The capacity to tell a joke: reflections from work with Asperger's children
nonsense in jokes is made to serve the same aims of representation [as in dreams].
(Freud, 1905b, p. 175)
I would like to suggest that the capacity to tell a joke is a highly complex interpersonal event that depends upon the maturation of certain developmental achievements that are absent or stunted in children with Asperger's Syndrome. These include, but are not limited to: the capacity for symbol formation, the realization that other people have a separate mind of their own, a sense of the rhythm and timing of interactions, and an empathic ability to place oneself in another's experience. Difficulties in these areas of development leave the Asperger's child in a concrete world in which symbolic play is a puzzling activity, metaphors make little sense and the world of emotions can be an incomprehensible maze of misunderstanding. One 10-year-old boy I saw told me of being teased at school and when I said that I wouldn't want to be in his shoes, he looked at me blankly and said, "But your feet are too big." In my clinical experience, the evolution of the capacity to tell a joke may be an important milestone in the progress of analytic work with some of these young patients and, I believe, offers us a valuable opportunity to observe the unfolding of factors that permit a child to enter, however belatedly, the magical realm of metaphor and play.
In this paper I will be referencing two separate areas of the psychoanalytic literature – the many contributions to understanding humor and those that address the nature of Asperger’s children – that comprise a large and fascinating terrain that is much too broad to be encompassed in an individual paper. This contribution assumes a narrower focus that specifically deals with the development of the capacity to tell a joke in Asperger’s children. Of necessity, the analytic literature on humor will be discussed but with attention to those studies that examine the developmental factors associated with the ability to understand and tell a joke. Similarly, analytic contributions to the understanding and treatment of Asperger’s children are numerous and the focus here is on the elements that impede, and help the growth of, the capacity for abstract thinking upon which a sense of humor rests. I believe that the abilities involved in the capacity to tell a joke, when disturbed, are intertwined with aspects of the nature of Asperger’s pathology and that the treatment of these young patients also opens a window to further insights into the evolution of being able to tell a joke. These issues will be illustrated in clinical material from the psychoanalysis of a young Asperger’s boy.
Poland (1990) has poignantly written about the “adult gift of laughter” and has discussed how the capacity for humor may unfold in analytic work with adult patients, with a particular emphasis on the emerging ability to deploy humor as a means of softening the inevitable pains and disappointments that occur even in a satisfying life. He goes on to link the gift of laughter with the attributes of the strength of drives and the ability to harness these, frustration tolerance, the capacity for symbol formation and the faculty for play with a range of ideas. Poland considers jokes as “steps toward mature humor” (p. 219), but in my view they are also important achievements in themselves and akin to dreams and reveries in their structure.
In the Introduction to his 1905 book Jokes and Their Relation to the Unconscious, Freud stated that jokes play an important role in psychic life but there has not been sufficient attention given them in psychoanalytic thinking. Although he was writing about humor, Freud’s primary focus in the book was on the unconscious dynamics and the structure of a joke. Although the subject of humor has received considerable attention in the analytic literature, Freud alone has addressed the joke as a structure, akin to a dream, that formed unconsciously and spontaneously. He (Freud, 1900) posited the role of dream-work in the construction of a dream and in the Jokes book proposed an analogous process, joke-work, in the formation of jokes. Both procedures involve the use of condensation, displacement, faulty reasoning, absurdity and turning into the opposite. For the purposes of our discussion, I want to emphasize that there is an underlying psychological mechanism necessary for each of these factors: the capacity for symbol formation or representation by which one thing can stand for another. Noting that absurdity and silliness in dreams is one channel of representation, Freud similarly observed that “nonsense in jokes is made to serve the same aims of representation” (1905b, p. 175).
But what is the process by which joke-work produces the joke? Freud states that jokes appear spontaneously and involuntarily in the joke-teller’s mind, the appearance of which is preceded by
an indefinable feeling . . . which I can best compare with an absence [the French term], a sudden release of intellectual tension, and then all at once the joke is there – as a rule ready-clothed in words.
(1905b, p. 167)
Furthermore, the joke is a product of an instantaneous unconscious process by which a barely recognized (preconscious) thought “plunges into the unconscious . . . seeking there the ancient dwelling-place of its former play with words” (p. 170). Thus, the joke is a temporary structure that appears unbidden in the joke-teller’s mind, like a dream or a reverie, and is one pathway to representing unconscious (or unrepresented) psychic material.
