|Norman Cousins, the storied journalist, author and editor, found no pain reliever better than clips of the Marx Brothers. For years, Cousins suffered from inflammatory arthritis, and he swore that 10 minutes of uproarious laughing at the hilarious team bought him two hours of pain-free sleep.
In his book Anatomy of an Illness as Perceived by the Patient (W.W. Norton, 1979), Cousins described his self-prescribed laughing cure, which seemed to ameliorate his inflammation as well as his pain. He eventually was able to return to work, landing a job as an adjunct professor at the School of Medicine at the University of California, Los Angeles, where he investigated the effects of emotions on biological states and health.
The community of patients inspired by such miracle treatments believes not only that humor is psychologically beneficial but that it actually cures disease. In reality, only a smattering of scientific evidence exists to support the latter idea-but laughter and humor do seem to have significant effects on the psyche, even influencing our perception of pain. What is more, psychological well-being has an impact on overall wellness, including our risk of disease.
Laughter relaxes us and improves our mood, and hearing jokes may ease anxiety. Amusement's ability to counteract physical agony is well documented, and as Cousins's experience suggests, humor's analgesic effect lasts after the smile has faded.
Cheerfulness, a trait that makes people respond more readily to laugh lines, is linked to emotional resilience-the ability to keep a level head in difficult circumstances-and to close relationships, studies show. Science also indicates that a sense of humor is sexy; women are attracted to men who have one. Thus, in various ways, life satisfaction may increase with the ability to laugh.
Ancient Greek philosopher Aristotle viewed laughter as «a bodily exercise precious to health.» But despite some claims to the contrary, chuckling probably has little influence on physical fitness. Laughter does produce short-term changes in cardiovascular function and respiration, boosting heart rate, respiratory rate and depth, as well as oxygen consumption. But because hard laughter is difficult to sustain, a good guffaw is unlikely to have measurable cardiovascular benefits the way, say, walking or jogging does.
In fact, instead of straining muscles to build them, as exercise does, laughter apparently accomplishes the opposite. Studies dating back to the 1930s indicate that laughter relaxes muscles, decreasing muscle tone for up to 45 minutes after the guffaw subsides.
Such physical relaxation might conceivably help moderate the effects of psychological stress. After all, the act of laughing probably does produce other types of physical feedback that improve an individual's emotional state. According to one classical theory of emotion, our feelings are partially rooted in physical reactions. American psychologist William James and Danish physiologist Carl Lange argued at the end of the 19th century that humans do not cry because they are sad but that they become sad when the tears begin to flow.
Although sadness also precedes tears, evidence suggests that emotions can flow from muscular responses. In an experiment published in 1988, social psychologist Fritz Strack of the University of Würzburg in Germany and his colleagues asked volunteers to hold a pen either with their teeth-thereby creating an artificial smile-or with their lips, which would produce a disappointed expression. Those forced to exercise their smiling muscles reacted more exuberantly to funny cartoons than did those whose mouths were contracted in a frown, suggesting that expressions may influence emotions rather than just the other way around. Similarly, the physical act of laughter could improve mood.
Additional studies have shown that laughing at a funny film can cause a drop in the blood's concentration of the stress hormone cortisol (although other stress hormones appear to be unaffected). Because chronically elevated cortisol levels have been shown to weaken the immune system, this mechanism could conceivably help ward off disease. Indeed, experiments have indicated that laughter increases the activity of immune cells called natural killer cells in saliva in healthy subjects.
In some cases, though, laughter may dampen inappropriate immune responses. In a 2007 study allergy researcher Hajime Kimata of Moriguchi-Keijinkai Hospital in Japan measured levels of the hormone melatonin in the breast milk of nursing mothers before and after the subjects watched either a comic Charlie Chaplin video or an ordinary weather report. Melatonin regulates the sleep-wake cycle and is often disturbed in the allergic skin condition atopic eczema, which all of the 48 babies in the study had. Kimata found that laughing at the funny film, but not hearing the weather report, increased the amount of melatonin in the mothers' milk. In addition, the laughter-fortified breast milk reduced the allergic responses to latex and house dust mites in the infants. Thus, making a nursing mom laugh might sometimes serve as an allergy remedy for her baby.
The idea that laughter itself, independent of humor, provides physiological and psychological benefits motivates proponents of «laughter yoga,» a group exercise in simulated laughter, which (like yawning) quickly becomes contagious. Many participants in such programs, which are growing in popularity, report feeling looser and happier after them. Some researchers are skeptical that feigned laughter has direct health benefits, however. Psychiatrist Barbara Wild of the University of Tübingen in Germany, for example, believes that the sense of well-being that people report after such sessions results from the social experience of giggling and interacting as a group and not from a direct physiological effect of laughter itself.
