Language, Humor and Silence

By Ofer Zur, Ph.D.
 

 

Therapy has been dubbed the “talking cure,” and spoken language is the primary tool of psychotherapists and counselors. Language can help connect people and heal clients, but it also can be a barrier between therapists and clients. Language has been considered a therapeutic boundary issue and is usually discussed with regard to formalities, tone of voice, choice of words, type of language, and the use of silence (Gabbard & Nadelson, 1995; Gutheil & Gabbard, 1993; Zur, 2007). Language is an obvious boundary that separates when therapists and clients do not speak the same language, when one is lacking minimal proficiency, or when dealing with clients who are hearing impaired.

The culture, class, region, and age of therapists and clients often determine the use of first name versus last name. More formal therapists or clients or those from more European cultures, as well as those who are older, are more likely to use the last name as a respectful way to address a client. Consistent with their therapeutic modality and their stance on the nature of therapist-client connection, feminist or humanistic therapists are more likely to ask clients to address them by their first name and use clients’ first names rather than last as a way to reduce the power differential and level the playing field (Zur, 2007). National surveys of psychotherapists and clients revealed that most clients address therapists by their first name (Pope et al., 1987; Ramsdell & Ramsdell, 1993).

Tone of voice is another potential language variable as it can vary between businesslike and personal and between appropriate and inappropriately hostile, violent, or sexually seductive (Zur, 2007). Similarly, choice of words is of extreme importance as it can connect or separate people. Freud expressed his fondness for his patient Ferenczi by addressing him as “dear son.” Therapists’ use of jargon can be educational or distancing. Using jargon, the F word, or even the N word can be highly connective between certain clients and certain therapists.

Humor in Therapy

Humor is an important part of language. Much has been written on the general health benefits of humor (e.g., Cousins, 1985; Galloway & Cropley, 1999), and several authors have discussed its use in psychotherapy (Lemma, 1999; MacHovec, 1991). Like any form of language, humor can increase comfort and decrease anxiety, but it also can be offensive if it includes distasteful themes. Vulgar, abusive, sexist, racist, or other inappropriate, offensive language is a clear boundary violation (Gutheil & Gabbard, 1993; Zur, 2007).

Obviously, when therapists and clients are not equally fluent in the same language, there is a language barrier that separates them. The use of an interpreter who speaks the language or one who can help interpret for deaf clients brings a third party to the therapeutic exchange and can be helpful, destructive, or invasive. When the language used in therapy is a second language for either therapist or client, the nature of the barrier would depend on the verbal proficiency and cultural awareness of both. Even when client and therapist are both fluent in the language they speak to each other, the same words may have different meanings for each of them if they come from different cultures or socioeconomic classes. Language used without sensitivity to the vocabulary level of the listener can also create a barrier. Spoken language is a barrier if either therapist or client is hearing impaired unless both are fluent in signing.

Silence in therapy can be respectful, providing clients with the space they need to be quiet, to contemplate, to get in touch with memories or feelings, or to gather their thoughts. However, silence, which can be initiated by therapists or clients, can also be a form of therapeutic boundary as it may create a space between therapist and client. Silence can show respect, disrespect, abandonment, or hostility. The meaning of silence varies with people’s cultures, personalities, mental disorders, emotional state, and age. The modality used in therapy and the quality and type of the therapeutic relationship are also likely to affect the perceived quality of the silence.

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