Psychoneuroimmunology and the Relationship to Health and Humor

"Don't take life too seriously, you'll never get out alive," is a quote which many people have heard, especially when someone is stressing out about something minor. So is laughter really the best medicine? Well those followers of the belief in psychoneuroimmunology would say that there is a strong mind-body connection, making humor, a cognitive and emotional process, important to everyone's physical health .

Psychoneuroimmunology, also referred to as PNI, is the field of research devoted to the interactions between the brain, nervous system, and immune system and their affect on one another (Wikipedia, 2006). One example of the experiments used to determine the efficiency of PNI is the use of placebos but another field being looked up more closely is the area of health and humor.

Stress can be very debilitating when the person suffering it does not know how to cope with the situation accordingly. Some diseases which develop at least in part due to stress overload include, hypertension, peptic ulcers, insomnia, ulcerative colitis, and coronary heart disease (Wooten, 1991). There is a group of researchers who believe that adding some laughter and positive thought into your everyday life can decrease your chances of developing those diseases.

Humor is comprised of more than just laughter, in fact it contains three elements: wit, mirth, and laughter. Wit is the cognitive, or thought process one goes through to fully understand the humor in something. The emotional experience, referred to as mirth, is just a feel good experience which is usually heightened when the humor is shared within a social group of people. Then there is the physiological process of laughter, which tends to be contagious but it doesn't necessarily have to be present to define something as humorous (Kemp & Rosellini, 2004). Although all three elements don't have to be there for someone to define something as humorous, the first two, wit and mirth, are almost always present even though most people would assume that the physical act of laughter was most important.

Laughter helps the body in two main ways, physically and psychologically. The natural painkiller of the body is called an endorphin and it is believed that they are increasingly released when one partakes in the act of laughter (Clarke, 2002). Laughter helps the body out in so many other ways including how it lowers the heart rate which in turn lowers blood pressure and it also help decrease stress (Clarke, 2002). The stress response has protective qualities such as initiating the fight/flight response but when stress isn't handled properly and someone doesn't cope in a healthy way, that stress will eventually lead to immune system depression (Lusk, 2005). Partaking in the activity of laughter will also influence the levels of serotonin in the body which can help with sleep and depression problems (rxlaughter, 2000). Laughter also reduces and to a certain extent protects the body against heart disease. It will also increase the activity of the white blood cells whose job it is to fight disease, attack tumor cells, and in general boost the immune system's ability (Clarke, 2002). Another physical benefit that arises from laughter is that it helps increase healing time of bodily injuries by increasing the oxygen in the blood and it also increases Gamma interferon, T cells, and B cells, all which help fight off any foreign bodies that are detected in the body (Kemp & Rosellini, 2004).

The University of Maryland School of Medicine in Baltimore performed a study to test the vasodilatation, or the ability of the blood vessels within the body to expand (Stein, 2005). In this study twenty men and women watched both a stressful violent film clip and then one of a much more humorous comedy clip and then had their vasodilatation tested both before and after each film using a blood pressure cuff. It was determined that in 14 participants out of 20 blood flow was significantly reduced after watching the stressful film and 19 out of 20 participants showed signs of significant increase in blood flow (Stein, 2005). This goes to show that laughter does physically help the body by increasing blood flow and circulation.

The serotonin in the body is a naturally occurring chemical released into the blood stream which helps to regulate someone's mood and it's been shown that more serotonin is released when someone is laughing and in a good mood in general (Wikipedia, 2006). When levels of serotonin drop too low one may experience depression or other mood problems and often see a doctor who will prescribe a medication known as an Selective Serotonin Reuptake Inhibitor, referred to as an SSRI. A lack of serotonin is usually present in anxiety disorders because serotonin is needed to regulate stress hormones which then in turn take away from the serotonin that can be used as a mood stabilizer (wikipedia, 2006).

There are many SSRI drugs prescribed by doctors to help increase the levels of serotonin available for use in the body such as: Prozac, Seraphim, Zoloft, Paxil, Luvox, Celexa, and Lexapro (Tracy, 2006). Why should you take psychotropic medications which alter your bodies natural chemicals when you could get a natural "high" through laughter? SSRI's can also be damaging to someone taking them if they chose to abuse them. When someone is depressed and find out that their new medication makes them feel better, they may assume taking more will make them feel even better but instead it may lead to serotonin syndrome. This will have negative effects on ones cognitive senses as well as cause problems with autonomic and somatic effects (Wikipedia, 2006). Not only is laughter healthy but it won't cost you anything except a few minutes of your time each day to enjoy life.

