2000 ASHT PRESIDENTIAL ADDRESS
Hand Therapy:
The Healing Touch with a Touch of Humor!
Joan L. Sullivan, MA, OTR, CHT
ASHT President, 2000; ,
Co-owner, Hands-On Rehab
Valhalla, New York
She knew what all smart women knew: Laughter made you
live better longer.-GAIL PARENT
I never expected to be here with you today as
President of ASHT, because I never intended to be a
hand therapist or, for that matter, an occupational
therapist. You see, when I was growing up, my
dream was to be a clerk typist for the FBI. I applied
for a job with them and was offered a position when
I was still in high school. My mother, however, had
different plans for me. She insisted that I be the first
in the family to go to college. She bribed me with
promises of a car. So off I went to college, where I
majored in education.
Of course, I didn't know what I was going to
teach-my advisor cringed every time I walked into
his office, and said things like, "Now what do you
want to be?" Fortunately for my advisor, my mother
secured a summer job for me at Creedmoor State
Psychiatric Facility, where she worked. I wasn't
enamored of the prospect of teaching, but career
options for women were somewhat limited in the
1960s. I still had my eye on that clerk typist position
at the FBI, so to polish my skills, all I wanted to do
that summer was secretarial work.
Much to my annoyance, my mother-do you see a
pattern here?-changed my job application from a
secretarial position to a position as an OT aide. I was
furious. My mother said, and I quote, "Oh, shut up.
You'll love working in ~T. They are always laughing
and having a good time!"
Well, the rest, as they say, is history. I loved ~T. I
~oved t~e patients. Even though this was a challeng-
mg envIronment, not unlike the hospital portrayed in
This paper is a slightly edited versions of the Presidential Address
prese~ted at the 23rd Annual Meeting of the ASHT, on October 6,
2000, III Seattle, Washington.
Correspondence and reprint requests to Joan L. Sullivan,
Hands-On Rehab, 503 Grasslands Road, Suite 105, Valhalla, NY
10983; e-mail: jshandson@aol.com.
One Flew over the Cuckoo's Nest, I enjoyed having an
impact on these patients, enabling them to be as inde-
pendent as possible in this difficult setting. Mother
was right. I had a lot of fun with the OT staff and
patients. This experience opened my eyes to OT as a
better career choice than clerk-typist for the FBI.
I was fortunate to be selected by the hospital to
receive a full scholarship to the occupational therapy
program at New York University. The promise of
laughter changed my life. Let me thank my mother
publicly now for helping me to find my life's work,
because like a typical mother she always complains
that I don't give her enough credit. Thanks, Ma! Oh!
By the way, my mother never did buy me that car she
promised, and the closest I got to a job with the FBI
was by marrying one of New York's Finest,
Lieutenant Clem Sullivan.
The theme of this conference is "Overcoming
Adversity-Hand Therapists and Hand Surgeons
Shaping the 21st Century." I wanted this address to
tie into the overall theme. Because of the ever-chang-
ing health care environment, therapists face many
challenges. Managed care companies often have little
or no understanding of patients' conditions. We are
given a limited number of visits to rehabilitate the
patient and are often faced with compromising our
standards of excellence. Every day, we are faced with
shrinking reimbursement dollars while the costs for
providing care soar. The paperwork that needs to be
completed to secure those limited visits and dollars is
overwhelming. I believe that this address will pro-
vide you with a strategy to overcome these adversi-
ties as well as a strategy to deal successfully with
people who have sustained catastrophic and life-
altering injuries.
When I thought about how hand therapists could
overcome adversity and shape the 21st century, I
thought about one of the basic tenets of occupational
therapy-therapeutic use of self. By using our own
strengths and skills, we can overcome adverse situa-
January-March 200 I 3
tions and have an impact on the future, whether the
difficulties be patient or management related. Hand
therapists have mastered one of the ultimate tech-
niques in the therapeutic use of self, by the use of a
healing touch.
