Sep 28

Comedy As Therapy: Five Notable Examples

Comedy as therapy is a widely supported approach. See the selected examples below.

I. Stand Up for Mental Health

Counselor and humorist David Granirer created a program called Stand Up For Mental Health in which people with mental health issues can learn how to do stand-up comedy as therapy. In the video below called “Cracking Up,” participants introduce us to it.

You’ll need over six minutes to watch this—but it’s worth it.

If this whets your comedy appreciation appetite, clips of individual routines that have emerged from this program are available on their website.

Below Granirer himself riffs to an audience on the topic of mental health stigma:

II. Comedy Warriors

Another program, Comedy Warriors, was designed to aid soldiers who are injured physically and mentally.

Five veterans who were hurt in combat—four men and one woman—are featured in a documentary about their experiences of learning stand-up comedy from some well-known comedians, including Bob Saget and Brad Garrett.

As stated on their website, “As any comedian will tell you, the most poignant comedy comes from pain. And no one knows this better than a service member with a life-changing injury.”

Comedy Warriors: Healing Through Humor was released in 2013.

III. Taylor Glenn: Reverse Psycomedy

The show of comedic performer Taylor Glenn titled “Reverse Psycomedy”—about her former life as a therapist—has been performed at the Edinburgh Fringe Festival in Scotland.

Glenn spoke with Mark Smith about her therapist humor (click here for the article):

…’I learned to yawn through my nose, for example, which is the kind of thing they never taught you at university,’ she says. ‘They don’t tell you if you have to yawn don’t let your patients see that because they’ll be devastated so you learn to yawn and look really interested.’

Being honest about therapy in this way has been hard for Glenn because she was a conscientious psychotherapist; she took it very seriously. ‘I would never break my ethical code or anything like that but I have to be honest about what it was like on the other side of that chair. And I think it’s refreshing for an audience to see that therapists are just normal people who swear and have weird thoughts and have a sense of humour.’

Below Glenn offers bits of help and advice—“Fringe Therapy”— to fellow comedians:

IV. Dr. Lisa Levy: Faux Therapy Sessions

Dr. Lisa Levy is “a Bebe Neuwirth type with Ashleigh Banfield glasses—combined common sense, dry humor, and a winning feeling that anyone can be an analyst if they want to, as long as they never actually studied being one,” Michael Musto once said.

In one article/interview, Levy noted that she traces her interest in therapy back to high school when her father experienced severe depression and was hospitalized. Later, when she was in college, she went to therapy herself to deal with her own depression.

Below is one of her live faux sessions with comedian Eugene Mirman:

V. Tig Notaro: As Funny As Cancer

Maybe at some point you’ve heard or said something along the lines of, “That’s (you’re) as funny as cancer.” Obvious meaning: “Cancer funny? Not so much.”

But, maybe you can be funny about cancer? And maybe it’s therapeutic? Not only for others but also to the comic who actually has cancer.

The dryness of Notaro’s style and delivery is a comedic tone that works well. Here’s a brief snippet of her routine:

Sep 14

Confidentiality: Keeping Secrets (Or Not) In or Out of Therapy

Most people, whether ever in therapy or not, are aware of the code of confidentiality. As therapist Daryl states to a client in my novel Minding Therapy, “Keeping secrets about you not keeping secrets is one of the therapist’s main obligations…”

From GoodTherapy.org:

Confidentiality includes not just the contents of therapy, but often the fact that a client is in therapy. For example, it is common that therapists will not acknowledge their clients if they run into them outside of therapy in an effort to protect client confidentiality. Other ways confidentiality is protected include:

    • Not leaving revealing information on voicemail or text.
    • Not acknowledging to outside parties that a client has an appointment.
    • Not discussing the contents of therapy with a third party without the explicit permission of the client.

For licensed mental health professionals, confidentiality is protected by state laws and the Health Insurance Portability and Accountability Act (HIPAA)

One of the main reasons it’s so important not to breach confidentiality is because therapy may be the first, maybe the only, place one’s confidences are disclosed. And people need to feel their secrets are in good hands.

This is not to say that everyone divulges all their private thoughts to their shrinks. For good or for bad, often there are things kept out of sessions. What to divulge is an individual choice based on any number of factors.

Even therapists in therapy might hold back. Andrea Rosenhaft for one. She’s a clinical social worker who calls her own years of omission “living heavy” and states on her Psychology Today blog:

I regret all the deceit, the secrets, and the manipulation. The blatant lies, the lies of omission have come back to hurt me in the form of the hands of the clock making endless rounds. I alienated psychiatrists, therapists and nurses with my calculating actions designed to mislead.

If I had been forthright, as difficult as that would have been, if I had simply told the truth, my treatment would have progressed much faster and perhaps I would not still need to be in therapy.

