Humour in Gestalt therapy curative force and catalyst for change: a case study

Susanne Jacobs Institute for Child, Adolescent and Family Studies, Huguenot College, Wellington, South Africa sjacobs@goalnet.co.za I report on the findings of a study into the use of humour in therapy, which forms part of ongoing attempts to identify new ways in which to enhance therapy towards a positive experience for both client and therapist. In contrast to the many clinical papers that deal with the patient's inability to cry and mourn, few discuss the inability to laugh or use wit and humour. Most research points to this behaviour as a maladaptive response and uses humour for developmental assessment. In contrast, this exploratory article describes a single case, where the client revealed a habitually resisted contact through deflection and where she moved from a denial state to full awareness to emotional wellness through the use of humour techniques. Furthermore, it is argued that humour can be taught and used constructively as a coping mechanism in potentially harmful situations. In addition, humour can create awareness with the client, therapist and other users to improve humour capabilities. Keywords: awareness; contact boundary; Gestalt; humour; psychotherapy; resistance, therapy One extremely potent yet apparently little recognised mechanism in therapy is humour (Olsen, 1994). Since the desire to be entertained through humour is strong and near universal, the establishment of the return of a positive sense of humour may well be considered a goal of therapy. In this article I report on the findings of an investigation into the use of humour in the therapeutic situation and try to answer the question of whether its application is conducive to a situation where a client deflects and avoids contact. I used humour particularly for its attributes as a deflective mechanism in order to address contact boundary disturbance. I also seek to investigate Yontefs (1989) argument that useful purposes may be served by deflection. Furthermore, the aim was to investigate if through the use of humour the experience of pain and avoidance could be turned into enrichment and clearer boundaries in order to create more interpersonal comfort instead of discomfort. The reader is provided with background to the lack that exists in literature pertaining to a clients use of humour. To be able to guide the reader to what can be expected further on, the concept humour and its relation to awareness from a Gestalt therapeutic perspective will be described. In order to arrive at possible answers, the terms awareness and contact are described, and deflection is narrowed down to contact boundary disturbance indicating how the client uses humour as deflection. After the method is discussed, the case study is described, in which categories are identified according to baseline and second baseline responses, followed by a discussion of the synthesis for the Gestalt therapeutic process. Subsequently, recommendations are made with regard to its implementation, implications and the use of techniques, after which the conclusion follows: humour can be taught by making the client aware. Context The point of entry for this study is the holistic approach used in Gestalt theory as interpreted by Perls, Hefferline, and Goodman during the early 1950s (Yontef, 1989), based on the phenomenological existential perspective. The focus is on peoples existence, relations with each other, joys and suffering, personal awareness as well as process (Yontef, 1989). Gestalt therapy consists, in part, of introducing a process of heightened awareness so that the persons natural functioning can reinstate itself. It is concerned with and focused on the present, aiming to enhance personal growth, expand self-awareness, and help clients to accept responsibility for who they are and what they are doing,
Psychological Society of South Africa. All rights reserved. ISSN 0081-2463 South African Journal of Psychology, 39(4), pp. 498-506

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and to make choices (Harris, 2007). Gestalt theory argues that if the process of awareness can be increased then the clients may receive feedback from themselves and others and the environment more efficiently (Yontef, 1989). The value of deflection can be understood against the background of awareness and contact boundary disturbances. Literature survey Although laughing and crying are two basic inborn emotional relations, psychoanalysts and psychotherapists have been much more interested in the phenomenon of crying than laughing (Strean, 1994). A variety of studies have indeed shown that humour strengthens the immune system and often speeds recovery from illness and can be an important curative force for children, both psychologically and physically (Kaduson, Cangelosi, & Schaefer, 2004; Cattanach, 2003; Van Eeden, 2006; Kekae-Moletsane, 2008). However, theorists globally claim that humour should play a limited role in psychotherapy since it has significant drawbacks, and spell out cautionary advice concerning the destructive potential of humour in psychotherapy (Pierce, 1994). In Gestalt play therapy many references point to the use of games, fantasy and imagery techniques in order to create pleasant and safe surroundings for the internalisation of behaviour (Cattanach, 2003; Kaduson