Laughter packs a healing punch
By Robin Mohr
The medical mechanics
Not all laughs are equal. Laughter exercises, like those used in laughter yoga, utilize hearty laughs that are sustained longer than the fleeting guffaws elicited by a joke or funny movie.
The laughter in each exercise lasts about 45 seconds and is followed by deep breathing and stretching. Even the breathing is specific.
The techniques rely on diaphragmatic or "belly" breathing designed to purge the body of carbon dioxide, oxygenate the blood and promote relaxation.
The exercises also provide an internal massage of sorts, according to proponents. With each deep breath, the bottom of the diaphragm massages the liver, stomach and other organs.
Want to spend the day laughing? A hotline is available 10 times a day: 6 a.m. (EST), hourly from 9 a.m. to 1 p.m., and at 3 p.m., 4 p.m., 8 p.m. and 9 p.m.
Most sessions are 20 minutes and led by certified laughter yoga leaders.
Call 712-432-3900 and enter 6071292.
The only cost is the long-distance fee. It's like dialing up your own private laugh track.
Laughter clubs are turning out be as contagious as laughter itself. The laughter yoga movement boasts of 6,000 clubs in 60 countries, while the World Laughter Tour Inc., has more than 200 registered clubs in eight countries.
The sites also have information about training programs for laughter leaders and how to start a laughter club.
“Ho, ho, ha, ha, ha.” Laughter yoga leader Linda Batchelor-Ballew and her students, clapping to each ho and ha, are just warming up. Soon, the Brit is teaching a silly routine that includes forced laughter. The group “glug, glug, glugs,” pretending to drink a milk shake, finishing off with a hearty laugh. They also shake hands, throw back their heads and cackle. Then they laugh like lions, tongues hanging out: “Roar-ha-ha-ha-ha!”
“My first thought was, ‘This is so corny,’” says Ivory Steward of Indianapolis, a first-time student in Batchelor-Ballew’s class. “Next thing you know, you’re laughing.”
Part fun house and part acting class, with stretches and breathing exercises mixed in, a laughter yoga session offers participants more than an hour of fun and games. Proponents say it also improves circulation, relaxes muscles and reduces stress. “Laughing releases the body’s natural pain relievers,” says Jeffrey Briar, director of The Laughter Yoga Institute in Laguna Beach, Calif., where laughter sessions are held on the beach seven days a week.
But don’t take laughter too lightly. A growing body of research shows there may be real health benefits to adding a few chuckles to your workout routine. Separate studies at the University of Maryland School of Medicine, Loma Linda University in California and the University of Tsukuba in Japan, for instance, have shown that laughter has a positive effect on blood vessels, stress hormones and blood sugar. Simply anticipating cheerful laughter may be good for you, according to some research. As the science grows, those in the medical community are also taking notice, incorporating laughter classes into programs for patients.
In November, for the first time, Ohio State University’s James Cancer Hospital scheduled a laughter class. Conducted by registered nurse Susan Stewart, “Loosen Up with Laughter” was a hit, according to program specialist Anne Harding. The session drew about 20 participants who ranged in age from their late 20s to early 70s. “Everything we do is very gentle,” says Stewart, a certified laughter leader with the World Laughter Tour Inc., a group that trains laughter leaders. “You’ve heard no pain, no gain? Our version is no pain, no pain.”
The exercises, which can be done sitting down or standing up, help people recapture the zest for life enjoyed by children, Stewart says. “As we grow up, we sometimes grim up. We just forget the simple pleasures.”
Developed in India in the mid-’90s by Dr. Madan Kataria, laughter yoga doesn’t involve any pretzel-like poses. Nor do instructors have to be stand-up comedians. Instead of using jokes or comedy to trigger laughter, the methods combine mirthful activities with simulated laughter. Eventually, those forced ho-hos and ha-has turn into the real thing. The overall effect, adds Briar, is better than a good joke or a funny comedy routine. “It’s more like your heart opens up and you feel wonderful,” he says.
As the techniques catch on, laughter clubs are becoming as popular as, er, knock-knock jokes. Manhattan, N.Y., chiropractor Alex Eingorn has been using laughter yoga to help patients and relieve his own stress since becoming a certified laughter yoga leader a few years ago. Eingorn says he stumbled into the power of laughter when struggling to treat a patient with a severe back spasm. “It struck me he was depressed, so I told him a joke,” he says. The patient laughed and his muscles loosened, allowing Eingorn to work on him.
A first-responder following the Sept. 11 attacks, Eingorn says the tragedy caused an emotional breakdown.
He credits laughter yoga with his recovery: "It's amazing. It's the only therapy I do for myself."
Fast-forward six years to 2002. Eingorn’s former patient calls out of the blue. The man, a French filmmaker, was shooting a documentary about Kataria, who was going to be in New York, and encouraged the chiropractor to go see the Indian doctor. “He told me, ‘When you made me laugh, you saved my life,’” says Eingorn, who took Kataria’s training and now runs a laughter club Monday nights from his office. “People come mostly to address stress.”