It is the touch of the therapist's hands that helps the
patient to relax and make progress.-PAUL BRAND, MDl
When a patient enters the clinic for the first time,
we evaluate them. We touch their hands, we feel the
skin. We explore their wounds and scars with our
hands. We feel how their tendons glide, how the
muscles work, and how the joints move. We feel for
inflammation. My practice, like many of yours, is
composed of patients who have sustained major
traumas-such as burns, crush injuries, replants,
amputations, and fractures. They have been through
devastating injuries and surgeries. Initially, they are
physically challenged and emotionally overwrought.
Their self-images are impaired. They are unsure
whether they can re-enter society as productive per-
sons. Through our touch, during that first session
and every subsequent session, we let our patients
know that we accept them as they are. We are not
afraid to share one of the most basic human func-
tions-touching other human beings. I believe that
this symbolic "laying on of the hands" is as impor-
tant as anything else that we do as hand therapists.
Through our touch, we validate our patients' worth
and start them on the road to recovery!
I believe that it was Sterling Bunnell, MD, who said
that a "good therapist looks like Venus de Milo." He
said this in the early days of hand surgery, before the
advent of the specialty of hand therapy. I'm sure that
if Dr. Bunnell were practicing today, he would have
a new respect for hand therapists and what they can
accomplish with their touch.
Sometimes, when a patient is referred to me after
an unsuccessful course of treatment at a nonspecial-
ist facility, and I complete my usual hands-on evalu-
ation and treatment, the patient starts experiencing
what hand therapy is all about. The patient invari-
ably confides in me, saying, "Nobody ever touched
me before. All I ever did was work on machines." I
believe the former therapists missed out on one of the
most fulfilling interactions in the therapeutic rela-
tionship-the simple act of touching another human
being.
Humor is the antidote to all ills.-PATCH ADAMS, MD
It is certainly not necessary for me to preach to the
choir. You must value the power of human touch or
you wouldn't be in this area of specialization. What I
do want to focus on is the importance of humor in the
therapeutic relationship, because I believe that main-
taining a good sense of humor and having a little fun
with the patients is an integral part of "therapeutic
4 JOURNAL OF HAND THERAPY
use of self." Over the course of 30 years, I've discov-
ered when you integrate a healing touch with a touch
of humor, you have a very potent therapeutic tool.
I have seen what a laugh can do. It can transform almost
unbearable tears into something bearable, even hopeful.-
BOB HOPE
Therapeutic humor is inclusive; it brings people
together. It decreases prejudice by focusing on the
universal human experience. It encourages a positive
atmosphere, and builds rapport and trust. 2 To use
humor effectively in the clinic, the therapist needs to
be moderately humorous. There are different strate-
gies that can help you develop a more acute sense of
humor. Techniques include learning to belly laugh
and tell jokes, laughing at yourself, finding humor in
the midst of stress, creating a humor library, and
associating with people who are funny.2,3
My own sense of humor developed early in life. I
can attribute the greater part of my humorous side to
my father and his family. I still remember family
gatherings as being joyful occasions. As children we
were encouraged to participate in the fun by telling
jokes and funny stories. My sense of humor was fine-
tuned by watching reruns of "Abbott and Costello,"
"Laurel and Hardy," "The Three Stooges," and "I
Love Lucy" on TV after school. I read newspaper
comic strips every day. I especially enjoyed reading
"Humor in Uniform," "Laughter Is the Best
Medicine," and "Campus Comedy" in Reader's
Digest.
Humor is the greatest thing, the saving thing, after all.
The minute it crops up, all our hardnesses yield, all our
irritations and resentments slip away, and a sunny spirit
takes their place.-MARK TwAIN
I was well served by a good sense of humor when
I worked with my patients. After I graduated from
OT school 30 years ago, I returned to Creedmoor and
worked in psychiatry for about a year. I realized that
the chronically depressed and even the actively psy-
chotic patient could still appreciate a good joke or a
funny movie. I watched their faces light up and
learned that the patients were better able to partici-
pate in activities during OT sessions after hearing a
funny story or joke or having a little fun. We always
laughed and had a good time in OT, because it bene-
fited the patients!
