Case Study


Case Study

Managing Hecklers in the Therapy Room: An Ex-Comedian Puts Her Old Skills to Use

By Kirsten Lind Seal

May/June 2016


Family therapy is a second career for me. For 20 years, I was a professional performer, during which time I was a regular at standup comedy clubs in New York City. Many of the skills I learned as a performer have proven readily transferable to therapy, but one skill set in particular has been most helpful: the skill of using humor to defuse tension, create alliance, and challenge what we often call resistance in difficult clients.

When you go out on stage as a standup, you’re uniquely vulnerable. You’re asking a disparate group of people, some of whom are probably quite drunk by the time you start your set, to listen and laugh and basically buy what you’re selling. It’s the job of the comic on stage to join with the audience and bring them into your reality to show them a new way of thinking about things. Nonetheless, as a beginning therapist, I discovered that I had no idea how to go about challenging difficult clients without getting angry and defensive myself. I eventually realized that what I’d learned the hard way on comedy stages was actually the key to succeeding with these clients.

The case study that follows isn’t laugh-out-loud funny. It’s not about how I make my clients fall about the room laughing at my uproarious jokes. Instead, it’s about using what I learned on the standup comedy stage to nudge difficult clients into opening their eyes to what they’re doing that’s not helping in a relationship—and how I use the some of the rules of comedy to manage my own irritation and frustration with them so as not to blow up the therapy before it has a chance to work.


Comedy Rule 1: Know the Difference Between Tragedy and Comedy

As Mel Brooks once said, “Tragedy is when I cut my finger. Comedy is when you fall into an open sewer and die.” It’s important to understand the difference. Not that we want our clients to think of their issues as cut fingers, but what Brooks is talking about here is the change of perspective that’s integral to getting good therapeutic outcomes. For sure, some types of comedy can be brutal. But if, with the use of thoughtfully applied humor, we can help our clients go from here to there—from crying about their cut finger to seeing a cut finger for what it is—then we can create the movement necessary for growth. And this is what they come to us for, even if they don’t know it. That was the case with Daniel, a hard-charging attorney, who’d just moved to the Midwest from Los Angeles.

He came to see me because of ongoing conflict with his teenaged daughter, Maya. His wife had died years before, leaving him a single dad with a toddler. At one time, the father–daughter relationship had been quite close. But now, with the move to a new town, things appeared to be falling apart, and he’d come for help.

“Well, I don’t even really know where to start,” he said in my office, looking grim. “It’s just so incredibly frustrating. We used to talk all the time! But now it’s like I’ve been shut out completely. It doesn’t seem to matter how or what I ask her about her day. She just mumbles something and tries to escape as soon as possible. And she’s being really disrespectful to me,” Daniel added.

“That sounds hard,” I said. “How so?”

“Well,” he answered mournfully, “every day she tells me that I chew too loudly.”

“Hmmm.” I said. “Do you think you chew too loudly?”

“No,” he replied, shooting me an indignant look. “My chewing is perfectly normal!”

“Okay,” I said. “I just ask because I’m wondering what might be going on in your relationship with—.”

He cut me off. “Why are you asking about that?” he snorted. “It’s not me: it’s her. She’s incredibly disrespectful. I need you to get her to stop. That’s what I’m here for.” He leaned back, folded his arms across his chest, and glared at me.

I sighed. “Well, okay, we can work on that,” I told him. “But things will go better if you come to therapy, too.”

“I disagree,” he said.

We sat and looked at each other for a few moments. A thought occurred to me: Am I actually being heckled in my own office?

“Can we just try it my way first?” I asked. “I mean, maybe I’m crazy, but didn’t you come to me with this? Just sayin’.”

“Oh, alright,” he sighed. “You win.”

“That’s a good thing,” I said, and smiled.


Comedy Rule 2: Work the Silence

Working the silence means not being afraid of it. This rule tells you to pay attention to the pace—when to pause, when to go fast, how long to wait before you land a punchline. Though silence can feel frightening at first, it can be your friend on stage. This rule is one that comedy most definitely shares with therapy: silence can be very telling in the therapy room. In this case, being able to work the silence gave me insight into the relationship between Daniel and his daughter when they both came in for the next session.

