Gallows Humor and Secondary Traumatic Stress in The Workplace
by Mickey Marie
Is your dark sense of humor ruining your job?
In this paper, studies on the use and misuse of humor in fields of work that involve exposure to secondary traumatic stress will be analyzed. This will also look at the past mistakes of other studies in not defining the differences in types of humor in relation to their effects on both professionals and clients. Making the distinction between lighthearted and gallows humor can change the entire meaning of a study. This thesis analyzes and explains the results from multiple studies and also explain why this field requires more research before any solid conclusions can be made.
gallows or negative humor, secondary traumatic stress, lighthearted or positive humor, successful humor
Many studies have been done on humor and its uses as a coping mechanism in the workplace. The majority of these studies conclude that humor in the workplace is beneficial. Few of them differentiate between positive and negative humor, though. Because of this there is more than one answer to the question of “is humor in the workplace good or bad?” Professionals in career fields that involve Secondary Traumatic Stress often use forms of humor as coping mechanisms. In this essay, multiple studies that touch on the subject of humor in these types of workplaces will be analyzed. Gallows humor and negative humor will be used interchangeably, as well as lighthearted humor and positive humor and the following topics will be addressed:
- Explaining Secondary Traumatic Stress
- The distinction between lighthearted, gallows, and successful humor
- Positive effects of humor in the workplace
- Negative effects of humor in the workplace
- Effects of humor on clients
- Alternate coping mechanisms
- Further research
Through analyzing these topics, it can be concluded that, while successful humor can be a very good coping skill in stressful work environments, gallows humor is not and has even been linked to negative effects on the individual’s physical and psychological wellbeing.
What is Secondary Traumatic Stress?
Professionals who often deal with traumatic events experience a lot of stress. This type of stress, when it is severe, is referred to as Secondary Traumatic Stress. Secondary Traumatic Stress is defined in the Psychiatric Times as, “indirect exposure to trauma through a firsthand account or narrative of a traumatic event.” This means that individuals who assist others during traumatic events or hear recounts of traumatic events run the risk of developing Secondary Traumatic Stress Syndrome. The symptoms of Secondary Traumatic Stress, or STS, are similar to the symptoms of Post-Traumatic Stress Disorder which occurs in individuals who experience trauma first-hand. Professionals who deal with these kinds of issues include, but are not limited to: police officers, forensic nurses, firefighters, crime scene investigators, surgeons, therapists, and sex crime workers. In these professions, humor is often used to combat this stress or serve as a coping mechanism. The humor used as a coping mechanism in these careers can often be macabre due to the austere nature of their jobs. These professionals experience, secondhand, everything from serious injuries, to death, to the aftermath of sexual assaults and much more. These are not experiences that the average person goes through on a day to day basis. Because of this, it does take a toll on these professionals. This secondhand, or indirect, exposure to trauma can have huge emotional impacts on individuals and many believe humor can be used to combat this. In a study done on 133 human service professionals, ranging in age from 20 to 64, it was found that age, sex, and relationship status did not have much effect on Secondary Traumatic Stress levels. This means that anyone can be susceptible to developing Secondary Traumatic Stress in these career fields.
Different Types of Humor
In most contexts, humor is considered a positive aspect of communication while the darker side goes unmentioned. While humor can be used both in and outside of the workplace to lift spirits, this is not its only use. Humor was seen as an important staff skill by individuals involved in a study on Forensic Nurses, though timing and type were never clarified in the research that was analyzed. Humor can be intended for and perceived in many different ways. Humor can be seen as aggressive, rude, or sarcastic when at the expense of others. When used positively though, humor can be lighthearted and fun. It can also be used to express emotions like anger, frustration, and joy. While defining humor, Boes and Wormer point out that Freud thought of humor as “a coping mechanism that allows society to reduce tension by expressing… obscene impulses in a socially acceptable manner.” This statement implies that at one time gallows humor was believed to be tension-relieving and positive. Gallows humor refers to the dark sense of humor some develop while working in high stress career fields. It can be defined as “humor that makes fun of a life-threatening, disastrous, or terrifying situations.” It is often used only amongst certain groups of workers because others are seen as “outsiders” who would not understand their sense of humor. Craun and Bourke also touch on this, stating that professionals who all work with sudden traumatic deaths feel comfortable using gallows humor amongst themselves but know better than to use it with other workers, such as those involved in clerical work. Because of this, the group that uses gallows humor knows to censor themselves around “outsiders.” Successful humor is defined as a mutually amusing communication. Both gallows and lighthearted humor can fall into this category depending on the situation but just because humor is successful does not mean it is positive.