Laughter is the shortest distance between two people.
-VICTOR BoRGE
I eventually left psychiatry and took a job at New
York City's Bellevue Hospital. I was assigned to the
Rehabilitation Unit, which dealt primarily with
patients with spinal cord injuries. The very first day
on the job, the very first patient I worked with had to
be taught to move from a wheelchair to bed. John had
sustained a gunshot wound and was a high para-
plegic. He was a convicted felon, he was a large man,
and he was angry. So there I was, new to rehab,
remembering next to nothing about transfers, and
not wanting to admit that I needed help.
Like an idiot, I forged ahead. I explained to John
what we were going to do, positioned him, posi-
tioned myself, and said, "OK, let's do it." At that pre-
cise moment, both of John's lower extremities went
into spasm-he went flying over the bed and took me
with him. There we were, on the floor, his catheter
detached, urine everywhere. My life flashed before
my eyes, and I thought, "Oh my God, he's going to
kill me the first chance he gets." I looked at John, and
he looked at me. When we saw the state we were in,
we both burst out laughing.
This embarrassing but humorous situation set the
stage for an honest and open therapeutic relation-
ship. Many of the patients in that rehabilitation unit
had a good laugh at my expense, but it opened the
way for me to develop as a therapist. Fortunately, I
didn't impede John'S independence in activities of
daily living. Thirty years later, he is alive and well
and leading a productive life, and he is still one of my
best friends.
What exactly is humor? Humor can be in-your-face
funny, like the situation I just described, or it can be
much subtler. Steven Sultanoff, PhD, a psychologist
and mirthologist and founder of Humor Matters, Inc.,
defines it as the capacity to perceive, appreciate, or
express what is funny, amusing, incongruous, and
ludicrous. 4,5
A joke's a very serious thing.-CHARLES CHURCHILL
In doing research for this presentation, I was
amazed at the number of articles and books related to
humor. Therapeutic humor has become an art and
science unto itself. There are numerous professional
organizations specializing in humor, the largest
being the American Association for Therapeutic
Humor. Countless articles have been published in
professional journals in the fields of medicine, nurs-
ing, rehabilitation, psychiatry, psychology, research,
business, and management. There are even a number
of medical professionals who refer to themselves as
mirthologists, who study and write prolifically on
the value of therapeutic humor.
As it is not proper to cure the eyes without the head, nor
the head without the body, so neither is it proper to cure
the body without the soul.-SocRATES
Health promotion through humor has been dis-
cussed and written about since ancient times. "A
merry heart doeth good like medicine" can be found
in the Bible (Proverbs 17:22).
Both Socrates and Plato recognized the importance
of humor. In medieval times, the "humors," or bodily
fluids, were said to regulate man's temperaments. 6 In
1302, a French surgeon, Henri de Mondeville, wrote
"Let the surgeon take care to regulate the whole regi-
men of the patient's life for joy and happiness, allow-
ing his relatives and special friends to cheer him and
by having someone tell him jokes.,,6
In 1905, Sigmund Freud wrote "Jokes and Their
Relation to the Unconscious." In it, he described
humor's purpose as turning "pain into pleasure.,,7,8 In
1928, Freud wrote another treatise, entitled
"Humor.,,8,9 Freud's concept of joking was based on
his original theory of repression and unconscious con-
flicts. We laugh at things indicative of our problems or
inhibitions. Freud states that joking becomes a socially
acceptable way to handle problems. Rather than
falling into pathologic states of neuroses, psychoses, or
intoxication, we use humor to handle our difficulties.
In 1977, William Fry, MD}O reported his research on
humor physiology, or gelotology, the science of laugh-
ter. He analyzed humor and separated it into its three
components-the stimulus (the joke or sight gag), the
emotional response (mirth), and the accompanying
behavior (like laughing, smiling, or giggling).
