When David Granirer stood before medical students at the Vancouver General Hospital, explaining his alternative to traditional forms of therapy, his audience laughed at him.
Just as he'd hoped they would.
Granirer has developed a comedy workshop for people living with mental illness, which he’s dubbed Stand Up For Mental Health (SMH).
He runs weekly classes that bring together people with an array of mental health diagnoses such as bi-polar disorder, schizophrenia and obsessive-compulsive disorder. Over the course of a year, he helps his students develop stand-up comedy routines for live audiences.
Six years after thinking this approach might help people better manage mental illness, his program is so popular that he has to turn away aspiring comics.
When he addressed the medical students, who are enrolled at UBC, UVIC and UNBC, Granirer knew there might be skeptics in the crowd. He blended serious and humorous points, screened performance clips, and invited a few comedians to partake in small discussion groups after the lecture. The event was part of a pilot project, which aims to give tomorrow's doctors a greater understanding of -- and empathy for -- people with mental illness.
"We often say laughter is the best medicine, but nowhere in the system do we say, 'You've got a great sense of humour... let's see what we can do with that,'" said Granirer, who is experienced at both stand-up comedy and depression.
According to the Canadian Mental Health Association, one in five Canadians is directly affected by mental illness at some point in their lives. Indirectly, every Canadian is affected through a family member, colleague or friend.
"There are many myths about mental illness. Until people learn the truth, they will continue to deny that mental illness exists or avoid the topic entirely," states CMHA's website.
A personal knowledge of depression
Granirer hasn't always enjoyed visiting hospitals and talking to doctors.
Although his silly facial expressions and lively gestures may not suggest it, Granirer was diagnosed with depression in his mid-thirties. He believes the condition began sometime during his teen years. In those days, he said he felt an incredible sense of shame and worthlessness, and would even cross streets to avoid people he knew.
"There's a huge, essential part of you that doesn't live in those [day-to-day] interactions," he explained, emphasizing the wall of silence that surrounded him. Friends didn't ask how he was doing because they were afraid of putting him in the embarrassing position of having to actually tell them. His doctors coated their questions with euphemisms.
After his diagnosis, Granirer learned to manage his depression through a combination of comedy, counselling, and medication.
"When I'm on the right meds, I'm fine. But the meds stop working every so often," he said, explaining it's most difficult for him when he must transition to a new brand or dosage. Although he said it's not easy, he hasn't let his depression stop him.
Over the years, Granirer has become a registered professional counsellor through the Canadian Professional Councillors Association, a trainer for the Crisis Intervention and Suicide Prevention Centre of B.C., and the author of a book called The Happy Neurotic.
His work with SMH has been featured by CBC, Global TV and the BBC. It has also been studied by Master's candidates from cities like Seattle and London.
But even now, Granirer doesn't take for granted his ability to function at high level. And he still wishes he hadn't spent so many years in the dark.
"People come to their doctors and don't even know what's wrong," he said to the student physicians. "If you folks can catch it, you can save someone years."
'This has therapeutic effects:' Granirer
Granirer originally dreamt up SMH while teaching a comedy course at Langara College. He began to see stand-up as a potential platform for other people like himself.
At first, others discouraged him.
"People who are mentally ill are not going to show up for class... they're not going to be reliable," he recalled his colleagues saying. "You'll be lucky to get one or two shows out of them and then they'll all sort of flake off."
But in the first year, only four of his 15 students left the course, and the remaining pupils wanted the classes to be weekly instead of bi-monthly. The pulled off 30 shows while the program was still a fledgling, and also developed an alumni program for graduates who wanted to keep performing.
"I think that one of the most powerful ways to help people overcome whatever it is they're dealing with -- especially when it's being stamped on their foreheads for years -- is to give them a different identity," said Granirer, who refers to his students as comics, not patients.
The SMH model has attracted the attention of researchers from the University of Western Ontario, who are currently running a study that assesses the quantitative benefits of the program by comparing active comedians with people who passively consume comedy. In the meantime, students themselves have offered their own testimonials.
"Therapy happens. It just isn't called therapy and it doesn't feel like therapy," said Granirer. "The course isn't going to cure someone's schizophrenia, but doing this has therapeutic effects."
From misfortune to material
In stand-up comedy class, painful experiences take on a whole new meaning. Although he acknowledged that no one can change the past, he thinks writing jokes about difficult incidents gives people to access to their sense of humour, which enables them to re-write their own stories.
Melanie Rose, an alumnus who struggles with body image, has taken control of the narrative about her appearance.
