The Bible tells us “A merry heart doeth good like a medicine; but a broken spirit drieth the bones.” Of course this picture of our laughing grandson makes us want to believe that laughter is good for people. Modern writers who have explored the idea include: Patch Adams Regina Barecca Rod Martin Mary Kay Morrison Paul McGhee Norman Cousins William Fry Vera Robinson Patty Wooten 6
9 Rod Martin, and his colleagues in Canada have developed a questionnaire to measure two styles of humor. One of these is potentially beneficial. It is affiliative and self-enhancing humor. The other is potentially detrimental. It is aggressive and self-defeating humor. Anyone doing research with humor in relation to health needs to be aware of these differences.
10 Martin also writes about a state-and- trait cheerfulness inventory. This inventory developed by Willibald Ruch, Gabriele Köhler, and Christoph van Thriel is called the “State- Trait Cheerfulness Inventory.” It defines sense of humor as an emotional temperament (i.e., the tendency to be habitually cheerful and playful), which seems consistent with the way humor is most often conceptualized in the humor and health literature. Martin nevertheless warns that research on humor and health is “often simplistic, exaggerated, and unsubstantiated.” He is especially critical of methodological weaknesses in the research on humor and the immune system.
12 A Large Scale Sense of Humor Questionnaire in Norway Sven Svebak, Rod Martin, and Jostein Holmen developed the “Sense of Humor Questionnaire” and administered it to the entire adult population of a county in Norway (65,000 participants). Correlations were determined between a person’s sense of humor and illness symptoms (nausea, diarrhea, pounding heart, muscular-skeletal pain, blood pressure, overall health satisfaction, and body mass index [a measure of obesity]).
13 “After controlling for age, no meaningful relationships were found between sense of humor and either illness symptoms or objective health indicators, although the study did find a weak relationship between sense of humor and satisfaction with health (r =.12).” “These results suggest that, although high humor individuals do not seem to have objectively better health, they are somewhat more subjectively satisfied with their health.” Martin concluded that “despite reports in the popular media and claims made by adherents of the ‘humor and health’ movement, the research findings on health benefits of humor and laughter are not as strong, consistent, or unambiguous as is commonly believed.”
15 Paul McGhee, in his The Laughter Remedy: Health, Healing, and the Amuse System, takes these kinds of criticism into his book but nevertheless advises: “Become more playful; surround yourself with humor you enjoy. Begin telling jokes and funny stories. And laugh at yourself.”
18 John Morreall writes that hearty laughter: increases blood circulation, ventilates the lungs increases oxygen intake, reduces the water vapor and carbon dioxide in the lungs And decreases the risk of pulmonary infection. But Rod Martin cautions that hearty laughter may have deleterious effects as well, because while extroverts tend to laugh more, they also are likely to drink alcohol, to smoke cigarettes, and to be obese.
Other Research Findings John Morreal reports that humorous laughter lowers the level of stress hormones (epinephrine, cortisol, dopac, and growth hormone). In the brain, catecholamines are secreted, which may increase alertness, reduce inflammation, and trigger the release of endorphins, the brain’s natural opiates. This may account for the reduction of pain often reported by researchers including Norman Cousins and Ovra Nevo, who does research in Israel. 20
22 If Humor Is So Good For Us, Where Can We Find It? One place is at Alcoholics Anonymous meetings where humor is often used to transcend the moment and attain a broader perspective. One member told how even when she was drunk or hung over, she tried to be what society expected her to be. She volunteered to help with her son’s Cub Scout troop on a day they were making moccasins. Of course she got a laugh when she reported, “I remember sewing it, honest-to-God I can still feel it, onto my finger.”
Two Other OMG AA Stories A man stood up and told about backing his car out of his driveway and accidentally running over his wife. Everybody laughed—even his wife who was sitting in the front row. She limped a little, but she nevertheless laughed. The 2007 winner of the Newbery Award was The Higher Power of Lucky by Susan Patron. It is both controversial and humorous because of what the ten-year-old protagonist learns as she listens in on the AA meetings when members tell their stories about “hitting rock bottom.” She eavesdrops while she is supposed to be sweeping up the litter that accumulates from the Gambler’s Anonymous, the Over-Eater’s Anonymous, and the AA meetings held at the Community Center in her small California desert town. 24
Clowns have a long history dating from the 15 th and 16 th centuries and the Italian commedia dell’arte. Shakespearean HarlequinModern Scary Clown 25
All Cultures Have Clowns It takes nothing more than a prop of some kind to turn ordinary people into clowns. More formal clowns include circus performers and character clowns. Charlie Chaplin was the first world-famous clown because he did not rely on language. Sports mascots are also mimes working in arenas, wearing over-sized costumes, doing acrobatics, and using huge props. 26
Clowns Loved by Our Grandparents Emmett Kelly was so skilled at pantomiming the role of Weary Willie that Ringling Brothers allowed him to remain in the circus arena for the whole performance. His most famous act was sweeping a circle of light into smaller and smaller circles and then chasing it under a rug or into a trash can. Harpo Marx was mute and communicated by honks, whistles, and pantomime. He wore a fright wig and an overcoat with enormous inside pockets from which he pulled out ice cream cones, cups of coffee, and once in a while, a blowtorch. 27
Canadian Association of Therapeutic Clowns: http://www.therapeuticclowns.ca/index.html 28
