Newsletter - May, 2000

Humor and Laughter Reduce Pain (Part 2)

Paul McGhee, PhD

    "A clown is like an aspirin, only he works twice as fast.”
    (Groucho Marx)

Last month, we began looking at the research showing that humor can help reduce pain. Consistent with the data discussed last month, a Japanese study showed that listening to an hour of traditional comic stories (Rakugo) reduced the level of pain experienced by rheumatoid arthritis patients.1 This is an especially important finding, since the symptoms experienced by these patients (as well as patients with multiple sclerosis and numerous other medical conditions) generally worsen in the presence of negative emotional states. Finding something to laugh at when you’re in pain can help reduce the pain at the same time that it substitutes a more positive for a negative mood and lifts your spirits. This may explain why rheumatoid arthritis patients who report more chronic pain also say they look for humor more often in everyday life.2 They’ve learned that humor helps manage their pain.

A Swedish physician reported that six women suffering from painful muscle disorders got significant relief from pain through a 13-week course in humor therapy.3 Throughout this period, they read funny books, listened to or watched funny tapes, and worked at "giving higher priority to humor in their everyday lives.” They also attended lectures on humor research. Those patients who laughed the most in group sessions showed the greatest symptom reduction.

There is also widespread anecdotal evidence that laughter can help manage pain. Norman Cousins once described in a speech how he, Dr. Carl Simonton, and Jose Jimenez (a comedian from the old Steve Allen Show) went to talk to a group of patients at a VA Hospital. Jimenez had them falling off their chairs laughing. The doctors later told Cousins that 85% of the patients had been experiencing pain when they entered the room. But the laughter reduced or eliminated the pain for most of them.

In a study of 35 patients in a rehabilitation hospital, 74% agreed with the statement, "Sometimes laughing works as well as a pain pill.”4 The patients had such conditions as traumatic brain injury, spinal cord injury, arthritis, limb amputations, and a range of other neurological or musculoskeletal disorders. Given the power of humor and laughter to reduce pain, it is not surprising that humor has been applied as a "treatment” in managing pain associated with burns and dental work,5 and as a component of general nursing care.6

Nurses often tell me they know a patient who tried Cousins’ approach and found that it also reduced their pain. But not all who try it experience pain reduction. The reason for this inconsistency remains unclear.

What Causes the Pain Reduction Resulting from Laughter?

For those who do experience pain reduction following laughter, why does it occur? One possibility is distraction. Humor draws attention away from the source of discomfort--at least momentarily. The most commonly given explanation, however, is that laughter causes the production of endorphins, one of the body’s natural pain killers. This explanation makes good sense, but as of January, 2000, no one has been able to demonstrate it with data. Investigators who have tried to show the endorphin-humor connection have failed to do so.7

Regardless of whether laughter does or does not cause the release of endorphins into the blood stream, its ability to reduce pain is undoubtedly partly due to its reduction of muscle tension. Even brief relaxation procedures have been shown to reduce pain--both in laboratory and clinical settings.8 Many pain centers around the country now use meditation and other relaxation techniques to reduce the level of pain medication needed by patients. Laughter is just one additional technique for achieving the same effect.

This muscle relaxation effect has its practical side in hospitals. Some nurses tell patients jokes before giving them shots, because they know it keeps them from tightening up their muscles in anticipation of the shot.

[Excerpt from Dr. McGhee's book, Health, Healing and the Amuse System: Humor as Survival Training. Published by Kendall/Hunt, 1999. To order a copy by e-mail, see Click on orders. ISBN number is 7872-5797-4.]

Pun Fun

More Signs in English Found in Different Countries

(Language confusion designed to help you practice using your sense of humor in English.)

In a Tokyo bar (obviously unaware of how offensive this would be to many): "Special cocktail for the ladies with nuts."

In a Copenhagen airline ticket office: "We take your bag and send it in all directions."

In a Norwegian bar: "Ladies are requested not to have children in the bar."

In a Budapest zoo: "Please do not feed the animals. If you have any suitable food, give it to the guard on duty."

In the office of an Italian doctor: "Specialist in women and other diseases."

1. Yoshino, S., et al. Effects of mirthful laughter on neuroendocrine and immune systems in patients with rheumatoid arthritis. Journal of Rheumatology, 1996, 23, 793-794.
2. Leise, C.M. The correlation between humor and the chronic pain of arthritis. Journal of Holistic Nursing, 1993, 11, 82-95.
3. Ljungdahl, L. Laugh if this is a joke. Journal of the American Medical Association, 1989, 261, 558.
4. Schmitt, N. Patients’ perception of laughter in a rehabilitation hospital. Rehabilitation Nursing, 1990, 15 (No. 3), 143-146.
5. Trice, A.D. & Price-Greathouse, J. Joking under the drill: A validity study of the humor coping scale. Journal of Social Behavior and Personality, 1986, 1, 265-266.
6. McCaffery, M. Nursing approaches to non-pharmacological pain control. International Journal of Nursing Studies, 1990, 27, 1-5.
7. Berk, et al., 1989. Berk, L.S., et al. Neuroendocrine and stress hormone changes during mirthful laughter. American Journal of the Medical Sciences, 1989, 298, 390-396.
Yoshino, et al., 1996.
8. Kogan, R. & Kluthe, K.B. The role of learning in pain reduction associated with relaxation and patterned breathing. Journal of Psychosomatic Research, 1981, 25, 535-539.
French, A.P. & Turpin, J.P. Therapeutic application of a simple relaxation method. American Journal of Psychotherapy.