The article “Therapy Is Sometimes a Laughing Matter” in the July 4 issue jogged my memory back to the time I worked with recovering psychotic men in the Perry Point VA Hospital right after World War II. It was common knowledge that if a patient had a sense of humor, he had a better chance of getting better. One man followed me into private practice. As I supported him by “being there” every week, I learned many things from him, including how to sauté soft-shell crabs. No matter how well he dressed, the agony of his life was apparent on his face. One day he got up from his chair and illustrated his therapy experience with me with this joke:
A man goes into a tailor shop to buy a new suit. The tailor helps him try one on. It looks good. But then he sees that one leg is too long. The tailor suggests that he hitch it up. Then the arm is too long. He hitches that up, and so on. With these adjustments, he admires himself in the glass and purchases the suit. As he hobbles down the street holding his suit carefully in place, two men come along. One exclaims, “Look at that poor man!” The other replies, “Yes, but he's got a mighty fine tailor.”
The patient eventually became independent enough to move to the West. There were several letters. “God love you for your kindness to me. Thanks very much also for the chances you provided. I am sure, God willing, they will be very much worthwhile in comparison to the ones I would have had.”
Rarely am I the one who tells the joke. Recently I was working with an elderly man who had suffered with severe chronic anxiety all his life. Since the death of his father, which occurred when the patient was 50, he had been seized by a great hunger that no amount of food would assuage. Due to his excess weight and occasional cardiac arrhythmia, therapy was vital and yet had to proceed very cautiously. One day he was complaining that all the understanding we had achieved had not changed his situation. Not recognizing its relevance, I remembered a joke I had heard 50 years ago. I decided to share it with him.
The first night at a pension in Paris, when it was discovered I was a psychiatrist, I was told about the man who consulted a doctor because he thought he was nothing but a grain of wheat (un grain de blé). After they had worked together for some time, the doctor said, “I think it is time for you to stop. You don't believe you are a grain of wheat anymore.” The man replied, “ You're right, I don't.... Oh, no, doc, we can't stop now. I may believe I am not a grain of wheat, but the chickens in the street don't know it!”
Only at that moment did I realize the significance of the joke: how long it takes in treatment for what is known intellectually to filter down into every cell of our body. To have explained that to the patient directly would have had no impact. From then on, that became our mantra. He would say, “Yes, but the chickens in my stomach don't understand.” Gradually, the chickens learned, and the anxiety was reduced.
