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Originally appeared in The Globe and Mail, Saturday, May 24, 2003 Focus F9, Health
Also available in PDF Format
Laughter: the best medicine?
Members of the world's 1500 laughing clubs believe we can guffaw our way to good health, reports STEPHEN STRAUSS. Skeptics say the joke may be on them.
On a sunny Sunday in May, the dozen or so members of the Skull and Funny Bones Laughter Club have arrived at Catherine Lawrence's bright and upscale Toronto home to celebrate a holiday most of them never knew existed: World Laughter Day.
Ms. Lawrence, who is also bright and upscale - not to mention thin and blond and apparently endlessly laugh-filled - has started the meeting by explaining that Madan Kataria, the Indian physician who is the originator of laughter clubs and World Laughter Day, is marking the event by leading a massive laugh-fest of 7,000 - 8,000 people in Copenhagen.
This gets Robin Perry, a running shoe manufacturer, convulsively giggling.
"Robin, you are getting ahead of yourself," Ms. Lawrence says, her own giggles bracketing every word. "There is no laughing before we start the laughter club."
Which leads to general guffawing, because everyone knows the premise of the approximately 1,500 laughter clubs worldwide is to get together - preferably with a "Certified Laughter Leader" like Ms. Lawrence - and chuckle in pursuit of good health.
The point of it all, as Dr. Kataria argued in his book, Laugh For No Reason, is that "modern man has forgotten to laugh." To illustrate his argument, he refers to an anonymous study alleging that in the 1950s people laughed an average of 18 minutes a day. Today we spend only around six minutes. Other research supposedly shows that children laugh 300 to 400 times a day and adults only 15.
Dr. Kataria started the first laughing club in 1955, after reading American writer Norman Cousin's account of how Marx Brothers films and extensive belly laughing helped to bring him back from a painful near-total paralysis. The Indian physician and four other went to a public park in the town of Mumbai and started laughing.
Initially, the laughter was triggered by jokes, but quickly all the good ones were used up. This led to Dr. Kataria's first great apercu: "It is not at all difficult to laugh without jokes if laughter is practiced in a group"
Dr. Kataria officially suggested that clubs - which are offered free - meet outdoors early in the morning for 15 or 20 minutes, and have at least 25 to 30 members.
But the practice has become more relaxed in North America. "Our first principle is to do whatever you are comfortable with," says Steve Wilson, an Ohio psychologist and self-proclaimed "joyologist" who heads up laughter leader training in North America.
Ms. Lawrence starts her Toronto session with some light stretching, and then moves on to the main event: The women gather in a circle and Ms. Lawrence introduced the various laughs. The trademark of the clubs is a "ho-ho-ha-ha-ha" laugh, punctuated by hand claps to get the blood circulating, repeated at regular intervals.
In between come what Ms. Lawrence calls the "cocktail laugh" (the kind of snickering you emit over drinks), the lion laugh (tongue stuck out, hands posed like lion paws, and a roar), the argument laugh ("your body language is angry but you look happy") and the "vowel movement."
The silent laugh, strongly recommended in the Kataria book, is left out because "it is a bit uncomfortable," Ms. Lawrence says. Nor does this session include the recently invented "miming, talking on a cell phone" laugh, the ice-cube-down-the-back laugh, the airline safety instruction laugh, the walk barefoot on hot sand to get to the ocean laugh or many other of the other 70-odd laughs that leaders learn during their two-day training course.
The women end up tripping over one another laughing, and laughing at their laughing, until the formal session concludes with hand holding and another round of ho-ho-ho-ha-ha-ha. Afterward, the testimonials flood in.
"That made me really happy," builder Barbara Hackett announces.
"I think laughter is a bit like a shield - if you can smile at things people can't hurt you," architect Deborah Scott offers.
And as the women head for bagels and orange juice, that seems to be the final word on laughter.
But outside the club, not everyone is convinced.
Rod Martin, a University of Western Ontario psychologist, is skeptical about what sounds, literally, like a feel-good activity. "But I try not to be a laugh curmudgeon," he laughs over the telephone.
In a review in Current Directions in Psychological Science, Prof. Marin examined 45 published studies of how laughter or humor relates to health - and found confusion.
"It simply hasn't been demonstrated that laughter is good for your health," he says. "You can get lots of small-scale studies, often done quick and dirty, that often don't have money to do control groups. Basically, there is nobody who is looking at this in a systematic way." Take the activation of the immune system. Yes, studies have shown some changes upon exposure to comedy, but the changes are a jumble of findings. Sometimes humor ups your immune responses. Other times it suppresses it.
Then there is pain tolerance. While most studies replicate Mr. Cousin's self-report that laughter dulls pain, "we really don't know the mechanism of that," Prof. Martin says. "It could just be distraction, like if there is something funny you are laughing at, it keeps you from paying enough attention to your pain."
Blood pressure is even worse, in the short term; at least, the guffaw actually seems to raise blood pressure, although there may be a gender aspect to the laugh and pumping heart.
Tests of women with a good sense of humor say they have lower blood pressure, but blood pressure in jolly men is actually high. One possible explanation is the women's humor is more self-critical - but that is just a thesis.
The true test may be life expectancy. If laughter really is the best medicine, comedians and humor writers should live longer than serious entertainers and authors. In fact, Prof. Martin says they don't.
And then there is the life-cycle study of 1,178 12-year-olds that began in 1921, which yielded results that will surprise laughing club members. People who were judged to have the best sense of humor and were the most optimistic actually had higher mortality rates over the decades.
Why? Laughter may lead to self-delusion. Cheerful individuals may be less concerned about health risks than less cheerful individuals are, Prof. Martin suggests. As a result they may not take good care of themselves.
"I am not arguing that humor and laughter are not good for our health," he says. "I am just saying the evidence for it is generally weak and inconclusive. There is no proof." How does the laughing world respond?
Lee Berk of the University of California at Irvine, whose research was in part funded by Norman Cousins, says he has found definite relationships between lowered stress hormone levels and laughter. Yes, there is noise in the data, but that is because laughter isn't equally effective for everyone all the time.
"I think that chemotherapy for cancer patients doesn't work for all of them," he says. "You get my point?"
And to really work, laughter has to be what Dr. Berk has dubbed "mirthful laughter."
"I think that laughter which is demeaning and derogatory. I think that may go in the other direction, that it is in some sense pathological." Catherine Lawrence hears Prof. Martin's doubts, but also feels the persuasive power of her own laughter. "I passionately believe in my heart of hearts that more laughter plays a huge role in our health, whether it is smoothing over situations or coping with things…I believe it."
Stephen Strauss writes of science for The Globe and Mail.
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