Lifelong Learning Programme

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Training for Paediatricians and Paediatric Students

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This training package is addressed to students and medical practitioners in paediatrics on how to autonomously learn, develop and consolidate their soft skills for improving the quality of paediatric services.

Communicating with Health Care Staff

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5.6 - Humour
In the taxonomy of defence mechanisms, namely the psychological processes that each individual performs in response to stressful or conflicting situations, humour is among the highest level defences. A more adaptive level of psychological functioning allows the expression of optimal adaptability in the management of events, emphasizing the gratification for what is done, allowing the awareness of feelings and promoting an excellent balance between the reasons for the conflict.

Specifically, humour is the ability to grasp the paradoxical and therefore fun aspects of situations. It is the expression of our "lateral thinking", that is our ability to take an emotional and cognitive step backwards from the current situation, to see it from a different point of view.

Humour reveals an original, innovative intuition, able to overturn the order of the questions, reveal contradictions, internal fragilities that up to that point were dominated by problematic and/or conflicting aspects. Humour, unlike other forms of "alternative" thought expressions, such as irony, sarcasm does not cause unpleasant effects in the other, but on the contrary, involves it by surprising it and bringing it closer through a common laugh.

Irony emphasizes indeed aspects of reality that apparently indicate an opposite meaning, using semantic inversions or antiphrasis, sarcasm is a negative evolution in which the other is mocked, humour instead releases positive emotions, reducing the tension and the anxiety.

Freud in 1905 in his essay “Jokes and Their Relation to the Unconscious” describes humour as a mode of stable and economic psychic functioning: laughter dissolves potential elements of conflict very quickly and without putting in difficulty those involved, preventing immobility or emotional and relational blocks and avoiding pathological relapses. "Humour is not resigned but rebellious, it represents the triumph not only of the ego, but also of the pleasure principle, which here knows how to assert itself against the adversities of real circumstances" (Freud, 1905).

Freud anticipated what is now documented in the literature compared to the beneficial effects of laughter on the cardiovascular, hormonal, respiratory and muscular systems. A good laugh activates the sympathetic system, increasing the beneficial effects on the heart and lowering the production levels of cortisol, decreasing the activation of the stress axis (amygdala, pituitary, adrenal).

Resort to humour within the working group and in relationships with other operators helps to make the climate more confidential and relaxed, increases the sense of autonomy of individual operators and collaboration between them, encouraging a more stable operating mode and healthy, with potential beneficial effects also in the relationship with patients and parents.

There are scales to measure humour. A scale used in healthcare is the “Sense of Humour Questionnaire – 6” (Sveback, 1974), 6 item to evaluate the level and style of personal humour, self-affirming, that is aimed at facilitating the relationship with others and the style of self-reinforcing humour, which underlines the originality of its point of view. Within the relationships between health workers, we bring an example of affective humour and an example of self-reinforcing humour. Example 1. Affective humour: At the end of the transfer, a nurse comments: "Today will be particularly heavy". "Today?..." Answers the colleague who goes on duty with her.

Example 2. Self-reinforcing humour: At the end of the handover, a nurse comments: "Today will be particularly heavy". "Luckily it's ten o'clock in the evening", replies the college that goes on with her.
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This project has been funded with support from the European Commission. This web site reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.