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Integrative Psychiatry

Grin and Share It: Humor and Mental Health

Humor is an enjoyable feature of social interaction, creating shared pleasure that enhances personal wellbeing and interpersonal relationships. Evolutionarily, it is thought that humor supports social bonding and community survival. It may also be used as a psychological coping mechanism, or to help release emotional tension. In psychiatry, humor is a therapeutic tool that can be used to reinforce self-esteem, social reward, and symptoms of anxiety or depression. As we transition from Mental Health Awareness Month in May to Men’s Mental Health Month in June, I break down the neuroscience, psychology, and physiology of laughter in holistic wellness.

What Makes Something Funny?

A sense of humor, broken into humor production and humor appreciation, involves complex neurological functions, engaging both cognitive and emotional systems in the brain. The communication of a joke requires activation of language processing centers and working memory; meanwhile, laughing turns on reward centers of the brain that produce the sensations of amusement and pleasure. In tandem with these activities is the release of neurotransmitters like dopamine, serotonin, and endorphins, stimulating joy and relaxation.

The psychology of humor is still somewhat of a mystery. The “incongruity-resolution theory” suggests that the comedy contains two elements: unexpectedness (although this surprise should be non threatening) and re-interpretation of the information leading up to the punchline. So, the joke is generally funny when the punchline causes a person to re-conceptualize how they were thinking about the setup. However, people can find different comic styles and types of humor to be funny, for example the differences between dark humor versus dry humor. In research, the eight comic styles are labeled as benevolent, fun, nonsense, sarcasm, cynicism, wit, irony, and satire. And of course there are cultural regulations of humor, influencing how humor is integrated or experienced by both cultural and subcultural groups.

Holistic Benefits of Humor

The benefits of humor encompass psychological, social, and physical dimensions of health. Psychologically, laughter boosts mood. Likewise, there is evidence that humor acts as an effective coping strategy and regulator of negative emotions. Engaging with humor impacts cognition, too, encouraging cognitive flexibility, creativity, and problem-solving skills; using humor can help shape the way the psyche perceives and re-evaluates negative events. It can also shift psychological perspective toward a more positive orientation, alleviating psychological stress. 

Socially, humor enables constructive interactions with others by breaking down defenses and facilitating more open communication. The release of oxytocin upon laughing may help instill trust and compassion. Humor, when used appropriately, can defuse tension and resolve conflicts, promoting a more harmonious environment. In general, the social practice of comedy can increase feelings of connectedness, the number one protective factor for stress. 

Physiologically, laughter reduces the levels of stress hormones. Laughing has also been compared to exercise based on its benefits to the cardiovascular system. Laughing even supports immune function by regulating inflammation. The release of endorphins, the body’s “feel good chemicals,” may even help increase tolerance to pain.

Incorporating Humor into Psychiatry

Research shows that humor may greatly improve the quality of the therapeutic relationship. Integrating humor into therapeutic practice requires sensitivity and an understanding of the client’s personality, culture, and humor appreciation. Clinicians and clients alike will benefit from humor training. You can increase laughter for yourself and others by understanding your humor style; learning to laugh at yourself; playing with language, wit, and puns; and looking for humor during times of stress.

1. Humor in Storytelling

Integrating humor into storytelling can be an effective therapeutic tool. Sharing humorous stories related to therapeutic themes and reflecting on humorous observations or elements perceived in the client’s stories can help clients see situations from a perspective outside of themselves, reducing the intensity of negative emotions. 

2. Humor Exercises

Encouraging clients to explore and engage with humor in their daily lives has lasting benefits. Activities such as creating a “humor journal” (much like a “gratitude journal”) where clients note down funny events or thoughts each day is an effective intervention for fostering awareness of these joyous moments. Inspiring laughter through watching and discussing humorous content is one way to fill up the journal. 

3. Mindfulness

Intentional, non-harming use of humor may be thought of as a mindfulness practice by harnessing non judgment toward self and others. Harsh perspectives might be lessened or felt less negatively through laughter. In general, humor can help clients stay present and view their thoughts and situations with a lighter perspective. Combining mindfulness with benevolent humor might instill insight and compassion toward imperfections.

Conclusion

Humor is a powerful therapeutic element that may significantly enhance treatment outcomes. Mental health counselors can leverage humor to cultivate a strong therapeutic alliance, foster resilience, reduce stress, and empower clients to generate joy throughout the week. Embracing humor can transform psychiatry into a more dynamic, effective, and fulfilling journey for both clinician and client.

Sara Reed, MS, LMFT

Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness. Sara’s prior research work includes participation as a study therapist in psychedelic therapy research at Yale University and the University of Connecticut’s Health Center. Sara was the first Black therapist to provide MDMA-assisted psychotherapy in a clinical trial and continues to engage in ongoing advocacy work around health equity in psychedelic medicine.

