VUlogo

Psychology Department

Health Psychology Home Page

Papers written by students providing scientific reviews of topics related to health and well being

  HomeWeight LossAlternative Therapy | Supplements | Eating Disorders | Fitness | About this Page |

 

Health Benefits of Humor and Laughter:

Could it really be true?

By Jakai’ Nolan

October 24, 2008

“A good laugh and a long sleep are the best cures in the doctor's book.”  ~Irish Proverb

 

 

                I have a riddle for you: What’s more contagious than any cough, sniffle, or sneeze, yet desired by all human beings? {Pause} …You’ve got it! The sound of roaring laughter!

 

                Humor and laughter have been known to cause a domino effect of joy and amusement amongst all those that come in contact with it; beginning during the tender years of infancy.  After thousands of years of overlooking a key coping mechanism that we, as humans, have been endowed with, scientists have begun to look at the effects of laughter on one’s physical and mental health.  Studies have proven that when we laugh, there is an actual chemical change in our bodies that helps to ease pain and release stress.  However, some people still have their doubts about the efficiency of humor and laughter as an alternative medicine that physicians and patients can comfortably turn to.  Can laughter really be used as an alternative medicine and coping mechanism for disease and the normal stresses of life?  Furthermore, can laughter be used to help fight off diseases by bringing balance to the various components of the immune system?   

 

The Facts:

-What is laughter?

                To begin, one must understand the definition of humor.  According to Bennett and Lengacher (2006), humor refers to a stimulus that is “intended to produce a humorous response (such as a humorous video), a mental process (perception of amusing incongruities) or a response (laughter, exhilaration).”  As suggested in the definition of humor, laughter is that funny (no pun intended) noise that people make as a response to something that is found humorous.  Together, humor and laughter can be associated with a pleasant emotional state.  To take it a step further, Dr. Lee Berk and Dr. Stanley Tan (1996) present laughter/humor as it relates to stress.  The researchers state that stress comes in two forms, negative and positive.  Distress is the negative kind of stress that increases the body’s stress hormones (i.e. cortisol, beta-endorphin, corticotrophin, prolactin, growth hormone, and catecholamine).  Eustress is the positive kind of stress that works to decrease these hormones that the body releases during times of stress.  According to Berk and Tan, “laughter is a form of eustress that releases those bad and distressful emotions that cause harmful chemical effects on the body.”   While affecting fifteen facial muscles, the respiratory system, and in some cases tear ducts, the body behaves in a manner in which it emits sounds that can range from “sedate giggles to boisterous guffaws.” (http://people.howstuffworks.com/laughter.htm/printable)       

 

-What is alternative medicine?

                Alternative medicine is defined in varying ways, depending on the definer.  The National Library of Medicine places alternative medicine as a subheading under complementary therapies.  Their definitions states that complementary therapies are “therapeutic practices which are not currently considered an integral part of conventional allopathic medical practice.  They may lack biomedical explanations…” Furthermore, “therapies are termed as Complementary when used in addition to conventional treatments and as Alternative when used instead of conventional treatment.”  Others define alternative medicine simply as “medical interventions not taught at United States medical schools or available at United States hospitals.” (http://www.pitt.edu/~cbw/altm.html) The National Center for Complementary and Alternative Medicine integrated the two practices into a more common term of Complementary and Alternative Medicine, or CAM.    In an alliance with the Mayo Foundation for Medical Education and Research, four basic philosophies for CAM were created:

 

*      Prevention is key to good health. Taking steps to better your health before you get sick is the best way to keep yourself healthy.

*      Your body has the ability to heal itself. Alternative medicine practitioners see themselves as facilitators. To them, your body does the healing work, and treatment encourages your natural healing processes.

*      Learning and healing go hand in hand. Alternative medicine practitioners see themselves as teachers and mentors who offer guidance. To the practitioner, you're the one who does the healing.

*       Holistic care. The focus is on treating you as a whole person — recognizing that physical health, mental well-being, relationships and spiritual needs are interconnected and play a part in your overall health. (http://www.mayoclinic.com/print/alternative-medicine/PN00001/METHOD=print)

 

CAM practice includes a variety of therapies.  Some of these disciplines include: folk medicine, herbal medicine, diet fads, chiropractic, acupuncture, massage, music therapy, hypnosis, and yes, even laughter therapy.   For the individuals with “immunodeficiency syndrome, arthritis, cancer, back pain, and other medical conditions”, all of the claims and advertisement made by CAM treatment providers, of course, make the benefits of these therapies sound promising. (http://www.pitt.edu/~cbw/altm.html) However, researchers still do not know how safe these treatments are or even how well they actually work.  Studies are being done in the hope of determining the safety and usefulness of CAM practices.

 

Humor and Laughter Therapy:

- Can humor/laughter be placed together to create a useful CAM?