In the telling of a joke, Freud states that the joke teller begins by posing two seemingly disparate words or situations to create a feeling of “bewilderment” in the listener, which then gives way to a sense of “illumination” (the punch line) and release of laughter by revealing a similarity between things that at first glance appear unrelated and are stitched together by the play of words, double entendres and a likeness in sound. Freud implicitly assumed that each of us possessed a capacity for symbol formation, and therefore an intact and functioning dream-work or joke-work, but did not consider situations in which these faculties were either damaged or non-existent. In another publication, I (Brown, 1985) wrote that this impairment of symbol formation results in
the concrete patient’s imprisonment in a current situation . . . that casts a shadow of narrow meaning across all experiences. The concrete patient cannot lift himself out of the immediacy of the moment and is trapped in a state of mind that cannot see beyond itself.
(p. 379)
Unlike dreams, which are mainly visual, the joke stays at the level of language and aims to recover “the old pleasure in nonsense” (p. 176) that triggered laughter in childhood. I suspect that a central part of the verbal silliness in young children is the excitement over beginning to master language and also the thrill of linking two objects together1 in ways that are unusual for that child, which is often an expression of cleverness. That the little boy or girl can evoke laughter in other children or adults through this behavior adds another dimension of pleasure to these verbal antics.2 I witnessed this recently when my 22-month-old granddaughter told her first joke – “A, B, C, buttons,”3 which was delivered with a giggle that evoked a response of infectious and absurd silliness in her family audience. According to Freud, this is the long-forgotten childhood territory of verbal, nonsensical zaniness which the joke revives.
However, on a deeper level, this first expression of joke-work likely reaches down into my granddaughter’s preverbal (unformulated or unrepresented) experiences having to do with emotions about separation and union as though she was familiar with Freud’s (1905b) observation that “nonsense in jokes is made to serve the same aims of representation [as in dreams]” (p. 175). She is to putting together two seemingly unrelated concepts – letters of the alphabet and a button – and this pairing may well serve the aim of representation because the letters, though appearing to be individual elements, hang together as part of a whole (the alphabet) and a button both fastens objects together while also enabling their separation. My granddaughter’s joke-work seems to be the equivalent in word play of Freud’s (1915b) description of his 18-month-old grandson’s fort-da (“gone-there”) game in which the toddler made a toy on a string disappear by tossing it out of his crib and then reeled it in gleefully to make it reappear: each of these grandchildren in their own way were developing symbolic strategies (one through words and the other through action) to work through and represent early experiences of separation and reunion.
For Freud, though the mechanisms (condensation, displacement, etc.) by which joke-work and dream-work operated were essentially the same, jokes were constructed from verbal psychic material while the roots of dreams reached deeper down into the preverbal layers of the mind. However, he introduced the role of early object relations when discussing the origins of laughter and commented in a footnote that
the grimace characteristic of smiling, which twists up the corners of the mouth, appears first in an infant at the breast when it is satisfied and satiated and lets go of the breast as it falls asleep.
(p. 146, note 2)
Thus, Freud is suggesting that the capacity for laughter begins at the dawn of psychological life with the baby’s first smile in response to the pleasurable satisfaction of the infant’s hungry tension. Freud’s emphasis here is on the economic perspective (the building up and release of tension), which also is a factor in joke-telling: in relating a joke the comedian evokes tension and anticipation of relief by first eliciting a sense of puzzlement in the listener that is then alleviated by the discharge of laughter as the punch-line4 is delivered.
Playful joking between the mother and her infant offer the baby early experiences of learning to manage levels of excitement alternating with periods of relative quietude. A situation of danger5 arises from the threat of overstimulation that imperils the early sense of psyche-soma integration: there is a fine line between the pleasurable laughter of a baby being tickled and the terror of disintegration from too much stimulation. This anxiety of disorganizing laughter remains, in my opinion, an element in the adult enjoyment of a joke: a hilarious comic is described as “side-splitting,” one who “cracks me up” or makes us “die laughing.” Dick Cavett (2013), in his obituary of the late comedian Jonathan Winters, wrote how the comic could cheer people up but “at the risk of injuring themselves, laughing as hard as I was.” Regarding this point, Spero (2009) observed that
From early development onward, powerful states of manic exuberance, laughter, and gleeful aesthetic rapture are experienced as pleasurable and painful, requiring sensitive containment lest they overflow and overtake the infant mind.