The jaunty song “Secrets” by singer/songwriter Mary Lambert (of “Same Love” and “She Keeps Me Warm”), on the other hand, is about things she would appear not to be keeping under wraps. These include personal tidbits involving such matters as the status of her mental health, her family issues, and her personality weaknesses.

She’s saying, in fact, that she doesn’t care if the whole world knows her secrets. (Which makes them no longer secrets, of course!)

 

The first verse and chorus of “Secrets” by Mary Lambert are as follows. See the rest at Genius.com or watch the lyric video above.

I’ve got bi-polar disorder
My shit’s not in order
I’m overweight
I’m always late
I’ve got too many things to say
I rock mom jeans, cat earrings
Extrapolate my feelings
My family is dysfunctional
But we have a good time killing each other

[Pre-Chorus]
They tell us from the time we’re young
To hide the things that we don’t like about ourselves
Inside ourselves
I know I’m not the only one who spent so long attempting to be someone else
Well I’m over it

[Chorus]
I don’t care if the world knows what my secrets are (secrets are)
I don’t care if the world knows what my secrets are (secrets are)So-o-o-o-o what
So what
So what
So what

Aug 29

Journals: Writing for Therapeutic Purposes

Journals and journal writing have been proven to be therapeutic. But how should you go about it? Do it your own way? Or follow the advice of such experts as social psychologist James Pennebaker? His “rules” (per Susan David, The Cut) include the following:

  • Set a timer for 20 minutes and write freely.
  • “Write just for yourself, and not for some eventual reader.”
  • After a few days or whenever, discard it. Or decide to do something bigger with it.

“It doesn’t matter. The point is that those thoughts are now out of you and on the page. You have begun the process of ‘stepping out’ from your experience to gain perspective on it.”

One long-term keeper of journals, Jamie Friedlander, found that entering therapy automatically decreased her reliance on the form, however. “Speaking to someone about my problems, it seemed, had all but replaced my urge to write about them” (The Cut).

Writing still helps me cope with the little stuff that becomes overwhelming. And jotting down the things I’m grateful for always brings me joy. But I know that for the big stuff — being laid off, feeling frustrated with a close family member, obsessing about my weight — I need to speak, not write.

Therapist Ryan Howes (Psychology Today), on the other hand, emphasizes the benefits of journaling while in therapy:

First, you’ve just taken some time to look at yourself, which continues the flow of therapy and makes you more aware. Second, you’ve begun to organize what can seem like a bunch of disjointed material. Writing forces you to funnel disparate thoughts into one linear stream. Finally, you’re keeping a record of your progress. People who journal for a few months are amazed when they look back to see where they were. Sometimes they’re amazed at how far they’ve come. Other times they’re surprised to find they’re barking up the same tree.

A common resistance among clients is the fear of others finding their words. What I usually say in response is that you don’t actually have to get over this fear. Write stuff anyway, then destroy it; you still get the same effects. Ephrat Livni, QZ.com, agrees:

That final act, tossing the journal, is painful but liberating. Letting go is a Zen exercise. It’s practice in detachment, forcing me to face facts, the simultaneous truths that everything matters and yet, ultimately, nothing does. Shit happens. We keep going. Tomorrow there will be more news.

Another resource is Susan Borkin‘s The Healing Power of Writing: A Therapist’s Guide to Using Journaling With Clients (2014). Although targeted to therapists, anyone can benefit.

One of the author’s suggestions is a guide for keeping track of various internal changes. It’s called ATTEND, an acronym standing for Awareness, Thoughts, Emotions, Intuition, Dreams, and Distractions.

While some are afraid to write in a diary or journal,  Sarah Manguso is one who’s been afraid not to, she explains in Ongoingness: The End of a Diary (2015).

I wrote about myself so I wouldn’t become paralyzed by rumination—so I could stop thinking about what had happened and be done with it. // More than that, I wrote so I could say I was truly paying attention. Experience in itself wasn’t enough. The diary was my defense against waking up at the end of my life and realizing I’d missed it. // Imagining life without the diary, even one week without it, spurred a panic that I might as well be dead.

What Manguso reports, by the way, is that the original anxiety is now gone.

May 25

Malingering: When Psychiatric Conditions are Faked

Malingering involves the intentional production or display of false or grossly exaggerated physical or psychological symptoms, with the goal of receiving a specific benefit or reward such as money, an insurance settlement, disability status, evasion of legal consequences or release from incarceration, or avoidance of work, jury duty, the military, or other types of service. Psychologytoday.com

Some cases of malingering are relatively easy to detect, but some can be especially tricky for mental health professionals (and/or physicians) to identify. Such cases of malingering can lead to abuse of the system, with unnecessary tests and interviews being performed and time taken away from other clients and patients.