et al., 2004; Kottman, 2001). However, the literature fails to link the concepts of humour and playing in therapy to being taught as a coping mechanism where deflection presents itself as a contact boundary disturbance. I nevertheless believe that the therapist can use humour quite constructively in making therapeutic interventions by improving the potentially harmful situation, and can also make the client aware of and improve his humour capabilities. There are a variety of different perceptions of humour, as we see from the large numbers of definitions that exist. In a very simple explanation, humour can be seen as the ability or quality of people, objects, or situations to evoke feelings of amusement in other people (Kaduson et al., 2004). McGhee & Chapman (1980) distinguish between humour as a characteristic and as a state or condition, thus pertaining to a qualitative reaction to humoristic stimuli. In most cases, something is perceived as humoristic when it contains an element of surprise, for instance a sudden and unexpected incongruity (McGhee & Chapman, 1980), and takes an unsuspected twist at the end, all of which cause a pleasant feeling, a mounting pleasure as a result of a perceived incongruity, absurdity or strangeness. In a second exposure to the same context, the humour would lose its impact. Humour entails a process in which one needs a sense of humour, where sense refers to the ability to feel or appreciate something; the ability to be aware comes to the fore. According to McGhee & Chapman, (1980), the only prerequisites for humour are the capacity for play and the ability or sense to detect incongruities. Awareness, characterised by contact, sensing, excitement and Gestalt formation, is considered a primary therapeutic mechanism (Yontef, 1989) and a major cornerstone in Gestalt therapy (Joyce & Sills, 2001; Zinker, 1994; Harris, 2007). An attempt is made to help the client to become aware of that which he projects onto others in order to enhance his awareness of his self-identity with the aim of stimulating contact with the environment in a self-nurturing manner. In Gestalt terms, psychological health is having good contact with self and others. Contact means the awareness of, and behaviour toward, the assimilable, and the rejection of the unassimilable novelty (Harman, 1996). Contact boundary disturbances are processes, and not character traits, and can be further explained as the boundary between the self and the environment that gets lost and becomes vague and ill-defined (Zinker, 1994). One contact style leads to growth and development, the other to dysfunction. These disturbances may occur with certain people, under certain conditions such as stress, or may be manifested in a fixed (stuck) way in all interactions with others (Joyce & Sills, 2001). Interpersonal discomfort is avoided and the individual appears listless, depressed, hurt, in pain and depleted of energy, out of balance and incapable of suitable awareness. The person can therefore not share, or respond to his or her real needs, or work things out to everybody's satisfaction (Zinker, 1994).

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Disturbances at the contact boundary usually take one or more forms: projections, deflections, introjections, retroflections, and confluence (Joyce & Sills, 2001). For the purposes of this article the focus is on deflection, a common way of avoiding awareness in the figure formation phase. Deflection, as described by Zinker (1994), is avoidance of enrichment. According to Harman (1996), when a person deflects he or she turns aside or in some way, diffuses possible contact, or shifts the contact to some other topic that provokes less anxiety or waters down feelings. This is an active way of ignoring internal stimulus (feelings and impulses) and avoiding the needs or demands of the environment (Clarkson, 2004). As a boundary disturbance, deflections are used to interfere with contact by both receivers and senders of messages. Senders scatter their messages while receivers deflect contact, so that messages have little impact on them (Yontef, 1989). Examples include endless talking or laughing, avoiding eye contact, focusing on the need of others rather than self (a passive aggressive person might stare out of a window or sit sulking); verbosity (long-windedness), vagueness, understating and talking about, rather than to (Harman, 1996). By not noticing the deflection, the system collaborates to accept unfinished business. Deflection is therefore seen as a prime boundary disturbance. Yontef (1989) argues that useful purposes may be served by deflection where, with awareness, a situation needs cooling down. Since much of therapy focuses on unaware forces, a goal is to bring these unaware forces presenting as resistance to awareness so that clients can choose to transform themselves into more contact-full units. The therapists task is to entice clients to a curiosity about how these occurrences are managed, what is avoided, and the price that is paid for staying safe. The Gestalt therapist must be willing to ask, tease, cajole, persuade, flatter, coax, sweet-talk, provoke or demand contact in a humorous way. In responding the deflector begins to experience the contact boundary as an energising and exciting place to be (Harman, 1996). Research design The research