Laughing with and at Patients : The Roles of Laughter in Confrontations in Addiction Group Therapy

Abstract

In Minnesota treatment, the therapists aim at breaking clients' denial to encourage them to accept their addiction. However, the confrontation is risky since, instead of making the patient ready for a change, it may strengthen resistance against the diagnosis of addiction and the treatment recommendations. We will explore the role of laughter in confrontational practices. The study is based on conversation analysis of group therapy sessions in an inpatient addiction treatment clinic in Finland (7.5 hours of data altogether). The laughter prevails in three different kinds of practice: laughing off the troubles, strengthening the confrontation by laughing at the patient, and ameliorating the confrontation. Laughter is a flexible device for preventing or resolving the possible risks of confrontation.