(p. 195) [italics in original]
Bollas (1995) characterizes the mother as the First Clown to the infant who, through her playful antics, renders herself the Fool of the baby’s court, thereby transforming the child’s upset and distress into laughter; in essence “Laughing all our cares away, Just you and I.”6 Lemma (1999) additionally sees this interaction as a form of transformation, helping the baby digest what it is unable to manage on its own. This mode of relating lays the groundwork for the later capacity to modulate fear through laughing at one’s failings and gaining an appreciation of the human predicament, which Poland (1990) considers the apogee of a mature sense of humor. This First Clown mother is internalized and serves to buffer the baby against fears of fragmentation by inducing laughter to enhance a sense of well-being and integration. This internalized comforting presence was also addressed in Freud’s (1927) paper on humor, which up-dated his Jokes book from the perspective of the structural theory. There he described how the superego may comfort the injured ego by acting as though it was a benevolent loving parent, which Chasseguet-Smirgel (1988) characterized as the capacity to be a loving mother to oneself. Thus, these early experiences of shared laughter at the edge of bearable excitement and the internalization of a mother/infant digesting these potentially destabilizing states, what Bollas terms “cracking up together” (p. 243), establish an inner sense of well-being and help inoculate the infant against fragmentation.
Spero (2009) approaches the danger of damaging excitation from a different perspective and introduces the notion of a “joke envelope”7 that is part of the early developmental experiences which wrap the nascent psyche in a protective cover. The joke envelope evolves from what Spero calls early “auditory crises” of overstimulating acoustic experiences that shock the immature psyche which, like a delicate cake baking in the oven, can be readily deflated by abrupt excessive “noise.”8 Spero does not describe the interactional aspects of this early stage of the joke envelope, but I assume the playful teasing, tickling and funny sounds exchanged between mother and infant, Bollas’ “First Clown,” are its behavioral manifestations. In the mature joke envelope, the psyche is able to harness these primal anxieties with language and thereby further the capacity to tell a joke.
In addition to these factors that underlie the construction of a joke, there are other interactional capacities that must develop in order for the joke-teller to effectively “set up” his audience for the delivery of the punch line. It is commonly said that “timing is everything,” which is equally true for giving a psychoanalytic interpretation as it is for telling a joke (Lemma, 1999). In both situations, the “punch line” or interpretation is offered at a point of intensity: in the clinical encounter when the transference affects are heightened and within the reach of conscious awareness and, in telling a joke, when the listeners experience an inner tension created by “bewilderment” which is subsequently released through the “illumination” of the punch line. The comic must have the intuitive sense of timing, like that of the analyst or an empathic mother, of the moment at which maximum laughter will be produced: a punch line delivered either too quickly or too long after the body of the joke evokes minimal laughter. This is a situation not unfamiliar to the psychoanalyst, who is no stranger to the comic’s lament, “I was dying out there tonight.” Sinason (1996, cited in Lemma, 1999) observes that failed jokes – I would say interpretations as well – may be difficult to tolerate because they conjure feelings from early childhood experiences with mother of poorly timed interactions.
The ability to know another’s mind goes hand in hand with good timing. Just as the analyst must develop his intuitive skills to know what the analysand is capable of tolerating, so the joke-teller must have the aptitude of reading the mood of his audience and sensing their receptivity to certain material. The capacity to know another’s mind, of course, is a complex achievement that depends upon the ability to tolerate one’s separateness from, and concern for, the object that emerges in the depressive position, as well as curiosity about the contents of the mother’s body which Meltzer (1975) asserts is the wellspring of an infant’s fantasies. Finally, the appearance of mature symbol formation in the depressive position is the key that unlocks the infant’s mind from the narrowness of a two-dimensional world into the exuberance of a universe of infinite imagined possibilities.9
In addition to the dyadic elements of the capacity to tell a joke, Freud (1905b) observed that relating a joke is a three person event: the joke teller, the listener and the subject of the joke. It is this three-person aspect that Lemma (1999) refers to as the comic perspective, which, if we are to understand the joke, requires us to stand back and reflect on the comic contrast that the joke has challenged us to think about. She links the idea of comic perspective with Britton’s (1998) concept of the “third position,” which enables one to tolerate standing alone as an on-looker that underpins the ability to consider situations from different perspectives. We will see in the clinical material that follows how my young patient’s ability to appreciate humor was partly fostered by the active involvement of his father, and by me in the transference, to offer a third point of view.