was designed within the qualitative paradigm. Data were captured by making use of a single systems design case study as research strategy, an empirical enquiry that investigates a phenomenon within its real life context (Yin, 2006). Empirical data were collected over a specific period of time, both before and after manipulation (pre- and post-treatment), in a specific environment. The measuring instrument was developed after the literature research was undertaken, when an informed idea of relevant indicators that could be tested as baseline behaviour could be formed. Comparisons were made between first baseline deflective responses and second baseline responses (after intervention with humour took place). The continuous involvement, observation and reflection of the researcher in the research process and the gathering of data over a period of three months increased the value and credibility of this study. The use of audiovisual methods, repetitive field entry, triangulation, member-checking, reflexivity and peer evaluation further enhanced credibility, applicability, consistency and neutrality. This was undertaken with regard to the implementation of humour in the therapeutic process. The method used in this study was a single case (intensive investigation of an individual), using narrative in-depth analysis from which a detailed description emerged. Hofstee (2006) and Mouton (2004) have argued that case studies are subjective, giving too much scope for the researchers own interpretations. However, more scientific discoveries have arisen from intense observation than from statistics applied to large groups (Flyvbjerg, 2006). In addition, the choice of method should depend on the problem under study and its circumstances. According to Yin (2006,) even single case studies are multiple in most research efforts because ideas and evidence may be linked in many different ways. The immersion and engagement that is possible during a case study allows a researcher to become intimately familiar with the respondents lives and cultures. The researcher also brings own personal experiences into the description, without disturbing the flow of responses.

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Ethical considerations Permission was granted in writing from the various authorities of Child W elfare, as well as from the subject to use information as recorded. The principle of confidentiality was applied as I do not refer to the participants real name in the article. The participant was not exposed to any stressful, embarrassing, anxiety-producing, or unpleasant situations. Data collection and selection of participant Angelique, a girl from a childrens home was selected as a case for this study and participated voluntarily. Purposeful sampling, according to Neuman (2006), provides rich description of the experience and Angelique was the ideal subject who, in my judgement, was featuring deflective behaviour in many ways. The aim was to provide comprehensive description, through documentation and analysing of deflective baseline responses (repetitive measurement of the target problem at regular time intervals) before and after intervention of humour, to see if changes have occurred. The outcome focused on understanding rather than predicting general patterns of behaviour. As the situation, in which qualitative research is done, is unfixed and flexible (so too for case study inquiry i.e. it cannot be controlled, as in conventional research methods) the researcher has to rely on techniques such as interviews, observations, document analysis and nonverbal cues. The data for this study were collected by means of a series of structured and unstructured therapy/ interview sessions that were video recorded which enabled me to concentrate on the discussion. The interaction between me and the participant, who was at ease, was the most vital connection in the collection of information. The interview as a research design to collect data is considered to be an appropriate method when it comes to description of certain feelings, attitudes, intentions and interactions. Baseline responses revealing deflective and nonverbal behaviour were noted meticulously in the process notes. The recording of the sessions allowed for intensive revisiting of the whole process by me and a social worker. Quality assurance strategies (triangulation, crystallisation) In this study, the traditional reliability and validity is conceptualised in terms of trustworthiness (Neuman, 2006) and credibility. The techniques of prolonged engagement (12 one-hour therapy sessions over a four-month period), triangulation, member checks, collection of data from different sources and analysis were used for ascertaining trustworthiness. Research findings involved a continuous cycle of implementing interventions, evaluating the impact, modifying and implementing the intervention. THE CASE: BACKGROUND AND DESCRIPTION, ANGELIQUE Angelique, whose parents have been divorced for seven years, and with whom she has little contact, has lived in a childrens home since she was in Grade 4, and 10 years old. W hen the study was undertaken she was 13 years old, a time when intellectual development is marked by the onset of more independent thoughts, increased memory and attention span, the ability to compare, plan, reflect and reconstruct logically. Angeliques