Laughter - the best medicine?

 

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Karen Shultz wrote about the healing aspects of hearty, sincere laughter in the anthology The Essence of Healing. She says that it allows us to

1. exercise the muscles of the lungs, diaphragm, abdomen, chest and shoulders, stimulating the circulatory system and exercising the breathing muscles;

2. increase the oxygen in our blood;

3. become profoundly self-relaxed—after laughing, the pulse rate, heartbeat and blood pressure drop below normal and the skeletal muscles become deeply relaxed, indicating reduced stress; and

4. control pain by increasing production of endorphins, the body’s natural pain killers.

But how much evidence is there for all this? There is a small – but growing – dossier of medical studies teasing out the benefits of humor. Most people have heard how Norman Cousins, the long-time editor of Saturday Review, used laughter to help himself recover from a fatal disease. Norman Cousins was one of the first to discover the healing power of humor. In August 1964, Cousins had become critically ill. He could move only with great difficulty. He underwent extensive medical tests. He reports there was: …a consensus that I was suffering from a serious collagen illness—a disease of the connective tissue. . . . Collagen is the fibrous substance that binds cells together. In a sense, then, I was becoming unstuck. I had considerable difficulty in moving my limbs and even in turning over in bed. Nodules appeared on my body, gravel-like substances under the skin, indicating the systemic nature of the disease. At the low point of my illness, my jaws were almost locked.

The pain in his body was so severe he was not able to sleep. Specialists called in on his case found that the connective tissue in his spine was disintegrating also. Cousins asked his doctor about his chances for full recovery. "He leveled with me, admitting that one of the specialists had told him I had one chance in five hundred. The specialist had also stated that he had not personally witnessed a recovery from this comprehensive condition." How did Cousins react? He says, "All this gave me a great deal to think about. Up to that time, I had been more or less disposed to let the doctors worry about my condition. But now I felt a compulsion to get into the act. It seemed clear to me that if I was to be that one in five hundred, I had better be something more than a passive observer."

He started asking questions. His search for information about how people recover from terminal conditions led him to vitamins and the laughing cure. He decided that the hospital was not a place for getting well. He checked out and moved into a room. He borrowed videotapes of Candid Camera programs and obtained old Charlie Chaplin films and Marx Brothers movies. He found that ten minutes of belly laughter at frequent intervals enabled him to fall asleep and get the rest he needed. He gradually recovered his health. In his book Anatomy of an Illness, which created a worldwide sensation, Norman Cousins wrote about the value of humor, about how laughter helped him overcome a life-threatening disease.  

In 1990 researchers discovered that watching a video of Bill Cosby performing his stand-up routine results in enhanced production of salivary immunoglobulin A – a chemical that plays a key role in preventing upper respiratory tract infection (apparently these beneficial effects were significantly reduced when participants listened to Mel Brooks and Carl Reiner's classic `2000-Year-Old-Man' routine).

You'd expect that this information would have immediately spawned a whole raft of laughter therapies. No such thing. Even though some hospitals have now set up 'humor rooms' and mobile 'humor carts', they are merely for amusement, not cure. Part of the problem is that, half a century after Cousins published his book, medics claim there's not enough hard clinical data that laughter is more than a stressbuster or mood-enhancer. (How much data do they want?) For most of us, there's plenty of hard proof around. Recent work has supported a link between laughter, coping with stress, and psychological and physical well­being. According to this work, people who spontaneously use humor to cope with stress have especially healthy immune systems, are 40 per cent less likely to suffer a heart attack and strokes, experience less pain during dental surgery, and live 4.5 years longer than most.

There's research showing that it can help to relieve pain (Psycho' Bull, 2001; 127: 504-19), and tantalizing evidence that it can help diabetics by reducing blood sugar and preventing diabetes-related kidney disease (J Psychosom Res, 2007; 62: 703-6)—giving us glimpses of its potential. Among the most provocative experimental findings are the following:

*  The experience of laughter is associated with a lowering of serum cortisol level, an increase in activated T lymphocytes, an increased number and activity of natural killer cells, and an increase in the number of T cells having helper/suppressor receptors. These findings suggest that laughter quiets the body’s stress response and enhances immune activity.

*· After subjects viewed a humorous video or one involving trust, there was an increase in salivary immunoglobulin A (IgA), which is believed to protect against some viruses.