To summarize: joke-work, along with dream-work, is one of the pathways to representation. For Freud, the true joke is a temporary structure that appears unbidden in the joke-teller’s mind and, sharing similar qualities to a dream, is one pathway to representing unconscious psychic material. While dreams are largely visual in nature and reach down into the darkest depths of the unconscious, Freud (1905b) appeared to view the origin of jokes in the remnants of early experiences that are registered verbally, i.e., what he called the “ancient dwelling place of its [the joke] former play with words . . . [and] the old pleasure in nonsense” (p. 176). However, I believe that the lineage of the capacity to tell a joke originates in the earliest interactions between mother and baby. Laughter, which is released by the punch line of a joke, develops in the first months of life and is linked with rhythmic patterns of increased stimulation followed by sudden quietude, thereby establishing a primordial joke envelope that helps gather together the psych-soma into an “emergent self” (Stern, 1986) associated with nascent affects of pleasurable stimulation. As development proceeds, successful experiences in the early oedipal/depressive position that establish the child’s ability to tolerate a third position outside of the parental couple enables a growing capacity for empathy and understanding others have a mind of their own separate from the child. These achievements are the necessary bedrock, together with Freud’s emphasis on regression to childish play with words, which underlie the capacity to tell a joke.
It is well established that Asperger’s children typically are concrete, have an underdeveloped sense of humor and experience difficulty in understanding metaphorical language. Often highly intelligent and gifted linguistically, they can recite with encyclopedic accuracy the vast array of facts acquired about their favorite subjects yet simultaneously appear “numb and dumb” (Tustin, 1986, p. 27). Their joke-work, which is one pathway to representation/transformation of emotional experience, is either severely damaged or lacking completely. This impairment, of which the incapacity to tell a joke is one example, is reflective of the underlying limitations in their emotional and cognitive development. More specifically, the difficulties these children have with empathy, separation, managing states of “pleasurable excitement” (Tustin, 1983, p. 129) and profound terror lead the child to “autosensual maneuvers” (Mitrani, 1992, 2011) aimed at restoring a semblance of inner control, often through attempting to rigidly command their environment, because “If he fails in this rigid manipulative control, the child feels that he will cease to exist” (Tustin, 1984, p. 147).
For Tustin (1994), autistic states in patients are a means to deal with “the trauma of their catastrophic awareness in infancy of their bodily separateness from the mother’s body” (p. 120).
This is a body-to-body closeness whose goal is to adhere as much of the infant’s skin surface as possible to the mother’s skin surface, what Meltzer (1975) calls an “adhesive identification.” In ordinary circumstances, this auto-sensuous connection to the mother promotes the gradual consolidation of disparate sensory experiences in the child that begin to coalesce around a sense of a core self. Premature separation from this state results in an inchoate sense of having one’s “skin boundary frontier” (Grotstein, 1984) suddenly peeled away,10 resulting in
the experience of impending disintegration of one’s sensory surface of one’s ‘rhythm of safety’ resulting in the feeling of leaking, dissolving, disappearing, or falling into unbounded space.
(Ogden, 1989, p. 133)
In addition, the patient may have the sensory experience of a black hole where a core self should exist due to this catastrophic rupture from the mother.
Owing to the unique challenges that confront the Asperger’s child, his capacity for humor, especially the aptitude to tell a joke, is extremely limited. Their subjective experience of terror at separation from the mother forecloses the growth of a shared potential space (Ogden, 1985; Winnicott, 1971) in which symbols may form, because distance from the mother (as in having a separate mind) is felt as an existential threat. The failure of a potential space to develop strands the child in a two-dimensional terrain that lacks a “third position” (Britton, 1998) and thus there is no opportunity to attain a “comic perspective” (Lemma, 1999). Additionally, empathy in Asperger’s children is limited due to the curtailment of their capacity to put themselves in another’s shoes (as was the case literally of the boy mentioned earlier in this chapter). Furthermore, since the provenance of autistic phenomena is in the earliest somato-psychic world of infancy, the first boundaries of the self as defined and sustained though various “envelopes” (skin boundary frontier, primitive skin ego, psychic envelopes, joke envelope) always feel under threat of dissolution, so psychic energies are invested in an array of autistic maneuvers that preclude ordinary maturation. With regard to the joke envelope, the capacity for laughter and “pleasurable excitement” remains a particular danger due to the risk of disorganizing over-stimulation.
I have seen a half-dozen child and adolescent patients in psychoanalysis who have either Asperger’s or significant autistic enclaves in their personalities. Each of these cases also had noteworthy histories of sensory integration difficulties early in their life: it was as though separation from the sensory buffering mother left them denuded of protection from the glare of light, the abrasiveness of touch and the booming noise of sound. These inborn sensitivities, I believe, likely create some sort of feeling for the infant of having been born prematurely, experienced as being improperly protected by various skin envelopes, and thereby increasing the infant’s need for adhesive identification with the mother. This need for a “second skin” (Bick, 1968) from the mother may be so intense that even the most capable mothers are unable to provide the needed protections from sensory overload. In other situations, there may be an interaction between the baby’s moderate need for a sensory buffer and a mother who, for a variety of reasons, is not sufficiently available. In either case, autistic defenses may be automatically deployed to manage the infant’s onslaught of unbearable somato-sensory overstimulation. Interestingly, Asperger’s children are especially intolerant of emotional stimulation and it is my impression that the use of joking as a technique helps to promote a comic perspective which fosters symbolic thinking and advances the capacity for empathy. Furthermore, the laughter engendered by mutual joke telling offers a containing function to help the child manage potentially debilitating overstimulation.