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Jeffrey Guss, MD is a psychiatrist, psychoanalyst, and researcher with specializations in psychoanalytic therapy and the treatment of substance use disorders. He was Co-Principal Investigator and Director of Psychedelic Therapy Training for the NYU School of Medicine’s study on psychedelic-assisted psychotherapy in the treatment of cancer-related existential distress, which was published in Journal of Psychopharmacology, 2016. He currently is a study therapist in the NYU study on Psychedelic-Assisted therapy in the treatment of Alcoholism, a collaborator with Yale University’s study on psychedelic-assisted therapy for Major Depressive Disorder and a study therapist with the MAPS (Multidisciplinary Association for Psychedelic Studies) study on treatment of Post Traumatic Stress Disorder with Psychedelic-Assisted Psychotherapy. 

Dr. Guss is interested in the integration of psychedelic therapies with contemporary psychoanalytic theory and has published in Studies in Gender and Sexuality and Psychoanalysis, Culture and Society. He has published (with Elizabeth Nielson, PhD) a paper on “the influence of therapists’ first had experience with psychedelics on psychedelic-assisted psychotherapy research and therapist training” in The Journal of Psychedelic Studies, August, 2018. He is an Instructor and Mentor with the California Institute of Integral Studies’ Center for Psychedelic Therapies and Supervisor in NYU’s Fellowship in Addiction Psychiatry. 

Dr. Guss maintains a private practice in New York City.

Will Van Derveer, MD

Will Van Derveer, MD is Co-Founder of Integrative Psychiatry Institute and Integrative Psychiatry Centers. Dr. Van Derveer was co-investigator on a phase 2 MAPS study of Psychedelic-assisted psychotherapy for treatment-resistant PTSD, and co-authored the publication of this study in 2018. He has also provided Psychedelic-assisted psychotherapy in two MAPS training studies. An active provider of KAP at his clinic in Boulder, CO, he has been teaching others KAP therapy for several years. Dr. Van Derveer contributed a chapter on mescaline in the 2021 "Handbook of Medical Hallucinogens" (edited by Charles Grob and Jim Grigsby). He is co-host of the Higher Practice Podcast.

Dr. Van Derveer regards unresolved emotional trauma as the most significant under-recognized root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass.


Scott has been a student of consciousness since his honors thesis on that topic at the University of Arizona in the 1970s under the tutelage of Dr. Andrew Weil. Following medical school, Scott studied Jungian therapy and acupuncture while working as a primary care physician in a rural area for four years. Psychedelic-assisted psychotherapy became a facet of his practice before this medicine was scheduled in 1985. He then completed a psychiatry residency at Columbia program in New York. Scott studied cross-cultural psychiatry and completed a child/adolescent psychiatry fellowship at the University of New Mexico.

In 2010 he founded Wholeness Center in Fort Collins. This innovative clinic provides cross-disciplinary evaluation and care for all mental health concerns. Scott serves as a site Principal Investigator and therapist for the Phase III trial of psychedelic-assisted psychotherapy for PTSD sponsored by (MAPS). He has also published numerous articles about his research on (CBD) in mental health. Currently, Scott works extensively with psychedelic-assisted-psychotherapy. He lectures all over the world to professional groups interested in a deeper look at mental health issues, safer tools, and a paradigm-shifting perspective about transformative care.

Will Van Derveer, MD is co-founder of Integrative Psychiatry Institute (IPI), along with friend and colleague Keith Kurlander, MA. He co-created IPI as an expression of what he stands for. First, that anyone can heal, and second that we medical providers must embrace our own healing journeys in order to fully command our potency as healers.

Dr. Van Derveer spent the last 20 years innovating and testing a comprehensive approach to addressing psychiatric challenges which transcends the conventional model he learned in medical school at Vanderbilt University and residency at University of Colorado, while deeply engaging his own healing path.

He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices. Dr. Van Derveer regards unresolved emotional trauma as the most significant root cause of psychiatric symptoms in integrative psychiatry practice, along with gut issues, hormone imbalances, inflammation, mitochondrial dysfunction, and other functional medicine challenges. He is trained in Somatic Experiencing, EMDR, Internal Family Systems, and other psychotherapy techniques. His current clinical passion is psychedelic-assisted psychotherapy, which he mentors interested doctors in providing. An avid meditator, he has been a meditation instructor since 2004.

For the past several years Dr. Van Derveer has taught psychiatrists and other psychiatric providers integrative psychiatry in a number of settings, including course directing the CU psychiatry residents’ course as well as with Scott Shannon and Janet Settle at the Psychiatry MasterClass. In addition to his clinical work and teaching, he was co-investigator in 2016 a Phase II randomized clinical trial, sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). He continues to support this protocol, now in a Phase III clinical trial under break-through designation by FDA.

Dr. Van Derveer is a diplomate of the American Board of Integrative and Holistic Medicine (ABoIHM) since 2013, and he was board certified in the first wave of diplomates of the new American Board of Integrative Medicine (ABIM) in 2016.