Using Humor in the Treatment of an Adolescent Girl With Mutism: A Case From Japan

Abstract

This article presents the treatment of a 15-year-old hospitalized girl suffering for over 3 years with total mutism and school refusal. It explores the role of humor in this treatment, illustrating how it can serve to regulate a patient’s sense of anxiety and sensitivity to arousal. The therapist appreciates his patient’s efforts to protect herself and keeps in mind not to over-stimulate her. He uses humor to engage and protect her from feeling hurt. Finally, the patient initiates humorous exchanges with the therapist. Their shared use of humor helps the patient to expand her scope of activity.

Keywords:

• adolescent treatment
• developmental disorder
• humor
• hypersensitivity
• mutism
• regulation

Acknowledgments

The original version of this article was presented at the 2016 one-week seminar in NYC provided by the Institute for the Psychoanalytic Study of Subjectivity for the Japanese Forum for Psychoanalytic Self Psychology. I am grateful to Amy Joelson, L.C.S.W., and Jackie Gotthold, Ph.D. for this wonderful opportunity. I thank Ms. Machika Kondo for translating my original draft, and Koichi Togashi, Ph.D., for his invaluable editorial assistance and translation.

Additional information

Notes on contributors

Kazunori Nakanishi

Kazunori Nakanishi, M.A. is the Director of The Japanese Forum for Psychoanalytic Self Psychology in Kobe, Japan; and a Clinical Psychologist at Aisei Century Hospital in Nagoya, Japan.