When is Humor Good in Regards to Secondary Traumatic Stress?
Having a good sense of humor has long been seen as something that decreases depression, anxiety, and stress while increasing immunity to illness and enhancing moods. Positive humor can illicit positive responses, therefore having the potential to improve group processes in the workplace. Mesmer-Magnus, Glew, and Viswesvaran come to the conclusion in their meta-analysis that positive humor can build affinity, reduce burnout, increase workplace cohesion, and enhance coping effectiveness. Through analyzing the results of prior research, they were able to deduce that lighthearted humor was able to increase job performance and satisfaction, as well as, save money that would usually have been spent as a side-effect of employees being burned out. It can also be said from their research that positive humor in the workplace can be linked to better overall physical and mental health. So, it can be said that positive and lighthearted humor do correlate with positive effects. In Craun and Bourke’s qualitative study of 500 sex crime workers, they were able to show that lighthearted humor was used frequently by the Internet Crimes Against Children members through the use of several surveys. The use of lighthearted humor correlated with lower Secondary Traumatic Test scores and had more effect on the scores than social and coworker support.
A type of humor that usually has a positive impact on workers is “play on words” humor. Play on words humor can be considered as a type of lighthearted humor. In a study done on humor used in the emergency room, this type of humor was discussed. This kind of humor can be purposeful, or it can come from a Freudian slip. An example given by Wormer and Boes is of a doctor accidentally saying, “Just eat 'em and street 'em” rather than “Just treat 'em and street 'em.” Another example given was of a nickname made for a surgeon who often wore cowboy boots and was “very aggressive” during his procedures. It was always said out of his ear shot, but his staff called him the “cowboy surgeon.” This kind of humor is harmless and facilitates a sense of community amongst the coworkers in the emergency room.
Tension relieving nonsense was another form of lighthearted humor discussed in Wormer and Boes’ analysis of humor in the emergency room. They called it tension relieving nonsense because this kind of silly humor often results in laughter. Laughing can help relax muscles, relieve tightness, and aid in creating a sense of well-being. Wormer and Boes pass on a story told by a nurse administrator, named Alice Guy, that encompasses tension relieving humor, stating:
Hospital staff members were having a party when word came that a patient was on the roof threatening suicide. Guy was furious at this threat to their fun. Rushing to the roof and speaking without thinking, she ordered, 'Get off that roof! You're interrupting the party.’ The man did. The humor of the story was that despite the fact that others had tried for hours to get the man off the roof, he obeyed the one person who simply spoke her mind – and in doing so went beyond the bounds of good professionalism. This amusing story was shared at the hospital for years after.
There are many positive ways to use humor as a coping mechanism, but this does not mean that all ways of using humor for coping are good.
The Use of Gallows Humor
In their meta-analysis, Boes and Wormer suggest that gallows humor is a way of maintaining sanity in insane conditions; that it is an illogical response to a hopeless situation. This is where the research begins to clash, because while this may be partially true, others believe the results of Craun and Bourke’s study help clarify that even if gallows humor gives you a sense of relief, it is only temporary because in the long run the effects of its use are not positive. Boes and Wormer gave an example of an inmate on death row jokingly turning down a cigarette because he had quit the prior day. This is an example of gallows humor because, generally speaking, people stop smoking for health reasons. They do not want to get cancer, emphysema, or they want to live to see their grandchildren, etc. Because this inmate is on death row though, none of these things apply to them so the inmate is seen as using gallows humor to make light of the fact he may not be alive much longer. Another example they give is about an inmate on death row asking about when they are going to start a weight watchers program. Again, this is gallows humor because realistically, this person will not be alive very long, so their weight is not an actual concern. The humor is just being used as a coping mechanism to make light of the fact the inmate is on death row.
