Clown therapy, or medical clowning, is different from a medical clown entering hospitals to cheer up patients and staff. Medical clowning is more akin to drama therapy and helps patients discover their inner clowns and act them out in group settings. Once this inner clown is set forth, these patients embrace the absurdity and contradictions in their everyday lives. They also find new ways to communicate.
The therapeutic potential of playing the clown was first presented by mental health practitioner Cheryl Carp in a 1998 article titled “Clown Therapy: The Creation of a Clown Character as a Treatment Intervention.” Carp’s insights were rooted in her own personal experiences as a clown and clown instructor.
According to Carp:
As a young adult, I was invited to teach clowning to inmates at a men’s maximum security prison. Again, I witnessed the power of the clown. The men struggled with exaggerating emotions they had buried long ago. They engaged in childlike play and mentally escaped through the release offered by their characters. The idea that clowning offers a therapeutic benefit began to form in my mind through this experience.
Medical clowning has found good use in the treatment of people with drug dependency. Clowns have the ability to suspend or unite opposites, such as power versus powerlessness or competence versus incompetence. In people with drug dependency, medical clowning can serve to contain ambivalence using laughter, merriment and mirth. Ambivalence stands in stark contrast to the motivation and willingness to engage in drug treatment.
In a February 2018 article from The Arts in Psychotherapy, Gordon and co-authors reflect on more than 10 years of clown-therapy workshops in the realm of addiction therapy. Their project, which was recognized by the Israeli Ministry of Social Welfare, was carried out in day-treatment/rehabilitation centers among patients who had experienced physical withdrawal secondary to substance abuse. The patients were mostly men, aged between about 20 and 60 years, and exhibited personality disorders and a history of criminal behavior stemming from dependence. Notably, the group contained a mixture of Jews, Arabs, Christians, and Druze who were continuously monitored for relapse.
After surveying 70 participants in clown therapy, the Israeli Ministry of Social Welfare published the following results in 2010:
Although Gordon and colleagues have principally examined clown therapy in the realm of dependency and drug abuse, the authors suggest that this intervention may prove useful to patients with other conditions.
Participating in the art of clowning has proved effective for improving the quality of life of people with disabilities, youth at risk, and other marginalized groups. Perhaps this is so because the liminality of the clown may offer a voice to those who find themselves in marginalized positions. Ultimately, since under certain circumstances every one of us can be an ‘outsider’ in need of self-acceptance and social inclusion, clown therapy can be an aid for all of us.
Carp CE. Clown Therapy: The Creation of a Clown Character as a Treatment Intervention. The Arts in Psychotherapy. 1998;25(4):245-255.
Gordon J, Shenar Y, Pendzik S. Clown therapy: A drama therapy approach to addiction and beyond. The Arts in Psychotherapy. 2018;57:88-94.