There seems to be nearly universal consensus that humor and laughter are good for humans and that good humor promotes good health. The phrase “laughter is the best medicine” has been tossed about as proven as the sun rising in the east each morning. But is it? And if laughter should be the best medicine, does that mean therapeutic humor would be, as well? Does the medicine help just the body, or could laughter—and perhaps humor—help the whole person in other ways? The fact is, there is very little conclusive evidence that definitively demonstrates that either laughter or humor can improve physical health.
Despite the existence of only limited research that supports the use of humor as a healing modality, many professions have an interest in its role in maintaining and promoting health and healing. Interestingly, it was Norman Cousins’s personal story, an anecdote in research terms, that launched today’s interest in humor and laughter as a viable therapy for healing (
Cousins, 1979). His intriguing experience with using laughter to overcome illness helped initiate today’s emerging interdisciplinary fields of psychoneuroimmunology and, somewhat less directly, positive psychology. There is a growing body of evidence that validates humor as an appropriate complementary therapy.
SCIENTIFIC BASIS
To put the evidence into perspective, it is important to understand some of the history of today’s interest in therapeutic humor and laughter. In 1963, psychiatric researcher Dr. William Fry published a small book, Sweet Madness: A Study of Humor, in which he organized his personal thoughts about humor’s relationship to mental health. This theoretical publication and its author were mostly confined to the academic community. Sixteen years later, in 1979, Saturday Review editor Norman Cousins (1915-1990) introduced to popular culture his award-winning book Anatomy of an Illness as Perceived by the Patient. In this work, Cousins recounts his personal journey forcing a debilitating and painful illness, ankylosing spondylitis, into remission by using a self-prescribed (with his physician’s approval) regimen of mirthful laughter and megadoses of vitamin C. His thought for trying this was: if negative thinking can make you ill (validated by research by that time), then could positive thinking make you well? Interestingly, Mr. Cousins’s book is credited with launching today’s growing interest in humor and laughter as complementary therapies in health care.
The International Society for Humor Studies (ISHS; www.hnu.edu/ishs) is a scholarly organization specifically dedicated to furthering the study and understanding of humor in a wide range of disciplines, including therapeutic humor-related areas. This community of scholars has helped aggregate and strengthen research efforts within this emerging field. As with all professional development, nurses are encouraged to examine original research works as they gain knowledge. This organization allows firsthand connection with the international community of scholars informing the conversations around therapeutic humor.
In general, it is agreed that humor is fundamentally a social phenomenon. However, because it involves cognitive processing, it is available to individuals in isolation as well. Some of the most compelling qualitative examples of humor’s value as a coping mechanism for individuals, as well as groups, are revealed by those who have experienced captivity.
Lipman’s (1991) compilation of interviews with Holocaust survivors serves as a powerful testimony to how valuable humor is to human survival. Lipman noted that “during the Holocaust, religion and humor served a like—though not identical—purpose” (
p. 11). He concluded that “the former [religion] oriented one’s thoughts to a better existence in the next world, the latter [humor] pointed to emotional salvation in this one” (
p. 11).
Within the realm of social interaction, researchers have worked to understand how humor is used to incorporate, embrace, and even celebrate the contradictions, incongruities, and ambiguities inherent in interpersonal relationships (
Mulkay, 1988). Within this sphere,
Martin (2007) cautions that more study is required before the full extent of the interpersonal, cognitive, mental health, coping, and other psychological impacts of humor can be fully understood.
One finding that appears to be building empirical support of late is that the mere
anticipation of a humorous or laughter event triggers at least as much positive impact on a variety of health indicators as does mirthful laughter. Additionally, there appears to be a secret weapon available to nurses that may, one day, undergird the connection between therapeutic humor and the effectiveness of nursing care:
get the patient to smile! And the more pleasant (mirthful) the emotion accompanying the smile, the greater the positive responses. Researchers do not yet fully understand everything about why and how this works, but even simply moving one’s facial muscles into a smiling position appears to improve stress- and mood-related indicators, similar to what happens in anticipation of a joyful event. In one revealing study, subjects who simply held a pencil in their mouths to stimulate the facial muscles used in smiling rated cartoons as funnier and reported greater increases in positive mood (compared to subjects who held the pen in a way that inhibited such muscle contractions) (
Strack, Martin, & Stepper, 1988).
Martin (2007) concludes that “of all the health benefits claimed for humor and laughter, the most consistent research support has been found for the hypothesized analgesic effects” (
p. 331). Further, he goes on to say “Although humor may not produce all the health benefits that have been claimed, at least it is not likely to be harmful and it can enhance people’s enjoyment if not the duration of their lives” (
p. 331).
As is understandably the case with studying a phenomenon as complex as humor, one can certainly find arguments against virtually every finding published.
Exhibit 8.1 provides some of the significant findings related to therapeutic humor, along with at least one citation related to that finding that is representative of the body of research examining and exploring the respective conclusions. The citations included were selected to include one or more of the key scholars involved in this area of study.