Despair affects the immune system ... I try to leave patients
with something to smile about.-BERNIE SIEGEL, MD
Therapeutic humor came of age in 1979 when
Norman Cousins, an editor and author, published a
book entitled Anatomy of an Illness as Perceived by the
Patient. 6,1l,12 Cousins had been diagnosed with anky-
losing spondylitis in the mid-1960s. His prognosis
was poor, and he was in constant pain.
Cousins had been embroiled in an extremely stress-
ful situation when he experienced the first symptoms
of the disease. He was familiar with Hans Selye's
book The Stress of LifeY Selye explained that stress
caused adrenal exhaustion, impairing the function of
the adrenal glands, which could in effect lower the
body's resistance to diseasep,13 Selye detailed the
disruptive effects of negative emotions on body
chemistry. Cousins hypothesized that if negative
emotions caused adverse chemical changes, why
wouldn't positive emotions-like love, hope, faith,
laughter, and confidence-produce a beneficial
chemical change?
Cousins already had love, hope, faith, and a strong
will to live, so he started experimenting with laugh-
ter. He noticed that when he laughed, real good belly
laughs, his pain diminished for hours and he was
able to sleep more restfully. His sedimentation rate
actually decreased five to nine points after laughing.
He watched movie and TV comedies and read
humorous books and articles.
Cousins continued researching and writing about
the power of positive emotions and laughter for more
than 20 years, was given an honorary degree at
UCLA, and was named an adjunct professor of psy-
chiatry and behavioral science.
January-March 200 I 5
 A clown is like an aspirin, only he works twice as fast.-
GROUCHO MARX
What is it about laughter that makes us feel better?
Sultanoff writes in his many articles that laughter effects
us physiologically, cognitively, and emotionally.S,14
Pain is deeper than all thought; laughter is higher than all
pain.-ELBERT HUBART
Physiologically, laughter increases the heart rate,
blood pressure, and pulse rates, thereby increasing
. 1a t'IOn. 316-19
Clrcu ' Pu 1monary fu"
nctlOn Improves as we
breathe deeper and take in more oxygen while
expelling more carbon dioxide, which enhances
blood oXigen levels much as aerobic exercise
does. 16,20,2 Laughter exercises muscles in the face,
diaphragm, abdomen, arms, legs, and back, toning
them and easing tension. 16--18 Laughter enhances neu-
roendocrine function in patients with rheumatoid
arthritis,18,22 acts as a natural pain killer throu§h the
release of endorphins and catecholamines,16,18, sand
increases the protective action of the immune sys-
tem.n,13,18,24,2S,~7,28 Immunoglobulin-A levels increase
dramatically in the saliva after a hearty laugh, pro-
tecting us from staphylococcal and streptococcal
infections. I am living proof that this last statement is
true. I left my last job with 122 unused sick days!
Humor is the healthy way of feeling a "distance" between
one's self and the problem, a way of standing off and looking
at one's problem with perspective.-RoLLO MAY, PHD
Cognitively, humor allows us to control our reac-
tion to those events in the outside world over which
we have no contro1. 4,s Sultanoff states that humor
consists of wit, which is a thought-oriented process.
Wit changes how we cognitively process, appreciate,
or "think" about life's events and situations.
Sultanoff explains that when we listen to a joke, we
are guided down one path, only to be tracked over
onto an alternative path. It is the discrepancy and
even the trickery of the alternative path (the punch
line) that we experience as humorous. This alterna-
tive thinking process provided by wit provides per-
spective and can reduce the negative thinking that is
common in depression, anxiety, and anger. Humor
provides us with an alternative view of how we per-
ceive our problems.
The crisis of today is the joke of tomorrow.-H. G. WELLS
So, have you heard the one about the hand thera-
pist who was losing her practice because of poor
reimbursement rates? She prayed to God to let her
win the lottery. The lottery was drawn on Saturday,
but she didn't win. She prayed to God again the next
week to win the lottery, because not only had she lost
her practice but this week she was going to lose her
car. The numbers were drawn on Saturday, but she
didn't win again. She was really desperate the third
6 JOURNAL OF HAND THERAPY
week. Not only had she lost her business and her car,
but this week she was going to lose her house. She
prayed to God again to let her win the lottery, and
she heard a voice. "It's me, God! Give me a chance to
help you. Buy a ticket!"