Tall and unhappy, Maya nodded briefly at me before sitting as far as she possibly could from her father on the couch.

“She won’t talk to me,” Daniel charged right off the bat. “Even when we’re driving somewhere—nothing!”

“Hmmm,” I said.

Maya said nothing.

“See?” said Daniel. “It’s like, it’s like . . . I don’t know what it’s like!”

Maya said nothing.

“Is it like talking to a wall?” I asked. Maya rolled her eyes and stifled a smile.Daniel glared at me. “Very funny.”

We all sat there for quite a few minutes, waiting for someone to say something. I tried not to panic as I struggled to think about what to do, what intervention to insert. Then I realized that on stage, when a joke lands with some in the audience getting it and some not catching on, you wait—and you lean into the silence. So I just tried to sit quietly, not freak out, and see what would unfold—which turned out to be Maya continuing to not say a word. We sat there for several more minutes. Finally, Daniel couldn’t take it anymore.

“You see? You see what I have to put up with?” he erupted, waving a hand vaguely in Maya’s direction while turning to me. “She doesn’t want to have a relationship with me at all.”

This was too much for Maya. She looked at him crossly. “Whenever we’re having a conversation, it always turns into a lecture where you tell me all the things I’m doing wrong and how I need to be better or smarter or quicker or something,” she said. “ You never just listen to me.”

“I don’t know what you’re talking about,” said Daniel. “I do listen to you. But when you’re talking nonsense, then I need to let you know. I’ve been around the block a few times and I have a lot to teach you.”

“But I’m so tired of listening to you tell me all the things I don’t know. And you don’t ever listen to me. Even now you’re not listening to me,” she shouted. “And it makes me never want to talk to you again!”

And she went silent again. Luckily, we were near the end of the session. But by letting Maya be silent when she wanted to be—which was most of the time—I could clearly see the dynamic between the two of them. Even though he complained about it, Daniel always wanted to have the floor and was unwilling to share it. This bullying behavior on his part was a big part of the reason for the relational stress between the two of them. He clearly had good intentions, but getting him to change his behavior was going to be tricky.


Comedy Rule 3: You Don’t Have to Make the Audience Like You

This may seem counterintuitive, but you can do well as a comedian if an audience doesn’t actually like you. What matters is whether what you’re doing is working. The same goes for therapy: getting to the heart of the work is more important than a client’s liking you, because, in the end, it’s not about you. Of course, joining with the client is important, but it’s always possible that no matter what you do, the client won’t be happy with you. On the flip side, sometimes we might not like our clients, but we stick it out because we have faith in a turnaround—which I hoped for in the next session as Daniel and Maya came in, looking furious with each other.

“So tell me what’s going on,” I began.

“It was time for school, and I was going to be late for my meeting. Even though I told her four times it was time to get up, she still wouldn’t, so I had to drag her out of bed by her ankles,” Daniel explained.

“You actually dragged her out of bed?” I asked in astonishment.

Maya shot her dad an angry look. “I was so tired this morning because I couldn’t get to sleep at all last night! I can’t believe you actually dragged me out of bed. I hate you,” she screamed.

At this point, knowing what I do about teenagers and hormones and sleep cycles, I thought it’d be helpful to do some psychoeducation. And it didn’t matter if Daniel liked me less because of it. I had to press on.

“Well,” I started to say, “the research on teenagers and their sleep cycles is pretty clear: they have a hard time getting to sleep any earlier than midnight, and it’s hard for them to get out of bed early. The medical term for this is delayed sleep phase.”

“You and your theories,” Daniel scoffed.

Me and my theories?! I tried not to yell at him. I was frustrated, and to manage this, I breathed in. And then I breathed out. And then I asked him calmly just exactly what he expected me to do.

Work with Maya,” he said firmly. “She’s the one with the problem.”

Maya jumped in. “You’re the one with the problem! You say want to have a relationship with me, but you never ever listen. You’re always talking at me.”

“Okay,” I said firmly, sensing that this wasn’t going anywhere and seeing that we were at the end of the hour. “We’re out of time for today, so I’m giving you some homework for the week. Daniel, I’d like you to practice listening. Set a timer for five minutes and listen to Maya that whole time. Don’t talk! Then Maya, I’d like you to spend the next 10 minutes or so in conversation with your dad. Try going back and forth. Aim to do that once a day, and next time we’ll talk about how that went.”

