Laughter: Is It Healthy?
By Tammie S. Diggs


In a nation that spent some 75 million dollars on prescription drugs in 1993, not to mention illegal drugs, we sometimes overlook the coping mechanisims we have been endowed with (U.S. 1995). Our bodies were created to take care of themselves for the most part, and we sometimes botch things up when we try to alter our system with drugs. In Proverbs 17:22 (1989), it says "A merry heart doeth good like a medicine, but a broken spirit drieth the bones." For many years scientists and lay persons have done studies, research, and performed experiments concerning the effects of laughter on one's physical and mental health. These studies have proven that when we laugh, there is an actual chemical change in our bodies that helps to ease pain and release stress. Laughter is a coping mechanisim for the normal stress of life.

There are two kinds of stress--distress, which is the negative kind of stress; and eustress, which is the positive kind of stress. While distress increases stress hormones such as beta-endorphin, corticotrophin, cortisol, growth hormone, prolactin, and the catecholamines, eustress decreases these hormones and instead increases the activity of Natural Killer (NK) cells that help fight diseases (Berk & Tan 1996). Distressful events and major life changes can obviously impact our bodies negatively. It has been proven that stress depletes the immune system's ability to fight against disease. Dr. Lee Berk and Dr. Stanley Tan of the Loma Linda University Medical Center have done an abundance of research in psychoneuroimmunology (PNI). PNI simply says that the immune system is directly connected to the brain; therefore, it would be effected by the emotions. One of Berk and Tan's experiments showed that immunosuppressive hormones (hormones that harm or deplete the immune system) such as epinephrine and cortisol were lower in those participants that laughed than in those who did not (Wooten 1995). Another experiment performed by Berk and Tan (1996) in which they presented their results at a conference on April 18, 1996, proved that laughing (while watching a humorous video) increases the amount of NK cells.

Indirectly, stress is probably our number one killer. It effects us physically and mentally, wearing our immune systems down, and causing us to be more susceptible to sickness and disease. We try to treat the disease, when we really need to treat the cause. How does one treat something like stress? Many times the stressors cannot be removed from a person's life; they are permanent fixtures. Laughter, if used generously, can help drain the stress away. As Mark Twain once said, "The human race has only one really effective weapon, and that's laughter. The moment it arises, all our hardnesses yield, all our irritations and resentments slip away, and a sunny spirit takes their place."

What is laughter? Laughter is a form of eustress that releases those bad and distressful emotions that cause harmful chemical effects on the body (Berk & Tan 1996). Laughter is like an exercise; that is why your stomach sometimes feels sore after a good belly laugh. Just as in exercise, there are two stages to laughter: the arousal phase--when the heart rate increases--and the resolution phase--when the heart rests. A person's heart can reach up to 120 beats per minute (bpm) when laughing. Laughing can lower your blood pressure, increase vascular flow, and boost the immune system. It gives the diaphragm, abdominal, intercostal, respiratory accessory, and facial muscles a complete workout. Some people, depending on how they laugh, may even use their arm, leg, and back muscles when laughing. Laughter also releases endorphins in the brain; these are our bodies' natural pain killers (Wooten 1995). Endorphins are neurotransmitters that attach to the same receptors in our brains as the opiates. Opiate drugs not only cause us to lose touch with reality, but they also numb pain. When we laugh, it releases the endorphins in our brain; thus, laughing is like taking opium or morphine without the adverse side effects (Kalat 1995).

In Berk and Tan's (1996) experiment concerning the laughter immune connection, they used ten healthy fasting males who volunteered for the experiment, and had them view a one hour, funny video. They took blood samples of their interferon-gamma (IFN) before, during, and after they watched the tape. They had significant results that showed increased activity in IFN after watching the funny video and on into the following day. What is IFN? It activates the T cells, B cells, immunoglobulins, and NK cells; it helps to fight viruses, and regulate cell growth. This could be very important in the research for cancer since it also fights against tumorous cells.