Everything is funny as long as it is happening to some-
body else.-WILL ROGERS
Emotionally, humor counters the effects of stress,
provides a balance in the mind-body-spirit continu-
um, and provides a perception of control in stressful
SI'tua t'Ions. 34614
' , , D'd . or fa,
1 you ever tnp 11 d 0 some-
thing stupid, or watch someone else's pratfalls?
What's the first thing you usually do? You laugh or
giggle, experiencing an emotional release-it's
natures' way of venting stress. Sultanoff14 states that
humor and distressful emotions cannot "occupy" the
same emotional and psychological space.
If you can laugh at it, you can survive it.-BILL COSBY
I once treated a teenaged boy who should probably
be nominated for a Darwin Award. He and his
friends decided that it would be great fun to shoot
firecrackers into a lake using a bow and arrows. As
he pulled back on the bowstring with the lit M80
attached to the tip of the arrow, it exploded. The blast
amputated three of his fingers, one of which became
embedded in his eye, and subsequently the damaged
eye needed to be removed. We received an order to
change his dressing and make him a splint prior to
discharge. Knowing the stupidity of his accident, we
were uneasy about his impending visit to the clinic.
When he finally arrived, a hush fell over the room.
He sat down and announced loudly, "Hi! I'm here for
eye-hand coordination therapy." There was a preg-
nant pause and then patients and staff alike burst out
laughing. By starting out with a joke, he immediately
dispelled everyone's anxiety. We laughed with him
and not at him. That simple witty remark told us that
we didn't have to feel sorry for him. We knew he
would easily adjust to his handicaps with such a
great attitude!
We're all in this together-by ourselves.-LILY TOMLIN
In his article "Keeping Them in Stitches," Rick
Rader, MD,B states t4at laughter forms the basis for
emotional health by letting people share an enjoyable
common experience. Dr. Rader writes that humor
makes us more open and receptive to one another
and that humor enables human connectivity.
Christine Muhleman shared a story with me about
a patient who sustained severe burns of the hands
and lived a great distance away from the center
where Chris worked. The patient could only be seen
sporadically, so Chris had to show him what to do at
home. She warned him over and over again about
debriding his own hand, because it could easily get
infected. One day the patient came in complaining
about increased pain in his hand. Chris started taking
down the dressing and was horrified to find a great
deal of blood and yellow matter in the dressings. The
patient couldn't keep a straight face and started
laughing. Finally he admitted that he had put
ketchup and mustard in the dressings over a very
well healed wound. The patient thought it was a riot,
and, once she got over the shock, so did Chris.
Humor established a connection between the patient
and the therapist and actually made it easier for Chris
to treat him, even at a distance.
No matter what your heartache may be, laughing helps
you to forget it for a few seconds.-RED SKELTON
My partners and I had treatment tables built that
could comfortably seat three patients and a therapist.
We did this for a number of reasons. Besides the
obvious ones of saving space and increasing produc-
tivity, these tables were built to facilitate patient
interaction and group cohesion: Over the years, we
learned that therapy is a great leveler. No matter how
depressed a patient is about his condition, when he
looks at the guy sitting next to him and they start
comparing injuries, they each appreciate just how
lucky they are. There is usually someone sitting close
by who has more difficult hardships to overcome.
Perhaps I know why it is man alone who laughs; he alone
suffers so deeply that he had to invent laughter.-
FRIEDRICH NIETZSCHE
Most patients are emotionally vulnerable when
they first begin treatment. Many have had a life-alter-
ing injuries, diseases, or surgeries. They have lost
control of their lives. They rely on their surgeons to
fix the problems, the therapists to restore function,
their families to help them with their ADLs. In many
cases they are out of work and are not able to provide
for their families. These feelings of helplessness and
worthlessness are anxiety provoking. Sharing experi-
ences with someone in the same boat or at the same
table, so to speak, enables the patient to form
alliances to work on these problems. Once they start
talking about their situations, they invariably start
laughing and joking.