*· Laughter appears to be a form of ‘internal jogging,’ as Norman Cousins put it. Laughing initially causes an increase in the heart and respiratory rate, raises blood pressure, increases oxygen consumption, gives the muscles of the face and stomach a workout, and relaxes the muscles not involved in laughing. Shortly following laughter, however, these cardiovascular indices fall to levels below previous resting values.

*· When researchers asked professional actors and scientists to mimic prototypical emotional facial expressions and then to experience various emotions by reliving a past experience, they found striking differences in heart rate, hand temperature, skin resistance, and muscle tension. In contrast to the changes seen with anger and fear, happiness was associated with much lower rises in heart rate and hand temperature.

*· The experience of positive emotions such as happiness during exercise appear to produce beneficial cardiovascular effects.

*· Individuals who said they turned to humor as a way of coping with difficult life situations had the highest initial concentrations of salivary IgA, suggesting that a consistently cheerful approach to life enhances one’s immune capacity.

*· Tears in response to laughter and pain have a different composition than do those induced artificially by cutting onions.

*  'Emotional teardrops' have a higher concentration of proteins and toxins, suggesting that they may be helpful in ridding the body of injurious substances.

The start of this new millennium provides a little more of the hard evidence demanded of “laughter as good medicine”. In 2003 researchers at Indiana State University (USA) found the most conclusive evidence yet of a link between laughter and the body's ability to overcome disease. Laughing out loud can boost the immune system by up to 40 per cent! In tests involving 33 women, one group watched a comedy movie together while the others were shown a dull tourism film. The scientists took samples of the women's immune cells and mixed them with cancer cells to see how effectively they attacked the disease. The women who laughed out loud at the comedy had significantly healthier immune systems, they found.

In 2005, Michael Miller, and his colleagues from the University of Maryland, studied the relationship between finding the world funny and the inner lining of blood vessels. When such vessels expand they increase blood flow around the body, and promote cardiovascular well­being. Participants were shown scenes from films that were likely to make them either feel anxious (such as the opening thirty minutes of Saving Private Ryan), or laugh (such as the 'orgasm' scene from When Harry Met Sally). Overall, participants' blood flow dropped by around 35 per cent after watching the stress-inducing films, but rose by 22 per cent following the more humorous material. On the basis of the results, the researchers recommend that people laugh for at least fifteen minutes each day.

In a similar vein, James Rotton examined the effects that watching different kinds of videos had on hospital patients recovering from orthopedic surgery.' One group of patients was asked to select funny films from a list including Bananas, Naked Gun, and The Producers. Another group was denied access to any material that might induce a smile, and were instead asked to select movies from a 'serious' list, including titles such as Brigadoon, Casablanca, and Dr No. The experimenters secretly monitored the quantity of major pain-relievers that the patients consumed via a self-controlled pump. Those watching funny films used just over 60 per cent less pain-relieving drugs than those looking at the serious movies. In an interesting twist to the experiment, the researchers also included another group of patients who were not allowed to select which comedy films to watch, but instead were given the movies selected by others. This group administered significantly more drugs than either of the other groups, scientifically proving that there is nothing more painful than watching a comedy that doesn't make you laugh.

Another team of researchers asked participants to reflect on their mortality by constructing a mock will, completing their own death certificate (including an estimate of their date and cause of death), and writing the eulogy for their own funeral." Researchers discovered that those who had exhibited a prior tendency to laugh at the absurdities of life did not find the tasks as stressful as more gloomy participants. Exactly the same effect has emerged in more realistic settings. Bereavement counselors interviewed people six months after they had lost a spouse, and found that those who could laugh about the loss were more able than others to come to terms with the situation and move on with their lives.

Other research, led by cardiologist Dr Michael Miller of the University of Maryland, further supports this valuable discovery by Norman Cousins about the value of humor. Miller carried out a series of studies on humor and heart disease after being struck by how little his cardiac patients seemed to laugh. He decided to formally test this observation on the next 150 heart patients by using a simple questionnaire designed to "measure the propensity to laugh under a variety of situations encountered in everyday life". Compared with 150 healthy controls, he found that the heart patients "were significantly less likely to experience laughter during daily activities, surprise situations or social interactions". The statistical significance of the effect was far greater than for other standard risk measures such as cholesterol or high blood pressure (Int J Cardiol, 2001; 80: 87-8).

