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A laugh a day . . . Some doctors take humor seriously when it comes to treating patients Tuesday, April24, 2001 By Amanda Greene, Staff Writer Wilmington Morning Star Copyright 1999 Wilmington Star-News, Inc. A side-splitting, cheek-aching, tear-shedding laugh. Sounds painful, but most people feel relief all over after having a good chuckle. Now physicians and even bosses are recognizing that those tee-hees and ha-has are healthy for the body, mind and soul. Laughing is so natural, but many adults do very little of it. "We know that 4-year-olds laugh five hundred times a day, while the average adult laughs only fifteen times a day. If we could laugh as frequently as a 4-year-old, we could have the heart rate and blood pressure of a 4-year old," said Annette Goodheart, a cathartic and laughter therapist quoted in the Sept. 1998 issue of Science of the Mind. For the real-life Hunter "Patch" Adams, making an effort to practice laughter is ridiculous because he sees laughing as an inherent part of being healthy and "bring(ing) fun, friendship and the joy of service back into health care." He still practices his happy brand of health care at his Gesundheit! Institute in West Virginia. "I would never consider laughter as a therapy," Dr. Adams said last week while on a speaking tour in Canada. "For me, laughter is a context for human life. You wouldn't have love therapy or wonder or curiosity therapy. They're contexts for a living and being culture and should be part of us already." But an array of laughter studies show that laughing can relieve allergy and arthritis symptoms, increase memory retention and creativity in the workplace, lessen pain from chronic diseases and strengthen the immune system. Interest in humor's effects has grown so much that the field has a name - psychoneuroimmunology, the study of how psychological factors, the brain and the immune system interact to influence health. Norman Cousins, the former editor of The Saturday Review, started the laughter fervor in 1964 when he was diagnosed with acute case of ankylosing spondylitis, a degenerative inflammatory spinal disease. The disease left him in almost constant pain, and he noticed that when he watched comedy films and laughed hard, it reduced his pain. He wrote of the pain-reducing power of humor in his book Anatomy of an Illness. In his last book, Head First: The Biology of Hope, he noted that 10 minutes of belly laughter (just counting the laughing time) would give him two hours of pain-free sleep. The reason laughter relieves pain is because it produces endorphins, one of the body's natural painkillers, said Paul McGhee, the president of The Laughter Remedy, in Montclair, N. J. He has done extensive research and has published 11 books on humor. Researchers at the Jonsson Cancer Center at the University of California, at Los Angeles are trying. Last year, they started a five-year study called "Rx Laughter," on ill children and adolescents with depressed immune systems to determine if laughter (watching funny videos) can help reduce their pain and prevent and treat diseases. Laughter is by no means a cure-all for illnesses, but some researchers say that people who laugh are less likely to get sick. Lee Berk, a pioneer in laughter studies and associate director of the Center of Neuroimmunology at Loma Linda University School of Medicine, maintains that laughter beefs up the immune system. In his 1989 study, published in the American Journal of Medical Sciences, he found laughter reduces blood levels of cortisol, epinephrine, and other substances, which, when at high levels, tend to suppress the immune system. So decreasing their levels is believed to be beneficial. Groucho Marx once said that "a clown is like an aspirin, only he works twice as fast." In kind, one Durham woman has put laughter on wheels and in clown shoes in 12 hospitals throughout the country for 15 years. In 1986, Ruth Hamilton, a volunteer at Duke Medical Center, and David Kleinbaum, then an epidemiologist at the University of North Carolina at Chapel Hill Hospitals, teamed up with Duke Oncology Recreational Therapy to set up the Duke Humor Project. They designed a Laugh Mobile, a roving cart packed with games and humor props such as rubber chickens and water guns that they wheeled into cancer patients' rooms. Humor-trained clowns still interview patients about their humor preferences, and Ms. Hamilton devises a humor prescription such as watching funny videos or blowing bubbles or smile push-ups. New Hanover Medical Center also has a humor program that includes a laugh mobile and clowns, a separate program based on Duke's Laugh Mobile. "After laughter, research has shown that it boosts immune function by raising levels of T-cells, Gamma-interferon and B-cells that fight disease and infection. Laughing also forces moisture out of the lungs so they don't harbor disease as much," Ms. Hamilton said. "There are secretions in the tears that only happen after laughter that clear the eyes. It even raises your energy levels and body temperature." Ms. Hamilton established the Carolina Health and Humor Association (a.k.a. Carolina Ha-Ha) to spread the word about the healing effects of laughter. She will hold a certified humor presenter conference to teach people to be humor therapists, Nov. 2-3 in Durham. Many doctors use laughter or humor in their practices to gain patient trust. "You can imagine, there are some uncomfortable issues to discuss in urology, and it's hard to get patients to remember what their doctors tell them if they're already worried," said Robert Bennett, with Urology Associates of Southeastern North Carolina. "I try to make patients laugh so they let their guard down and listen to me. If a mother is convinced that her child is going to die, and I can relax her with a joke then I can get crucial information from her to treat her child." Dr. Bennett tells a special brand of joke - urologic jokes, "most of which are not bad, they're just not fit to print in the newspaper," he said, laughing. Humor draws attention away from the source of discomfort. "Laughter is just good for our psychology because people regress to a childlike state and socially it's contagious," Ms. Hamilton said. "It's been called the universal language because no matter what language you speak, if people are laughing you can laugh with them." It's even okay to laugh at work. Many workplaces are inviting humorists to speak about how laughter increases creativity because "humor improves team building, communication skills, conflict management, morale, job satisfaction, problem solving, resilience, stress management and productivity," Dr. McGhee said. "People forget in this busy world that there is humor around them, and they confuse being professional with not being funny in the workplace," Ms. Hamilton said. "You need laughter for creativity especially in the workplace because it fully engages the brain." TO LEARN MORE ABOUT LAUGHTER
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