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Humor Therapy

October 15, 2010 Written by JP       [Font too small?]

Every so often I’ll encounter a client who isn’t open to the possibility of changing his diet and/or incorporating nutritional supplements and lifestyle changes into his daily routine. At first thought you might wonder “What’s left to recommend?”. I like to treat situations such as this as a puzzle. Certain pieces clearly don’t fit. But if someone comes to me asking for help, I have to assume they’re at least willing to consider my advice. He might even adopt my suggestions, if I respect his wishes and find the right fit for him (or her). Laughter therapy is a treatment modality that frequently falls into this category.

Virtually everyone enjoys a good laugh. But the concept of harnessing the power of laughter and directing it as a healing force is foreign to many patients and physicians alike. Perhaps it’s just hard to accept that serious health benefits could actually be attributed to such a mirthful activity. After all, when you’re sick you go see a doctor not a comedian. Medicine is no joking matter. Come to think of it, that may be debatable in some people’s minds. However, that’s a discussion for another day. What I want to delve into this Friday are some recent studies that demonstrate why laughter should play a regular part in all of our lives.

Laughter Improves Depression - Two new studies report that the use of a “humor group” and “laughter yoga” are effective and safe means of reducing depression in a senior population. The first trial examined the effects of laughter yoga as compared to exercise therapy. Both treatment options proved helpful in decreasing depression scores. However, only those engaging in laughter yoga reported an improvement in “life satisfaction”. Similar success was also exhibited in the so-called humor group study. Pre and post-trial measurements reveal that participation in a humor group (vs. a control group receiving no specific treatment) conferred benefits in many areas pertaining to depression including cheerfulness, resilience and satisfaction with life. What’s also interesting to note is that these studies were carried out in very different parts of the world: Germany and Iran. (1,2)

Laughter Protects the Cardiovascular System - Japanese scientists are at the forefront of laughter therapy research. The latest example of this is presented in the September 2010 edition of the American Journal of Cardiology. The experiment in question enrolled seventeen “apparently healthy adults (23 to 42 years of age)”. They watched either 30 minutes of a comedy program or documentary on separate days. The participants blood pressure, heart rate and B-mode ultrasound imaging were recorded prior to each viewing to establish changes in cardiovascular and circulatory health status. The findings indicate that watching the comedy programming resulted in improved blood flow by 17%, while the documentary footage reduced brachial artery flow-mediated vasodilation by 15%. Vascular function also improved after the comedic sessions as evidenced by a 10% increase in carotid arterial compliance. The concluding remarks of the authors state: “These results suggest that mirthful laughter elicited by comic movies induces beneficial impact on vascular function”. (3)

Laughter Alters Intestinal Flora - This next item sounds like something straight out of a science fiction film. But I assure you it’s 100% science fact. Twenty-four healthy individuals and twenty-four patients with atopic dermatitis (eczema) were asked to view 7 comedic films for one week and then 7 nonhumorous films during the following week. Fecal samples were taken before each trial period and after, and tested for bacterial metabolites (polyamines). The patients with eczema demonstrated increased colonization with beneficial intestinal bacteria (bifidobacterium and lactobacilli) and lower levels of pathogenic bacteria (S. aureus and Enterobacteria) after the 7 day trial of comedic therapy. The authors of the trial surmise that “Viewing humorous films may modulate fecal levels of polyamines by restoring intestinal flora in atopic dermatitis”. This may be a great option for those who are allergic to yogurt. I’m only half-kidding. (4)

Laughter Lowers Blood Sugar in Diabetics - A group of researchers from the Foundation for Advancement of International Science recently discovered that laughter yields numerous health benefits for type 2 diabetics including: a) a suppression of post-meal blood sugar levels; b) a decline in serum prorenin concentrations – which is “involved in the onset of diabetic complications”; c) “NK (natural killer) cell-mediated improvement in glucose tolerance at the gene-expression level”. (5)

How Humor Therapy Can Benefit Mental Health
Source: eCAM Advance Access published online on August 17, 2009 (link)

Another fascinating study which was just published in the journal Twin Research and Human Genetics examined the importance of laughter in a population of 201 adult twins from North America. Two questionnaires were used to form the basis for this unique analysis: the Humor Styles Questionnaire and the MT48 (a mental toughness inventory). According to physicians at the Department of Psychology at the University of Western Ontario, Canada, “Positive correlations were found between the positive humor styles and all of the mental toughness factors” which are comprised of: challenge, confidence, confidence of abilities, commitment, control, control over life, emotional control and interpersonal confidence. (6)

