LOL: It's Good For You Ever since the writer Norman
Cousins’ groundbreaking Anatomy of March 2008
In late January, in a small triangular meeting room
of a Philadelphia hospital, a dozen cancer patients and some of their
family and caregivers suspended reality for 45 minutes. Urged on by a
therapist who assumed the role of tour guide, the group escaped on a
much-needed vacation to Hawaii without stepping foot out of the room. They
laughed all the way there. Mimicking an airliner carrying them off, they
extended their arms and flew in circles around the room; imaginary welcome
drinks awaited their landing. They scampered on sun-baked sand and fished
along the Hawaiian shoreline. They fluttered around a tropical garden like
butterflies and hummingbirds. At the suggestion of therapist Gerri Delmont
to “key down,” they ended the trip, gathering handfuls of sand and gazing
calmly into the ocean. Each exercise began with artificial laughter—a
series of prompted “hee hee, ha ha, ho ho” chants. Those gave way to the
genuine giggles, cheer and glee that were the real aim of the therapy. A
half-hour after the session ended, patient Mary Domina still wore a broad
smile that pushed up her round red cheeks. “I feel bright, jubilant,
alive,” she said. “It was just like a shot of oxygen. When I get in a bad
mood, I’m going to think ‘hee hee, ha ha, ho ho.’” Standing near Domina in the Philadelphia branch of
Cancer Treatment Centers of America, Scot St. Pierre said the laughter
therapy was like a religious cleansing of the soul. “It almost feels like
you’ve been to church,” said St. Pierre, whose mother Madona, a patient,
likened the therapy’s effects to the tranquility she feels from watching
the sea. With chuckles that sometimes lead to bliss, the
sick and ailing—as well as those who don’t want to be—have been tapping
the healing power of laughter with increasing fervor since the writer
Norman Cousins famously recognized laughter as a source of vitality in his
groundbreaking 1979 book Anatomy of an Illness (W.W. Norton &
Company). In that work, Cousins chronicled his recovery from
ankylosing spondylitis, a deterioration of the connective tissue in
the spine that struck him in 1964, with the help of loads of vitamin C and
pain-reducing laughter sessions that let him sleep peacefully and that he
repeated each time his discomfort would return. Today, laughter is known to have a wide array of
healthcare applications. And it has become more apparent why so many
comedians who have had troubled and sometimes tragic upbringings, from
Charlie Chaplin to Rodney Dangerfield and Carol Burnett, were so drawn to
their line of work. One study by the University of Maryland School of
Medicine in Baltimore showed the positive effects of laughter on the
functioning of blood vessels and on overall cardiovascular health. Healthy volunteers watched two movies shown at the
extreme ends of the emotional scale: the furiously violent opening D-Day
scene of Saving Private Ryan and a segment of the comedy
Kingpin. Laughter provoked by the second clip appeared to cause the
endothelium, or inner lining of the participants’ blood vessels, to expand
in order to increase blood flow. In contrast, the stress response from watching the
first clip triggered vasoconstriction, or reduced blood flow, within the
blood vessels. Overall, average blood flow increased 22% during laughter
and decreased 35% during stress—even among those who had previously seen
Ryan and knew what to expect. “The act of laughing out loud vigorously has
benefits similar to a workout,” says Kelly McGonigal, PhD, a health
psychologist at Stanford University. “It increases heart rate and
stimulates deep breathing.” Scientists continue to examine the exact source of
the benefits: Is it in the humor, the laughter that expresses the humor,
or both? And what precise benefits, if any, come from artificial laughter,
that is, laughter in the absence of humor as in the therapy session at the
Philadelphia cancer hospital? Nor has research been completed that
compares the value of laughter with expressions that might be physically
similar, such as crying or yelling. Research does show that just the anticipation of
laughter is beneficial, says Lee Burk, DrPH, MPH, associate director for
the Center for Neuroimmunology at the Loma Linda University School of
Medicine, where he is also assistant research professor. Laughter also appears to ease pain, as Cousins
found. In 1989, Burk conducted research to determine if laughter boosted
the release of endorphins, chemicals that give the body pleasure. The
results were questionable, with only minimal increases recorded. But later
research showed that the increases were relatively small after laughter,
when measurements were made in the original study, because endorphins were
being released before the subjects were even exposed to a
stimulus, in this case a funny video. This information, presented to the American
Physiological Society in 2006, showed that people who simply anticipated
laughter had a 27% increase in beta-endorphins and 87% more human growth
hormone when compared with a control group that was not expecting to
laugh. Though neither that research, nor any other that
people interviewed for this story know of, assigns a precise value to
artificial versus humor-driven laughter, Burk and others say people
undoubtedly benefit from laughter without humor. “You get the physical
neurochemical effects relative to the laughter experience,” Burk says. To
naysayers, Burk compares artificial laughter to the use of a stationary
bicycle or treadmill: They don’t bring anyone anywhere, but provide the
same benefit to people who bike or walk the same distance from, say, their
homes to their jobs. With modern origins in India, so-called laughter
clubs that do not use a funny stimulus have sprouted up around the world.