Nearly 2000 years ago, the physician Galen stated that cheerful women were less likely to get cancer than those women who were depressed (Simonton 1978). John Steinbeck once said "A sad soul can kill you quicker, far quicker, than a germ." Laughter's ability to be a pain reliever and its ability to fight tumorous cells have added an exciting new area of research to cancer. Some of the research done by O. Carl Simonton, M.D. and Stephanie Matthews-Simonton (1978), leads us to believe that a person's emotional status does indeed effect their likelihood of getting or overcoming cancer. Perhaps, if people would start relieving their stress through laughter before they get cancer, there might be a reduction in the number of cancer patients altogether.

Norman Cousins (1979), the man who started the laughter health craze in this century, was editor of the Saturday Review for over thirty years, and has written numerous books including Anatomy of an Illness. In August 1964, Cousins came home from a meeting in Moscow with a fever and feeling achy all over. Within a week he could not move and his sedimentation rate was up to 88. The sedimenation rate relates to how much infection is in the body and a sed. rate of 60 to 70 is thought to be very high. He was eventually diagnosed with ankylosing spondylitis, which is a collagen illness that attacks the connective tissues of the body. He once said it felt as if he was being pulled apart at the joints. The doctors told him it was probably caused from exposure to heavy-metal poisoning, so he began to think of when he could have been exposed. The only thing he could remember was that his hotel in Moscow was next to a major highway where diesel trucks passed all night long, and since there was no air in the room, he had kept the windows open all the time. However, his wife was with him, and she did not become sick. He started reading material about stress and how it can wear down your immune system. He came across a book by Hans Selye called The Stress of Life that proposed the theory that negative emotions cause stressful and harmful effects on the body. He hypothesized that if the bad emotions do harmful things, then the good emotions should be helpful or healthful.

At the time the hospital was mostly trying to keep Cousins out of pain since there was no cure or treatment for his disease. He was being given the maximum amount of aspirins (26) and phenylbutazone (12) every day, along with sleeping pills and codeine. Realizing that that amount of medicine was very toxic, he decided to try laughter. He moved home and hired a nurse to oversee his medical treatment. His nurse would also show him Marx Brothers films and read humorous stories and books to him. Within days he was off of all pain killers and sleeping pills and discovered that ten minutes of genuine belly laughter gave him two hours of pain-free sleep. He wrote an article in the New England Journal of Medicine about his findings in laughter and was greatly criticized. He never once claimed that laughter had been the only factor in his healing process, but said that it had aided in his recovery by relieving pain. Despite the criticism, he stood by his claims, and was finally vindicated in January 27, 1989, when the Journal of the American Medical Association published an article entitled "Laugh If This Is a Joke." Lars Ljungdahl, the Swedish researcher (1989) who wrote that article concluded that "a humor therapy program can increase the quality of life for patients with chronic problems and that laughter has an immediate symptom-relieving effect for these patients, an effect that is potentiated when laughter is induced regularly over a period".

Gelkopf, Kreitler, and Sigal (1993) researched the effects of humor on hospitalized schizophrenic patients. Although they did not have any negative findings (mostly no change at all), they did have positive results from six out of twenty-one variables. They took thirty-four similar schizophrenic patients from two different hospital wards and showed each group seventy videos within one month's time. The control group saw all different kinds of videos and the experimental group only watched humorous videos. There was no change in their health, but there was a significant change in their aggressive behavior. They were observed to have less "verbal hostility" and fewer psychiatric symptoms such as depression and anxious tendencies. Gelkopf and his colleagues (1993) state that one of the reasons schizophrenic patients may not be as receptive to humor as other people without schizophrenia, may be because it requires certain cognitive processes to appreciate humor. Since those with schizophrenia have ailing minds, they may be unable to recognize humor. Regardless, if humorous videos help to lower aggressive behavior and depressive tendencies, then it could still be useful.

