Patty Wooten presents ... 
Humor Therapy Group
Interview with Pamela Minden, MSN
From Journal of Nursing Jocularity, Fall 1996, 6(3), pp 46-47.
Pamela Minden is an assistant professor of nursing at Edgewood College in Madison, Wisconsin. One part of her job is supervising senior nursing students during their psychiatric rotation on a forensic psych unit at Mendota Mental Health Hospital. I heard Pamela discuss the humor group therapy program she began at Mendota during the 1995 conference for the American Association for Therapeutic Humor. I was so inspired by her success and with the concept of using a structured humor program with acute psychiatric patients, I wanted to share this with our JNJ readers.
Patty Wooten:
Pamela, tell us about the beginning ideas for this project.
Pamela Minden:
Actually, I conceived this idea in 1984 during graduate school at Boston University. I wanted to research humor for my master's thesis in psychiatric nursing. I was always more interested in why people stayed healthy than why they got sick. I believe that people with a sense of humor are often very healthy. I was working at a VA Hospital with a group of Vietnam vets and noticed their flat affect. Whether they talked about their families and children or of the atrocities they witnessed during the war, they had the same emotional tone. I also noticed that they rarely laughed and seemed to lack a sense of humor. I wanted to focus my thesis research on developing their humor. Ultimately, I worked with a group of WW II vets instead, because my clinical supervisor felt they would be more appropriate.
PW: What did you actually do to help them develop their humor and did you quantify any changes?
PM: Since most of the WW II vets had moderate to severe depression, we used the Zung Depression Scale before and after the humor training group. We attempted to coach the patients toward an observable manifestation of humor through very simple and then gradually more complex skills. We led them through exercises during the group and then gave them homework assignments. First, in group, we would all try smiling together, and they were told to practice smiling in front of a mirror, gradually working up to smiling at other people. Then we began sharing jokes and cartoons in group and they were asked to bring humor into group to share with others. Then we moved on to playful children's games like Simon Says.
PW: What kind of changes did you see with this initial research and have you published this study?
PM: Well, the most significant change was improvement in their depression scores. All but one of the eight patients improved. I published a description of this research project in the Handbook of Humor in Clinical Applications of Psychotherapy.
PW: Tell us about your current clinical project with nursing students and forensic psych patients.
PM: Most of my nursing students are white, middle class, females from rural areas in Wisconsin. Their psychiatric clinical experience is provided in a male forensic psych unit where the patients are either accused or convicted of crimes like larceny, rape or murder. Patients on this unit have a combination of affective disorders, thought disorders (schizophrenia) and personality disorders. As you might suspect, my students are highly anxious about working with this population. The humor group therapy is a process where the students and patients can connect on a more natural, relaxed and human level. It's interesting that both words humor and human have the same Latin root: humus, which means earth. I hoped that the humor work would provide a foundation of connection and trust that would facilitate other therapeutic interventions. We have three goals for the group: to introduce the students to the concept of humor as a therapeutic intervention to create an opportunity to develop practical applications, to provide the patients a respite from the boredom of the hospital, and finally, to provide a forum for both the patients and the students to "lighten up" and see each other in a more realistic perspective.
PW: What is the structure of the group routine and are there any ground rules?
PM: We have two basic rules which are reviewed at the beginning of each group. Disruptive behavior is not allowed and the humor should include everyone, rather than the caustic, offensive humor of laughing at people.
We begin each group with an introduction of everyone and this is usually done in some kind of a game format. We do this because patients may drop in to the group. Also, this serves as a warm-up, ice breaking exercise.
Next, we have a call for jokes, which both students and patients enthusiastically share. It's interesting to note that sometimes patients will tell me a joke before group to validate that it won't be offensive to others. I think we are helping them develop some basic sensitivity skills.
After the jokes we have some type of humorous activity or team activity. Each week, a different student is assigned to lead the group and to plan this humor activity. Students learn some leadership skills and their creativity and courage is tested as they involve others. I'm constantly amazed at what they come up with. One activity called, "Walk like an Egyptian" was just hilarious. We all came up with our own interpretation of what that would look like. Another time, we went outside to play "Balloon Football". Each team stood in lines and we were not allowed to move our feet, but had to hit the balloon towards the goal. It was a windy day, so you can imagine how funny we all looked.
After the humorous activity, we have a discussion where people have a chance to share. We specifically ask if anyone was offended by anything. By that time, the humor has helped to disarm the defenses we usually hold and a deeper disclosure or insight can occur. I remember one man (a convicted pedophile) expressing concern that one of the jokes might be offensive to another group member who had an arm amputated. Through this process of "appropriate humor" training, we are teaching about the importance of a developing a sensitivity to people's boundaries.
Finally, we close the group with some sort of amusing activity, such as a funny handshake.
PW: Pamela, just briefly, how would you summarize the impact of your humor group therapy?
PM: I believe that sharing humor draws people together in a way that connects them at a spiritual level. By "lightening up" the students and patients are to find the "light", or the goodness, in each other, and thus transcend their stereotypical views of one another. At the end of every seven-week session of the Humor Group, students and patients alike comment on how the experience has enlightened them: "It was great to lighten up", "It helped my light side come out", "I can see things in a different light". Research has already measured the benefits of humor and laughter on the mind and the body. We all know intuitively that they also have great relevance for the human spirit. Quantifying that knowledge however, will be a challenge.
Resources:
- Minden, P. (1994). "Humor: A corrective emotional experience." In E. Buckman (Eds.), Handbook of Humor: Clinical Applications in Psychotherapy. Malabar, FL: Krieger.
- Pamela Minden's e-mail address is:
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This article was originally published in "Jest for the Health of It", a regular feature in the Journal of Nursing Jocularity.
Feature columnist Patty Wooten, BSN, is also a past President of the American Association for Therapeutic Humor, author of two books related to humor, and a national speaker presenting on the benefits of humor.
