Contenu du sommaire : L'humour et la surprise en psychothérapie

The authors present the advantage of using humor in psychotherapy.

In the light of Bergson, Freud and Bateson, the author analyzes the common and specific aspects of humor and unheimlich.

What is the meaning of our psychiatric patient's humor? Several ways of using humor are analyzed, allowing making a difference between those that seem to be useful for the patient's psychological well-being, and those that are not. But moreover, what are the effects of the practitioner's eventual humor on the patient and the psychotherapeutic relationship? We will examine its potential utility to lower relational tension, to develop both therapeutic alliance and process, and to reframe some of the patient's clinical situations. The attention is drawn on the type of patient with which humor is used, and on the risk of derision and sarcasm, which can be harmful for therapeutic alliance. Several concepts are illustrated by clinical examples.

Emphasizing the importance of using reframing or “deframing” in psychotherapy, the author stresses that humor and surprise are efficient tools to that purpose. In fact, one of the main goals of every types of psychotherapy is to lead patients/families to shake up their uncomfortable and painful world's representation, helping them so to become able to build another image of their reality and therefore a new experience of it.

In therapy the paradoxical interventions are often comparable with humour or provocation. After a clarification of the various concepts, their similarities and their differences, we would like to propose an ecological design of the therapeutic paradox which is different from humour.

Brief therapy relies on the therapist's seemingly unplanned casual use of creativity to transform therapy into an actual healing emotional corrective experience. Humor and paradoxes represent some of the creative ways to induce change.

The children early victims of violence were exposed to the hatred of their attacker. This fundamental experiment involves a major upheaval of their personality. The state of post-traumatic stress of which they suffer implies that the therapists have to take into account at the same time their capacities of impact strength and the interiorized and prohibited hatred expression which is opposed to their evolution. The fragmentation of their identity and the existence of an identification of these young victims with the aggressor will likely contaminate the members of the child welfare without their knowledge, by maintaining a submission to the relation of influence created by the attacker. The therapeutic injunction to create with humor a nickname which caricatures the author of the criminal facts and to use it from the first meeting will gradually release these children of the fear. This therapeutic process activator of impact strength authorizes hatred symbolic system authorized, supporting the mourning of the idealized relative by legitimating the perception of the major negative emotions. Positive emotions will then be released and expressed: jubilation, relief, and pleasure of learning.

This article describes the challenges faced by a psycho-social intervention team working within an organization catering to adolescent girls. An analysis of situational factors reveals that the adolescents' attitudes and resources, as well as those of their families, are not always readily identifiable. Interactions with these families are also filled with unanticipated moments that become key factors for the continuity of the working relationship. The authors question possible ways to move the family out of its habitual pattern by initiating change through a disruption of the system. Finally, the article emphasizes co-intervention as a tool that, in this specific context, allows for an effective capitalization of the unexpected in interpersonal relationships.

Would the surprise in family therapy and in training be the experience of being surprised to see differently the world? This article stresses the importance of creating, during training as during therapy, contexts where the emotional implication is called for, allowing change to emerge. This change will often be a surprise with unexpected effects, enlarging the possibilities. This surprising effect is more felt than thought because it is an emotional experience deeply related to body experience.

Being able to understand interactional patterns that connect the behavior of one person to the behavior of others is basic to developing systemic strategies of intervention. And yet there are times when even seasoned therapists and supervisors can find themselves stuck, temporarily unable to conceptualize the relational and contextual dynamics of which symptoms and difficulties are a part. Twelve ways (maps) are offered as conceptual tools that may be useful when a therapist or supervisor find themselves in need of jogging themselves out of the habit of seeing problems as individual in nature, and as a way of shifting more automatically to asking questions that enlarge the picture to include how the behavior of someone with a problem is connected to the behavior of important others involved in the situation.

Action and change are inseparable in the therapeutic process. Starting from an epistemology centered on the notion of a facilitator, the intervention of the therapist helps the patient, couple or family to commit themselves to using their inner resources.