Professional Clowns Have a Code of Conduct While in character, they should never be seen doing “normal” things like shopping or eating. They should not appear in public wearing only part of their costume. When at sports events or community celebrations, they should be willing to fill in dead time, provide photo opportunities, give young children someone to relate to, and remember that their job is bringing happiness. 30
Clowns Protested When...... Bob Dole referred to President Clinton as “Bozo.” Larry Harmon, the creator of Bozo, said he didn’t like his character’s name being used as an insult.... One Halloween, a Paulsboro, New Jersey police officer dressed as a clown managed to arrest 12 individuals, mostly wanted for routine traffic offenses. He bragged that the costume got him inside homes where if he had come in his uniform and asked for someone by name, he would have most likely been told, “He isn’t here.” 31
There is no end to the types of clowns now being developed. These “live” clowns at Disney World are plants. The newest clowns are connected to hospitals. In more than 100 U. S. hospitals, clowns either roam the halls pushing humor carts, giving out smiley faces, joke books, and clown dolls, or managing full scale “humor rooms.” 32
The Humor in Hospitals is usually provided by nurses rather than doctors. This might be because they work more closely with patients than do doctors so that they get to know them better over time. Or it might be because nurses are caught in the middle of a hierarchy and gain power by joking and clowning around with patients, often at the expense of the doctors. 33
2012-2013 Teddy Bear Toss for 12,947 Kids at Penn State Hershey’s Children’s Hospital: http://www.youtube.com/watch?v=P4ENgOxVZm0 34
36 NORMAN COUSINS Did More Than Any Other Writer to Promote the Idea of Humor as a Healer In 1979, Cousins, a skilled writer and editor of the Saturday Review of Literature, published his best-selling Anatomy of an Illness. He had developed a serious collagen disease that affected the connective tissue of his spine and joints. The disease was life-threatening, his pain was intense, and the doctors gave him little hope for a full recovery. He was frustrated by the hospital routines and his slow progress, so he checked himself out of the hospital and into a nearby hotel.
37 Because of his celebrity status, the doctors continued to see him and to deliver his medication, while he used what he called “humor-intervention therapy.” He read humorous books, and watched funny movies, and tapes of TV’s Candid Camera. He found that the more he laughed, the longer his body was without pain. He persuasively made the case that if it is possible to have a psychosomatic illness, then it is also possible to have a psychosomatic wellness.
38 In 1971, Dr. WILLIAM FRY Began Empirical Studies on the Effects of Humor and Laughter. Dr. Fry, at Stanford University’s Medical School, was among the first to go beyond anecdotal stories about the benefits of humor. He conducted testing and measuring that could be replicated by others. He found that the chemicals, i.e. the hormones in a person’s tears are different when a person is laughing as compared to crying. He also showed that people’s bodies are tense when listening to a joke, but relaxed at the end. He compared the body’s production of dopamine when laughing to a runner’s high, which is why he calls laughter “Internal Jogging.”
39 William Fry says that hardy laughter is a kind of internal jogging Here is an exercise that you might want to consider
VERA ROBINSON, a Nurse Educator, published an influential book Humor and the Health Professions in 1977. PATTY WOOTEN, Past President of the American Association for Therapeutic Humor, dresses as a clown named Nancy Nurse and continues to teach nurses how to be humorous caregivers. PATCH ADAMS is a real health care worker and clown. His story was told in the 1999 film starring Robin Williams. He agreed to the film in hopes of earning money to support his dream of building a “free” hospital, but in general the film was too exaggerated to be taken seriously. 40
Alleen and Don Nilsen: American Association of Therapeutic Humor Doug Fletcher Lifetime Achievement Award Winners: http://www.aath.org/lifetime-awards http://www.aath.org/past-award-winners 41
42 John Morreall, in his writing explains that the relief theory has two forms. Humor can be a relief from pre-existing nervous energy as when rambunctious kids are forced to sit quietly for a long time. Once the pressure is off, they often resort to horseplay, buffoonery, and laughter. The second kind is the “set-up” for a joke or cartoon that may require concentration, attention to detail, and emotional engagement. The punch line is a release of either type of pent-up energy. For an example he gives: –I had written to Aunt Maud –Who was on a trip abroad –Then I heard she’d died of cramp, –Just too late to save the stamp.
43 We Are Hopeful about the Wish-Fulfilling Belief that Humor Is Good for People, but We Also Want to Offer Some Warnings We decided this when a neighbor’s mother died from cancer. After the funeral, she told us that she got her mother “funny videos and told her jokes, but she died anyway.” Here are some of the things we wished we had talked with our neighbor about before she put so much faith in laughter as a healer. First: People have individualized senses of humor, and what makes one person laugh might annoy or insult someone else. Also…
44 1.Even if it is true that people who have a good sense of humor live longer, the sense of humor might not be the reason. The relationship could be circular in that people who are healthy, also tend to be happy and cheerful. 2.Also, it could be simply that pleasant patients with a sense of humor receive better health care than do the grumpy and hostile patients. 3.If laughter enhances the immune system, then what about implant patients? A stronger immune system could cause them to reject their implants.
45 5. Although a hearty laugh does pump adrenalin and other “good” chemicals into people’s blood streams, there are other things that have the same effect. In hospitals, visits from pets, from friends, and members of the clergy also have a positive effect on health and healing. In conclusion, we will go along with the scholar who compared using humor to changing a baby’s diaper. It doesn’t permanently solve any problems, but it makes things more acceptable for a while.