Seriously Considering Humor as a Therapeutic Support for Addiction Recovery

Humor interventions can increase happiness and reduce mental health symptoms such as depression and anxiety. Several authors have direct lived experience of these benefits, with humor being transformative early and throughout their addiction recovery. Yet the scientific study of humor as a support for recovery remains largely unexamined. We argue this is a missed opportunity and offer a rationale for advancing this area of research. We propose that humor aligns with putative therapeutic processes central to recovery: cognitive (i.e., psychological flexibility), reward (i.e., non-substance reward), and social processes (i.e., peer support, stigma reduction). Humor-based interventions could take many forms, including humor-focused cognitive reframing, digital comedy content, and delivery by counselors, peer recovery coaches, or other providers. Humor may strengthen treatment engagement and may also have synergistic benefits with established approaches such as CBT and mindfulness-based relapse prevention. Here, we present a humor-based intervention that integrates humor-focused cognitive reframing in group therapy and daily life, diaries to savor humorous experiences, and stand-up comedy content, including material from comedians in recovery. Our intervention example corresponds to mechanisms linking humor and outcomes (e.g., psychological flexibility, increased substance-free enjoyment, and reductions in craving via distraction). We also describe the exciting potential for humor interventions to serve as engagement and retention approaches as part of treatment. We then identify three main areas-relevant across putative processes and intervention approaches-for advancing the science of humor and addiction. This includes (1) heterogeneity in comedy preferences (e.g., comedy about addiction), (2) individual differences (e.g., anhedonia and fear of being laughed at "gelotophobia"), and (3) dynamic aspects of humor and recovery (e.g., humor across stages of recovery, humor in relation to changes in mood and social context). We conclude that research on humor in addiction should maintain a bi-directional relationship with lived experience: we should always be "in on the joke."