Laughter can also psychologically help people by enhancing ones ability to connect with others. Having a social network can be vital to learning how to cope in a healthy way but when creating a social network, people want to be with happy people (Kemp & Rosellini, 2004). Sure there are people in the world who want to help people in need but having a sense of humor is beneficial when trying to cope with life's problems. Laughter also helps to replace distressful emotions with a more pleasurable feeling, if you're laughing, you aren't going to be thinking about the negative emotions you may have felt minutes before. Without humor in your every day life your thought process tends to stagnate, especially when you're only focusing on the negatives, which in turn leads to distress and lessens your energy (Kemp & Rosellini, 2004). Laughter also helps to cope with negative or embarrassing situations primarily by giving someone the power to transcend above the situation they're facing (Singer, 2000).

There are people who strongly believe in psychoneuroimmunology and make a career out of teaching people how to laugh to get themselves out of stressful situations. One of these professionals is Loretta LaRoche who is a stress humorist that gives presentations all over the United States to women who are facing too much stress in their lives and don't know how to cope with it to continue living a healthy life. LaRoche has been on four PBS specials and written the book Relax - You May Only Have a Few Minutes Left. At a presentation she gave at the Boston's World Trade Center one of the first things LaRoche tells the women to do when they're stressed out is to exaggerate the problem to the extreme, act up about it so much that eventually you'll begin to laugh at it (Singer, 2000).

Loretta LaRoche gives several techniques which are beneficial to those looking for a good laugh. The first one is known as shout it out! LaRoche says that shouting something silly such as "Whoopee!" during an anxious moment would release a lot of stress but she doesn't expect people to be willing to do that so she suggests just imagining yourself screaming such a thing will be enough to make you giggle (Singer, 2000). Just imagine you're waiting in a long line at the grocery store and decide to yell out "whoopee!" the looks you would receive from everyone around you would most likely be more than enough to let a giggle out.

The next technique she discusses has been given the name get some distance with a twist. She thinks if you can't mentally get away from what is stressing you, you should do it physically. The example she uses is if you're computer breaks say, "Oh my God! The computer's down?" and then do a twirl. The fact that they are both so incongruous to each other will cause you to laugh at yourself and help release some of the tension you're experiencing (Singer, 2000). Doing something silly will you make you laugh, especially if you're alone in the room not worrying about what anyone else may think about your reaction or coping strategy.

One of the most humorous techniques she recommends is to be a drama queen. She believes it is the most effective way to exaggerate your reaction to a stressful situation and in turn release a good laugh or two. Singer (2000) exemplified in her article, when someone leaves dishes on the counter, one reaction that would help relieve stress would be to stand there fling your arms and say, "Look! Oh my God! Again! Dishes on the counter! Nobody cares! I'll be dead soon. They'll find me jammed in the dishwasher." It would be hard to focus on the negatives in that situation when you're hamming it up so much, laughter is inevitable (Singer, 2000).

Martin and Lefcourt designed the Coping Humor Scale which is a seven item questionnaire in the Likert format that is used to assess the use of humor in ones methods of coping with stress. It has been shown that those who score high on the Coping Humor Scale score low on number of mood disturbances and report low levels on stress (Celso, 2003). This goes to show that those who use humor in their methods of coping with stress in turn experience lower levels of stress in their lives, showing the usefulness of humor.

Since it's been shown that humor does benefit people, not only physically but mentally as well, it is a good idea to find ways to heighten your own sense of humor. One way suggested by Clarke (2002) is to create a humor library which is readily available for use. She defines a humor library as a collection of funny videos, performances of comedians, and to identify a group of people who are fun and witty to keep things lively in social settings. Instead of going to the doctor when you're stressed out and having them give you pills to mask your feelings and make you believe you're feeling better, it's recommended that you just give yourself a dose of laughter, it's not only natural and safe, it's also free (Clarke, 2002).