Watson has a similar concept of gallows humor as Freud. Watson is quoted in her qualitative research on gallows humor in the medical field saying, “blanket dismissals of gallows humor as unprofessional misunderstand or undervalue the psychological, social, cognitive, and linguistic ways that joking and laughing work.” Another source states that laughter can be used to help interrupt physiological stress responses because it increases exhalation and it eases muscle tension. Humor though, can exist as a separate entity than laughter and therefore does not correlate. Not to mention that in Craun and Bourke’s study, they found that the use of gallows humor correlated with higher Secondary Traumatic Stress scores and even had a higher effect on the scores than using denial as a coping skill did. Gallows humor was also linked to an increase in alcohol consumption in participants in the past year and reduced psychological wellness. Craun and Bourke point out previous studies imply that the use of gallows humor may be an indication of psychological distress in workers. These studies show that use and increasing use of gallows humor is an indicator that the professional is no longer compassionate enough to fulfil their job properly, as well as, the possibility that it is a red flag indicating that the individual is not coping with Secondary Traumatic Stress well.
Some researchers believe that using gallows humor as a coping mechanism is not a big deal. They believe that professionals in career fields where Secondary Traumatic Stress is experience should use whatever methods necessary to cope. One of these studies makes the claim that “The use of black humor among emergency services professionals would thus be seen as a form of stress release, relieving the professional of intolerable feelings of horror, helplessness, and anger, and this in turn would reduce psychic anxiety.” They also acknowledge, though, that using this kind of humor to cope could end up with adverse effects such as increasing anger. They use the old concept of superiority theory to support these claims. Superiority theory states that using humor at the expense of others helps raise our self-esteem and by blaming victims for the unfortunate things that happen to them. Individuals can convince themselves they would never be in a position to experience the same misfortune. In their examination, they use a quote from Wear and Colleagues to support their stance, citing “students enter the clinical world full of enthusiasm and optimism for what medicine can achieve and are met with obstacles of all sorts, including cynical faculty, uncooperative or unappreciative patients, and their own unanticipated emotional responses to the experience of hospital based medicine. Every day they encounter something that should be otherwise, and humor may be one way of managing the incongruencies.” While it can be seen that humor is important in the workplace as way of managing the day to day events, once again, this quote from this study does not point out what kind of humor they are discussing. The study itself may go into further detail, but what is provided in the examination by Regehr and Rowe does not.
Effects on Work Relationships and Clients
Humor can be used as a tool to bond with people. In the study on forensic nurses, they focused a part of their research on humor as a relational tool. They specified this as the use of humor with patients. The results were split, a good portion of the nurses said they believed humor helped with their patient relations while others stated that the use of humor in general was challenging the institutional order. They also stated that even the most well intended jokes can be misunderstood and taken the wrong way and that this possibility might make it less worth it to employ humor with patients, but correct use of humor could lead to a more relaxed patient. In another study of nurses, it was indicated that those who were experiencing Secondary Traumatic Stress were more likely to be impersonal or angry with patients therefore reducing the quality of the patient and care taker interaction as well as colleague to colleague relationships. Another source reported acknowledging that using gallows humor with patients could dehumanize those who the jokes are about.
This open-ended result on the effects of humor on patients is just one of the many reasons more research needs to be done in this field. When patients use gallows humor, it is often seen as giving themselves power in a situation they are otherwise powerless in. While this is definitely one way to explain this phenomenon, it is possible that this could be interpreted in another way. The use of gallows humor as a coping mechanism may be a way of deflecting, preventing full acknowledgment of their emotional state. This room for interpretation is another reason why more research needs to be done in this field that distinguishes between lighthearted and gallows humor.