Andrew’s parents consulted me regarding longstanding concerns about their son: an only child and now four and a half years old, he was a very anxious boy who needed to control his environment lest he erupt in tantrums. They were also very troubled by his lack of friendships, fearfulness of separations, hitting, spitting and biting. Nevertheless, he could also be warm and cuddly as well as good company at times. When asked about home life, his mother laughed nervously and said that he ate all his meals in the bathtub, which, of course, I was quite shocked to hear and so inquired about this. The parents spoke with much anxiety about numerous pregnancies that had failed in miscarriage, exhaustive medical tests and procedures, all of which came to naught. Finally, with the help of a donor egg impregnated by father’s sperm, Andrew came into the world. Consequently, his mother and father appeared to forge an unconscious pact never to expose Andrew to any frustration; thus, if he desired to eat in the bathtub, so be it. The story reminded me of the legend of the Buddha’s childhood: that his parents, too, kept their son within the walls of their royal home sheltered from the harsh reality of poverty and sickness lurking just over the ramparts. However, unlike the Buddha who reacted with grief and compassion upon contact with reality, Andrew, terrified and overwhelmed, desperately sought to keep everything rigidly the same. For example, he was terrified of birthdays because he feared growing up meant he would disappear and be unrecognizable to himself and his parents.
Like many children and adults with Asperger’s Syndrome, Andrew was highly intelligent with areas of esoteric expertise that felt wooden and pedantic – for example, Andrew knew every imaginable detail about the Titanic but lacked empathy for the human suffering of that tragedy. How are we to understand this lack of empathy? The deficiencies in empathy resulting from a limited ability to experience another mind as separate and to tolerate ideas distinct from one’s own are central factors, but in my view there is another level to this enigma having to do with the quality of representations, a topic of great current interest in contemporary analytic thinking.11 In a series of papers, Elizabeth and Elias da Rocha Barros (2000, 2002, 2011, 2013, in press) have explored how dream symbols (representations of affects) develop in complexity as indicators of progress in analysis. In a recent paper,12 Elias da Rocha Barros (2013) stated that “dream-work becomes an incubator of symbolic forms,” which are products of what he and Elizabeth da Rocha Barros (in press) call the expressive function of the mind. Following Langer (1942), the Barros’ distinguish between presentational symbolism, which is expressive of emotions through intuitive processes that evoke affective associations in the listener through projective identification, and discursive symbolism, which conveys objective meaning, i.e., the dictionary definition, to the recipient.
I find the distinction between presentational and discursive symbolism to be very helpful in understanding how the empathic or expressive function of the mind of an Asperger’s child operates. With regard to Andrew, his initial communications were almost entirely discursive in nature: he amassed descriptive facts about the Titanic that imparted much knowledge but he was incapable of “incubating” presentational symbols by which to transmit something of the affective human tragedy. His factual recounting of the Titanic communicated little emotionally and felt more like a wall of discursive bricks on which a “stay out” sign was plastered. Consequently, my initial reaction to his recitations of data was fascination followed by boredom, but with no sense of terror or sadness about the catastrophe. I am reminded of Bion’s (1992) description of dream images that are not true symbols for the communication of affect, but are proto-symbols that serve as vehicles for (evacuative) projective identification of unprocessed emotional experience. Thus, Andrew’s use of evacuative projective identification of discursive and proto-symbols added to other factors that precluded an empathic response in me.