                Using therapeutic laughter to relieve stress and strengthen the immune system; that in turn helps to combat disease; is a practice that is gaining popularity in the medical field as an appropriate form of alternative medicine.  The therapy is based off of the idea that “humor is healthy and that a hearty laugh make a person feel much better”.  The case of Norman Cousins (1979), followed by many articles and a book (Anatomy of an Illness), is what started the laughter health craze.  Diagnosed with ankylosing spondylitis, a collagen illness that attacks the connective tissues of the body, Cousins was often placed in the hospital as he tried to cope with his painful disease.  Out of interest, he began to read material about stress and how it can wear down one’s immune system.  Hans Selye wrote a book called The Stress of Life, in which he theorized that negative emotions cause stressful and harmful effects on the body.  Cousins then hypothesized that if the bad emotions do harmful things, then the good emotions should be helpful or healthful.  At the time of his hospital visits, there was no cure or treatment for his disease.  He decided to treat himself with laughter and found that ten minutes of genuine belly laughter had an anesthetic effect and would allow him at least two hours of pain-free sleep.  Hunter ‘Patch’ Adams developed the idea of laughter therapy at the Gesundheit Institute in Virginia, USA.  Patch’s contributions were immortalized by actor Robin Williams in the film Patch Adams. (http://www.indiadiets.com/Alternative%20Healing/Laughter.htm

Stress relief, Mumbai style ... with the Guru of Giggle, Dr Madan Kataria. Photo:AP

Since the development of laughter therapy, laughing clubs have appeared throughout the world.  This can be attributed to Madan Kataria of Bombay, India.  He started the first of the Laughing Clubs International in March of 1995.  Currently, over 6000 clubs can be found in 60 different countries.  The website pushes this movement by stating that finally “modern science has ‘discovered’ that a rich network of emotional connections is the number-one reason for people to be happy and that the most powerful factor in happiness is good relationships.  This is more important that money, job satisfaction, or marital status.” (http://www.laughteryoga.org/index.php?option=com_content&view=article&id=198:laughter-clubs&catid=90:about-laughter-clubs&Itemid=266)   Wow! What a way to place laughter therapy above all the rest.  

 

The Studies:

-How is laughter related to brain?

The physiological study of laughter is termed gelotology.  Scientists have observed the following features when it comes to laughter in the brain:

 

*      The left side of the cortex (the layer of cells that covers the entire surface of the forebrain) analyzed the words and structure of the joke.

*      The brain's large frontal lobe, which is involved in social emotional responses, became very active.

*      The right hemisphere of the cortex carried out the intellectual analysis required to "get" the joke.

*      Brainwave activity then spread to the sensory processing area of the occipital lobe (the area on the back of the head that contains the cells that process visual signals).

*      Stimulation of the motor sections evoked physical responses to the joke. (http://people.howstuffworks.com/laughter.htm/printable)

 

Scientists are also finding that laughter seems to be most closely related to the limbic system.  This is an interesting find because the limbic system is responsible for the behaviors that are essential to the life of all mammals.  Is this, in itself, enough evidence that laughter is a good aid to the immune system for our overall well-being and health? 

 

-Is laughter the best therapy? (Part I)

                Empirical data focusing on laughter therapy and its effects on health has been difficult to obtain.  Laughter therapy is based off of humor.  Humor itself is a complex topic.  Everyone does not view the same things as being humorous; therefore, the topic remains difficult to measure.   However, it is common to find information about how laughter is related to stress and the immune system.  In a manner to express ways that laughter is related to health, Howstuffworks explains how the process of stress vs. laughter works.  The site states that:  “Laughter reduces levels of certain stress hormones.  In doing this, laughter provides a safety valve that shuts off the flow of stress hormones and the flight-or-flight compounds that swing into action in our bodies when we experience stress, anger, or hostility.  These stress hormones suppress the immune system, increase the number of blood platelets (which can cause obstructions in arteries) and raise blood pressure. When we're laughing, natural killer cells that destroy tumors and viruses increase, as do Gamma-interferon (a disease-fighting protein), T-cells, which are a major part of the immune response, and B-cells, which make disease-destroying antibodies.  Laughter may lead to hiccupping and coughing, which clears the respiratory tract by dislodging mucous plugs.  Laughter also increases the concentration of salivary immunoglobulin A, which defends against infectious organisms entering through the respiratory tract.” (http://people.howstuffworks.com/laughter.htm/printable)  Other studies support this website’s claim as well.  

