Never a Dull Moment - Laughter and Purpose — Part 1

Most of the time when we laugh it has little to do with humour and more to do with the social bond. We use laughter and humour to manage situations, to display our willingness to engage, to show those present that we are on the same page. We are also more likely to laugh when there are other people around. Friends spend on average 10 per cent of a conversation laughing and clearly we laugh more if we know and like the people we are with. The most important thing on our horizon is other human beings and how they interact with us and what they think about us. Laughter is therefore key to important social interactions and matters because of the interactive role it plays in enabling bonds with others, which are core to survival and still play meaningful physiological and psychological roles, including key roles in ageing.

So, laughter connects us with others. Just as with smiling and kindness, laughter is contagious; we can ‘catch’ laughter from someone else and are more likely to catch it if we know them. By elevating mood, laughter reduces stress levels in all parties involved.

Chapter 4: Never a Dull Moment - Laughter and Purpose

Laughter has also been described in a number of animal species. This makes sense of course because it is part of our mammalian evolution and, if you think about it, laughter closely resembles an animal call. This is true of some people’s laughs more than others! Great apes produce laughter when they are socially playing. Dogs laugh and, in order to set themselves up for play and laughter, they have a ‘play bow’ which they perform beforehand. Even rats laugh: mother rats tickle offspring inducing a laughter response from the young. Consistent with the bonding role of tickling, it requires at least two animals or people. Try to tickle yourself – it is not possible because tickling is a social interaction coupled with trust. A stranger cannot come up to you on the street and start to tickle you. The intent of tickling is playful, safe and non-threatening, and the result is laughter.

Thus, humour, laughter, learning, bonding and health are all linked. The benefits of humour and laughter are well detailed through history, as early as the reign of Solomon, 971 to 931 bc, in the Book of Proverbs, where it states: ‘A cheerful heart is good medicine, but a crushed spirit dries up the bones,’ indicating that even then people understood that a joyful spirit has positive therapeutic effects.

Chapter 4: Never a Dull Moment - Laughter and Purpose

Ancient Greek physicians, as an adjunct to therapy, prescribed a visit to the hall of comedians as an important part of the healing process. Early Native Americans used the impact of humour and laughter in healing, coupling traditional medicine men with the services of clowns. During the 14th century, French surgeon Henri de Mondeville used humour to distract patients from pain endured during surgery – there were no anaesthetics until 1847. Even for amputations, de Mondeville used laughter both during and after surgery to aid recovery. He supported this practice in his book, Cyrurgia, stating, ‘Let the surgeon take care to regulate the whole regimen of the patient’s life for joy and happiness allowing his relatives and special friends to cheer him and by having someone tell him jokes.’ The English parson and scholar Robert Burton extended this practice by using humour to treat psychiatric disorders in the 16th century, which he discussed in his book, The Anatomy of Melancholy. During the same period, Martin Luther, German priest and founder of the Lutheran religion, used humour to treat psychiatric disorders as a critical component of pastoral counselling. Luther advised individuals with depression not to isolate themselves but to surround themselves with friends who could joke and make them laugh. Laughter has a long and successful history in medicine.

Chapter 4: Never a Dull Moment - Laughter and Purpose

So what happens when we laugh? Laughter is fundamentally a different way of breathing. When we laugh, we are using the intercostals (the muscles between the ribs) to repeatedly blow air out from the lungs without inhaling. Laughter also increases the pressure in the chest by effectively breath-holding and stopping the normal regular rhythmic flow of air in and out. The increase in chest pressure lowers blood flow to the brain which sometimes makes people feel dizzy or pass out. This is why the expression ‘I almost passed out laughing’ holds true.

I run a specialist clinic for adults who experience blackouts and occasionally encounter patients who have an exaggerated physiological response to laughter, where the heart rate slows to a stop, blood pressure consequently drops and they pass out. One memorable patient only suffered these attacks when her son-in-law told a joke. The jokes were invariably smutty and it had become such a common occurrence that her family brought many videos to clinic to illustrate the frequency and characteristics of the blackouts triggered when she laughed a lot. We attached her to equipment that simultaneously measured blood pressure, heartbeat and brain blood flow. We then asked her son-in-law to tell one of his jokes. She duly burst out laughing and then passed out. Her heart transiently stopped, thereby stopping blood flow to her brain. She required a pacemaker to prevent the blackouts and the good-humoured family brought me subsequent video recordings of the patient in peals of laughter with no untoward consequences. In other words, the pacemaker kicked in when her heart started to slow as she laughed and thereby prevented any pause in heart rate.

Chapter 4: Never a Dull Moment - Laughter and Purpose

Laughter provides a physical release; it creates a ‘workout’. A good belly laugh exercises the diaphragm, contracts the abdominal muscles and works out the shoulders, leaving muscles more relaxed afterwards. It even provides a good workout for the immune system and the heart.

Is having ‘a good laugh’ really beneficial at a chemical level? Yes, because laughter lowers the stress hormones cortisol and adrenaline. Low cortisol stabilises blood sugars and insulin, regulates blood pressure and reduces inflammation. Adrenaline is a fight-or-flight chemical, which increases blood pressure and the intensity with which the heart pumps. It is implicated in irregularities of the heart and heart attacks. Its actions are the opposite to relaxation hormones. So, lowering adrenaline calms the nervous and cardiac systems. Diminishing or blocking the effect of adrenaline by laughter has even been shown to work in patients after heart attacks. A single one-hour episode of daily mirthful laughter lowered the rate of recurrent heart attack by 42 per cent.

Laughter also increases endorphins – chemicals produced naturally by the nervous system to cope with pain or stress, the ‘feel-good’ chemicals. It raises serotonin and dopamine, both endorphins which play a critical role in sensations of pleasure, motivation, memory and reward. They make us feel calm, poised, confident and relaxed. When serotonin and dopamine levels are low, we are nervous, irritable and stressed. Certain substances, especially cocaine and nicotine, are addictive because they stimulate the dopamine-mediated reward system in the brain. How much better to stimulate these systems through laughter, which has no side effects, only copious benefits.