31/07/2016 17:27 BST | Updated 01/08/2017 06:12 BST

Laughter, Trauma and Building Resilience

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Of all the sights and stories to emerge from the wreckage of the Syrian civil war and the refugee crisis spreading across Southern Europe, one stands out as unexpected.

The images of people dressed as clowns, in bright colours and face paint, doing handstands and playing saxophones in refugee camps dotted all over Greece might confound some. The non-profit organisation Clowns without Borders runs free shows to entertain children living in crisis, to make them laugh and offer them some respite from the chaos they experience every day. In many cases, parents report back that interaction with the clowns is the first time they have seen their children laugh since being forced to flee their homes.

As any parent can attest, playing is a fundamental part of childhood. Children 'play' by imagining reality and in so doing learn to master it by imagining controlling it. Children who are traumatised may play in different ways from their peers, termed 'post traumatic play behaviours'. This can include unusually intense play, or patterns where children re-enact the same scenario over and over again. They might also seem deeply sad or angry while playing. We hypothesise that trauma disturbs the healthy progression of a child's development, which then also impacts on the normal symbolic play that children engage in. For the traumatised child, reality has become simply too serious (or even dangerous) a subject to permit being played with. Trauma is adversity that is experienced alone. Adversity becomes traumatic when it is compounded by a sense that one's mind is alone: normally an accessible other mind provides the social referencing that enables us to frame a frightening and otherwise overwhelming experience as manageable. All the more important that they recover the capacity for putting themselves in charge, to re-join a community which imagination and playfulness allows.

Apes laugh, and dogs - even rats do, if you tickle them the right way. But animals only laugh in response to tickle and touch. Charles Darwin seriously appreciated the importance of laughter, and it was he who first observed that only humans laughed at ideas, at jokes, at general silliness. He called this 'the tickling of the mind. ' Our ability to tickle the mind is what that makes the human brain - with all its capacity for darkness and distress - also so magical. It helps us keep perspective, stop arguments, and reassure ourselves about the world.

Being able to laugh together in the way that only humans can, allows us to access and connect with other people's minds. Anyone who has swung a giggling baby in their arms, or delighted in sharing an absurdist joke with a chortling toddler recognises that laughing together is a uniquely wonderful way of recognising and enjoying another person's mind. Children who have seen the worst that humans can be capable of, who have experienced directly what it is like to be in in a world where their mind is not recognised as valid, as human, as deserving of comfort and safety may, quite rightly find it hard to laugh. Physical security and safety are of course the immediate and overriding needs for these children. But in laughing with them we are also recognising their humanity, we get closer to their thoughts and feelings, and through this, we address their need for support, for restoration, for reassurance. We create a community of spirit and invite them to join.

And laughter matters because it is one - fundamental - way in which we communicate engagement, affection, connection. We know that laughter plays a crucial role in the development of bonds between parents and children; there is evidence of a connection between laughter and resilience. One study found that humour can enhance mental health across the general population and specifically for persons experiencing mental health challenges. We need more research in these areas. But we do know that resilience is not something that we can expect anyone to simply have or not have - it is a process that is borne out of supportive relationships.

We have many tools at our disposal to help people in overcoming mental health problems and we have come very far in developing effective treatments. But we can - and must - go further. Rigid seriousness can exaggerate threats, amplify slights and close down our openness to different ways of responding to things. Humour can protect us; it gives us the ability to see a situation from another point of view, and gives perspective when we might feel overwhelmed. Mental health professionals must keep this quintessentially human experience in mind for patients during treatment. In the words of Clowns without Borders volunteer Linn Holm, 'Food and shelter will keep you alive but it will not give you the power to fight for life'.

Indeed. Scientific enquiry may yet prove her words to be true.

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