Opinion
The clown/fool/jester is a recognizable figure in every culture. The clown is an archetype, a universal image that’s embedded in the brain. These images dwell in the unconscious mind. They can be animals, people, gods/goddesses, or objects (a tree, a house, a cross, or mandala) that are a staple in many myths and legends.
The clown lightens the mood; encourages us to laugh at ourselves (and the ridiculousness of life), pokes fun at convention, provides social commentary, and can get away with revealing that the emperor has no clothes. The clown is irreverent, flaunts taboos, and diffuses anxiety; in many cultures, the clown is a sacred healer, wisdom keeper, and serves as the community’s psychotherapist. The clown’s purpose is to help us look at the familiar from another perspective. This also is the purpose of psychotherapy; we psychiatrists help patients look at their old landscape with new eyes, and in so doing help them create new endings to their old stories.
It took me until midlife to embrace myself as clown healer, and I took this step only after many years of working with Native Americans as chief of psychiatry at the Phoenix Indian Medical Center. I went finally went public after meeting Dr. Patch Adams, perhaps the world’s most recognized humanitarian clown, more than 20 years ago.
Dr. Carl A. Hammerschlag
This is the third year we have been conducting mental health clinics in the streets of Iquitos, Peru, which I have described before most recently last year . These street clinics are staffed by clowns who also happen to be health professionals representing many disciplines (doctors, nurses, psychologists, social workers, counselors, body workers, chaplains). They’re also part of a humanitarian clown trip that I make every year with Dr. Patch Adams and the Gesundheit! Institute in Hillsboro, W. Va., along with more than 100 clowns from around the world.
The impact of the clinics and on both ”patients “ and “therapists” has been profound. These encounters remind us that even in the presence of unimaginable suffering, connecting in this heartfelt way and remaining actively present in every moment makes suffering more bearable. They also remind us of the value of incorporating culture into treatment plans.
What is clown therapy?
Our clown-therapists will talk to people about anything that’s troubling them and work with them in open spaces (football fields, storefronts, loading docks, markets), sitting in a tight circle (with an interpreter for non–Spanish-speaking therapists) wearing a clown nose. We listen intently and are acutely present in every moment. We see people for 20 minutes and do not make diagnoses or prescribe pills, although we sometimes hand out amulets and give blessings.
As clown-therapists, we welcome the opportunity to get out of their heads and connect with people at the heart level. We delight in spontaneity, which facilitates opening channels into our unconscious minds, trusting that we will come up with something to say or do that will be helpful.
These clinicians can acknowledge suffering without becoming consumed by it … in the midst of crisis and/or pain they don’t “awful-ize” or “catastrophe-ize”; instead they have the capacity to identify people’s strengths and resilience and get a sense of what gives meaning to their lives. In a short time, such heartfelt connection can have a profound impact not only on the recipient but also the provider.
A case study
As a rule, we see people only once, but this year, I saw Maria, a 42-year-old woman twice. She was acutely suicidal, and after her morning prayers, decided today was the day she was going to kill herself. After 6 months of unbearable torment, she’d reached the end of her rope; she told me that her 20-year-old daughter had been raped 6 months earlier and was now pregnant. Maria’s family blamed her, saying that if she hadn’t divorced her husband 15 years earlier, this would not have happened. Maria knew she was not to blame, in which I concurred, but alas, she could not (as her family suggested) get over it and move on.
After listening, I told her I thought today was a miracle; this morning, she was ready to die, and this afternoon, we happened to show up on her street. I also said I believed the seriousness of her suicidal intent and told her she had two choices; I could hospitalize her, although I had no idea if that was even possible, or she could make me a promise – at least for today – that she would not kill herself.