Predictably, as with other Asperger’s children, my countertransference was a mixture of boredom, frustration, discouragement and an experience of “reverie deprivation” that Ogden (2003b) describes. In the midst of struggling to make emotional contact with Andrew, an adolescent Asperger’s boy I had seen for many years was in my waiting room attempting to come up with a caption for a cartoon in the New Yorker weekly caption contest. His unexpected clever suggestions surprised me with their subtle and lively wit that had rarely emerged in our attempts at conversation. Though I did not consciously link this with Andrew’s treatment, I noticed a short time later that I had begun to spontaneously engage in word play with him. I also found myself making puns and Andrew was curious what I meant; I explained that I was making a “pun” and soon after he started to invent some of his own. A few sessions later, he arranged the toy cars in three lines, saying they were stuck in traffic and I attempted to speak for the drivers: “Oh this traffic is terrible, I’ll be late for work (or getting home).” He said they don’t have any feelings and then took out the Freud figure from the toy box, noting that he looked like me, which Andrew then placed motionlessly watching the traffic. I tried to speak for him, commenting that the drivers must be frustrated and Andrew said, “The traffic’s frozen, that’s all.” It then dawned on me that this was an exact representation of what was happening between Andrew and me: that I felt like an on-looker observing our interactions, which were frozen in an inanimate state. This realization enlivened me and I felt encouraged because for the first time he communicated something about our relationship that enabled me to understand him more fully. In addition, he used the Freud figure to stand for me, which signaled Andrew’s beginning capacity to form symbols about an interpersonal situation. I said that I thought the doctor would like to unfreeze the traffic but didn’t know how to do that. Andrew did not reject my statement and appeared to be listening.
A short time later, Andrew came into the office, made a beeline for the window blinds and removed the plastic rod that adjusts the amount of light coming in. Earlier in the analysis, he would play with the blinds by repetitively raising and lowering them to soothe himself, but on this day he stood on the analytic couch and pretended to lift himself with the rod, saying that he was a pole-vaulter. I was stunned and delighted by this sudden appearance of imaginative play, asked if I could join him, then grabbed the rod from the other window and enthusiastically entered the play. I remember thinking, “This is up-lifting,” and then realized I had made a pun. I said “This is fun using the rods to pretend we are pole-vaulters,” and he responded, “They can also be fishing poles, let’s go fishing.” We pushed two office chairs together side by side and pretended to be fishing off of a boat, catching imaginary salmon, lobsters, etc. I felt energized by this play and decided to try making a joke: I pretended to struggle reeling in an object, feigned coughing and said, “Oh no, I think I caught a cold!” Andrew laughed and said, “You can’t catch a cold in the ocean, that’s a funny joke.”
How can we explain the apparently sudden appearance of symbolic thinking and Andrew’s ability to understand my rather subtle quip about catching a cold with a fishing pole? I think this was the end point of an evolution that began with my seeing the value of comic word play in my adolescent patient, followed by creating puns with Andrew, thereby fostering a mindset in which one thing might stand for another, i.e., the Freud figure for me. In retrospect, I could more easily enlist Andrew in fanciful word play than in pretend play with objects. I believe these off-the-cuff strategies helped to create a shared play space between us and that my use of puns and absurdities made “comic contrasts” (Freud, 1905b, p. 10) that helped to foster the capacity for presentational symbol formation.
Andrew’s nascent ability to understand metaphor, fostered by our play with words, gave him the initial tools needed to work through emotional experiences such as separations from me. Andrew, ordinarily a well coordinated boy, stumbled when coming into my office the day before his one week vacation. He said, “I tripped,” and I said he’s going on a real trip tomorrow with his family and we won’t be seeing each other. He laughed and said that was “funny.” On the day of his return, Andrew looked sad and commented that I got a new curb [actually true, installed while he was away] in front of my house. I said it makes him sad to see that and he said he didn’t know that would happen. I replied, “Maybe when you saw the new curb you wondered whether other things changed, like whether I’d be here or look like me.” He said he knew I’d be here and that I always look like me, then commented that he’s taller than he used to be. I interpreted, “We haven’t seen each other for a week and maybe you’re worried I wouldn’t know you because you got taller.” He responded by opening the office door to check that his mother was in the waiting room and said, “my mother is always there too.”
In the week prior to his sixth birthday, Andrew had us playing as farmers who were planting and harvesting potatoes. The day before his actual birthday his mother left me a voicemail saying that Andrew had asked to see her vagina. On his birthday, which landed on the last session of the week, Andrew arrived wearing a Burger King crown. He was very anxious, running back and forth across the office, compulsively touching objects and whisking his sleeve with his hand as though brushing off invisible dust. I said, “It’s a very exciting day and you’re full of energy,” and he replied, “Yes, it’s a special day, it’s my birthday.” I said that it was his sixth birthday today and that birthdays could be exciting and also scary at the same time. Attempting to reassure himself, Andrew replied that “I was born in the nighttime, so I’m not really six years old yet.” With pressured speech, he spoke briefly about riding the school bus, which he did not yet do, and this reminded me of some recent play of a school bus crashing. As I was recalling the earlier play, Andrew said, “Wanna hear a joke?” and I asked him to tell me. “Did you hear about the giant who threw up?” he questioned with obvious glee, and before I could finish saying “What happened?” he said in one breath, “It was all over town get it?” He fell back in a chair as we both laughed, asked if I’d like to hear another one, and when I nodded he offered, “What did the necktie say to the hat?” I asked for a moment to think about it, but he quickly told the punch line, again in one breath: “Go on ahead I’ll hang around here get it?” As the session drew to a close, Andrew said he’d like us to return to our play of planting and harvesting potatoes and instructed that we were to dig holes, then plant seeds in them. I said, “It’s very easy to grow potatoes, but it’s much harder to make a human baby.” Andrew said he once saw a picture of a baby before it was a baby and “it was like muscles together, it was just muscles.” Then he told me a funny story about a bird sitting on an egg and there was such a strong wind that the egg got blown away six times; thus, the mother had to run after it to sit on it again and again.