I could go on to recite some of the likely reasons why laughter promotes a healthier body and mind. If you’re interested in learning more about laughter’s role in prompting “the release of beta-endorphins which in turn have high affinity for mu3 opiate receptors” which take part in the “direct release of NO (nitric oxide) and associated biological consequences”, please click on the footnotes directly following this paragraph. My editor will thank you for it. Too many scientific details about humor somehow seem to defeat the purpose of it in the first. It’s like trying to explain a joke by using a mathematical equation. What’s far more important is what we know intrinsically. Laughing feels good and those positive sensations translate into beneficial physiological reactions within the body. If you can embrace that simple piece of wisdom, then you’re an excellent candidate for laughter therapy. (7,8,9)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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Posted in Diabetes, Heart Health, Mental Health

14 Comments & Updates to “Humor Therapy”

  1. Nina K. Says:

    Good Morning, JP :-)

    i’m still loughing about the “intestinal flora study”, funny research hahahaaa:-)

    Wish you and yours a relaxed and joyful weekend :-)

    Nina K.

  2. JP Says:

    Yeah, imagine enrolling in that experiment. “Laughing is going to do what?!” :)

    I hope you and your husband have a lovely weekend as well, Nina. All my best to you both!

    Be well!

    JP

  3. Mark Says:

    I’m laughing just thinking of all the jokes one could throw out about intestinal flora. Good ol bathroom humor.

    Humor is absolutely free(most times) and it looks like it packs a healthy punch

  4. elsa Says:

    Yea, I realized that.

    Apparently laughter / humor does not only affect health, but also success.

    I’ve heard that people are more inclined to hire others who have sense of humor.

    Andrew Carnegie even said that there is little success where there is little laughter.

  5. JP Says:

    Ah yes, intestinal flora is a comedic goldmine. :)

    Glad we agree on this one, Mark. Have a great weekend!

    Be well!

    JP

  6. Danii Says:

    Think I will try and implement a little ‘laughter therapy’ in the office today. Brilliant post. I love that Carnegie quote too Elsa.

  7. Anonymous Says:

    Laughter remains one the great underrated therapies for good health. Your points are all so well-taken and should be embraced by everybody.

    Great blog. We’ll be back soon to read more.

  8. Lewis Says:

    ha ha ha ,yes it really works with me in reducing 60 points..
    But I’m type1 diabetic. I can’t laugh whole day to reduce 500 to 120.I really appreciate if laughing reduces at least 400 points of sugar.Its good for people who don’t have high sugar.
    Now I’m consuming some stupid herbal medicine what my sister got from India..but even this herbal medicine not bad,they have reduced my 150 points.Its called SB medicine from India.cool

  9. JP Says:

    Update 04/28/15:

    http://online.liebertpub.com/doi/10.1089/acm.2014.0152

    The Journal of Alternative and Complementary Medicine. April 2015, 21(4): 217-222.

    The Effects of Laughter Therapy on Mood State and Self-Esteem in Cancer Patients Undergoing Radiation Therapy: A Randomized Controlled Trial

    Background: To investigate whether laughter therapy lowers total mood disturbance scores and improves self-esteem scores in patients with cancer.

    Design/Setting: Randomized controlled trial in a radio-oncology outpatient setting.

    Patients: Sixty-two patients were enrolled and randomly assigned to the experimental group (n=33) or the wait list control group (n=29).

    Interventions: Three laughter therapy sessions lasting 60 minutes each.

    Outcome measures: Mood state and self-esteem.

    Results: The intention-to-treat analysis revealed a significant main effect of group: Experimental group participants reported a 14.12-point reduction in total mood disturbance, while the wait list control group showed a 1.21-point reduction (p=0.001). The per-protocol analysis showed a significant main effect of group: The experimental group reported a 18.86-point decrease in total mood disturbance, while controls showed a 0.19-point reduction (p<0.001). The self-esteem of experimental group was significantly greater than that of the wait list control group (p=0.044).

    Conclusions: These results indicate that laughter therapy can improve mood state and self-esteem and can be a beneficial, noninvasive intervention for patients with cancer in clinical settings.

    Be well!