They both reluctantly agreed to this plan, but left grumpier than when they had come—and liking me even less. That I was sure of.


Comedy Rule 4: Don’t Pander

This rule has to do with holding your audience to a high standard, having faith in their ability to get what you’re talking about, even if the material is challenging. In comedy, if you’re worried the audience won’t get a joke, you still try it. Not pandering means not backing down from what you want to say.

It seemed clear that Daniel was prone to bullying—and even clearer that this bullying came from a place of fear. Terrified of losing his daughter, he was becoming more and more bombastic in his attempts to fix things, which were failing miserably. I wanted to validate his frustration with his daughter’s behavior, but I was growing increasingly frustrated with him myself. If I were his daughter, I wasn’t sure that I’d want to talk to him any more than Maya did, given his penchant for bluster. So the next time they came in, I knew I had to move forward with Daniel by not pandering, saying what I knew, in a way he could hear.

“She doesn’t talk to me with respect,” Daniel complained right out of the gate, not even waiting for Maya to sit down.

“Why should I?” retorted Maya. “You never talk to Grandma with respect.” This silenced Daniel, and he looked at Maya as she went on. “Last night when you were talking to Grandma about her IRAs and you were just yelling at her for like 15 minutes! And then you want me to talk to you with respect?”

“Daniel, I wonder if these things could possibly be connected,” I mused aloud.

“Well, I just lose my temper because my mother is so stubborn,” he grumbled.

“You know, there’s a reason people say that the apple doesn’t fall far from the tree,” I told him.

“Yeah,” said Maya.

Daniel sat silently for a bit. “I disagree with you,” he finally said.

“Well, you’re outnumbered here,” I responded firmly. “Maya seems to be naming something that she sees is connected—that your habit of yelling at your mother isn’t good role-modeling for her if you want her to be respectful to you. Do you see how this works?”

“Maybe,” he admitted reluctantly.

I continued to push, adding, “You have to walk the walk here, and not just talk the talk. Also, if you disagree with me so much, then why on earth do you keep coming back?”

“Well,” he sighed, “I don’t really know what else to do. So I guess I’m here until you throw me out.”

This felt like forward movement to me, until the next session, when Daniel came alone—with a plan.

“I know how my kid works, and this will work with her,” he started. “You’re an authority figure. Tell her she needs to have a relationship with her dad. You need to break through to her somehow.”

I cocked my head and looked at him quizzically. What was going on here? I was getting exhausted from all this circling back to where we’d started. So I leaned in toward him with a surprised look on my face, interrupting him as if I’d just noticed that he had spinach in his teeth, and said, “Wait, wait, wait a minute, hang on. Let me just check something out with you. Are you actually telling me how to do my job?” I asked with a frown on my face.

There was a pause, and then he leaned back and laughed. “Yeah, I guess I kind of am,” he replied. “I have a tendency to do that, I know.”

“Well, just make sure you don’t do that again,” I scolded. “Remember, I’m the one sitting in this chair. And Daniel, you have to stop being such a bully. If you keep trying to bully me, then I’m going to have to throw you out.”

He laughed again and shook his head. Then, as we sat there together, me pondering the result of this interaction and wondering if I’d done the right thing, he suddenly began to weep.

“I’m just so sad about our relationship,” he said with a catch in his voice. “She’s so much like her mother, and the fact that I can’t get her to talk to me just kills me. I miss her mom so much. If she were here, this wouldn’t be happening.”

I let him cry for as long as he needed. It was clear that this was something he’d been keeping tightly held inside, and it was clear that by not pandering to him, by calling him out on his bullying behavior, I’d made the right move. Yes, it was a risk, but when we challenge our difficult clients, we’re implicitly saying, “I think you can handle this,” which is in itself a statement of our belief in their potential to grow and change.


Comedy Rule 5: Close Strong

At this next session, they came in together. Daniel looked happier and less stressed than I’d seen him before. “You seem a bit more relaxed,” I said. “How have things been going?”