Apart from the fascinating content in this hour, we can see Andrew’s growing capacity to represent his emotional experiences of loss, terror of growing up and curiosity about how human existence comes into being. However, at the outset of the session he was in a near psychotic state: running around the consulting room, having concretized his fear as unseen dust to be whisked away, and falsely believing that he rode the school bus. This evoked my recollecting his play of crashing school buses and also his earlier association of birthdays with disappearing. It was at that moment that Andrew asked if I wanted to hear the two jokes, which seemed to have an organizing effect in the session, partly as a manic defense (saying his birthday was at night), but also and perhaps more importantly, harnessing his overstimulated state by engaging me as a modulating container to laugh along with him. In addition, the content picked up on and expressed what was happening in the session. The joke about the giant who threw up seemed to capture Andrew’s psychic state of vomiting up his terror through action and what Bion (1965) calls a transformation in hallucinosis (the invisible dust and believing he rode the school bus). The second joke was more organized and appeared to represent the underlying theme of separation and loss (“you go on ahead”), which segued into the latter part of the session characterized by a higher symbolic level.
In the later portion of the hour immediately following the two jokes that helped him manage the excitement and terror of his birthday, Andrew regained his capacity for symbolic (presentational) forms and narrated a fascinating story about prenatal life and the subsequent struggle to be born. I had been thinking about how the entire hour was about growing and surviving; I said that “it’s much harder to make a human baby,” to which he responded by telling me that he had seen a picture of a baby in utero and “it was like muscles together.” I found this comment to be very poignant, conveying a phantasy of himself as formless, and the “funny” story about the mother bird trying to nurture her egg which blew away six times amplified my sad feeling. It was as though he was communicating the fragile sense of his own existence and also, perhaps, some unconscious knowledge of his mother’s many miscarriages and difficulty getting pregnant.
In a meeting with his parents around this time, his father revealed that he and Andrew had been reading a joke book together, the first I heard of this. I had not mentioned my use of humor in the treatment, so I inquired how this began and the father said he noticed Andrew was more humorous lately; thus, prompting his purchase of the book. The father described that he explained some jokes to Andrew and why they were funny. I told them that Andrew and I had been using jokes to communicate and the parents said they were unaware of that. Now, having heard of this humorous play with his father, it appeared that Andrew used the relationship with his father and me as a pathway to opening up a comic perspective that enlarged his growing capacity for abstract thought and, significantly, as a channel to tolerate the necessary separation from his mother in order to find a third position with his father (and me) and a mind of his own.
I believe that Andrew’s joking with his father and me served as important opportunities in continuing to build a capacity for symbolic thinking and metaphor that are essential for the growth of an inner emotional world. Three dimensional narratives of oneself develop to foster an experience of subjective depth that replaces the clusters of mechanical facts thinly papered over the infinite ink of black holes. In addition, working with Andrew’s jokes and other word play contributed to his growing ability to gain a sense of mindfulness, that is, an understanding that others have a mind separate from his, which may also think differently. For example, when Andrew was unable to allow me time to think of the punch line for one of his jokes, it was in essence an inability to recognize that I had a mind of my own (Caper, 2000), which needed time to think. Thus, I let him know that even though he was eager to share his joke, that I needed time to think about it. This brief hiatus also allowed the building up of anticipation of the punch line that brings about the “sudden release of intellectual tension” (Freud, 1905b, p. 167) through laughter. Allowing himself to tolerate not telling me the punch line improved his capacity to withstand unpleasant feelings and therefore to represent them.