These findings set Dr Miller to wondering how it was that laughter—or the lack of it—could have an effect on the body. He used funny movies to check it out. He measured blood flow in viewers' arteries while they were watching clips from both comedies and war movies. He found that laughter expanded the blood vessels, increasing blood flow to the heart by 22 per cent. Stress did the reverse, reducing the arterial lumen by 35 per cent (Heart, 2006; 92: 261-2).  Increased blood flow helps improve the health of the lining of the blood vessels, which is important for warding off heart disease. "We know " says Dr Miller "that exercising and not smoking both benefit the heart. Regular, hearty laughter should probably now be added to the list." 

In fact, laughter is as good for your heart as a gym workout: watching comedies can improve the health of blood vessels. As we laugh, the blood vessels in our body expand, increasing the blood flow and improving the performance of our circulatory system, the research team discovered. "Laughing may be important to reduce the risk of cardiovascular disease” said Dr Miller. "The magnitude of change we saw in the blood vessel lining is similar to the benefit we might see with aerobic activity, but without the aches, pains - and muscle tension associated with exercise," he claimed.

"We don't recommend that you laugh and not exercise, but we do recommend you try to laugh on a regular basis. 15 minutes of laughter on a daily basis seems to be very good for the circulation system," said Dr Miller. The team also found that watching disturbing films, caused viewers' blood vessels to constrict. After watching the opening battle scene of Saving Private Ryan, it was found that subjects' blood vessel linings developed a potentially unhealthy response called vasoconstriction, which reduces the blood flow.

Just how does laughter affect blood vessels? Researchers at Loma Linda University in California attempted to find the answer. Again, funny films were shown to volunteers, and their hormone levels measured afterwards. The researchers found significant reductions in the stress hormones cortisol and epinephrine, both well-known risk factors for heart disease (Am J Med Sci, 1989; 298: 390-6). Encouraged by these results, the Loma Linda group widened their research to the immune system in general. This, too, showed that laughter offered major benefits, boosting the body's production of natural-killer (NK) cells, B cells, helper T cells and immunoglobulins. Some of these effects persisted hours after having seen the humorous films  (Altern Ther Health Med, 2001; 7: 62-72, 74-6).

Which part of the brain is involved when we laugh? Peter Derks, a researcher at the College of William and Mary, recorded electroencephalograms on individuals as they were presented with humorous material. While the joke was being set up, activity in the left cerebral hemisphere dominated as the subject analyzed and processed the information. Then the dominant activity shifted to the frontal lobe, the center of emotionality. Moments later, when the subject seemed to be trying to ‘get’ the joke, the right hemisphere’s activity joined in. A few milliseconds later, prior to laughing, increased brain activity spread to the occipital lobe, where the processing of sensory information takes place. As the person ‘got’ the joke and laughter began, delta waves increased and reached a crescendo. Derks’s findings suggest that there is no ‘humor center’ but that various parts of the brain work together when we experience delight and laughter. Whereas most emotions tend to involve only discrete parts of the brain, laughter uses most of the brain’s primary areas – that is, the cortex, the frontal lobe and motor regions.

A study of cerebral blood flow with positron emission tomography yields additional insight into how the brain functions during the experience of positive emotions. Investigators examined cerebral blood flow during states of sadness and happiness in healthy women. During happiness no detectable increase in blood flow was found anywhere in the cerebrum; in fact, there was decreased flow in the prefrontal and temporoparietal cortical areas, suggesting that positive emotion puts the brain momentarily at rest - precisely what appears desirable for healing.

Note: Cousins was careful not to recommend laughter as a panacea: ‘Obviously what worked for me may not work for everyone else. Accumulating research points to a connection between laughter and immune enhancement but it would be an error and indeed irresponsible to suggest that laughter – or the positive emotions in general – have universal or automatic validity, whatever the circumstances. People respond differently to the same things. One man’s humor is another man’s ho-hum. The treatment of illness has to be carefully tailored to suit the individual." Further, he clearly realized that more than laughter had been involved in his improvement. For instance, he had taken large doses of vitamin C in addition to focusing on positive emotions. And humor was not the only emotion he brought into the mix. He says he tried to include the full range of positive affect: included love, hope, faith, will to live, festivity, purpose and determination.  

Energy Detox
gives the body the needed boost to start to return integrity to the body,
enabling it to reverse the decades of accumulated poisons.
It does not treat disease.


The information provided is intended for educational purposes;
it is not to be construed as providing medical advice or
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