The Use of Aberrant Medical Humor by Psychiatric Unit Staff

Abstract

The purpose of this study was to develop a grounded theory about the joking behaviors of psychiatric unit staff. Fifty nine staff members (Male D 23, Female D 36), ages 28 -62, who worked in an urban, public facility were observed in unit meetings over a two year period. Data were analyzed using the constant comparative method. Participants used aberrant humor to deal with the basic social process of facing a series of ultimately unresolvable problems. The factors involved included the organizational context of the working environment, contact with a stigmatized patient group, and stressful staff-patient interactions which led to the erosion of a sense of professional competence and the resulting demoralization, resentment, and vengeful counteraction. Two major categories of joking emerged: whimsical and sarcastic humor. Six subcategories of humor also emerged: incongruous, bravado, self-mocking, discounting, malicious and gallows humor. Staff engaged in more sarcastic than whimsical humor. Findings support the need for professionals to recognize the potentially detrimental effects of joking behaviors on their treatment effectiveness.Setting: Morning staff conference on a psychiatric unit First psychiatrist: This new admission is manic-depressive; he tried to kill himself by breaking a thermometer and swallowing the mercury.

From critical care to comfort care: the sustaining value of humour

“…Assumptions about what constitutes professionalism sometimes suggest that humour is not consistent with professional conduct (Sayre 2001, Sobel 2006. Our research refutes this assumption.…”

“…Dark humour was present in both settings. Many studies of humour in health care report the prevalence of dark or gallows humour (Rosenberg 1991, Sayre 2001 which pokes fun at death or serious situations. Some (Thornton & White 1999) suggest that the more serious the situation, the greater likelihood that dark humour would appear.…”

“…There is considerable evidence of the significance of humour in healthcare relationships. Research has addressed the social functions of humour in various settings (Rosenberg 1991, Yoels & Clair 1995, Astedt-Kurki & Isola 2001 and the use of humour in specific settings such as psychiatry (Griffiths 1998, Sayre 2001, ICU (Thornton & White 1999) and medical education (Smith & Kleinman 1989). Despite variability in settings and approaches, findings consistently identify the importance of humour as a means of enabling communication, fostering relationships, easing tension and managing emotions.…”

Language matters: towards an understanding of silence and humour in medical education

“…68,69 Exploring these questions might improve our understanding of the sophisticated functions of humour in medical education situations, particularly if we build on existing humour research. This scholarship has established a range of functions of humour and laughter in social interactions, including as emotion management tools, 70 as a means of increasing intimacy through conversational play, 71 as a strategy for reducing stress, 72,73 as a way of modulating strong disagreements in cross-cultural settings, 74 and as a means of group demarcation. 75 As such functions suggest, power is a central feature in episodes of humour and laughter, just as it is in episodes of silence.…”

The purpose and function of humour in health, health care and nursing: a narrative review

“…Or is it the case that certain types of humour may be less adaptive than others? Sayre (2001) studied the disparaging humour use of psychiatric nurses in relation to patients and concluded that it may have a negative impact on the therapeutic process.…”