Humor Therapy (Part 2 of: 1 l 2 ) The Few, the Proud, the Funny. by Michael Braunstein

Patch Adams is the founder of the Gesundheit Institute and has become world-famous as the medical doctor whose work inspired Robin Williams to portray him in the recent eponymous film. As anyone familiar with the movie or Adams' story might know, Patch Adams is the doctor who has devoted his life and medical career to the application of laughter and humor as the medicine that can lift the human spirit and act as a source of healing as well. Patch Adams, M.D. has put aside many of the conventional perceptions of the medical field and has made laughter and humor the primary prescription he and his staff dispense.

It's not a new idea, this humor therapy notion. Sources cite it in classical period Greek civilization as gelotology, using the Greek root gelos- or laughter. Historical, (or maybe hysterical) physicians in ancient Greece would send patients to athenia to view humorous shows. In many other cultures, jesters were considered an important part of every royal court. Native Americans used clowns as a part of the shamanic ritual. One can hardly drive a mile in the American Southwest without seeing the image of one Hopi symbol of humor, Kokopelli. The work of this mythical mirthmaker is to bring harmony, fertility and joy to the tribe by making the tribe laugh. He often appeared with his sidekick, the Trickster or Coyote. And now, as the 21st century approaches, even stuffy old Western culture is seeing the healing power of the ha ha.

"LAUGH, LAUGH, I THOUGHT I'D DIE..."
Over 30 years ago, Norman Cousins lay dying in his hospital room at UCLA Medical Center. Doctors told him his disease was terminal and there was nothing they could do. They were half right. Cousins didn't accept their diagnosis. Though he was in excruciating pain from a rare disease that inflamed the spine, he found that after watching a Marx Brothers movie on television, he laughed so hard that it exhausted him and he slept soundly without narcotics for the first time in weeks. The doctors had been half right - there was nothing they could do. That didn't mean there was nothing he could do. He immediately ordered in a film projector and all the Marx movies and slapstick comedy he could get his hands on. (This was in the pre-VCR days of the '60s.) He noticed immediate improvement. The pain decreased to a tolerable level. He slept soundly. And amazingly, blood tests showed his immune system was healing and inflammation went down.

Cousins, who had been editor of The Saturday Review, went on to chronicle his recovery in the highly acclaimed book Anatomy of an Illness published in 1969. That book is credited as a cornerstone of much of the awareness of humor therapy that has followed. Furthermore, Cousins spent the last 12 years of his life at UCLA Medical School in the Department of Behavioral Medicine exploring the scientific proof of his belief. He established the Humor Research Task Force which coordinated and supported world-wide clinical research on humor.

Varying numbers appear in the literature that point to stress as a leading cause or contributing factor in disease. Some figures go so far as saying 80 percent of all disease is due to stress. In that regard, humor is certainly one of the ways we can release and cope with stress. You can't laugh and hold on to your blue mood for very long. You can't guffaw and hold on to anything very long. A good belly laugh has even been said to cure constipation. Anal retention may not be a disease but it certainly isn't pleasant.

But humor has to be of a certain mold to make the grade as therapeutic. One of the psychological profiles weeding out astronauts for the NASA Mars flight program cites humor as an important attribute. But we are reminded that some humor isn't at all positive. Joyous, sharing humor is better than needling, sarcastic humor. The right sense of humor might go a long way toward making a journey to Mars tolerable. But would anyone want to be cooped up with David Letterman for six months? Think about it. Or how about living day in and day out with Andrew Dice Clay? Now that's food for thought! And isn't Richard Lewis kind of proof positive that humor of some types hardly heals? Wow. And look at Woody Allen. Truly, there is humor and there is humor. Just as there is happiness and there is happiness; one is healing, one isn't.

In our Western-mind fashion, we have begun researching what happens when we joyously laugh. It's somehow not enough to just know that laughing feels good, that it results in effects that are pleasant. We Western anal-yzers have to put numbers on it to prove that humor is good for us. Ok. Numbers can be good for some people. Who's to say?

What the numbers are telling us is that Patch Adams and Norman Cousins were right. Laughing is really a form of healing.

Loretta LaRoche is a member of the Mind/Body Medical Center in Boston. She is also author of Relax - You May Only Have a Few Minutes Left, a book on using humor to reduce stress and be healthier. She cites a number of studies.

Studies often noted by LaRoche and also the American Cancer Society are those done by William Fry, psychiatrist at Stanford University. Fry's studies range from 1971 to current and have been published in a number of peer-reviewed journals such as the Journal of the American Medical Association and the Journal of Biological Psychology. Research done by L. Berk at Loma Linda University School of Medicine also appears prominently in the literature. Some interesting areas come out in the research. The findings include the following.

SEARCHING FOR "A FEW GOOD LAUGHS"
Response to laughter can include an improvement in circulation. Blood flow reaches all parts of the body more easily. Skin temperature increases and we warm up. Blood pressure lowers and heart rate can stabilize. Blood chemistry changes too. Laughter has been shown to increase blood oxygen levels. That in itself can be a healing event. It certainly will lead to reduced tension.

Berk found that laughter lowers the presence of cortisol in the blood stream. Cortisol is a derivative of corticosteroids that appears when a system is under stress. It has been shown to interfere with the proper function of the immune system.

Other positive things happen with laughter. The immune system is boosted in other ways. T-cell and killer cell production is elevated. White blood cell activity is increased. According to LaRoche, laughing has been shown to increase the production of other elemental immune system cells and gamma-interferon, suspected of fighting cancer.

Those famous neurohumours, endorphins, increase with laughter. They are natural pain killers often called natural opiates. Ten different muscle groups are exercised when we laugh. They contract and relax and in a very real way perform a sort of visceral massage on our internal organs.

The Stanford study plugged catheters into college students and made them watch funny movies. With laughter, white blood cell activity increased immediately.

Laughter is good for you.

This is serious business

The American Cancer Society notes that "the value of humor has been confirmed to the point that many hospitals and ambulatory care centers now have incorporated special rooms where materials — and sometimes people — are there to help make people laugh." One hospital in North Carolina has funded a "laughmobile" that visits patients and makes them laugh. Using slapstick tricks like whoopee cushions and goofy jokes and clowns, the providers thought the results certain enough that the laughmobile continues to provide this service throughout the area.

There is an American Association for Therapeutic Humor headquartered in St. Louis that has a yearly international convention. In addition, there are many associated organizations that support continuing education credits for nurses and other health care professionals who learn to use humor as a complementary form of therapy.

Recently, Patch Adams made a trip to Macedonia to lay groundwork for an ongoing project to bring mirth and merriment to an area that appears devoid of any happiness at all. The Gesundheit Institute was recruiting for applicants to take part in the excursion. It is to last for seven days in the Kosovar refugee camps and the requirements were pretty simple according to the released announcement. It presents an opportunity to do some clowning in the Kosovar camps in Macedonia. They are looking for 20 people who would be willing to clown. "No previous experience is necessary but you should have a willingness to help others through laughter."

And how could you do that without benefiting yourself? After all, if laughter is the best medicine, shouldn't the physician heal thyself first?

Be well.