They appear to work in part because laughter can be infectious. Producers
of live television sitcoms used to plant people with infectious laughs
into audiences, Burk notes. Burk’s 1989 study accidentally gave researchers
another insight—that a person who is laughing without a funny source
appears to gain the same benefit as someone who finds something funny but
does not overtly laugh. “One of our subjects in the early days was a pathologist, and pathologists aren’t necessarily known for having a great sense of humor,” Burk recalled. “When we had IVs in his arm taking the blood sample, and he was watching what he thought was a humorous video, humor he selected, we thought we were wasting the whole experiment because he wasn’t boisterous or laughing out loud. Yet when we got his data, he was similar in terms
of stress hormone reduction to a psychiatrist we had done who was very
overt and very boisterous.” The pathologist’s results support the idea that
humor, even without laughter, changes negative emotions such as chronic
anger, anxiety and depression. And the research that such “distressing”
emotions lead to illness, including heart disease, is well documented,
says Steven Sultanoff, PhD, a clinical psychologist and professor at
Pepperdine University in Irvine, California. “My belief is that we are going to eventually find
that the most dramatic health benefit of humor is not in laughter,”
Sultanoff says. “It’s actually in the cognitive and emotional management
that humor gives. Humor changes negative thinking patterns.” Allen Klein, a self-described San Francisco-based
“jollytologist, ”says he teaches humor, not laughter, “to show people that
no matter what the situation, you can lighten up.” In contrast, advocates
of therapy that incorporates laughter without humor believe the role of
humor is limited because it is so subjective. Humor proponent Sultanoff does not discount the
benefits of laughter. “The idea here is that humor stimulates a cognitive
shift in perspective, an emotional shift and physical shift,” Sultanoff
says, the latter being laughter, which he agrees has been proven to have
benefits. “It appears serum cortisol, the commonly called
stress hormone, is secreted when people are under stress,” Sultanoff says.
“Some studies in laughter show a decrease in serum cortisol, but one
problem is that there were one or two studies that showed the opposite
effect, an increase in serum cortisol.” Other studies, however, have shown an increase in
certain antibodies—killer T cells, for example—after deep, heartfelt
laughter, he says. Likewise, increases of immunoglobin A, an antibody that
fights upper respiratory disease, have been seen with laughter. “Probably the best research is on pain tolerance,”
he says. “With deep heartfelt laughter, tolerance to pain appears to go
up.” Sultanoff takes that finding seriously: He plays a Robin Williams CD
in his car on the way to the dentist. When it comes to the debate over artificial, forced
laughter versus a more natural expression, Sultanoff comes down on the
side of natural, humor-induced laughter. After all, the writer Cousins
derived his laughter from a source—Marx Brothers movies. “My bias is that we can’t get the same benefit
because spontaneous laughter is triggered by a humorous event, and that
humorous event is also going to affect cognition and emotion,” he says,
“whereas in a forced laugh, you’re not experiencing the same emotional
uplift or cognitive shift, though you are having the physical benefit.” Indeed, hearty laughter, artificial or not, may not replace a sweaty aerobic workout, but it does burn calories. Researchers at Vanderbilt University gathered 90 people who watched comedy video clips, including the movie There’s Something About Mary and episodes of Saturday Night Live. The researchers concluded that laughing burned
about 1.3 calories per minute—about 10 to 20% more than in a calm state.
