Alessandra Suuberg considers the role of humor in treating or coping with mental distress

Is it ever okay to laugh with your callers on a suicide prevention line?

I have asked myself this question a few times while working on crisis lines for the better part of five years. In this role I am part of the largely anonymous community of professionals and volunteers—students, retirees, social workers, lawyers, entrepreneurs—trained to answer phone calls or text messages from people in distress. My job is to reduce callers’ or texters’ distress through supportive listening. In practice this can include everything from chatting about a bad day at 3 in the morning, to listening quietly while the caller works through childhood trauma, to being the remote presence that sticks around until help arrives to rescue them from danger.

In my years on the lines, I have worked at different locations and followed unwritten policies with respect to humor. We generally seemed to avoid laughter during calls at my first location, but the phone room at a more recent location, maybe due to our larger numbers or that we skewed towards a student crowd, has often struck me with its less somber atmosphere. During calls, I might estimate that at least one conversation per shift has included a few good laughs initiated by the caller—and a chance to consider the role of humor in treating or coping with mental distress.

On the one hand, I can understand the arguments for avoiding humor in a crisis: tactlessly or ineptly used, it can be offensive, minimize pain, or leave the impression of laughing at someone, not with them. Particularly because crisis line staff can often be students or volunteers with very little mental health training or experience, it may be easier to avoid this territory altogether (unless the caller clearly initiates), rather than risk making a poor judgment call and leaving the caller feeling worse than they already did.

On the other hand, there are strong arguments in favor of sharing a laugh with someone in distress. Many of the people I speak with on the lines are repeat callers who say they rely on us as a substitute family or because they have limited social contacts. They talk about their disillusionment with a mental healthcare system that makes it hard to find a counselor at all, let alone someone who seems to understand or care in the particular way that they need. Many report loneliness and isolation due to the loss of friends or relatives, advanced age, geographic location, or a physical condition—and many express a need for genuine human connection. For whatever reason, humor, and the reciprocal act of sharing a laugh with another human, seems to be one of the quicker ways to form a meaningful connection in a limited amount of time. Across hundreds of calls, I have frequently noticed that shared laughter leads to spontaneous positive feedback from callers at the end of a conversation.

These observations are consistent with humor’s oft cited function as a destressor and tension diffuser. Well timed jokes have shown remarkable power in various crisis situations, such as convincing people to open the door for assistance in a domestic dispute.[1][2]

Beyond the acute crisis context, many have turned to humor as a longer term coping strategy under stressful circumstances. The comedy enthusiasts I know have been quick to point out that some of their favorite comics use humor to cope with depression. Individual performers have also opened up publicly about using comedy as an outlet for negative emotions, like the anger and frustration related to identity and loss; as a way to help loved ones face their own grief; and as a way to regain a sense of control in situations where they would ordinarily feel powerless.[3][4][5]

Meanwhile, in today’s covid-19 context, which manages to bridge the categories of acute crisis and chronic stressor, many healthcare workers on social media have turned to accounts that offer relief through humor. Examples include @DocAroundThClok’s dialogues about a pediatrician redeployed to an adult intensive care unit, and @DGlaucomflecken’s videos documenting the struggles of an ophthalmologist learning to operate a ventilator or sitting at home in quarantine. “@DGlaucomflecken on [TikTok] is what makes life worth living right now,” commented one physician on Twitter, and he has been far from alone in sharing that sentiment. 

So while I cannot say that a well timed joke can save a life, I do think that healthcare professionals should be aware of its potential to de-escalate a crisis, or generally support wellbeing and morale for both the patient and provider. Attempts at humor will not be appropriate for every audience or circumstance, and an exercise of judgment is necessary—jokes, for example, that come off at someone else’s expense should of course be avoided. Yet that does not foreclose the tactful use of humor and laughter where they have the potential to connect, rather than offend. 

Alessandra Suuberg is a crisis line operator based in the United States, in addition to holding healthcare-adjacent positions in legal aid and supportive services for clients with disabilities. These opinions and observations are shared in her individual capacity.

Competing interests: The author is employed part time as a crisis line operator at a non-profit organization.

Recommended resources: If you are in crisis or need to talk, help is available through organizations around the world. Lines may vary in terms of training, policies, and topics that staff and volunteers are prepared to discuss. Readers in the US may refer to the Substance Abuse and Mental Health Services Administration (SAMHSA) website (https://www.samhsa.gov/find-treatment), and UK readers may refer to the NHS website (https://www.nhs.uk/conditions/suicide/), to identify local talk or text lines.

References

[1]  Morgenthaler J. Humor as a weapon: how to defuse a bad situation. January 2013. http://skinlessproject.com/2013/01/08/humor-as-a-weapon-how-to-defuse-a-bad-situation/

[2]  Costello J. Humor them. A well-timed laugh speaks volumes. Entrepreneur. January 2015. https://www.entrepreneur.com/article/242411

[3]  Blair E. ‘You get paid for doing therapy’: stand-up comedians on anger. NPR. February 2019.
https://www.npr.org/2019/02/20/689926199/you-get-paid-for-doing-therapy-stand-upcomedians-on-anger?t=1567435376800

[4]  Hatjoulis M. Crying clowns: comedy’s relationship with mental health. June 2019. https://theartifice.com/comedy-mental-health/

[5]  Janus S. The great comedians: personality and other factors. Am J Psychoanal. 1975;35(2):169-174.