“There does seem to be a better feeling around the house,” he replied. “Sort of like the roof has opened up and I can see blue sky and sunshine above.”

“Maya, how do things seem to be going from where you sit?” I asked.

“Better, I think.” she replied. “But he’s still been on my case to do my reading for summer. And the thing is, I am reading!”

“Well, the thing is,” Daniel interjected, tears welling up in his eyes. “I don’t know if you know just how much I love you.”

Maya leaned toward him, somewhat astonished. “Yeah, I know, Dad. I know how much you love me.” And then she teared up as well.

He reached over and took her hand. “I’m sorry I can be so hard to live with. I’m just trying as hard as I can, and sometimes I just don’t do a good job of it. I’ll try to do better and not be so—.”

“Stubborn,” Maya joined in.

“I would totally agree with that.” I said.

They both smiled. This was a good moment for them, to feel connected after the rocky times they’d been through.

I’m not quite sure if I really “closed strong,” as all good stand-ups are supposed to do. But for this particular family, I think this is what success looked like at the time: just being able to actually talk to one another, not as often as Daniel would’ve liked, but more than they’d been doing before. And as Daniel backed off on giving his daughter advice, she began to talk to him more. This cheered him up and helped them feel closer during this rocky stretch of her adolescence, when she needed space and respect from her father. In the end, though, my real discovery was that when things got rocky in the therapy room, the rules of comedy proved invaluable­—and they just don’t teach that in grad school.


CASE COMMENTARY

By David Waters

This case raises a lot of strong responses from me, not only because I’m a great fan of humor and play in therapy when applied well, but also because the way I work depends on a strong personal connection between client and therapist. Daniel is certainly a poster boy for someone who’s hard to connect with. So while I enjoyed the standup/therapy comparison, and felt as if the therapist used it well to stay grounded in the difficult interactions she described, for me the big question is: how do you stay personally connected to someone as prickly and defensive as Daniel?

A heckler is a good analogy for him. Like the folks who go to standup shows to put the comic down, Daniel went to therapy to show his superiority. This is difficult material to work with, and the way Seal used the “rules of comedy” seems on point. For example, as Daniel sets up a right/wrong dialectic, Seal disarms him nicely in their first skirmish by offering a nonconfrontational way out, asking, “Can we just try it my way?” And Daniel’s response is true to his distorted view of the world: “You win.”

This feels to me like a pivotal moment in the case, one that gets played out again and again. With the wisdom of the Monday-morning quarterback, I’d take this opportunity to try to reorient Daniel away from the win/lose mentality toward deeper personal connection with his daughter. I might say, “Though I know you think that way, I really want to try to steer us away from winning and losing toward a more heart-based view of what you want, which is to be close to your daughter.” With a client like Daniel, a therapist needs to stay personal and openhearted, rather than take the win. In fact, despite her initial “win,” Daniel gets her back with a run of difficult and challenging sessions where he’s increasingly brittle and defensive, and where Seal’s best tries at opening things up fall pretty flat. While she manages not to get reactive and fight back, for the most part, Daniel isn’t giving an inch.

Where he does give an inch is when she doesn’t pander, and in Maya’s absence engages him more personally, creating an opening for his deep and painful emotion to emerge. He accepts Seal’s input for the first time, and the Big Shift is underway. The persistence and determination to connect that Seal managed to maintain, using her standup training, prevails. Could it have happened sooner? That’s always a question in therapy. The vital thing, and what makes this case a pleasure, is that it did happen. The vulnerability and sweetness of the last session shows the outcome of Seal’s years of practice at hanging in with a tough crowd.

***

Kirsten Lind Seal, PhD, is a marriage and family therapist and an adjunct assistant professor of MFT at Saint Mary’s University of Minnesota. Her research has been published in JMFT and Psychology Today. She cohosts a biweekly segment on relationships on WCCO (CBS) TV’s Midmorning show. 

David Waters practices individual and couples therapy in Charlottesville, VA, after 37 years at the University of Virginia. 

Tell us what you think about this article by emailing letters@psychnetworker.org.

Illustration © Sally Wern Comport




Read 2537 times
Comments - (existing users please login first)
Your email address will not be published. Required fields are marked *

*
*
*