The benefit is akin to what you’d get doing some light indoor gardening,
while jogging burns about 10 calories per minute. Still, based on that
finding, 10 to 15 minutes of laughter a day could help you drop as much as
four pounds a year. Laughter, says Marshall Brain, author of the
How It Works books, has two physical components: gestures and the
production of sound. The brain signals the body to do both at the same
time, and the effects of hearty laughter can trickle all the way to the
arm, leg and trunk muscles. Some 15 facial muscles contract, and the
zygomatic major muscle lifts the upper lip. Laughter, Brain observes, triggers some physical
activities that on the surface don’t sound all that great. For instance,
the respiratory system becomes upset when the epiglotis closes the larynx
halfway. Hearty laughter activates the tear ducts and the face becomes
moist and red in the struggle for oxygen that ensues. Citing a study of laughter’s sonic structure, Brain
notes that laughter can trigger “ha-ha-ha” or “ho-ho-ho” sounds, but never
a hybrid of the two. That observation underscores the artifice of the “hee
hee, ha ha, ho ho” stew of chants practiced at the laughter therapy
session at the Philadelphia cancer hospital and among other laughter
groups. Nevertheless, a growing number of proponents of
laughter as medicine are embracing the idea that harnessing self-driven
laughter can yield tremendous therapeutic benefits. Laughter enthusiasts trace the movement to Madan
Kataria, MD, himself inspired by Cousins. Kataria started a playful form
of laughter yoga in Mumbai, India, in 1995. Steve Wilson, a psychologist,
met Kataria three years later and picked up the torch, creating a training
program (www.worldlaughtertour.com)
through which therapists become Certified Laughter Leaders who direct
sessions and laughter clubs. Some 5,000 laughter clubs are organized in 40
countries, according to Kataria’s website,
www.yogalaff.com. Certified
Laughter Leaders have been dispatched to help families of military who
have shipped out to Iraq or returned home with permanent injuries. They’ve
also helped train teachers to introduce laughter into the classroom,
hoping to develop more receptive students. At the laughter therapy session at the Philadelphia
cancer hospital, patients, their family members and hospital staff
appeared to shift from the artifical laughter into heartfelt giggles and
sincere laughs very quickly. Delmont, a Certified Laughter Leader who led
the session, explained that the deeper their anxiety, the more open
participants are to laughing. “The higher the stress, the quicker they fly
into a relaxed state,”Delmont says. “The pendulum swings equally.” It may be one reason that Mike Weiss, a New York
comedian, says audiences are so receptive to the Middle Age Wasteland
comedy shows he produces about the trials of aging. “People would oddly
enough much rather hear about somebody’s large prostate than some young
comedian on a date,” Weiss says. “Middle age is a bit daunting. We’re not
young, we’re not old, and it’s a strange place to be. Things are starting
to give out. Our warranty is up, and you can’t renew the warranty so you
might as well just laugh about it, and people do.” Laughter therapy is but one tool in the Cancer
Treatment Centers of America psychoneuroimmunology program, which includes
naturopathic medicine and Reiki. And even those natural treatments are not
meant to work in a vacuum; CTCA provides those treatments only in concert
with traditional medicine. Still, lost in their laughter, the Philadelphia
cancer patients and families seemed empowered solely on the cheer that
filled the room. Linda Swartz, whose sister is a patient, said after the
session, “How you react to what’s happening to you—that’s all you can do.” Linda Melone contributed to this article. Article originally published: http://www.energytimes.com |