-Laughter-Immune Connection

                Berk and Tan (1996) did an experiment focused on the laughter immune connection.  To begin, they used ten healthy, fasting males who volunteered to participate.  Each male viewed a one hour, funny video.  Berk and Tan collected blood samples and measured their interferon-gamma (IFN) before, during, and after the participants watched the video.  IFN is a natural protein produced by the cells of the immune system.  It activates T cells, B cells, immunoglobulins, and NK cells.  Furthermore, it helps to fight viruses and regulate cell growth. (http://en.wikipedia.org/wiki/Interferon)  The researchers found significant results for the practice of laughter therapy.  The results showed that there was increased activity in IFN after watching the funny video and on into the following day.  They were able to conclude that laughter has a positive correlation, at the molecular level, with the immune system.  The positive effects of laughter are capable of modifying components of the immune response through an increased production of IFN.  (http://www.hospitalclown.com/Past%20Issues/Final%20PDFs/Vol%202-2Berk.pdf)                      Bennett, et al. (2003) did a study to determine the effect of laughter on self-reported stress and natural killer cell activity.  33 healthy women were recruited from a rural Midwestern city.  An inclusion and exclusion criterion was used to prescreen the women for symptoms such as depression, unexplained weight changes, taking herbal supplements, or using antidepressants.  These persons were excluded from the study.  Each participant took various surveys to measure depression, arousal, and the possible effects from exposure to recent negative life event stress.  Allowing each subject to pick one of three humorous movies, under the assumption that they would pick the movie style that they found most humorous, the women were then placed into video-viewing groups.  The subjects were randomly assigned to experimental (humor) or control (distraction) groups.  They, as well as the researcher controlling the viewings, remained blind to the group assignment until the actual video began.  Using the Humor Response Scale (HRS), the researchers documented mirthful laughter.  Finally, natural killer cell levels were measured through various NK cell activity assays.  The results showed that stress decreased for subjects in the humor group, compared with those in the distraction group.  This was further shown in the positive correlation between postintervention stress measures and mirthful laughter for persons in the humor group.  They also noted that subjects who scored higher on the humor response scale had increased immune function postintervention as compared to the remaining subjects.  There was also a correlation with the changes in natural killer cell activity.  Bennett et al., (2003, page 38) were able to successfully state that “laughter may reduce stress and improve NK cell activity.  As low NK cell activity is linked to decreased disease resistance and increased morbidity in persons with cancer and HIV disease, laughter may be a useful cognitive-behavioral intervention.”  The results of this study is positive in the sense that it highlights how laughter is related to stress and the immune system, however, it does not provide adequate proof on how successful laughter therapy is as an alternative medicine.  The study has three major flaws.  First, it filters out the samples of people that would be most susceptible to turning to laughter therapy (i.e. the depressed and disease-ridden).  Second, it focuses only on a small population of women in a concentrated area.  Lastly, the research was not conducted in a manner that suggests any possible effects of the study that are cumulative over time.

 

Is laughter the best therapy? (Part II)

                Saper (1990) presents a review paper in which he discusses humor and laughter treatment.  He agrees that humor is effective in treating both physical and mental illness, and promoting health and happiness.  He, however, questions the implementation of humor/laughter therapy.  Saper wonders if the clinic, hospital, or sanctum sanctuary of psychotherapy the best or proper place to introduce humor.  He questions what makes it better than watching a funny movie or playing a prank on a friend.  He continues on to ask if an internist, surgeon, or psychiatrists should be require to train in the comic arts before they try to apply humor in the office, or will “humor surrogates” become another specialized field for physicians. (270)  Overall, Saper concludes that he cannot doubt the fact that laughter positively affects the body, however he feels that it is necessary to determine under what conditions “humor and laughter work best, if at all, with what types of therapist and patient personalities; what severity of illness, and what kinds of humorous stimuli.” (271)  Seeming to take the route that pushes laughter therapy past a form of alternative medicine, he believes that it would be crucial for psychiatrists to be trained in the techniques of humor; for psychiatric programs to offer formal courses in Humor.  And finally, as is the case with all current studies, further research on the topic is needed and desired.   

 

Conclusion:

            So after all of the research, we know and can argue that laughter is not always good.  Excessive laughter after abdominal surgery can lead to torn-out stitches and I’m sure that laughing would not feel good to a patient with broken ribs.  The implementation of laughter therapy may be up in the air for some people, but one important thing must be remembered.  As an alternative medicine, humor/laughter therapy is not meant to be the sole treatment for disease or stress.  It replaces an already proven conventional treatment.  This leaves the choice of treatment open to the discretion of the patient and their doctor.  Many hours of research has been done that can, in fact, prove that laughter has the amazing capabilities of providing a number of positive effects on the body.  The fact that laughter is good for one’s health is quite evident, so why not laugh?  Françoise Sagan sums it up the best: “There can never be enough said of the virtues, dangers, the power of a shared laugh.”     

 

 

 

 

Literature Cited

 

Berk, Lee, Dr.P.H., M.P.H. & Stanley Tan, M.D. Ph.D. (1996). The Laughter-Immune Connection: from the American Association of Therapeutic Humor. Nov. 1997. 4 Oct. 2009. 

Bernard Saper. (1990). The therapeutic use of humor for psychiatric disturbances of adolescents and adults. Psychiatric Quarterly, 61(4), 261-272.

Cousins, Norman (1979). Anatomy of an Illness As Perceived by the Patient. New York: W.W. Norton & Company, Inc.

Mary P. Bennett , and Cecile A. Lengacher. (2006). Humor and Laughter May Influence Health. I: History and Background. Advance Access Publication, 3, 61-63.

Mary P. Bennett, Janice M. Zeller, Lisa Rosenberg, Judith McCann.  (2003). The effect of mirthful laughter on stress and natural killer cell activity. Altern Ther Health Med, 9(20), 38-47.

 

VUlogo

Psychology Department

The Health Psychology Home Page is produced and maintained by David Schlundt, PhD.
  

me

VuLogoVanderbilt Homepage

Return to the Health Psychology Home Page
Send E-mail comments or questions to Dr. Schlundt