losses include family unity, parental involvement, physical contact, trust, own identity, supporting relationships due to relocation, social status, economic security and quality of living, which all have effects on the body, the affect, cognition, and behaviour. The experience of having to adapt to the home and a new school intensified the trauma the client was subjected to. The initial reasons why the client was referred was a result of her stealing, lying, disobedience, throwing tantrums, framing other children, poor school performance, laziness and showing aggressive behaviour; these behaviours result in her being in trouble often, both at school and at home. Observation of the clients process pertaining to first baseline responses during the first session indicated a variety of behaviours: frustration, uncertainty, aggression, manipulation, loss of pleasure,

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uninspired to play, troublemaking, promiscuity, disinterest in schoolwork, irritability, withdrawal, argumentativeness, blaming, confusion, egocentrism, pessimistic, reasoning, rebellious, resistant. From the observations it was deduced that the client was functioning from the false layer of her personality, incomplete Gestalts, with contact boundary disturbances such as introjections, projections, retroflection and deflection all occurring at the same time. The core beliefs that were communicated were: I can do everything by myself, and other people cannot be trusted. First baseline verbal deflectors observed were that Angelique did not want to come to therapy and made many excuses, used vague and open-ended answers, hints and remarks such as the following: I dont have time now, if I come now, I will not be able to finish my homework and then I will be in trouble at school. The conversation was marked with responses such as I dont know, Why? as well as resistance: I cant choose you choose for me, which revealed very little awareness of her own behaviour. The most important indicator of her deflective behaviour was that Angelique was not able to be here, she only lived in the past and in the future; and refused to use the word now. Nonverbal deflectors pertained to looking away, changing the topic every few seconds, ignoring questions asked, looking at me cross-eyed, slouching, fumbling and fidgeting to an extreme extent and a sad and unhappy look. According to Joyce and Sills (2001) problems arise when habitual responses are not updated for new or changed conditions. It may become a general style of contact across a range of situations which can pervade all aspects of the persons way of making contact. The client in this case did not realise that she deflected from any difficult emotion by changing the subject, and that she tensed her body every time she spoke about her father. She was also unaware of the options for self-expression. No sense of humour was detected or observed by the therapist. Therapists must choose therapeutic pathways to suit the childs intellect and emotional development. Once the therapist knows the childs process, humour can be selected and modelled in a directive manner. The therapist needs to be aware of what is on the foreground of the child on that particular day, before implementing humour. During the second session the therapist brought in exaggeration, modelling and banter, by exaggerating many of the problems the client seemed to have, in a playful tone of voice. Also, the therapist often said: I am joking, as this message about the message was an invitation to the child to join in the humorous frame of mind. M odelling can be regarded as the environmental process of influencing humorous behaviour, either purposeful or not, and should be used with banter (Strean, 1994), which was found to be very effective. One of the most difficult things for many clients is to develop and maintain a truly positive sense of self-worth while finding out something about themselves that does not fit their self-ideal. During the interpretation phase, where the session is clarified and evaluated, humour became a marvellous technique used by the therapist for allowing the client to see some of the useless things she was doing, taking off the edge and lessening resistance without causing offence. W hen some of the strongest interpretations were presented with a glint in the eye or phrased in a humorous way, the therapist had better results with a higher degree of acceptance by the client. The therapists message became, This is what you are doing to louse yourself up, but I still like you anyway, or W ho could like you?. Birner (1994) suggests that a patient may say, Im pretty bad. In this case the therapist responded: You are absolutely the worst. That is not true, the client protested in joyful disagreement, thus encountering the former neurotic posture. Humour can also be used by the therapist when there seems to be no direct or other way to communicate criticism. Kind, loaded humour can be the most pleasant or sugar-coated way of offering constructive criticism. The goal of the third session was to establish the clients process in board games, how she reacted to choices and responsibility, competition and an awareness of humour. The client did try to bend the rules all the time, but did not express meanness, and appeared to be relaxed and somewhat playful.

