Clifford Kuhn, MD: healing with humor

Healthcare Financial Management, Dec, 2006

Clifford Kuhn, MD, has been a practicing physician for 40 years. He is professor of psychiatry at the University of Louisville School of Medicine in Louisville, Ky., and president of Laugh Doctor Enterprises, Inc. Kuhn is the author of the book The Fun Factor: Unleashing the Power of Humor at Home and on the Job (Louisville: Minerva Books, 2002). He offers keynotes and training sessions that teach his HA HA HA Prescription for creating and sustaining fun.

Q. How did you get started with your ideas for injecting humor into health care?

A. it was a three-step process. The first step started when I was a child. My father was a tremendous model for using humor to defuse tense situations. He would break the tension with something silly or humorous.

As a doctor, I was working with patients who had chronic, unremitting problems, such as chronic pain and spinal cord injuries. Eventually, I was working with cancer patients almost exclusively. In each of those groups, the patients who stood out were those who were able to keep their sense of humor while they were going through all the pain, frustration, disappointment, fear, and all that that entails. Those patients, I noticed, were doing better. About that time--this was back in the late '70s--research was starting to show the capacity of humor to enhance the healing process. I was fueled by what we were finding out about humor. So I encouraged my patients to keep their sense of humor active. That was the second step.

As my patients began to experience benefits from humor, they told me I was not following my own prescription. So I had to look at how I was living and what role humor was playing in my own health. That was the third step. It got me into exploring ways that I could share this information in a more fun way and lighten my life as well.

I started working with comedians to understand how we laugh and how we set the conditions for laughter and make it easier for ourselves to enjoy our sense of humor. Then I started doing standup comedy to learn how humor works and what kind of circumstances are adverse to laughter and what kind help.

Q. Tell us about your HA HA HA Prescription.

A. The HA HA HA Prescription is a three-step formula that is guaranteed to inject more positive energy into you and anything you're trying to accomplish. The first HA is humor attitude. We all need to correct our attitude about humor if it's going to help us. We have been taught that humor is for recreational purposes only. Nobody has ever taught us that the way to become more effective and efficient when we're in the midst of a terrible problem is to lighten up. All the emphasis is on bearing down and getting serious, and then after you have accomplished your responsibilities, it's OK to have fun and celebrate. We've never been taught that humor is a valuable commodity.

The best way to reverse our humor attitude is to recognize that there's a big difference between being funny and having fun. Being funny is just a small part of fun, and sometimes it's not even fun. It's hard work, and sometimes it's inappropriate or hurtful to people. A lot that goes into being funny is risky. Having fun, on the other hand, is not a behavior or a performance. It's an attitude of willingness to look for the positive element in any situation, no matter how dire it is. If we can get hold of that attitude, we discover that it's possible to have more fun anytime, anywhere.

I advocate focusing on having fun as a way of changing our attitude toward humor, because once you see that having fun is possible and that it gives you energy, you begin to respect that you have this resource within you. It can serve you in many ways.

The second HA is humor aptitude. We're all naturally humor-based. For example, we made our first communication with another human being when we were six or eight weeks old and we smiled. And nobody had to teach us how to play when we were young. It was a natural tendency. Through education, maturation, and disciplining one another, we have lost touch with that naturalness, and we are more focused on getting serious and being responsible. We need to get back in touch with very simple aptitudes, such as smiling. None of us smiles as much as we could, and that's a powerful aptitude. So is willingness to take ourselves less seriously.

The third HA is appropriate humor action. This is the least important step. The first two are essential before going on to the third. A mistake we make is to think, "I'll lighten the situation up," which is a humor action. Sometimes the humor action falls flat, we're sorry we did it, or people are offended. But if you've taken care of the first two HAs and you're trying to have fun, and not to be funny, humor action is almost a natural thing. Listening carefully, for example, is an appropriate humor action. You would think of humor action as something that produces a laugh, but listening carefully is a marvelous, positive gift that you give not only to yourself--because if you listen carefully, you learn more--but also to the person you're listening to. You give somebody more focused attention. It creates a very positive response. You're deepening the positive energy between the two of you.