When in doubt, make a fool of yourself. There is a micro-
scopically thin line between being brilliantly creative and
acting like the most gigantic idiot on earth. So what the
hell, leap!--CYNTHIA HEIMEL
I'm not exactly sure what unique personality char-
acteristics hand therapists have, but in my experience
they are fairly rigid about following protocols and
enjoy telling patients what to do, how to do it, and
when to do it! As a therapist who certainly fits that
profile, I just love it when the patients develop
enough emotional strength to "revolt" and "gang-
up" on me. This coup d'etat takes the form of humor
in our clinic, because it is a safe and emotionally
healthy way of dealing with stress and control issues.
Humor allows the patient to develop mastery and
take charge in the therapeutic milieu. Some days I
feel that I am prepping for a stand-up comedy rou-
tine rather than for treatment sessions. Patient
alliances prevail, and the therapist usually gets voted
off the island!
One loses many laughs by not laughing at oneself.-SARA
JEANETTE DUNCAN
I am currently treating a patient who is the presi-
dent of a large corporation. One day, after a particu-
larly difficult treatment session, he presented me
with a newly released book entitled The Beasts of
Valhalla. That doesn't seem extraordinary, but my
clinic is in Valhalla, New York. He and the other
patients in the clinic thought the sentiment of the title
was apropos and extremely funny. Before long,
everyone was making wisecracks. I was the willing
victim of their jokes and even joined in the fun by
promising them that their next session would be
extremely painful!
What's important to realize in a situation like this is
that in one small way the patients were developing
mastery. We had such a strong therapeutic relation-
ship that the patients felt enough control to poke fun
at me and the situation in which they found them-
selves. I proudly display this book along with other
mementos that grateful patients have given me over
the years-hand cuffs, whips, riding crops ... !
Trust your gut.-BARBARA WALTERS
There are many other examples of patients taking
control of their situations through humorous meth-
ods. We see them decorating and personalizing their
splints, dressing up for holidays, and mugging it up
like the patient who threatened to blow up the clinic
by plugging 'his TENS unit leads into his therapy
putty! Therapists should encourage this behavior. A
research study by Patricia Wooten, RN, found that
people who were encouraged and guided to use
humor gained a sense of control in their lives. 29
Gaiety is the most outstanding feature of the Soviet
Union.-JOSEF STALIN
Laughter is so important when you want to put
people at ease. We once sublet space for our satellite
office in a private general rehab practice. On many
occasions we were asked by the owner, a therapist, to
keep the laughter to a minimum because her patients
wanted to know what they had to do to get treated in
my part of the clinic. I think she was afraid that she
was going to lose business! She never quite learned
the importance of laughter as a therapeutic tech-
nique. Now, I'm not going to say for sure that one
January-March 200 I 7
thing had anything to do with the other, but we had
to move when her practice closed!
Life does not cease to be funny when someone dies, any
more than it ceases to be serious when someone laughs.-
GEORGE BERNARD SHAW
Is humor ever inappropriate? Yes. SultanoffI4 sug-
gests that we avoid negative humor, like sarcasm and
put-downs; humor that is insensitive to the emotional
experience of the receiver; and humor used to create
distance from the emotional experience. Self-directed
humor is usually safer than humor directed at another
person. Humor directed toward a situation is safer
than humor directed at others. In our large therapy
clinics, we must be sensitive to others in the environ-
ment to be sure that only those for whom the humor
was intended experience our humor.19 We do set lim-
its on jokes told in the office. We don't allow cultural-
ly or ethnically biased jokes, and we discourage jokes
that would cause anyone to blush.