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Games function to promote and enhance the process of change due to the game creating mini life-situations through which children can learn social rules and procedures while developing new strategies for use in real life settings (Dunn, 2004). Games may then help children feel more comfortable in strange situations and promote engagement with therapy through improving their ability to communicate thoughts and feelings. If therapy can be derived in a fun way, children can learn that they can be part of a social experience of having fun and being fun to be with. This may then add to their feelings of self-worth (Kekae-Moletsane, 2008). A marked difference with regard to humour came to the fore. The games left ample scope for introducing spontaneous enjoyment and laughter, but also became a metaphor for her powerlessness. Games help children to identify strengths and abilities, and help to make ideas concrete and address the problem in the context of the here and now. The client strongly requested the therapist to please come again, and to bring more games. The client was given an assignment, namely, to look out for a funny situation and tell the therapist during the next session. The telling of a joke by a child reflects a positive motivation of wanting to share an enjoyable experience. Many childrens favourite jokes are often related to underlying sources of conflict or distress points and can be aligned to the importance of the coping functions of humour (McGhee & Chapman, 1980). An outcome of this is that humour helps children overcome conflict and anxiety. By playfully confronting stressful situations in the context of humour, many children appear to be able to master the anxiety associated with those situations. The client tended to deflect less than during previous sessions but still said I dont know. It was remarkable that the client ceased to squint and was able to look the therapist straight in the eye. During the next three sessions of therapy a game that focuses on deflective behaviour was played by the therapist and the client. In this case use was made of A game of learning about FUN: the talking, feeling and doing way, which enabled competence and ability transfer where skills obtained in the therapeutic environment were moved to the problem context of deflection as contact boundary disturbance. Some of the questions (that focus on the recognition of humour, and deflection, based on the cognitive, psychomotor and affective domains) were: How can a person learn to see things less seriously? W hat would you suggest? Do you tend to laugh when you are feeling serious?/ Frightened?/Depressed? W hen somebody talks about something that you dont like what do you do? Also explain why, and consider what else you could have done? Angelique enjoyed talking about and discussing the various options. She revealed remarkable insight into deflective behaviour of other people, and her own deflective behaviour, and mentioned being aware of the fact that people sometimes laugh when they are shy or trying to evade a painful situation. She was able to distinguish between healthy deflection and evasive deflection. In these sessions it was also addressed that problems have more faces than originally anticipated. The atmosphere of the game play inevitably meant that a light atmosphere existed. During the last sessions a much stronger sense of self was revealed by the client, as she often initiated humour and provoked the therapist by teasing. Second baseline responses that were observed after treatment pertained to two major categories of behaviour: argumentativeness and reasoning. It can be deduced that the clients much stronger sense of self and insight into her behaviour might be the reason. Contact boundary disturbances were reduced to a point where the client felt free to argue and reason in a healthy way, also reflecting her developmental level. It can be deduced that changes occurred during and after treatment. In addition, the client seemed to be content, satisfied, calm, confident, inoffensive, constructive, playful, smiling, teasing, interested, in a good mood, present, challenging, enlightened, altruistic, proactive, accepting and trustful. It was found that Angelique not only has a strong and a good sense of humour, but also the ability to enjoy humour as well as create it. She did not cease to deflect altogether. Here I would like to refer the reader to Harman (1996), who states that doing therapy with deflectors requires helping clients establish contact in order to add zest and freshness to their