    JP

  10. JP Says:

    Update 05/18/15:

    http://synapse.koreamed.org/search.php?where=aview&id=10.4040/jkan.2015.45.2.221&code=0006JKAN&vmode=FULL

    J Korean Acad Nurs. 2015 Apr;45(2):221-30.

    Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women.

    PURPOSE: This study was done to examine how laughter therapy impacts serotonin levels, QOL and depression in middle-aged women and to perform a path analysis for verification of the effects.

    METHODS: A quasi-experimental study employing a nonequivalent control group and pre-post design was conducted. Participants were 64 middle-aged women (control=14 and experimental=50 in 3 groups according to level of depression). The intervention was conducted five times a week for a period of 2 weeks and the data analysis was conducted using repeated measures ANOVA, ANCOVA and LISREL.

    RESULTS: Results showed that pre serotonin and QOL in women with severe depression were the lowest. Serotonin in the experimental groups increased after the 10th intervention (p=.006) and the rise was the highest in the group with severe depression (p=.001). Depression in all groups decreased after the 5th intervention (p=.022) and the biggest decline was observed in group with severe depression (p=.007). QOL of the moderate and severe groups increased after the 10th intervention (p=.049), and the increase rate was highest in group with severe depression (p<.006). Path analysis revealed that laughter therapy did not directly affect depression, but its effect was indirectly meditated through serotonin variation (p<.001).

    CONCLUSION: Results indicate that serotonin activation through laughter therapy can help middle-aged women by lessening depression and providing important grounds for depression control.

    Be well!

    JP

  11. JP Says:

    Update 05/31/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26026141

    Altern Ther Health Med. 2015 May;21(3):16-25.

    Humors Effect on Short-term Memory in Healthy and Diabetic Older Adults.

    Context • With aging, the detrimental effects of stress can impair a person’s ability to learn and sustain memory. Humor and its associated mirthful laughter can reduce stress by decreasing the hormone cortisol. Chronic release of cortisol can damage hippocampal neurons, leading to impairment of learning and memory.

    Objectives • The study intended to examine the effect of watching a humor video on short-term memory in older adults.

    Design • The research team designed a randomized, controlled trial.

    Setting • The study took place at Loma Linda University in Loma Linda, CA, USA. Participants • The study included 30 participants: 20 normal, healthy, older adults-11 males and 9 females-and 10 older adults with type 2 diabetes mellitus (T2DM)-6 males and 4 females.

    Intervention • The study included 2 intervention groups of older adults who viewed humorous videos, a healthy group (humor group), aged 69.9 ± 3.7 y, and the diabetic group, aged 67.1 ± 3.8 y. Each participant selected 1 of 2 humorous videos that were 20 min in length, either a Red Skeleton comedy or a montage of America’s Funniest Home Videos. The control group, aged 68.7 ± 5.5 y, did not watch a humor video and sat in quiescence.

    Outcome Measures • A standardized, neuropsychological, memory-assessment tool, the Rey Auditory Verbal Learning Test (RAVLT), was used to assess the following abilities: (1) learning, (2) recall, and (3) visual recognition. The testing occurred twice, once before (RAVLT1) and once after (RAVLT2) the humorous video for the humor and diabetic groups, and once before (RAVLT1) and once after (RAVLT2) the period of quiescence for the control group. At 5 time points, measurements of salivary cortisol were also obtained. The Kruskal-Wallis test was used to measure significance of the data based on the 3 groups.

    Results • In the humor, diabetic, and control groups, (1) learning ability improved by 38.5%, 33.4%, and 24.0%, respectively (P = .025); (2) delayed recall improved by 43.6%, 48.1%, and 20.3%, respectively (P = .064); and (3) visual recognition increased by 12.6%, 16.7%, and 8.3%, respectively (P = .321). For levels of salivary cortisol, the research team found significant and borderline decreases for the humor group between baseline and (1) post-RAVLT1 (P = .047), (2) postvideo (P = .046), and (3) post-RAVLT2 (P = .062). The diabetic group showed significant decreases between baseline and (1) post-RAVLT1 (P = .047), (2) postvideo (P = .025), and (3) post-RAVLT2 (P = .034). The study found no significant changes for the control group.

    Conclusion • The research findings supported potential clinical and rehabilitative benefits for humor that can be applied to whole-person wellness programs for older adults. The cognitive components-learning ability and delayed recall-become more challenging as individuals age and are essential to older adults for providing a high quality of life: mind, body, and spirit. Because older adults can experience age-related memory deficits, complementary, enjoyable, and beneficial humor therapies should be implemented for them.