Of course, humor elicits various thoughts and emotions in addition to a social response such as laughing, smiling, groaning or verbal banter. Indeed, most humor researchers believe that the psychology of humor, rather than laughter per se, is what most benefits mental and physical health.
Humor is an intellectual skill that requires an ability to view situations in a particular light. Humor and comedy are often based on a logical twist, paradox or displacement. In Lewis Carroll's Alice in Wonderland, the Mad Hatter announces to Alice: «If you knew Time as well as I do, you wouldn't talk about wasting it.» And after Alice says she has to «beat time» when she learns music, the Hatter replies: «Ah! That accounts for it. He won't stand beating.»
Understanding a reference to «time» as if it were a living thing with feelings requires the ability to shift perspective away from the conventional view of the concept. Clinical psychologist Michael Titze, founder of HumorCare, an association that promotes humor as therapy, believes the humorous perspective creates cognitive distance between yourself and the circumstances in a way that can be psychologically protective. As Sigmund Freud wrote in 1928, «No doubt, the essence of humor is that one spares oneself the affects to which the situation would naturally give rise and overrides with a jest the possibility of such an emotional display.»
Such cognitive and emotional distancing may help keep anxiety at bay. In a 1990 study Nancy A. Yovetich, now a pharmaceutical researcher at Rho, Inc., along with psychologists J. Alexander Dale and Mary A. Hudak of Allegheny College, told 53 college students they would receive an electric shock in 12 minutes (although no shock was forthcoming). During the wait, some students listened to a funny tape, whereas others heard a humorless speech or nothing at all. Those exposed to the humor rated themselves as less anxious as the fictitious shock approached than did those in the other two groups. In addition, participants who in a prior personality test had scored higher on «sense of humor» showed the least tension of all, suggesting that humor is indeed calming.
For similar reasons, humor can take the sting out of defeat and disappointment, helping people weather difficulty. In the mid-1990s psychologist Willibald Ruch, now at the University of Zurich, and his co-workers at the University of Düsseldorf in Germany created a measure of cheerfulness and sense of humor called the State-Trait Cheerfulness Inventory (STCI). Its questions distinguish between a person's momentary mood (state)-triggered, say, by a joke-and a general disposition for enjoyment (trait). A high cheerfulness score means a person gets in a cheerful mood easily and laughs readily.
One benefit of a cheerful character is resilience, a psychic robustness that emotionally buffers people against crises and enables them to see silver linings in major disappointments such as the dissolution of a marriage or the loss of a job. «Humor strengthens the psyche,» Ruch says. In a study published in 1999, he and his colleagues assigned 72 students, all of whom took the STCI, to one of three rooms: a «cheerful» room with large windows, yellow walls, funny posters and colored drapes; a «depressing» room painted black and lit only by a small frosted bulb; and a small «serious» room filled with scientific equipment, books, manuals and presentation posters. The participants performed tasks such as drawing and filling out questionnaires in each of the rooms, as an excuse for spending time in the separate environments. As expected, the ambience of the rooms had a much larger effect on the less cheerful individuals: the depressing and serious rooms put the more humorless students in a worse mood but did not alter the mind-set of the sunnier participants, as measured by a mood test.
In another test of the buffering power of cheerfulness published in 1996, Ruch, physician Claus-Udo Wancke and their colleagues in Düsseldorf measured this trait in 68 adults and then asked them to discuss emotionally laden proverbs. The researchers found that talking about the negative proverbs put people with more sober personalities into a bad mood, whereas the more upbeat folks stayed as jovial as before, again indicating that being a cheerful person with a sense of humor may help you endure negative events and situations.
In addition to being less affected by negative events, individuals with a sense of humor may also be able to distance themselves from the threat of pain. As early as 1928, New York physician James J. Walsh noticed that laughter seemed to dampen pain after surgery. Since then, research has indicated that humor can have painkilling properties. One 1996 study demonstrated that patients who watched funny movies needed less of their mild painkillers after orthopedic surgery than did patients who viewed serious flicks or nothing at all.
Humor's analgesic effect requires enjoyment but not necessarily laughter, according to a 2004 study by Ruch, along with his then graduate students Karen Zweyer and Barbara Velker. The researchers asked 56 women to submerge a hand in ice-cold water before, immediately after and 20 minutes after a funny seven-minute film. In response to the film, some of the women were instructed to get into a cheerful mood without smiling or laughing; others were asked to smile and laugh a lot; the rest were told to create humorous verbal commentaries on the film while watching it.