A legitimate question may be raised regarding the role that my word play and joke-work had in the significant gains achieved in Andrew’s analysis. Put another way, we may wonder about the extent to which these clinical improvements were the result of my analytic approach or whether, instead, his capacity to tell a joke was secondary to other factors. As in any child psychoanalysis, there are many interacting dynamics that combine to create the therapeutic action: the conscious and unconscious dimensions of the analytic relationship, the analyst’s interpretations, the inherent potential for growth in the child and work with the parents, to name just a few. Thus, it is difficult to identify the relative weight of each of the elements, which will vary from one treatment to another. However, in analytic work with Asperger’s children, the therapist seeks to employ treatment approaches that foster an emotional relationship with the analyst, help to develop empathy, diminish concrete thinking and improve peer relationships. I believe that engaging Andrew in verbal play, including making puns and jokes, played a significant role in his analysis.
In this particular analysis, the approach I adopted included the verbal play Andrew and I engaged in but also involved, especially later in the treatment, more “traditional” interpretive work. However, in order to reach a point at which Andrew was amenable to interpretations, “there is a need for upstream operations to overhaul, sometimes to a considerable extent, the patient’s actual apparatus for thinking thoughts [alpha function]” (Ferro, 2009a, p. 18) and fostering Andrew’s capacity for telling a joke catalyzed the emergence of abstract thinking. By initially introducing puns, I helped Andrew to get a sense that a word may have more than one meaning, thereby creating a “comic contrast” to enable his awareness that there is meaning beyond the obvious and initiated a nascent ability to think more abstractly. In addition, it seems reasonable to speculate that our lively verbal engagement unconsciously offered Andrew a containing “First Clown” (Bollas, 1995) experience that was lacking in his mother’s complete indulgence of his every whim (e.g., eating meals in the bathtub). Furthermore, our word play also seemed to represent his need for a paternal figure that could open up alternative views of reality, i.e., a “third position,” beyond the two dimensional one in which he and his mother were encased. All these elements combined to activate a capacity for abstract thinking, including the emergence of presentational symbols that subsequently allowed me to work with Andrew more interpretively.
The growth of a symbolic function enables a child to master various conflicts via the working through of play. Andrew had evolved from play with words to playing out stories with me that were more or less verbatim from books he had read; however, these are no longer mere recitations but are unconsciously picked to convey a difficult situation in his concurrent life and evoke sympathetic feelings (presentational symbols) in me for his dilemmas. Andrew is presently 11 years old and in the seventh year of analysis: his symbolic capacities and the associated ability for interactive play have considerably grown such that his aggression has become our current focus. Now we are, at Andrew’s suggestion, two soldiers learning about the science of war and fighting a variety of enemies with an array of potent weaponry. He recently had us create his version of the Battle of Dunkirk in which we were instrumental in rescuing the embattled fighters; an apt storyline to describe our long work together to bring him back from the edge of emotional entrapment and psychological disaster.
1 The word symbol derives from the Greek word symbolon that suggests throwing things together for contrast and comparison.
2 Trevarthen (2005) observes that parental failure to respond to the infant’s attempts to evoke pleasure induces shame in the baby.
3 In effect, this “joke” was employing a mechanism found in more sophisticated humor that offers “a judgment which produces a comic contrast” (Freud, 1905b, p. 10), that, in essence, says, “Isn’t it ridiculous to think of A, B and C connected with buttons?”
4 Freud, of course, did not use the words “punch line” since it is an English language term that came into usage in the 1920s or 1930s, many years after his Jokes book.
5 See Kris (1938) and Jacobson (1946) regarding the dangers of overstimulation.
6 Lyrics from Chad and Jeremy, A Summer Song (1964).
7 Together with Anzieu’s (1993) notion of the skin ego, Bick’s (1986) discussions of the importance of skin in early object relations and Frances Tustin’s (1994) work on the rhythm of safety, the joke envelope is a central element in this constellation of archaic organizers of the psyche-soma.
8 Perhaps this is one of the sources of humor underlying jokes of flatulence? These reach down into the early unrepresented bodily experiences characterized by sound, the buildup of abdominal pressure and subsequent discharge.
9 Rhode (2011) states that many Asperger children have a sense, albeit not always well developed, of others having an inside in clear distinction from autistic children who lack this capacity.
10 An adult woman I (Brown, 1996) previously reported on felt that she had neither an inside nor an outside and that she was like “a face on a pane of glass” (p. 44). Separations from me reminded her of burn patients with skin grafts: if the bandages were taken off too soon, the new skin would peel off with the gauze.
11 See Levine, Reed and Scarfone’s (2013) recent compendium of papers on this subject.
12 Paper given at the Boston Psychoanalytic Institute, December, 2013.