Humor & Health Letter, March/April 1993, ISSN 1066-3088
Laughter Groups
An Interview with Dr. Michael Titze

H&HL: The concept of Laughter Groups is unfamiliar to many of us in the United States. Tell us about the phenomenon of the Laughter Group and its popularity in Europe. What is a Laughter Group and what happens in one?

Laughter groups are becoming very popular in Central Europe. I have conducted laughter groups and seminars on laughter groups for several years.

Laughter groups utilize humor and are psychotherapeutic in nature. Patients joining a laughter group must first learn to change their mode of breathing. Many who come to the groups are restrained and shy. So they have to find their way out of a symbolic cage which narrows their mobility and, literally, takes away their breath. These people have to learn to widen their respiration, i.e. to breathe in such a manner as to increase their oxygen levels. Breathing style correlates with general life attitude. Thus laughter group participants must learn to breathe from the diaphragm -- from deep in the belly. We get them to breathe slowly and intensively, groaning with very long «aaah.» After that they have to utter a short «ha!» in a hearty way. Correct breathing is fundamental to therapeutic laughter.

For several years I have used a special respiration method in laughter groups which I have conducted. Deliberately and as quickly as they can, group participants are encouraged to transport a considerable quantum of air into their lungs, thus producing a mild form of hyperventilation. After this hatcheling exercise they will usually feel tension and dizziness. While lying on the floor they start liberating themselves from such stress symptoms by laughing uproariously -- thus getting rid of the tension and experiencing simultaneously an excellent feeling of vigor. Thus people realize that they are able to master their lives in a dynamic and resolute way. Assertiveness and effective breathing go together.

H&HL: Is laughter used to help people breathe more effectively or must people learn to breathe effectively before laughter can be therapeutic?

From the experience of my colleagues and from my work as well we find that most people do not know how to breathe properly. In using laughter in psychotherapy we find that people must learn to breathe effectively first.

H&HL: What else do you emphasize in a Laughter Group?

We deal with constructive aggression. Constructive aggressiveness is a very important concern in laughter theories. This is true for instance for Bergson, Gregory, Grotjahn and Koestler and is especially important to ethologists like Lorenz and Eibl-Eibesfeldt. Moreover, George Bach's concept of «creative aggression» is particularly important. People suffering from the stress of civilized life usually feel like victims who are condemned to an indifferent, submissive, and passive life. Patient and passive come from a common root word. Patients in psychotherapy usually behave in a passive-dependent rather than an assertive way. Often this has roots in childhood where such people were raised to feel ashamed of their refractory tendencies. As a result they fear -- perhaps an unconscious fear -- disclosing their true feelings or even exposing themselves. They fear being laughed at by their mates.

People getting into our laughter groups have usually had painful emotional experiences. When they join our groups they are encouraged to psychologically disclose themselves and expose their hidden fears. The experience begins with the therapist. That is to say, s/he exhibits, in an overdrawn way, behaviors which patients generally fear expressing: that is, on the first meeting the therapist is something of an actor and does a sort of parody. For instance s/he may express «his/her fear» by stuttering, trembling, gasping for breath, or sharing other experience of painful imperfection. The therapist does this parody for about 10 minutes. At the end of this period most of the group participants are usually in a high state of tension, because the therapist did what they secretly fear so -- to be without self-control and doing embarrassing things! After the presentation the therapist asks each person in the group, «What did you experience? What do you feel?» Usually they say that it was terrible for them and add, «Because this is the way that I might behave. Therefore, I try to control myself to prevent such a disaster.» Patients say, «You acted out what I always feared that others would see in me.» After this introduction, each participant has to perform likewise the most terrifying social situation which he or she could imagine. They may take material from the past -- something that really occurred -- or may develop a horrifying fantasy. This is very liberating for the patients. They start enjoying it immediately. They feel as if they are being released from a nightmare and they desire to share this experience with their mates! Generally they laugh and a strong group cohesiveness develops. This takes several hours. Because as they get into it, they want to act out all the fears and terrifying fantasies which they have held for years.

H&HL: What is the role of the therapist in a Laughter Group?

The therapist is a moderator letting the participants act out their fears and agonizing fantasies. From my experience with laughter groups, people start laughing spontaneously almost from the beginning. It is not necessary to get them to laugh by telling jokes or forming a comedy routine. As people do things which they have always wanted to but have refrained from or disguised or covered up, they gradually develop feelings of strength and self-confidence. This is what I mean when I use the term constructive aggressiveness. Feeling inferiority, insecurity, inhibition, and shame has something to do with not being allowed to express oneself as a authentic person. This relates somehow to our inner regulating sense, the superego or conscience. In laughter groups people are explicitly allowed and encouraged to act freely -- the way they would if there were no social pressure or condemnation.