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interactions and that useful purposes may be served by deflection. The following types of humour (McGhee & Chapman, 1980) were spontaneously used by the participant: conflict humour (used as a weapon to reveal aggression); control humour (here the client maintained order where people would otherwise be antagonistic towards each other); consensus humour (promoted comradeship and friendship, and elicited the client to dare and take more risks easily, here the element of pleasure was recognised most strongly); and concealment humour (which allowed the client to avoid/deflect in a healthy manner). Findings: Synthesis for Gestalt therapeutic process The therapeutic work with Angelique centred primarily on the awareness of contact boundaries and enhancing her awareness continuum. This was congruous with the objective of Gestalt Therapy, where the goal is awareness (Yontef, 1989) and where growth and autonomy are achieved through an increase in conscience. Awareness of sensations and feelings but also automatic mannerisms and habits are brought into awareness. The product of awareness is to discover the self, to get to know the environment, to take responsibility for choices, and to develop self-acceptance and the ability to be in contact. In the case of Angelique these processes were approached through engagement in Gestalt play therapy. Angelique became aware of sensory experiences, discovered who she was, related to objects and people and learned to take responsibility for her choices. These processes took place within a secure relationship, maximised through structured handling strategies and making consciously use of humour in a directive and nondirective way throughout the sessions. DISCUSSION My overall aim in this article was one that sought to investigate the dynamics of humour as a curative force and catalyst for change, by adding new findings to the successful use of humour in therapy, specifically focusing on the value of making use of humour as a treatment technique for addressing deflection as contact boundary disturbance. Some of the positive effects that clients have attributed to the Gestalt approach include increased levels of self-actualisation and personal effectiveness, maximum development of personality potential and the expansion of awareness and of experiencing (Clance, Thompson, & Simerly, 1994). The most important findings were that children who make use of deflection do not use their energy efficiently in order to receive feedback from themselves, others and the environment. This agrees with the literature which says that as we look at deflection as contact boundary disturbance in order to protect against the risk of psychic pain, hurt, discomfort, difficult confrontation and rejection, we also witness the price paid: listlessness, lack of intellectual spark, depleted energy, depression, loss of humour and playfulness. The impact of the study is that humour can be used in a positive manner to enhance awareness for long enough to facilitate change towards positive well-being. It was found that deflection is useful as it can take the heat out of responses where the situation needs cooling down, not to respond to all the stimuli so that it is possible to remain in contact and not to withdraw, or, in extreme cases, not to attack. In this sense deflection can be regarded as healthy, and this agrees with the literature. It was also found that a good sense of self is a prerequisite for good contact (Steyn & Mynhardt, 2008). W hen contact-making skills are used optimally, a person can start reacting in more playful ways, and can both react towards humour initiated by the therapist and initiate humour. The stronger the sense of self, the more scope there is for humour and a humorous personality, whether created and initiated or enjoyed. In addition it is stated that sadness and unhappiness can be seen as the polarity of humour. It is found that this is not completely true: humour does not take away the unhappy situation the client finds himself in, but it changes the perception of the situation. Adding a humorous atmosphere and quality to therapy helps the client to feel uplifted, which then alters the perspective.

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However, it seems critical to keep in mind that humour is a means to an end and not an end in itself in therapy. Given a choice, most children prefer to interact in a playful way. Serious discussion and methodological problem solving may impose on childrens communication, shutting out their voices, inhibiting their specific abilities, knowledge and creative recourses (Freeman, Epston, & Lobovitz, 1997). The process of choosing seriousness from us as therapists may be dampening our own resources, such as the ability to think laterally, remain curious, be light-hearted enough to engage playfully with the child, and have faith that the situation is resolvable. Lacking these, we may have our wits dulled, lose our appeal to kids or become overwhelmed. Do we dare to be playfully creative in the face of worrisome problems? W e believe this leads to the rise