Malingering is a condition not listed in the DSM-5. However, “It is similar to, but distinct from, factitious disorder, in which an individual fakes symptoms of physical or mental illness but without a concrete motive or expectation of reward. Malingering is also distinct from somatic symptom disorder, in which someone experiences actual psychological distress due to imagined or exaggerated symptoms” (psychologytoday.com).

It may go without saying that individuals who do have ulterior motives for showing up at your therapy door don’t really want or need your help of the therapy kind; what they want is to manipulate you so that they get something else—something they presumably feel they can’t get otherwise.

A couple examples from pop culture: 1) Corporal Max Klinger (actor Jamie Farr) on the old TV show M*A*S*H (1972-83). His plan for getting out of the Army involved trying to prove that he was psychologically unfit. He couldn’t achieve his goal, though, and eventually gave up.

2) Liz Lemon, played by Tina Fey on the more recent TV sitcom 30 Rock. Her goal was to escape jury duty. See below:

A malingerer presenting at a mental health setting could also be driven by such motives as getting out of work, obtaining disability insurance, and seeking drugs.

Reportedly, research has shown, though, that a person who fakes symptoms of mental illness can actually start to believe the illness is real (Scientific American). Put into action, this means Klinger would start to really believe, for example, that he can fly (in his pink bathrobe and slippers), while Liz Lemon would settle into the delusion that she’s a Star Wars character.

On a more positive note, psychologist Elizabeth Loftus is quoted in the above-cited article as envisioning “therapeutic potential in the new study”…

…musing on a hypothetical strategy she calls ‘feigning good,’ which could motivate patients by helping them believe in improved cognitive skills and diminished symptoms of illness. ‘Should clinicians be prescribing a form of feigning? You wouldn’t want patients to feign anxiety, but maybe they could feign the opposite. Maybe they could feign crystal clear concentration.’

May 04

“Can’t Just Stop” All Kinds of Compulsions

While extreme compulsions often appear odd, irrational, pitiable and self-destructive, our emerging understanding of compulsions implies something quite different: Even the craziest-looking compulsions are adaptive, even pragmatic, and all too human. A compulsion is at once psychological balm and curse, surface madness (or at least eccentricity) and profound relief. Sharon Begley, author of Can’t Just Stop (Wall Street Journal)

Behaviors such as OCD, hoarding, exercise, shopping, video-gaming, hyper-conscientiousness, and even hyper-do-gooding—which can all be responses to anxiety—are examined in Can’t Just Stop: An Investigation of Compulsions by science journalist Sharon Begley (1956-2021).

Compulsions “are repetitive behaviors that we engage in repeatedly to alleviate the angst brought on by the possibility of harmful consequences,” states Begley. Examples of compulsions of varying levels of severity are offered (Wall Street Journal):

There’s the woman who hit the treadmill so compulsively that she could do little else—and all because, every moment that she wasn’t exercising, the thought of fat cells proliferating in her body drove her nearly mad with anxiety. There’s the actor who was so certain he suffered from a dire illness that he compulsively pressed his doctors to give him CT scans, over and over, to assuage his angst. And there are the millions of us who feel compelled to check our phones before we get out of bed in the morning and constantly throughout the day, because FOMO—the fear of missing out—fills us with so much anxiety that it feels like fire ants swarming every neuron in our brain.

Publishers Weekly notes that Begley’s research and writing “demystifies compulsive behavior, exploring its history and manifestations and the many difficulties its sufferers face in finding appropriate diagnoses and treatment.”

Selected Quotes from Can’t Just Stop

The saddest thing I came to understand in researching and reporting this book is that so many of our behaviors draw us into them not because they bring joy but because they promise to quiet anxiety. But the most heartening thing was the realization that the ability of compulsive behaviors to quiet anxieties great and small is one of the greatest gifts our brains can give us.

For compulsions, according to a growing body of scientific evidence, are a response to anxiety. Suffused and overwhelmed by anxiety, we grab hold of any behavior that offers relief by providing even an illusion of control.

We cling to compulsions as if to a lifeline, for it is only by engaging in compulsions that we can drain enough of our anxiety to function.

Selected Reviews of Can’t Just Stop

Joel Gold, MD: “At once fascinating and compassionate, funny and informative, this volume should be on the bookshelf of every psychiatrist, and on the nightstand of anyone who enjoys absorbing and incisive writing.”

Gary Greenberg, therapist and author: “Sharon Begley has done us all a service, writing about compulsion without writing about disease and offering a new perspective on a phenomenon that is common if not universal. People troubled by their own compulsive behavior will appreciate her nuanced and balanced approach and perhaps come away with a new understanding of themselves.”

Publishers Weekly: “Begley’s final chapter on brain function in the compulsive mind contains fresh insight that could fundamentally alter how we think of, and treat, mental illness going forward.”