As expected, seeing the funny film did boost pain tolerance in all the women: after exposure to the comedy, all the participants required a longer exposure to the water to feel pain and could tolerate longer submersions before pulling their hand out. These changes in pain perception were lasting, persisting for 20 minutes after the film ended. Smiling, but not necessarily laughter, seemed to be most important for the pain-suppressing effect. The women who were asked to refrain from smiling in response to the film generally felt the most pain, and the members of that group who failed to suppress a grin showed more pain tolerance than the others did.
A lack of seriousness (the counterpart to cheerfulness, though not its opposite) also seemed to help, the researchers found. The individuals who ranked low in seriousness, as measured by the STCI, showed the most genuine smiling and laughter, which lessened their pain. The authors speculate that people who are less sober in general may also take pain less seriously. They propose that seriousness or its opposite, playfulness, might be a good indicator of whether an intervention involving humor would alleviate pain in an individual.
In addition to suppressing pain, being funny and cheerful can cultivate friendships. Cheerful people have a lighthearted interaction style that facilitates bonding closely with others and builds social support. They also may get more dates. In 2006 psychologists Eric R. Bressler of Westfield State College and Sigal Balshine of McMaster University in Ontario reported that women are more likely to consider a man in a photograph a desirable relationship partner if the picture is accompanied by a funny quote attributed to the man. In fact, the women preferred the funny men despite rating them, on average, less intelligent and less trustworthy.
Although the men in Bressler and Balshine's study did not prefer witty women as partners, other research indicates that both men and women value a «sense of humor» when choosing a partner. Either way, males do seem to like ladies who laugh at their jokes. A 1990 study suggests that when women and men chat, the amount of laughing by the woman indicates both her interest in dating the man and her sexual appeal to the man. (The man's laughter did not relate to attraction in either direction.)
Healing with Humor
Because of humor's many psychological benefits, some psychologists and mental health experts are testing comedy as a remedy for stress, mild depression or just feeling down. Psychologist Paul McGhee, a former humor researcher who is now president of the Laughter Remedy in Wilmington, Del., has developed a widely used humor training program to help people manage stress. In an unpublished study, Ruch, along with graduate students Heidi Stolz and Sandra Rusch, found that the McGhee program helped 96 mentally healthy individuals become more natrally cheerful and content with their lives, an improvement that lasted for at least two months.
In 2008 psychologists Ilona Papousek and Günter Schulter, both at the University of Graz in Austria, described a novel method of teaching people to make themselves cheerful that left participants in a better mood for at least two days after their three-week course ended. The subjects also felt calmer and showed reductions in blood pressure.
Wild and psychiatrist Irina Falkenberg, now at the University of Marburg in Germany, have adapted the McGhee program for patients with mild depression. Until recently, humor was taboo in psychotherapy. «Naturally, you can't just laugh away a serious mental illness,» Wild says. And nobody is suggesting humor as a treatment for severe depression. But being funny could ease moderate distress. In psychotherapy, patients often learn how to reinterpret or distance themselves from negative emotions such as stress and fear. Humor can help with these goals. «Having a sense for the comedic can be an important coping strategy,» Wild suggests.
Wild and Falkenberg coach patients to weave comedy into their daily lives. The researchers first determine what individuals find funny by asking each of them to recall a humorous experience and to provide pictures or cartoons that make him or her laugh. Later, the patients are encouraged to see the amusing side of situations-in some cases, brainstorming as a group-or to collect or create punch lines. No one is supposed to laugh at anyone else or turn a patient's illness into an object of fun. Also against the rules are potentially mean-spirited forms of humor such as sarcasm or schadenfreude (delighting in others' misfortune or misery).
So far Wild and Falkenberg have discovered that the humor therapy can temporarily improve patients' mood; they are now probing its long-term effects. Meanwhile another study hints that humor might be able to lift the veil of depression. In 2007 psychiatrist Marc Walter of the University of Basel in Switzerland and his colleagues reported that 10 elderly depressed patients who received humor training in addition to medication were more satisfied with their lives than were patients in a group that received only medication. «The patients open up more easily and are more lively in their interactions» after the therapy, Walter says.
One obstacle to such efforts is that some psychiatric patients have problems recognizing wit because social or memory impairments prevent them from understanding the intentions of the joke teller or from holding a joke in mind from start to punch line. Because of a failure to empathize, autistic persons also fail to see the humor in many jokes.
But for most of us, humor may be the balm we need to more calmly overcome the obstacles of everyday existence, to make friends and even to stave off physical pain. According to 18th-century philosopher Immanuel Kant, laughter is one of a trio of tactics humans may use to counterbalance life's troubles. The others are hope and sleep.