Client laughter in psychodynamic psychotherapy: Not a laughing matter.

Abstract

We studied 814 client laughter events nested within 330 sessions nested within 33 clients nested within 16 therapists at one community clinic in which doctoral student therapists provided psychodynamic psychotherapy to adult community clients. Each laughter event in Sessions 1 to 5 and 16 to 20 was rated for cheerfulness, politeness, reflectiveness, contemptuousness, and nervousness. Across all clients, there was an average of about one laughter even per session. The average laughter event lasted 3.5 seconds, and was characterized primarily by politeness and reflectiveness. Overall amount of client laughter and the characteristics of client laughter did not change across sessions. Most of the variance in the laughter characteristics was at the session level, with less variance attributable to clients and therapists. When client attachment avoidance was high, laughter was less cheerful and more contemptuous. When client attachment anxiety was high, laughter was more nervous. Sessions with more reflective laughter were evaluated more positively by clients, and therapists whose clients had more reflective laughter had more positive client session evaluations. Furthermore, within a therapist's caseload, clients with the most nervous and contemptuous laughter evaluated sessions most positively. Implications are discussed. (PsycINFO Database Record

Funny, right? How do trainee and qualified therapists experience laughter in their practice with clients?

“…In addition, the lack of focus on differences between counsellor and client, such as gender and culture, could also provide a further area for research to investigate, as the scant previous findings suggest that therapists should be mindful of these (e.g., Maples et al., 2001; Vereen et al., 2006). Another further area for therapeutic humour research could be to investigate a possible mediating effect of client attachment style (Gupta et al., 2018; Nelson, 2008).…”

“…Gupta et al. (2018, p. 464) define laughter as “any highly stereotyped utterance characterised by multiple forced, acoustically symmetric, similar vowel‐like notes separated by a breathy expiration in a decrescendo pattern.” Extensive empirical research has been conducted over recent decades to investigate both the physiological and psychological benefits of laughter, and this has been reviewed by numerous authors, including Mora‐Ripoll (2010) and Savage et al. (2017).…”

“…Also, in relation to counselling specifically, Gupta et al. (2018) found that clients evaluated their therapy experience more positively when reflective laughter had occurred in their counselling sessions.…”

“…This assumption is supported by evidence from Phillips et al (2018) who found that positive interactions between a clinician and their patient helped to build the relationship, enhance trust and also led to better health outcomes. Also, in relation to counselling specifically, Gupta et al (2018) found that clients evaluated their therapy experience more positively when reflective laughter had occurred in their counselling sessions.…”

Productive silence is golden: Predicting changes in client collaboration from process during silence and client attachment style in psychodynamic psychotherapy.

“…Attachment style has also been studied in relation to other aspects of psychotherapy process. For example, client attachment styles have been related to working alliance (Marmarosh et al, 2014), therapist immediacy (Hill et al, 2014), client crying (Robinson, Hill, & Kivlighan, 2015), and client laughter (Gupta, Hill, & Kivlighan, 2018), and therapist exploration skills (Anvari, Hill, & Kivlighan, in press). Bowlby (1969Bowlby ( , 1988 theorized that the attachment bonds that infants form with parents carry over to all relationships in adulthood, including the therapeutic relationship.…”