Alternative Coping Skills
One study that does look into alternative ways for workers to deal with Secondary Traumatic Stress suggests using resilience and mindfulness as an alternative coping mechanism. This study defines resilience as a “buffer which protects individuals from adverse environmental influences and forces” and “the ability to bounce back from adversity, persevere through difficult times, and return to a state of internal equilibrium.” The other suggestion is mindfulness. Mindfulness is defined in their research as “an intentional state of awareness, mindfulness concerns the process of bringing one’s attention to the present moment, in a non-judgmental and accepting manner.” Mindfulness is very effective in reducing stress and increasing what Harker, Pidgeon, Klaassen, and King referred to as resilience. Unlike resilience though, mindfulness has an explanation as to how to reach it. Mindfulness can be practiced through multiple techniques which range from quietly meditating to playing active games and are generally done in 5-minute increments in therapeutic settings but can be done for as long as the individual or group needs outside of the therapeutic setting. Increased mindfulness was linked with an increase of psychological well-being and with a decrease in Secondary Traumatic Stress scores. They also found that “research investigating the beneficial effects of increased levels of mindfulness has reported improvements in distress tolerance, emotion regulation skills, and psychological flexibility. In order to conduct their study, they sampled a group of 133 human service professionals – mostly women – and gave them a series of questionnaires. The questionnaires they used were The Professional Quality of Life Scale, The General Well-Being Schedule, The Resilience Factor Inventory, and The Freiburg Mindfulness Inventory. The Quality of Life Scale has two subscales: one the measures exhaustion, frustration, anger, and depression symptoms and the other measures negative feelings brought on by work-related trauma and fear. Anxiety and depressive symptoms are assessed using the General Well-Being Schedule, along with overall psychological well-being. The Resilience Factor Inventory evaluates the individual’s level of resilience with 60 questions and The Freiburg Mindfulness Inventory evaluates the individual’s mindfulness using 14 questions.
The conclusions that these tests came to were that higher levels of resilience and mindfulness correlated with lower levels of Secondary Traumatic Stress. Mindfulness showed less effect on the levels while resilience showed much more. Mindfulness only made up for 1.77% of the variance and resilience made up 8.18% of the variance. The researchers did point out at the end, though, that the study was completely voluntary and therefore may have had skewed data. The way they framed the concern was that the employees who were experiencing the most Secondary Traumatic Stress may have been too emotionally fatigued to participate in the study and that this may have skewed the data. On top of this, they pointed out that self-report data can be unreliable due to the fact that people often show social desirability biases.
Because the symptoms of Secondary Traumatic Stress are so similar to the symptoms of Post Traumatic Stress, it could be said that treatments geared for PTSD may be effective in treating STS. One of these treatment paths are Cognitive Behavioral Therapies. “Cognitive behavioral therapies (CBTs) challenge the way individuals think and behave and are an effective intervention for treatment of PTSD.” One type of CBT is CPT, or Cognitive Processing Therapy. This is a therapy that was originally developed to treat rape victims. In CPT, the traumatic event is revisited in order to facilitate reshaping the negative world views created by the traumatic event. An example given is of someone being raped and developing a view that the world is not safe. In order to combat this the therapist would assist in changing this view from “the world isn’t safe” to “I can learn to protect myself in an unsafe world.” By doing this, the therapist can help lower the distress levels of the patient, as well as avoidance, which is a component of PTSD. CBT involves homework for patients as well to help generalize the skills being taught within the clinical setting.
Another treatment often used for PTSD is Prolonged Exposure Therapy. This is a behavioral therapy that “helps clients safely face frightening experiences and memories by recalling traumatic memories in a controlled fashion.” This process is done gradually in a controlled setting so as to not overwhelm the patient. It is believed that this process can help the patient assess their symptoms and reshape their feelings and thoughts about the event that caused them to develop PTSD. It can also help the patient to slowly begin regular functioning on a day to day basis.
Psychotropic medication can also be beneficial for PTSD patients. Some anti-depressants can help reduce the levels of depression, stemming from the traumatic event, in patients. There are many anti-depressants that are approved by the FDA to assist with PTSD symptoms. Anxiolytics, or antianxiety and antipanic medications, can be used to reduce stress and anxiety levels in individuals who have PTSD according to the Mayo Clinic. There are also medications such as Prazosin, an antihypertensive medication, that is not approved to treat PTSD by the FDA, but the Mayo Clinic believes could help keep nightmares at bay and combat insomnia.