"On my way here some guy called me giant," said Rose matter-of-factly, "I wasn't sure that's what he really said, so I picked him up and I held him to my ear."
In less than five minutes, Rose can deliver a routine with several references to her looks, her divorce, alcohol addiction, anxiety and bi-polar disorder.
When Rose combines comedy and confessionals, she gets positive feedback in place of pity from a laughing and applauding crowd.
"That's a completely different message to get back," said Granirer, "especially after years of pretty much being ignored or shunned or feared."
But not all comics have natural comedic timing and stage presence.
Michael Warren, an alumnus who lives with biopolar disorder and ADHD, has to practice his jokes over and over again, struggling with certain words. Warren knows what it's like to have a bumpy set, and even had one bad show permanently documented by the CBC.
Still, Warren continues to work on his routine, emphasizing the resilience of people who have survived everything from ridicule to suicidal thoughts.
"There certainly are risks involved, as in any process," said Granirer, who makes sure his students are as prepared and as rehearsed as possible before they finally perform. Given that his students often have tough stories to begin with, Granirer thinks "they can survive a few jokes that don't go well."
There are also few topics that Granirer discourages in class.
"If somebody says they want to write some jokes about being sexually abused, for example, I usually say I haven't ever seen anybody who's been able to pull that off," he explained. He also asks his students steer clear of jokes that are racist, sexist or homophobic.
Other than that, he'll work with just about any idea, be it pot-loving pets or writing a mainstream resume for an exotic dancer.
The power of catharsis must also work in combination with stigma-busting outreach. It's a delicate balance between what is genuine to the jokester and what is palatable to the public.
Pat Bayes is SMH's program coordinator. When asked how big the rest of the SMH team was, Bayes broke into laughter: "It's David and I!"
Granirer teaches comedy classes in person and over Skype. He also performs in shows and lectures for audiences, like the medical students, who seek more serious content. Bayes manages fundraising, program coordination, networking, and public relations. Their tasks regularly overlap.
With such a small organizing team, it's surprising that SMH reaches comics in other cities through a distance-learning module. Whenever the funding is available, they visit their liaisons in Victoria, Toronto, Guelph, Ottawa, Montreal and Halifax.
"We want to train trainers," said Bayes, who is modest about her own efforts. "There will never be another David, but we can train reliable comics."
So far they've trained one person: a psyche ward nurse named Janice Bannister.
"I find it really hard to find the right people" said Granirer, who always tells his students, "I'm not an outside expert -- I'm one of you."
Granirer also said he has nowhere to consistently send comics he can't accommodate. When people are on the waiting list, he's careful not to make promises.
Still, despite the challenges, they both project a "show must go on" attitude. As they build credibility, they've managed to secure better funding through a mix of public and private supporters.
"Of course we're tired," said Bayes, "But we're on a mission. These opportunities may not ever come around again so you have to take them and build on them."
A prescription for new doctors
Stand-up comedy isn't for everyone. Granirer repeatedly recognized the importance of traditional therapy groups, practices and the role that doctors play in the lives of the people they treat.
"One of the things you folks can do, to make it easier for the patients that you see, is talk about this stuff matter-of-factly," said Granirer. He also took a jab at the seemingly impenetrable wall between "normal people" and the mentally ill.
"I mean, really, look at the normal people here in this room. They're polite, they're well dressed, they're gainfully employed -- they could snap at any moment!" laughed Granirer.
The medical students leaned forward in their chairs throughout Granirer's talk. Many times, collective laughter rumbled through the room.
"I was surprised at how legitimately funny they were," said Bryn Runkle, a fourth-year student who attended the talk. "It wasn't just a form of therapy for them -- they were actually producing really solid results."
Colleen Sweeny, a second-year student, appreciated what she said was a different and effective approach. "We have had, in other classes, different patients come in and talk about their experiences," said Sweeny, "but none with the humorous side of things."
Next, classes for sex trade workers
In the future, SMH might become a permanent fixture of the "Doctor, Patient and Society" course. Jane Buxton, course director for second-year public health sessions, said a planning committee will make a final decision in April, although she herself seemed pleased with the results so far. "We have had extremely positive feedback from all sites from the students, tutors and course directors," said Buxton.
And even if the doctors don"t make more appointments, Bayes and Granirer have two other partnerships beginning this Spring. New stand-up classes for Vancouver sex workers begin in March, as SMH collaborates with the Prostitution Alternatives Counseling and Education Society. Another version of the workshop will soon be launched for inmates at William Head Prison.
"People don't want to hear from a stand-up comic that's happy and well adjusted," laughed Granirer. "That would be really boring."
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