Comedy is tragedy plus time.-CARoL BURNETT
Once in a while, though, humor that seems irrever-
ent or even "sick" is acceptable. We once treated two
patients named Walter. Walter #1 was a security
guard who had been shot nine times during an
armed robbery, and Walter #2 had sustained third-
degree burns over 70% of his body when he tried to
clean fleas from his dog's rug with gasoline and it
ignited. Somewhere along the line, the Walters start-
ed calling one another "Holey" Walter and "Crispy"
Walter. At first, other patients and staff were taken
aback. Once they experienced the compassion and
kindness in the way the Walters treated one another,
though, the "sick" humor became an acceptable way
for them to deal with their stressful situations.
Life must be lived as a play.-PLATO
There are many forms of humor you can use in
your clinics. You need to determine what type of
humor you are most comfortable with.3 Patch
Adams, MD,30 and his disciples are proponents of
clowning. Some doctors, nurses, and therapists wear
big red noses or funny hats. Others have humor carts
containing props, funny books, and movies. Karen
Schultz Johnson told me that she has a "humor book"
in her clinic that contains funny stories, jokes ,and
cartoons. Everyone is encouraged to read and con-
tribute to the book. Some medical professionals do
nothing at all but act their natural, funny selves. You
just have to find your own style.
Everybody knows if you are too careful you are so occupied
in being careful that you are sure to stumble over some-
thing.-GERTRUDE STEIN
It is important, especially for the younger therapist
or student, to learn that being professional doesn't
8 JOURNAL OF HAND THERAPY
necessarily mean you have to be cold or distant. 19
Humor can foster strong professional and therapeu-
tic relationships. A recent study by Levinson et al. 18,3I
reported on physicians who did not incur malprac-
tice suits. Humor and time spent with patients were
identified as the variables responsible for lower rates
of suits filed against physicians. A well-placed joke
or witty remark can provide the groundwork for a
productive collaboration with doctors, lawyers,
insurance companies, and others who create stress
and other adverse conditions in our lives.
Our humor turns our anger into a fine art.-MARY KAy
BLAKELY
Through the use of that basic treatment tenet,
"therapeutic use of self," hand therapists have the
power to reach out to others, the power to touch, the
power to laugh, and the power to heal all at our
fingertips. Every pun intended!
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4. Sultanoff S. Exploring the land of mirth and funny: a voyage
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Additional Readings
Buffman M, Brod M. Humor and well-being in spouse caregivers
of patients with Alzheimer's disease. Appl Nurs Res.
1998;11(1):12-8.
Draheim M. Humor: a powerful tool for health-care professionals
and patients. Diabetes Spectrum. 1995;8(3):137:42.
Kerivan L. Rise and laugh. Natural Health. 1999;29(3):26.
Moody R. Laugh after Laugh. Jacksonville, Fla: Headwaters Press,
1978.
Stone A, Cox OS, Neale JM, Valdimarsdottir H, Jandorf L.
Evidence that secretory IgA antibody is associated with daily
mood. J Pers Soc Psychol. 1987;52(5):988-93.
Vergeer G, MacRae A. Therapeutic use of humor in occupational
therapy. Am J Occup Ther. 1993;47(8):678-83.
Hodgkin J, Connors G, Bell C (eds). Pulmonary Rehabilitation.
Philadelphia, Pa: Lippincott, 1993.
Selected Humor Resources
American Association for Therapeutic Humor, 4534 W. Butler
Drive, Glendale, AZ 85302. Web site: www.aath.org.
The Humor Project, Inc., 480 Broadway, Suite 210, Saratoga
Springs, NY 12866. Web site: www.humorproject.com.
HumorMatters, Stephen M. Suitanoff, PhD, 3972 Barranca
Parkway, Suite J-221, Irvine, CA 92606. Web site: www.humor-
matters.com.
HUMORx, P.O. Box 1273, Hannibal, MO 63401. Web site:
www.humorx.com.
The Laughter Remedy, Paul McGhee, PhD. Web site:
www.laughterremedy.com.
January-March 200 I 9