of inspired problem-solving and the downfall of serious problems (Freeman, Epston, & Lobovits, 1997). As McGhee & Chapman (1980) note, children who are skilled at humour may be more successful in social interactions throughout their childhood, for it is difficult not to like someone that makes you laugh. Those who laugh together soon forget their differences as humour provides a common bond for mutually shared experiences, where the participants momentarily drop their guard and relate authentically. Humour can therefore be seen as a universal means of relationship building. Individual differences in humour may be important in the design and effectiveness of therapeutic interventions. In the future it may be beneficial to use different procedures for people with different personal attributes. W ith increasing knowledge of both humour and individual differences it becomes more important to know more about what kind of funny things should be done with whom. The limitation with this study, however, is that it focuses on one child only, and the researcher acknowledges that other factors that have not been mentioned could also have led to the client feeling safe and regaining control. In conclusion, it can be stated that humour can be taught and be made aware of, and only a minuscule shift can evoke change. Furthermore, a client who makes full contact is able to reveal liveliness, increase in humour and playfulness instead of loss of it. The case study provided a systematic way of looking at events, collecting data, analysing information, and reporting results. As a result I gained a sharpened understanding of why the instance happened as it did, and of what may become important to look at more extensively in future research. It appears that more extensive effort is justified to free humour ability and appreciation. REFERENCES Birner, L. (1994). Humor and the joke of psychoanalysis. In H. Strean (Ed.), The use of humour in psychotherapy (pp. 55-62). London: Jason Aronson Inc. Cattanach, A. (2003). Introduction to play therapy. Sussex: Routledge. Clance, P.R, Thompson, M.B, & Simerly, D.E. (1994). The effects of the Gestalt approach on body image. Gestalt Journal, 17, 95-114. Clarkson, N. (2004). Gestalt counselling in action. London: Sage. Dunn, M. (2004). The development of a board game as preventative measure against the sexual abuse of grade 4 children in South Africa. Unpublished D DIAC thesis, University of South Africa. Freeman, J., Epston, D., & Lobovits, D. (1997). Playful approaches to serious problems. USA: Norton Company. Flyvbjerg, B. (2006). Five misunderstandings about case study research. Qualitative Inquiry, 12, 219-245. Harman, R.L. (1996). Gestalt therapy techniques: working with groups, couples and sexually dysfunctional men. USA: Jason Aronson Inc. Harris, N. (2007). Renegotiation of life space. Gestalt Therapy, 13, 15-18. Hofstee, E. (2006). Constructing a good dissertation: a practical guide to finishing a Masters, MBA or PhD on schedule. South Africa: Sandton: EPE Publishers. Joyce, P., & Sills, C. (2001). Skills in Gestalt Counselling and Psychotherapy. London: Sage. Kaduson, H.G., Cangelosi, D., & Schaefer, C. (Eds). (2004). The playing cure: individualized play therapy for specific childhood problems. New York: Aronson. Kekae-Moletsane, M. (2008). Masekitlana: South African traditional play as therapeutic tool in child psychotherapy. South African Journal of Psychology, 38, 367-375.

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Kottman, T. (2001). Play therapy: basics and beyond. USA: American Counselling Association. McGhee, P.E., & Chapman A.J. (1980). Childrens humor. New York: John Wiley & Sons. Mouton, J. (2004). How to succeed in your masters & doctoral studies: A South African guide and resource book. Pretoria: Van Schaik. Neuman, W.L. (2006). Social research methods. USA: Pearson. Olson, H.A. (1994). The use of psychotherapy. In H. Strean (Ed.), The use of humour in psychotherapy (pp. 79-89). London: Jason Aronson Inc. Pierce, R.A. (1994). Use and abuse of laughter in psychotherapy. In H. Strean (Ed.), The use of humour in psychotherapy (pp. 42-53). London: Jason Aronson Inc. Steyn, R., & Mynhardt, J. (2008). Factors that influence the forming of self-evaluation and self efficacy perceptions. South African Journal of Psychology, 38, 563-573. Strean, H. (1994). The use of humour in psychotherapy. London: Jason Aronson Inc. Van Eeden, J. (2006). HaHaHaHaha In: Beeld, 20 April. South Africa: Media 24. Yin, K. (2006). Handbook of complementary methods in education research. London: Routledge. Yontef, G.M. (1989). Gestalt therapy: an introduction. Current psychotherapies. Illinois: Peacock Publishing House. Zinker, J.C. (1994). In search of good form: Gestalt therapy with couples and families. San Francisco: Jossey-Bass Publishers.

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