Another tip on increasing your sense of humor is to make a point of having every family member share something funny that happened each day at the dinner table (Stritof, 2006). This helps in several ways, it helps the family members feel closer to one another which in turn helps to create a social support network and it also makes each individual more conscious about the humorous events each day. It takes some work to pay attention to the little things every day that if you stop and think them through are humorous. In time you won't have to consciously think about finding something to laugh at everyday, with practice it is something you'll do automatically.

There is an organization based in Durham, NC known as Carolina Health and Humor Association who's primary goal is to bring happiness and joy to people in medical institutions in hopes of speeding up their recovery. This group was founded in 1986 by Ruth Hamilton ,MA Ed. as a "non-profit educational service organization dedicated to promoting a healthy lifestyle thru humor and entertainment in health care, business, and the community," (Carolina Health, 2006). Something that they are most well known for is their laugh mobile which is a portable display that contains props, books and videos to bring laughter to those in medical institutions around the United States (Carolina Health, 2006).

Although laughter can do wonders for one's soul, especially when it comes to bodily healing and coping with stressful situations, professionals needs to take certain things into consideration first. McGhee (2006) has established a guideline to follow when considering using humor in mental health procedures, some of points include: asking yourself if patients or colleagues will consider it unprofessional or will patients misinterpret humor as an indifference to their condition? Some other suggestions he gives are to remember to be sensitive to whether the patient is responding negatively or positively to humor, avoid joking with other staff in the presence of patients who are about to undergo a test, treatment, or surgery, and to remember that some patients may have religious convictions which stress reverence for the ill (McGhee, 2006).

There are certain situations in which trying to create a humorous setting is just inappropriate and will probably make the patient more uncomfortable and in turn cause more stress. These situations include: during an acute crisis, when the patient just needs to cry in order to feel better, when the patient needs quiet time to gather their thoughts and feelings, if there is a patient in the adjacent bed who may be very ill or dying, when the patient is trying to come to grips with an emotional crisis, or when the patient is trying to communicate something important to you (McGhee, 2006).

Humor is very beneficial to someone's health, both physically and psychologically as long as it is being used appropriately. It increases many bodily reactions that help fight off disease and help someone replace negative and stressful cognitions with something more lighthearted. Many professionals have added humor into their therapy sessions, some have made a living out of leading humor conferences but it is still important to take everything into consideration before a therapist or other professional starts making jokes at a patient to be sure it won't be taken in an inappropriate way.

References

Carolina Health and Humor Association (2006). Retrieved April 2006, from http://www.rtpnet.org.

Celso, B.G., Ebener, D.J., Burkhead, E.J. (2003). Humor coping, health status, and life satisfaction among older adults residing in assisted living facilities. Aging and Mental Health, 7(6), 438-445.

Clarke, S. (2002). The best medicine. Essence, 32(11), 76.

Humor (2006). Retrieved April 2006, from http://www.wikipedia.com

Humor: A Mind Body Connection (2000). Retrieved March 2006, from http://www.rxlaughter.org/press18.htm.

Kemp, C. & Rosellini, J. (2004). Humor and Laughter: Health Benefits and Online Sources. Retrieved March 2006, from http://www.helpguide.org/life/humor_laughter_health.htm.

Lusk, B. (2005). The stress response, psychoneuroimmunology, and stress among 100 patients. Dimensions of Critical Care Nursing, 24, 25-31.

McGhee, P. PhD. (2006). Concerns and Cautions About Using Humor in Health Care Settings. Retrieved March 2006, from http://www.nurseslearning.com/courses/nrp/NRPCX- W0009/htm/body.humor.page9.htm.

Singer, B.W. (2000). Get goofy now! Health, 14(8), 76-80.

Stein, R. (2005). Laughter's Link to Health May Be in the Blood. The Washington Post. March 14, 10.

Stritof, B. & Stritof S. (2006). Laughter and Humor. Retrieved March 2006, from http://www.marriage.about.com/od/humor/qt/laughter.htm.

Tracy, A.B., PhD. (2006). What you need to know about serotonin-enhancing medications. Retrieved March 2006, from http://www.drugawareness.org/Ribbon/SSRIMeds.html.

Wooten, P. (1991). Physiological Effects of Laughter. Journal of Nursing Jocularity, 1(3), 46-47.