Dark Humor, Navigating Laughter's Place in Medicine
Dark Humor, gallows humor, probably all of us have used it, cringed at it, felt uncomfortable in the face of it and perhaps even wielded it as a weapon. It is used when we are stressed, overwhelmed, upset, angry. Looking at stereotypes, it would seem that those professions that put people in the direct path of death, sickness, conflict and danger tend to call on dark humor more than most. Medical professionals, and nurses specifically, fall well within that description. Does dark humor help? Why is it used as a coping mechanism? Is dark humor healthy, or is it destructive to ourselves and those around us? The answers to these intriguing questions have us doing a deep dive into the human condition, work structure and coping mechanisms we use to simply get through our day.
According to a recent article by Claire Brummell, an expert in human behavior, in Patient, “When we are in a position of 'coping,' it's because one or more of our needs are being compromised in some way. It could be a period of intense grief, or overwhelming stress; we might have been through a trauma - the list goes on. So the things that we use to try to cope are behaviors that we believe, consciously or subconsciously, will either stop those needs from being impacted, or will meet them in some way," she explains.
In the case of dark humor, there are a few needs that people tend to be subconsciously trying to meet when using it as a coping mechanism. Brummell explains what these are:
Emotional Experience & Expression
"The first need we are trying to meet with dark humor is our need to experience and express the full spectrum of emotion. At times when we are engaging in dark humor, it's often because we are having an overwhelming experience of the more 'negative' or challenging emotions, such as grief, sadness and anxiety. When it feels like this is all we are experiencing, dark humor can be a way of trying to welcome in other emotions, like amusement or some sort of cheer, so we are no longer only battling with the more challenging emotions." She says dark humor is a way to not feel like you are drowning in difficult emotions, because there is something else being felt too.
Personal Power
Brummell says that when we feel that situations where we may be filling out of control or powerless may drive the need to engage in dark humor, we are in a situation in which we might be feeling out of control or powerless. "This can occur when we have lost someone we love, and perhaps we are going through a break-up or dealing with a serious medical diagnosis. Whatever it is, the situation is one where we don't feel in control. The use of dark humor can, if nothing else, offer a chance to choose how we respond to what is going on. It can make us feel a little more in control than we otherwise would have."
Love
Brummell offers that often, at times of great stress or trauma, we can feel very isolated and as though no one fully understands what we are going through. While some people know exactly what to say to comfort someone during difficult times, it isn't always easy. When someone doesn't know how to deal with what a loved one is going through, it can cause them to pull back out of their own discomfort. In this instance, the person struggling might use dark humor to connect.
"Using dark humor to connect with others doesn't deny the darkness that is present in our situation. However, it can be an attempt to connect at a more superficial level in a situation where we feel the opportunity or desire is not present to connect at a deeper level. In short, to stop us from feeling so alone." shares Brummell.
So, while these are the reasons why we may engage in dark humor, is it healthy? Does it add to our emotional lives or create a negative impact? Brummel explains using dark humor can be a bit of a double-edged-sword that can be difficult to recognize. "We are usually just focused on trying to minimize the impact of the tough situation on ourselves, so anything that offers us any kind of respite can seem like a good idea. But not everyone is comfortable with dark humor. "The reality is that sometimes dark humor can create a distance between ourselves and others, despite our attempts to connect. When we engage in dark humor, depending on how someone responds, it can make things awkward or drive away those we want support from the most." Probably each of us have been guilty of this terrible moment. Where we are trying to engage but are uncomfortable and draw on dark humor, only to immediately realize that it sounded MUCH better in our head than out loud. When we are in a place of love and caring but cross the line to offensive and inappropriate, it is a bell that cannot be un-rung.
The consistent use of dark humor runs the risk of making it part of our emotional DNA. Using dark humor as armor against our true feelings conveys to those around us that we are happy and healthy because, after all, look at us laugh when the actual fact is we are far from ok. We are suppressing the anger, hurt and distress we feel in that moment rather than addressing it. It is generally accepted that burying these feelings is unhealthy and can lead to both physical and mental health struggles in the future. As with all things, dark humor has its place but should be used in moderation. As Brummel states, "Dark humor is a tool that can be used to great effect while navigating some of the difficult times in our lives. However, it can also compromise our healing further.” As with most coping mechanisms in life, it's how you use it that makes the difference. For example, we might go out drinking following a relationship break-up, which there is nothing wrong with.
"However, becoming reliant on alcohol for escapism and comfort is when a problem arises. Likewise, dark humor can be funny and uplift our spirits, but overdoing it to a point where we push people away and refuse to accept what we're going through, that can cause issues."
Palliative care, without a doubt one of the most sacred and serious of callings in the medical profession, is a home away from home for dark humor. According to a recent Pathways Health article on palliative care, laughter can help diffuse the difficult circumstances of even the darkest of responsibilities. “According to a study by the American Journal of Hospice and Palliative Care appearing in Psychology Today, humor was present in 85 percent of nurse-based visits, with 70 percent of that humor being initiated by the patient. No, there’s nothing funny about dying, but the situations that go on before and after can present opportunities for laughter. Indeed, a huge part of being able to cope with life (and death) is being able to use humor as a buffer between the person, his or her family members, and friends — and the side effects of stress. In short, humor can make a difficult situation just a tiny bit more bearable.
Humor and laughter are a natural part of human interactions, points out ResearchGate. But chronic or terminal illness is rife with fear, anxiety, and sadness. “Palliative care not only emphasizes the quality of life but also the importance of human relationships. It’s in this context that humor finds its way as a part of authentic one-on-one connectedness.”
Can laughter ease the discomfort of dying? In a word, yes. According to a study by the American Journal of Hospice and Palliative Care, which was published in Psychology Today, “humor was present in 85 percent of nurse-based visits, with 70 percent of that humor being initiated by the patient.” No, there’s nothing funny about dying, but the situations that go on before and after can present opportunities for laughter. Indeed, a huge part of being able to cope with life (and death) is being able to use humor as a buffer between the person, his or her family members, and friends — and the side effects of stress. In short, humor can make a difficult situation just a tiny bit more bearable.
Humor and laughter are a natural part of human interactions, points out ResearchGate. But chronic or terminal illness is rife with fear, anxiety, and sadness. Palliative care not only emphasizes the quality of life but also the importance of human relationships. It’s in this context that “humor finds its way as a part of authentic one-on-one connectedness.” In fact, this study goes on to say that not only does laughter often make the mental process of dying easier, it may also ease the physical symptoms as well. It’s no secret that laughter has long been a distraction technique that’s actually beneficial to our health. In fact, research shows that laughter increases pain tolerance. When you laugh — really laugh, from the belly and not just a chuckle — your body starts to release endorphins, which are hormones that relieve stress, pain, and even muscle tension.
The “science of humor” is a young field, but research from the past three decades suggests the mechanisms through which humor positively impacts health can alleviate not only pain but also strengthen immune function, boost mood, moderate stress, dissociate from distress and improve interpersonal relationships. So the next time you feel a dark joke coming on, don’t be too quick to dismiss it!” Embrace and enjoy it (in moderation) because, as the old adage is apparently very accurate, laughter truly is the best medicine.
