Laughter can be the best medicine

Apparently, the expression that laughter is the best medicine comes from the Book of Proverbs. In itself, laughter may seem like an odd tool for a therapist to use. But humour, when carefully and sensitively used, can be really powerful in the fight against mental health problems.

In the mid 1990s, I worked as a behavioural therapist with two hospitalised clients—one battling Obsessive-Compulsive Disorder (OCD) and the other severe depression. It was during my time working with them, that I learnt how laughter and keeping a sense of humour can lessen the power of mental health problems.

Learning by Experience

I learnt so much from my client who struggled with OCD. Her days were dominated by an overwhelming fear of losing something valuable, making even the act of throwing out an old bus ticket impossible. I tried modelling behaviour, throwing away a crisp packet, a used tissue, an empty tube of toothpaste. But she remained paralysed by the thought, “what if I throw away something important and don’t notice?”. We were stuck. So, I took a chance, using humour. “Watch again and I’ll model how to do it”, I said. Then I threw my car key into the bin.

“You can’t do that!” she exclaimed.
“What?” I responded, looking confused.
“Your key!” she answered, exasperated.
“So, you do notice the important things then”, I smiled.

As she smiled back, the power of the OCD lessened. She managed to throw a wrapper in the bin. I kept it up using humour over the year I worked with her – throwing my purse, driving license, ID badge away – and every time, she noticed, smiling as she pointed it out. She called me a “cheeky wee bisum” - and humour became an act of defiance against the OCD, and a way for her to reassert control. It didn’t magically cure the OCD, but it helped her feel less alone in her struggle; we were on the same side of the ring, fighting the OCD and beginning to see its illogicality.

For my other client, who suffered from very severe depression, laughter felt even more risky. In working with this client, I made it my goal to, very carefully, try to encourage a smile or a moment of laughter. Some came without trying. She loved dogs and we would often go on walks with my old dog, Murphy, whose favourite game was to roll in fox poo. My dog’s utter delight – and my utter horror - was enough to make the client laugh, easing her sense of despair, if only for a moment. Laughter became a subtle reminder that there was another way to feel.

How Laughter Combats the Tyranny of Mental Health Difficulties

Mental health struggles like anxiety, depression, and OCD are relentless. They lack any sense of humour. Anxiety incites terror, depression steals energy, and anger snarls. But laughter does the opposite: it connects us and reminds us of our capacity for enjoyment.

The Science of Humour in Therapy

Research backs up the therapeutic benefits of humour. Laughter releases endorphins, reducing stress and temporarily boosting mood. It also creates a physiological shift: laughing slows the stress-response system and relaxes muscles, creating a sense of calm. This is particularly useful for individuals experiencing high anxiety, as laughter can provide a short-circuit to the cycle of anxious thoughts, giving clients a mental “pause” and a chance to re-evaluate their situation.

As a good example, my long-held fear of heights took over when I was skiing with a friend last winter and I became entirely unable to point my skis downhill, having seen a sign marking a cliff edge on one side of the piste. Obviously, the cliff edge was a long way off – but my fear of heights wasn’t telling me that. I came to a stop and sat down, immobilised by fear. My friend came over to help trying, gently, to encourage me back up. It didn’t work. “I can’t do it!” I said. “Not at the minute” she said, smiling at me, “but if you can pull your shoulders back down from above your head, you’ll definitely feel better!” Her smile worked in reducing my terror and releasing me from my crunched, hunched state. Slowly, I skied quite safely back down the hill.

Shaming the Shame

One of the most powerful examples of using humour came from a workshop I went to with Martin Bohus, a renowned German psychiatrist who specialises in working with complex PTSD. He asked each of us to recall a memory that triggered shame - and show how it felt. We automatically curled up in our chairs, reflecting how shame often makes us physically shrink. Bohus then surprised us: “Right, everyone – up out of those chairs and strut like flamingos!” He began to strut, flapping his arms, stamping his feet and coaxing us to follow suit. The exercise was both absurd and amusing - as we smiled, the shame feelings began to dissolve. Bohus’ example showed that responding “oppositely” to negative emotions can help lessen their hold.

Conclusion

Humour is not always appropriate. At times, it is simply not right to use at all. At other times, used too casually or at the wrong time, it can feel dismissive or hurtful – like you’re laughing at the other person, rather than with them. To go back to my friend skiing, it was her compassion that came in first – the laughter only came when she knew that I understood she was really only there to help.

Mental health issues have an addictive quality, looping us into spirals and patterns that become ingrained. Laughter, contagious as it is, can disrupt these loops, offering a different perspective. While laughter alone won’t cure mental health problems, it can be a powerful counterbalance to the relentless grip of anxiety, depression, and shame, pulling us away from our negative thoughts and giving us back a sense of control. As Dickens suggested, “there is nothing in the world so irresistibly contagious as laughter” – even a mental health problem can lose out to it.