H&HL: It sounds as though there is an element akin to paradoxical intention that occurs when the therapist acts out the patient's fears.

That is true. I first began to examine the realm of humor when I was close to Viktor Frankl. I admire him and got many insights from discussing and corresponding with him. It was also my privilege to watch him facing a group of disciples and teaching them how to apply paradoxical intention. There was so much cheerfulness, inspiration, and wit coming from Dr. Frankl! He once told us that humor is one the most powerful «existentials» -- a term he took over from Heidegger. Frankl was actually the first one to introduce humor into psychotherapy. In connection with his technique of paradoxical intention, Frankl explicitly pointed to the phenomenon of laughter. He declared that one of the results of paradoxical intention is that patients laugh involuntarily. This laughing, as humor in general, enables the patient to keep a distance from his neurosis. Paradoxically, Frankl pointed out that it is necessary for the patient to learn to laugh at his or her fears. To achieve this, the courage to be ridiculous has to be gained. Even the therapist should achieve this attitude! This means, as Frankl put it, to play or demonstrate this ridiculousness to the patient. (I speak in this context of an humoristic inversion of the therapist's augustness.)

H&HL: Is the primary approach that you use in Laughter Groups acting out life fears and embarrassing fantasies or do you employ other methods as well?

We use acting out in the first phase. Later when people have no particular problem facing fear evoking situations, they can go on into other techniques promoting their assertiveness. For example, we may use some of Albert Ellis' shame attacking exercises. Or we may engage in the «silly laughter» exercise which aims at a nonverbal defense of aggressive verbal attacks. For this purpose, first of all, group members have to list some of their «most disagreeable weaknesses.» Then each one of them is confronted, in the mode of a go-round, by the others with «reproaches» «thematizing» exactly these «weaknesses.»

A very important issue in this context is the training of a non-conventional style of communication. There are three basic lines to be observed:

1) questioning the questions («cunning silliness»);

2) exaggerating justifications and apologies («paradoxical submissiveness»);

3) giving nonverbal answers to verbal questions («nonplus body language»).

All of these techniques generate much fun and can be transferred into everyday life.

H&HL: In addition to the influence of Frankl I noticed that you have been influenced by Adlerian Psychology. What connections exist between humor and the Adlerian perspective?

At the heart of Adler's work was the inferior and superior paradigm which was based in Adler's concept of aggression. It was worked out by him as early as 1908. Later it was forgotten and Freud came up with the thanatos drive. Even today many psychotherapists are afraid of dealing with the fact that aggressivity is important in human life. For instance, look at parents abusing their children physically; or look at the world-wide terrorist activities and wars: all of this is very aggressive. Each of these incidents exemplifies aggressiveness without humor -- aggressiveness filled with rage and seriousness. What makes aggressiveness so terrible is that people are convinced that what they are doing is absolutely right and what others are doing is absolutely wrong. Humor gives us a means to see things relatively: to realize that nothing is absolute and that there are myriads of other possible solutions to be taken into account. As Adler put it, «Everything could be something else». This is the formula of paradox. The basic idea of applying therapeutic humor is, in the Adlerian sense, paradoxical encouragement: It is to convince persons who may feel inferior or weak that they have the power to feel the opposite and that they can behave assertively. Consequently, they learn to deal with aggressiveness. If it is not destructive, aggressiveness can be an inspiration for life and an avenue to active and assertive behaviors. Thus it may have a therapeutic value. In laughter groups people learn to be aggressive in a non-destructive, i.e. genuinely humoristic way.

H&HL: How did you first become interested in studying laughter?

It began five or six years ago when I was working with patients in groups and using paradoxical procedures. I observed that people were stimulated by that to get into a state of mirthfulness. When these people joined in laughing together it was more liberating (and thus «therapeutic»!) than the mere cognitive insight. When they spontaneously laughed together, it reminded me of the way children laugh. This is why I got into the habit of asking new group members to demonstrate how they laugh when they laugh at their best. It is very interesting to recognize that most of these persons are laughing in a flat way that is quite different from the way a child would laugh. When a child laughs the whole body is involved. Tears may be brought to the eyes. I used to invite the participants of my laughter groups to learn to laugh as kids laugh. Laughing like children do means to laugh without any restraint and taking all the potentialities the body has t its disposal. This may seem, in many cases, to be somehow embarrassing for our environment. People with emotional problems are used to control themselves and would not dare laugh as freely and easily as kids do. To realize this brings patients back to being the playful child which is within each of us.

When adults roar with laughter, there are often elements of infantile humor. Thereby, the vitality of the hale and hearty «inner child» is expressed. Humor and laughter is an excellent avenue for approaching this «inner child.»