Not only are psychologists and PNI researchers preaching about the positive effects of laughter, but even medical doctors have recognized its potential. Dr. Patch Adams of Hillsboro, West Virginia, who is the physician for Gesundheit Institute, a forty bed hospital, says to work at his hospital you must ". . .look funny and . . . be funny." Joel Goodman, a humor consultant who is in charge of the Humor Project has been contacted by numerous hospitals wanting to launch a humor program for their patients. These programs use such things as humor rooms, comedy carts, and Clown Care Units. Dr. John M. Driscoll, Jr. from Columbia-Presbyterian Medical Center in New York City believes that there will be shorter hospital stays due to the new humor programs that have been started. As Goodman says "like chicken soup, it couldn't hurt" (Finnerty 1995).

On average children laugh 400 times per day, and adults only laugh 15 times per day. So if laughter is so good, why are we not doing more of it? Maybe there should be a laughing room added to the many health clubs in our nation. Although this might sound crazy, laughing clubs have already been started. Madan Kataria in Bombay, India started the first of the Laughing Clubs International in March of 1995. In a years time eighty clubs had spread throughout India, and Kataria hopes other countries will follow their lead. The members of these clubs generally gather in the park in the morning before work. They raise their arms in the air, to erase inhibitions, and start with Ho-ho, ha- ha, Silent laughter with mouth closed, and then Silent laughter with mouth open. Some of the laughing clubs also incorporate jogging with their laughing. When asked why they did not just tell jokes to laugh he replied "at first we did take the help of jokes, but the stock of good jokes was over after about 15 days. After that, stale and silly jokes came. Camel jokes, vulgar jokes. It was no good." Members of the laughing clubs say they feel better, some say they have even lost weight, others say they are not depressed, and still others say it has helped to get out of the house, and meet people. Whether or not it is the laughter exercise, the physical exercise, or just being with other people, we all know that when we laugh we simply feel better (Roach 1996).

Laughter should be used as a coping mechanism for stress, though it seems to only be used as an outlet for the emotion produced by humor or happiness. Do we laugh because we are happy, or are we happy because we laugh? Both of these are probably true, but we only exercise the former. Laughter is a fascinating phenomena that works like a medicine. Although most drugs effect everyone differently, laughter is always the same. It exercises your entire body causing you to feel relaxed and pain free. The fact that laughter is good for one's health should be quite evident. So why not laugh? When one laughs, it is like taking a drug, yet there is no such thing as an overdose or, "laughter toxicity," as Kataria says. Maybe we can now say "A laugh a day keeps the doctor away."


Bibliography

Berk, Lee, Dr.P.H., M.P.H. & Stanley Tan, M.D. Ph.D. (1996). "The Laughter-Immune Connection." Available from: http://www.touchstarpro.com/laughbb3.html (17 April 1997).

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

Finnerty, Amy (1995, September). "Send in the Clowns". American Health, 68-69+.

Gelkopk, Marc, M.A., Kreitler, Shulamith, Ph.D. & Sigal, Mircea, M.D. (1993) "Laughter in a Psychiatric Ward." The Journal of Nervous and Mental Disease, 283-288.

Kalat, James W. (1995). "Synapses, Drugs, and Behavior". Pat Gadban & Richard Flyer (Eds.), Biological Psychology (87). California: Brooks/Cole.

Ljungdahl, Lars (1989). "Laugh If This Is a Joke" Journal of the American Medical Association, 558.

"Proverbs 17:22."(1989) Bible: King James Version. Republic of Korea: Thomas Nelson, Inc.

Roach, Mary (1996, September). "Can you laugh your stress away?." Health, 92-96.

Simonton, O. Carl, M.D., Stephanie Matthews-Simonton, & James L. Creighton. (1978). Getting Well Again. New York: Bantam.

U.S. Bureau of the Census, Statistical Abstract of the U.S.: 1995 (115th edition.) Washington, DC, 1995.

Wooten, Patty, RN BSN CCRN. (1995). "Laughter as Therapy for Patient and Caregiver" Jest Home Available from: http://www.mother.com/JestHome/PULMONARY.HTML (17 April 1997).


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