Eye Movement Desensitization and Reprocessing, otherwise known as EMDR, is evidence based when it comes to its effectiveness in treating Post Traumatic Stress Disorder. EMDR is a mixture of psychodynamic, behavioral, cognitive, and body-centered therapies. During this treatment, the therapist will use what is called “bilateral stimulation.” This means the client will work to process the traumatic event while the therapist uses “eye movements following hand, tactile or auditory cues.” During this process, the client goes back and forth between thinking of the traumatic event and focusing on the present moment. This is called “dual attention.”
While it is true that research has identified positive links between humor and emotional states, very few people have made the distinction between lighthearted and gallows humor. Because of this, studies that primarily focus on positive humor are often used to justify gallows humor in the workplace as well because the distinction was never made between positive and negative humor. The connection Watson makes between gallows humor and laughter earlier in the paper is an example of this, as well as Boes’ and Wormer’s interpretation of what using gallows humor as a patient indicates. The misconception that all humor is connected with laughing and therefore positive is just that, a misconception. This flaw in humor studies means that there is still a significant amount of research needing to be done in this area. Studies should be done to clearly determine what the effects of positive and negative humor are separately. Studies need to be done on professional-client relationships and the use of gallows humor. These studies should focus on groups where only the professional uses gallows, only the patient uses gallows, both use gallows, and then neither use gallows. It may be very difficult to find these relationships naturally but if it could be done, it could be said that this would be a very effective way of gathering data on these types of social relationships. It can also be said that it would be beneficial for professionals who use gallows humor to be evaluated individually to see if there is a correlation with things such as depression and anxiety and the use of gallows humor because very few studies do. Another aspect that would be good to look into is whether or not there is a difference in the effects based on sex and gender. Although one of the studies previously discussed sex alone, the study was almost 80% women and therefore could be biased. Even though many do not believe there are many physiological differences between men and women, the ways life is experienced in our patriarchal society may possibly leave one sex or gender more vulnerable to Secondary Traumatic Stress. In order to get past the self-report data bias, assessments in the future could be conducted using a psychiatrist or other assessment specific professional to administer the questionnaires in a format closer to how mental illnesses are assessed. A lot of these studies focused on correlation. This is an important factor, but future research should focus more on causation and include more factors that could be affecting the results of the experiments. Another beneficial thing to look into would be if certain therapies that show success with PTSD would show the same level of success with individuals experiencing Secondary Traumatic Stress. Because PTSD and Secondary Traumatic Stress have very similar symptoms, it is likely that there is some overlap when it comes to coping and treatment after the fact.
While many studies conclude that humor in the workplace is positive, it can be seen from analyzing research that distinguishes between types of humor that gallows humor is not a healthy coping mechanism. In some cases, it can be an indicator that workers are no longer compassionate enough to work in their field and others that the worker is not managing their Secondary Traumatic Stress well. There is not a lot of research into alternative coping mechanisms to replace gallows humor, but it is possible that treatments and skills related to dealing with Post Traumatic Stress could be beneficial for people experiencing STS due to the fact that PTSD and STS share a lot of the same symptoms. This cannot be said with certainty though because there have not been many studies done on this. Mindfulness and resilience were shown to be helpful in handling STS though, and this is a step in the right direction to help professionals who experience indirect trauma on a fairly regular basis. It is important to further this research because a lot of these careers are necessary and helpful to the population even though they have adverse effects on the individuals doing the jobs.
In order to stress the importance of the researching more into the effects, gallows humor has in these professionals, it may be beneficial to explain why it is important to care for the mental health of these workers. Some helping fields get a lot of attention from the public and are more valued because of it, such as firefighters, surgeons, and police officers. If it could be explained why mental health workers are so important or why nurses and sex crime workers are so important, it may bring people’s awareness to them and the issues they face from working such stressful jobs. Many people don’t think about how much of a toll being in helping field takes on you but without these professionals so many people would go uncared for and untreated. Many of these workers are behind the scenes doing jobs most people would not want to do and risking their own physical and psychological well-being for others, and they deserve to have concrete answers as to how they can help protect themselves from the side effects of their jobs.