and Cognitive Strategies for Treating Anxiety - 10 CEUs

Section 13
Integrating Humor in Cognitive-Behavioral Therapy

CEU Question 13 | CE Test | Table of Contents | Anxiety
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

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On the last track we discussed mirror anxiety.  This track focused on body image, discovering the good, and the technique of thought capturing. 

On this track we will discuss managing anxiety with humor.  We’ll examine how humor helps, using humor to cope with anxiety, the ‘Playing with Language’ technique, and increasing a client’s capacity for humor.  As you listen to this track, you might consider your client’s sense of humor.  Could he or she benefit from any of these CBT techniques?

As you know, in controlled studies, humor has been shown to increase pain tolerance, reduce muscle tension and stress hormones, and even boost immune system function.  Clients who learn to use humor frequently as a way of coping with anxiety typically decrease their anxiety significantly.  During a good hearty laugh your brain releases endorphins, the brain’s natural opiates, which reduce pain.

Would you agree that the power of recreation, laughter, and humor lies in their capacity to pull clients out of the anxiety caused by constant stress, and to replace those negative moods with positive, optimistic moods that lower stress hormones? 

How Humor Helps
First, let’s discuss how humor helps.  Laughter reduces muscle and psychological tension, which are the main goals of many anxiety management techniques.  Positive emotions from laughter and humor help reduce the level of stress hormones, blood pressure, and pain.  Positive emotions also nurture hope and determination to overcome stressors.  

Anything your client can do to sustain a more positive, upbeat frame of mind in dealing with the daily hassles and problems in life can help contribute to physical health and the ability to deal with anxiety.

Daily recreation and laughter can also provide a sense of control over anxiety triggers by giving clients more control over moods. As you know, positive emotional states give clients the resilience to cope with additional problems. Finally, recreation, humor, and laughter provide a means of letting go of depression, anger, and anxiety associated with chronic stress.

Using Humor to Cope with Anxiety
Next, let’s examine how your anxiety client might use humor to cope with anxiety.  As you know, a perceived lack of control, or sense of helplessness, is probably the most important single cause of anxiety.  

Finding something to laugh at in the midst of problems helps clients, like Theresa, feel more in control, because they really are taking a kind of control over the situation.  Theresa clearly took control over her emotional state.  Theresa stated, "When you find something to laugh at despite stressful and difficult circumstances, you show yourself and others that you are superior to anxiety and can choose your own reaction."

Theresa’s sense of humor grew stronger when used in managing the routine stress in her life, and then she had access to it when she was faced with greater challenges and stress.

Cognitive Behavior Therapy Technique:  Playing with Language
In addition to how humor helps and using humor to cope with anxiety, let’s discuss ways clients can begin to increase their capacity for humor.  One way Theresa managed to increase her capacity for humor was by using the ‘Playing with Language’ CBT Technique. 

I stated to Theresa, "When we can come up with our own funny one-liners on the spot, we are really starting to use our funny bone to cope with anxiety.  The puns we groan at are funnier when we are having a bad day.  Practice looking for extra meanings in words.  Coming up with a comment that connects with the "wrong" meaning can be a good beginning to witty "pun-up-man-ship."  The more you practice doing this, the better you will get at coming up with puns and other spontaneous verbal humor.  Look for alternate meanings in newspaper headlines, church bulletins, signs, and anywhere else you see printed language."  

At a later session, Theresa mentioned a sign in front of a church which proclaimed: "Don’t let today’s pace and stress kill you.  Let the church help." As Theresa’s capacity for humor increased, she began to find humor everywhere, especially on her job, which she associated with stress.  Think of your Theresa.  Could the more your client shares humor, the more "seeing funny" could become a part of his or her daily perspective on life?

Increasing a Client’s Capacity for Humor
Finally, you might consider suggesting to your client that he or she develop good humor skills on the days when things are going well, so they will be there to serve during times of anxiety.  

I stated to Theresa, "You exercise your physical body to prepare for stressful physical exertion.  You do not wait until the day you are actually running a marathon to get into shape."  

If your client, like Theresa, is still struggle using humor during anxiety, then perhaps a treatment goal could be to keep trying.  Theresa started with predictable, everyday stressors to ease into the habit of seeing the light side regardless of what’s happening.

Theresa found funny sayings, poems, or witty remarks to repeat to herself whenever she felt nervous or stressed. Perhaps your client can try using humorous exaggeration to help put things into perspective.  The following guidelines as I gave them to Theresa may help your clients build these skills as well. 

1. I stated, "Make a list of normal, repetitive stressful situations and practice image rehearsal to lighten up the situations. 
2. Think about what it means in stressful situations to see the glass half full instead of half empty. 
3. Look for humor in past stressful events. It may be easier to see the bright side after the stress has passed. 
4. Look for cartoons that are meaningfully connected to stress in areas of your life.  
5. Get a joke- or cartoon-a-day calendar to help you stay on the other side of stress." 
What can your client do to increase his or her capacity for humor?

On this track we discussed managing anxiety with humor.  We examined how humor helps, using humor to cope with anxiety, the ‘Playing with Language’ technique, and increasing a client’s capacity for humor. 

On the next track we will discuss treatment goals for recovery.  Two categories of treatment goals for recovery are behavioral treatment goals and cognitive treatment goals.
- Thorson, J. A., Powell, F.C., Sarmany-Schuller, I., & Hampes, W. P. (1997). Psychological health and sense of humor. Journal of Clinical Psychology, 53(6), 605-619.
- Berk, R. A. (2000). Does Humor in Course Tests Reduce Anxiety and Improve Performance? College Teaching, 48(4), 151-58.

Attitude Toward Humor in Patients Experiencing Depressive Symptoms

- Bokarius, A., Ha, K., Poland, R., Bokarius, V,, Rapaport, M. H. & Ishak, W, W. (2011). Attitude Toward Humor in Patients Experiencing Depressive Symptoms. Innovations in Clinical Neuroscience, 8(9), 20-23.

- Gelkopf, M. (2011). The Use of Humor in Serious Mental Illness: A Review. Evidence-Based Complementary and Alternative Medicine, 2011, 1-8. doi:10.1093/ecam/nep106

Peer-Reviewed Journal Article References:
Consoli, A. J., Blears, K., Bunge, E. L., Mandil, J., Sharma, H., & Whaling, K. M. (2018). Integrating culture, pedagogy, and humor in CBT with anxious and depressed youth. Practice Innovations, 3(2), 138–151.

Mayrhofer, M., & Matthes, J. (2020). Laughing about a health risk? Alcohol in comedy series and its connection to humor. Psychology of Popular Media. Advance online publication.

Young, D. G., Bagozzi, B. E., Goldring, A., Poulsen, S., & Drouin, E. (2019). Psychology, political ideology, and humor appreciation: Why is satire so liberal? Psychology of Popular Media Culture, 8(2), 134–147. 

Online Continuing Education QUESTION 13
What are three ways of managing anxiety with humor? To select and enter your answer go to CE Test.

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