    Be well!

    JP

  12. JP Says:

    Updated 10/19/15:

    http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-41572015000100012&lng=en&nrm=iso&tlng=en

    Biomedica. 2015 Jan-Mar;35(1):90-100.

    [Changes in depression and loneliness after laughter therapy in institutionalized elders].

    INTRODUCTION: Old age is a stage characterized by a number of factors, such as loneliness and depression, that have a negative effect on people´s lives.

    OBJECTIVE: To evaluate the impact of laughter therapy on the level of depression and loneliness in a group of institutionalized elders.

    MATERIALS AND METHODS: Exploratory research with quasi-experimental design applying Yesavage depression scale and the ESTE scale of loneliness, both validated for Colombia. The target population consisted of 49 men and women who were 59 years old or over, and lived in the Gerontological Home ´´Colonia de Belencito´´ in the city of Medellín (Antioquia); they were contacted between April and July 2013, and they received eight sessions of laughter therapy performed by the group “Hospital Clowns” of the Mediclaun Foundation from Medellín.

    RESULTS: There was a significant decrease in the level of depression especially in those with initial depression established (p<0,032). The most receptive were institutionalized elders who did not have a couple, they were between 65 and 75 years of age, and they belonged to socioeconomic level 2 and did not receive visits. No significant changes in the level of loneliness were recorded.

    CONCLUSION: The importance of laughter therapy in reducing the level of depression in elders is highlighted. These results agree with the statement indicating that the construct of loneliness is independent from depression.

    Be well!

    JP

  13. JP Says:

    Updated 12/09/16:

    http://hosppeds.aappublications.org/content/early/2016/11/29/hpeds.2016-0128

    Hosp Pediatr. 2016 Dec 1.

    Effects of a Humor Therapy Program on Stress Levels in Pediatric Inpatients.

    OBJECTIVE: Disease and hospitalization generate stress, which can affect the response to treatment. Humor has been used in many hospitals to decrease stress. The aim of this study was to evaluate the impact of a humor therapy program on stress levels in pediatric inpatients.

    METHODS: In the first phase, an intervention and a control group were studied over 2 consecutive 3-month periods; the interventions were performed by a team of artists trained in humor therapy. Salivary cortisol levels were measured by enzyme-linked immunosorbent assay, and the Weisz test, a pictorial chart that determines subjective stress perception, and the Parker test, which assesses objective stress, were applied. In the second phase, salivary cortisol levels were measured and the Weisz test was administered before and after the interventions.

    RESULTS: A total of 306 patients were recruited into this study: 198 in the first phase (94 in the intervention group and 104 in the nonintervention group) and 108 in the second phase. There were no differences between groups regarding age, sex, or medical diagnosis. The children in the intervention group presented lower cortisol levels, lower scores on the Parker test, and higher scores on the Weisz test than children in the nonintervention group. In the second phase, the children showed lower salivary cortisol levels and higher scores on the Weisz test after the intervention.

    CONCLUSIONS: Humor therapy has beneficial effects on stress and cortisol levels in pediatric inpatients. This supports the implementation and reinforcement of these therapies in pediatric hospitals.

    Be well!

    JP

  14. JP Says:

    Updated 01/16/17:

    http://www.ctcpjournal.com/article/S1744-3881(16)30055-X/abstract

    Complement Ther Clin Pract. 2016 Nov;25:1-7.

    The effects of a simulated laughter programme on mood, cortisol levels, and health-related quality of life among haemodialysis patients.

    OBJECTIVE: This study aimed to evaluate the effects of a simulated laughter programme on mood, cortisol levels, and health-related quality of life among haemodialysis patients.

    METHODS: Forty participants were randomly assigned to a laughter group (n = 20) or a control group (n = 20). Eleven participants completed the laughter programme after haemodialysis sessions and 18 control participants remained. The 4-week simulated laughter programme included weekly 60 min group sessions of simulated laughter, breathing, stretching exercises, and meditation, as well as daily 15 s individual laughter sessions administered via telephone. Mood, cortisol levels, and health-related quality of life were analysed using the rank analysis of covariance, and Wilcoxon’s signed rank test.

    RESULTS: The laughter group exhibited improvements in mood, symptoms, social interaction quality, and role limitations due to physical health.

    CONCLUSION: The simulated laughter programme may help improve mood and health-related quality of life among haemodialysis patients.

    Be well!

    JP

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