Friday, July 7, 2017

Laughter and Trauma

For ten years, I served refugees at administrative and policy levels. I missed working with clients, but I feared vicarious traumatization (being negatively impacted from the heavy weight of expe-riencing traumatic stories). A year after I returned to counseling clients, I wondered how that hadn’t yet happened to me. I also realized that I do something that I rarely did before as a thera-pist: I laugh with my clients about their trauma. I became curious of the role that laughter played in healing.

In serving refugees, we are privileged to witness parts of the healing journey resulting from crimes against humanity. Of course we are impacted by the stories we hear. As the Harvard Pro-gram in Refugee Trauma emphasizes, as the healer, you are also the student. You aim to learn from your client. Within this framework of a more equalized relationship, we are permitted to be human. Being human allows us to laugh (and in the rare event, cry) with our clients as we both face their trauma. I realized my shift from the humanitarian refugee field helped me develop a new coping skill as a clinician. I discovered how laughter could help me handle the stress of working with trauma. And it seems to work for my clients too.

Laughter is the Best Medicine
A proverb from the Old Testament says,
“A cheerful heart is a good medicine; But a broken spirit drieth up the bones.” -Proverb 17:22 (ASV)
This proverb, like the common saying, “If we don’t laugh, we have to cry!”, reinforces that laughing is an important coping skill. Laughing with our clients can be a simple tool to relieve trauma induced tension, and highlight a way to tolerate and manage life’s difficulties. Here is a framework for the process of my work: something traumatic is shared, laughter is allowed in the room, then tension is released from both the client, and me, the helper. We become human together.

Anxiety and Laughter: Counteracting the Stress Toxins
We know that horror and trauma can have an intense impact on the body. The impact in the body is anxiety. Anxiety is not a feeling. Anxiety is tension and it releases stress toxins. Anxiety can complicate lives in various forms and impacts our clients, colleagues, and ourselves. Unmanaged anxiety can have a significant negative impact on health, both in the short and long-term.

Let’s picture how laughter works. Instantaneously, air is exhaled, followed by a large intake of oxygen. This exchange occurs regardless of the type of release made: a smile, chuckle, or a loud burst of sound. This release can be mutually observed by you and the client. With this momen-tarily release and decrease in tension, it can be safer to go deeper, or just take a break from the impact of the trauma on your bodies. Furthermore, laughter releases endorphins, the body’s natu-ral pain reliever, similarly to those chemicals released with exercise and physical touch.

Laughter through Empathy
Empathy is a significant part of my approach with clients. I am usually able to laugh after I've empathized with the client—I find myself in their shoes and suddenly notice the absurdity of the event they may be describing. I also can sense their innocence in the past, and even in the present moment while they are telling me their story. I enter their experience through that route. Out-wardly, I enter with a smile. Then, depending on the client, the smile can lead to a chuckle as-sisted smile or lots of laughing together.

While helpful, deep empathy can connect us at a place where we are both vulnerable. Therefore, it is important to monitor your own physiological reactions. A sigh, a deep breath, a smile, a chuckle, are all signs of an empathic process that has caused enough anxiety within your body to require a release of tension. When we are hearing traumatic stories, if we can monitor the anxiety that rises with tension, or leads to numbness in our own bodies, we can help regulate ourselves and help the client to do the same.

Laugh and Connect
Empathy allows us to live in the moment and connect with our client. Laughter is often a social activity that happens with family and friends. However, in the life of our client, they may be iso-lated or living with others who are similarly depressed and stressed. Sometimes, a survivor of significant trauma may try to hide their worst stories, afraid that you may be repulsed—both about their story and them. Consequently, if we release the tension and fear through laughing to-gether, our empathy can spotlight the genuineness of the interaction. We can facilitate the pro-cess of joining and releasing tension together. Through empathy, our two hearts can connect with our laugh, building trust in the helping relationship.

Yes, there are times that I laughed, or wanted to laugh, that were not appropriate. In those situa-tions I apologized, which in its own way created another connection and allowed us to go deeper. I try to time my prompting for releasing tension without distracting from our discussion. Some-times, I ask for permission, “Do you want to hear something funny, that is (…absurd, awkward, strange, etc.) about this situation?” Other times I say, “This was really hard, do you want to laugh with me (and release tension)?

Torture, war, rape…the world’s traumas can destroy happiness—and lead to deep sorrow, confu-sion, and fear. Laughter can give power back to the client. It can allow them to say to their trauma, to their violators: ‘You don’t get to oppress me, you don’t get to destroy my psyche; I am still alive, I can still laugh…’

Human beings are resilient—and they can always smile and laugh again. That is my goal—to re-mind them of that, and to do it together.

This month's guest blogger: Goli Amin Bellinger, MSW, LICSW, University of Maryland Baltimore, School of Social Work

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