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. To subscribe or visit go to: http://www.energytimes.com |