We definitely laugh at what patients do. But we do not “make fun of them,” like by calling them names. But we do laugh at their words and deeds. Sometimes symptoms present in humorous ways. There are endless examples.
I had a patient who really liked thanking people. He was a menacing, hulking man (over 6 feet tall), but with the prepubescent voice of a 10 year old. Any opportunity he could find to thank people, he would take it. “Thank you for letting me sit in the lounge with you,” and, “thank you for doing rounds,” and “thank you for coming in to work today.” He would thank you, then he would wait. If you didn’t respond appropriately, he would say:
“Am I welcome?”
And sometimes you get these fantastic quotes. Two manic patients were talking to each other. The first finished up a statement by asking: “Do you jive?” The second patient replied:
“I don’t jive. I chirp. Jive implies falsity.”
Psychosis can be especially humorous. I had a patient who hallucinated, almost non-stop, that he was in a night club. Surrounded by the drab, medicated passerby crowd of a mental health unit, it was funny to watch him bobbing his head to dance music only he could hear, and striking sexy expressions to beautiful women only he could see, and then nod, knowingly, to people only he could know. Like many, he was totally consumed in his hallucinations. It was sad how out of touch with reality he was. But it was also undeniably funny.
It is a strange bond we have with people who are experiencing psychosis. They provoke empathy like no other pathology. I love them. Some of my favorite people I’ve ever met were psychotic. That being said, their separation from reality is humorous. But the humor is not derogatory. It is affectionate. It is that strange joy, that alluring feeling, of meeting someone so unique, you couldn’t even describe them to another. Someone who surprises you with their individuality. It is the carefree humor of someone, in a hopeless situation, who chooses joy instead of dread — like a shop owner putting his mannequins in humorous positions on the day his store goes out of business.