I bumped into Harry Hill on the way to a comedy evening. He was a surprise guest. He had his trade mark big white collar, thick glasses and goofy expression. When he came on stage he looked like he might trip up over the microphone cable that dangled between his legs as he pranced about the stage. I had to stop myself shouting out "be careful". His put down to a mild mannered heckler was "your the sort of guy who buys a pack of strepsils and sandwich for lunch at boots." It sounds innocuous but there was something caustic about its timing and delivery. The heckler-contributor was duly silenced. He seemed to put his feet up on the seat in front of him in a strop. Harry Hill also insulted an elderly couple who were audacious enough to be sitting in the front row. He made jokes about their contribution in the war, care homes and shock that they were still alive. They laughed the first time and then seemed genuinely upset. Did they not get his rudeness was part of the joke. Or was he not joking.

Therapists and comedians share much in common. We have to use words and timings to have an effect on our audience. How we deliver our lines is key. How our words are heard is unpredictable. Free association and the meandering path of psychotherapy is much like improv stand up. The unconscious and a good joke share much in common. We are both seeking to find the "mot juste", the perfect one-liner, to help the patient.

At the end of his piece Harry Hill danced a goofy dance. He alluded to his five years training as a medic. But in truth his comedy is a form of medicine for the side of us that the doctors in white coats dont have much time for. The irrational, chaotic, messy, speaking and laughing human.