A different sort of laughter class is held at the Montefiore-Einstein Cancer Center in the Bronx. Instead of laughter exercises like those used in laughter yoga, the hospital’s monthly “Strength Through Laughter” support program relies on jokes to lighten the mood. Gloria Nelson, senior oncology social worker, developed the program and gets a crowd of about 40 patients each month. “Every time they laugh, they feel like they’re putting cancer through a meat grinder,” Nelson says. “It’s a cathartic release.”
This fall, a group of doctors at St. Vincent’s Joshua Max Simon Primary Care Center in Indianapolis got in on the act. They attended a laughter workshop as part of a spiritual retreat that examined the connection between joy and medicine.
“Sometimes the serious nature of the work we do has the potential to suck the joy out of medicine,” says Dr. Curt Ward, associate program director for the family medicine residency program, who arranged for the residents to participate. “Laughter is a way to connect to that joy,” he adds. “We all benefit from a good belly laugh.”
Dr. Christine Kelly, a second-year resident in St. Vincent’s family medicine program, agrees. She says laughter revs up the body in a positive way and helps reduce stress. She also says positive, light-hearted laughter and humor bring people together. “If you can joke around with your patients and laugh with them, there’s a kind of bond there,” says Kelly. “It helps build trust.”
While the majority of laughter research has involved small numbers of volunteers, the science is promising. Two studies by Dr. Michael Miller, director for the Center of Preventive Cardiology at the University of Maryland Medical Center, show that laughter is linked to the healthy function of blood vessels. In 2005, Miller used blood-pressure cuffs and an ultrasound device to measure blood vessel dilation of 20 non-smoking volunteers who watched segments of “Saving Private Ryan” or the comedy “Kingpin.” In 2008, 10 volunteers were shown videos designed to induce laughter. In both studies, laughter had a positive cardiovascular effect.
"If you want to maintain a healthy heart, incorporate 15 minutes of laughter daily,"
“Laughter’s good medicine,” Miller says. “The increase in vessel diameter signifies not only improved blood flow but also the release of chemicals that reduce blood clot formation and hardening of arteries.”
His studies did not determine the source of laughter’s benefits, whether it was from the movement of diaphragm muscles or the release of chemicals, such as endorphins, triggered by laughter. That’s what he would like to examine next — the biochemical basis for the effects.
In general, money for laughter research is scarce. It turns out laughter and humor scientists are the Rodney Dangerfields of the research community. They get no respect — which in the research world means no money.
“They’re hard and expensive to run, and we’re all running it on a shoestring,” says Mary Bennett, director of the School of Nursing at Western Kentucky University in Bowling Green, Ky., who’s studied laughter’s effect on immune function and written a review on laughter research.
Miller’s one of the lucky ones. His research has been funded by the National Institutes of Health, the American Heart Association and a pending grant from the Veterans Administration.
The lack of funding for more research hasn’t curbed the enthusiasm for laughter clubs, however. The laughter yoga movement now has some 6,000 clubs in 60 countries. Most are free. There’s even a spin-off.
In 1998, psychologist Steve Wilson started The World Laughter Tour Inc. after more than 20 years of studying the link between health and humor. His organization trains laughter leaders and promotes laughter clubs.
Wilson has certified some 5,000 laughter leaders in his methods, which borrow from laughter yoga but also promote “Good Hearted Living,” his guide to incorporating more laughter, compliments, gratitude, kindness, forgiveness — and chocolate — into your life. “Laughter is a very natural phenomenon,” he says. “It’s built into the central nervous system.”
Proponents of laughter exercises see the benefits first-hand. “I know it helps me,” says Barbara Hee, who runs the Philly Phun Laughter Club in Philadelphia.
Hee — yes, that’s her real name — has a rare autoimmune disease: pemphigus, which causes painful blisters to form on the skin, in the mouth and in other mucus membranes. Hee says she developed the condition while going through a stressful period at her former sales job. Around the same time, she read an article about Wilson’s laughter classes and joined the ranks of certified laughter leaders in 2003.
Today, her medical condition is under control, and she’s turned her certification as a laughter leader into a business, providing laughter workshops to groups around Philadelphia. One of her regular classes involves working with Alzheimer’s patients. “Just getting a smile or a flicker in their eyes is so worth it to me,” says Hee, whose mother suffered from Alzheimer’s.
It’s also now possible to become a certified laughter leader while earning college credit. Columbus State Community College in Ohio added Therapeutic Laughter to its curriculum last year. The course is targeted at those who will work with substance abusers, or the mentally ill or disabled, says Lenore Schneiderman, chairwoman of the college’s Human Services Department. “It’s therapeutic,” she says. “It works wonderfully, especially people with Alzheimer’s. There’s nothing to remember — you laugh in the moment.”
Dolores Hayden wasn’t expecting the class to help her rheumatoid arthritis but, she says, it did. She took the course as part of becoming a substance abuse counselor. “After the first class, my pain started to decrease,” Hayden says. “I also had more energy. It’s just been amazing all around.”
Now Hayden does laughter exercises with her grandchildren. “They think I’m crazy,” she says, enjoying a hearty laugh.