Laughter is extremely powerful and few things are as emotionally satisfying as a good, deep, belly laugh. Mark Twain said, “Against the assault of laughter, nothing can stand.” Many people became familiar with laughter as medicine thanks to the work of Robin Williams in the movie Patch Adams. The film is based on the true story of Dr. Hunter “Patch” Adams who, in 1972, established the Gesundheit Institute dedicated to spreading humor, fun, and joy to patients.
There is so much literature specific to the beneficial effects of humor on health, but one truly advantageous benefit that is often missed is the impact on the doctor patient relationship. We are social individuals by nature, and humor is such an efficacious tool to allow a patient to feel comfortable and establish a sense of connection. Humor has the ability to transform a dry and stagnant interaction to one that embodies the opportunity for trust, conversation and most importantly, compliance. Patients want a chance to be heard and be themselves: a good joke, laugh and smile is many times the simple answer!
The use of humor and laughter as an integral part of the healing paradigm began long before Gesundheit Institute, however. The earliest physicians in Ancient Greece, prescriptions were made for visits to the hall of comedians and the theater as part of the overall healing process.1 In the 1300s, French surgeon Henri de Mondeville felt so strongly about the role humor played in healing that he told jokes to his patients in the recovery room.2
Humor is a free, easy, noninvasive, and scientifically supported therapy that provides many health benefits. Laughter encourages the release of the body’s natural “feel good” hormones that promote a sense of well-being as well as increase immune cells to provide resistance to illness.
But perhaps the most influential account of the health benefits of laughter come from the book, Anatomy of an Illness by Norman Cousins. The text was an anecdotal account of Cousins’ return to health after being diagnosed with a devastatingly painful, inflammatory condition known as ankylosing spondylitis for which he was told there was nothing doctors could do. The book was so profound that Cousins was eventually hired as a professor and researcher at UCLA School of Medicine where he spent the next 20 years teaching and researching the true merits of laughter in healing.1 As it turns out, that old adage of “laughter is the best medicine” may actually ring truer than once thought and there is even science to prove it! Here are five scientifically supported health benefits of laughter:
Laughing is an ab workout
As anybody who has had a good laugh the day after a hard-core ab workout will tell you, laughing causes the abdominal muscles to contract and relax in much the same manner as intentional workouts do. In a study of laughter yoga (a yoga practice focused on breath and laughter), researchers found that compared to traditional crunch and back lifting exercises, engaging in laughter yoga resulted in significant activation of five different muscle groups found in the trunk. The study further concluded that the activation level of the internal oblique muscle group during laughter yoga was higher compared to the traditional exercises.2
Laughing lowers blood pressure
High blood pressure is a very insidious condition that many people only find out they have incidentally at an appointment for something else entirely. It has few outward symptoms early on, but make no mistake, it is wreaking havoc on cells and organs inside the body.3 High blood pressure is a known precursor to more severe cardiovascular disease including death or serious disability due to heart attacks and strokes and the earlier one develops the condition the higher these risks are.4 Luckily, a number of studies have shown the beneficial impact of laughing on blood pressure. One 2017 study evaluated the impact of laughter on the blood pressure of patients undergoing hemodialysis treatments. Participants saw a decrease in blood pressure after listening to 16-30 minutes of recorded comedy over an eight-week time period.5 Another study exposed participants to either laughter or music and found that immediately following the sessions, the laughter group’s blood pressure was lowered by 7mmHg vs only 6mmHg in the music group.6
Laughter reduces stress hormone levels
Stress is associated with changes in levels of both hormones and neurotransmitters including dopamine, serotonin, and cortisol.7 Research reveals that humor and laughter have been shown to stimulate several physiological mechanisms known to decrease levels of stress hormones like cortisol and epinephrine and to increase activation of the dopamine producing reward system in the brain.8 Additional studies that involved viewing a comedic film found reductions in a variety of hormones related to the stress response.9
Laughter supports immune function
While getting the flu is nothing to laugh about, the next time flu season rolls around might be a good time to start laughing it up more often! Several studies have shown how powerful laughter can be when it comes to enhancing the power of the immune system. Researchers have found that in some instances, laughter has shown the ability to positively impact the function of a particular type of immune cell, the natural killer or NK cell.10 NK cells are specific cells that are best known for killing virally infected cells, and detecting and controlling early signs of cancer.11 Another study where college students viewed either a humorous video or an instructional video revealed that those that saw the humorous video had increased levels of salivary IgA (a marker of immunoenhancement).11
Laughing is good for your heart
The American Heart Association supports the use of laughter as a means to protect heart health.12 They go on to say that laughter has positive benefits on cholesterol levels as well as reducing arterial inflammation. Additional research found powerful benefits of laughter on the heart and cardiovascular system. The study exposed participants to comedy clips like Saturday Night Live or bleak scenes known to increase stress such as the opening scene from Saving Private Ryan. They then used a special ultrasound to assess brachial artery reactivity. Participants who watched the stress inducing scenes experienced a 35% reduction in flow mediated dilation (FMD). FMD is a measure of how blood vessels dilate or contract and a reduced rate is associated with increased risk for atherosclerosis. However those who viewed the comedy clips experienced a 22% increase in FMD meaning their blood was flowing better.13
NDs share success stories of patients treated with humor
A male teenager and his mother came to me for weight management issues. He was overweight and had a family history of diabetes and obesity. He performed well academically and was an avid fan of video games and water polo; however, he recognized that his health and weight were becoming an issue. Actually, his mother recognized this. In fact, it was his mother who answered the majority of my questions, interjected with stories and clinical caveats, while he sat there, and didn’t say much besides an occasional “Yes,” “No,” or teenage head nod. I was able to speak with him more when his mother left the room, and he confirmed that he wanted to lose weight, eat healthy and become active again. He had already taken initiative and was proactive about the process, eating meals that his mother prepared for him and getting more movement throughout the day. From my assessment, he was on the right track! I asked if his mother was helping with the process and he agreed. I asked if she was helping “too much” and he finally cracked a smile. When I was ready to deliver the treatment plan with both of them in the room, I asked a few more questions directed to the mother. “Are you preparing healthy meals for him?” to which she animatedly said “Yes!” I said “great,” and immediately moved on to the next question, “Does he suffer from any hearing loss or impediment?” Again, she vehemently denied, but now seemed curious as to my line of questions. I again said “good” and asked my next question, “Do you remind him that he needs to eat healthy and exercise?” Her eyes grew big and enthusiastically said “Oh yes, absolutely!” I quickly asked “How many times a day?” She paused and then answered, “A few.” I smiled and asked again, “Does he suffer from any hearing loss or impediment?” At that point, the mother began to laugh out loud and quickly covered her mouth. Her son looked at me with open eyes and a big smile, surprised that I “caught” his mother in the act, so to speak. We continued to have a long discussion on how to best support her son and for him to acknowledge and show appreciation. There were both tears and laughter on her part, but by the time the visit was over, she gave me a big hug and delivered a heartfelt “Thank you.” Her son shook my hand, with the same smile that never went away 10-15 minutes prior. The visit was so much more than a plan addressing weight loss and lifestyle modifications, rather, addressing the relationships that either get in our way or support the process.
Humor serves as a great communication tool to relieve stress and facilitate a healthy doctor-patient relationship. I use laughter in my consultations to lighten the mood which is helpful for my patients during dark times. Humor distracts patients from their fears and reduces their stress allowing them to open up about the challenges they’ve faced with their illness and diffuse their feelings of sadness, fear, and anger.
In the words of Patch Adams, “The most radical act anyone can commit is to be happy,” so let yourself be and remember to take time to fill your days with laughter.
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