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Laughter as Therapy: The Results are Excellent

by Ruth Hamilton

Humor is a perspective that enables one to view stress and pain with a softer edge. Though not an immediate cure for trauma, chronic illness, or emotional difficulty, humor can be a therapeutic tool. It offers positive outlets for chronically ill patients and also for chronically ill patients and also for stressed out medical and corporate staff.

For many years medical staff have recognized that those patients who maintained a positive mental attitude and shared laughter responded better to treatment. Physiological responses to laughter include increased respiration, circulation, hormonal and digestive enzyme secretion, and a leveling of the blood pressure. Many report a general sense of euphoria after vigorous laughter. But until the New England Journal of Medicine in 1979 published the Norman Cousins case study, few considered the therapeutic uses of humor.

The first documented case of humor positively affecting disease was in 1964 when Norman Cousins, published "Anatomy of an Illness". Medical professionals were for the first shown that humor biologically reversed Cousins' ankylosing spondylitis, a painful disease causing the disintegration of the spinal connective tissue. Given a one in five hundred chance of recovery, Cousins decided to infuse himself with humor treatments. With Cousins' self-designed humor treatments, he found that 15 minutes of hardy laughter could produce two hours of pain free sleep. Blood samples also showed that his inflammation level was lowered after the humor treatments. Eventually Cousins was able to completely reverse the illness.

Following the example of Cousins, many health care facilities as well as corporations have established humor programming as an aid to patient/employee health. To meet the growing demand for therapeutic humor, Carolina Health & Humor Association (Carolina Ha Ha), incorporated in 1986 as an educational service foundation. Carolina Ha Ha specializes in humor programming for health care, for business, and for personal growth. The founder, Ruth Hamilton, continues to serve as Executive Director.

An early program included the Laugh Mobile and was developed for Duke University Medical Center in 1987 by Hamilton. This became the Duke Humor Project and offers bedside humor interventions to cancer patients. Coordinated with the Department of Oncology Recreation Therapy, patients receive humorous interactions that invite them to use the Laugh Mobile. This rolling display cart with a circus motif delivers a wide variety of humorous media including books, audio and video tapes, games, and clowning props. Patients are invited to use their hospital time to learn a new skill that will increase creativity and keep the mind active. Distraction becomes a resource for pain management. Boredom is combated through positive experiences.

Humor interventions offer a plan to promote joy and laughter in patients which offers many positive effects in their recovery. Humor volunteers may engage in yo-yo demonstrations, guitar playing, or just friendly banter that reveals clues to patient humor preferences. Water-guns may be dispensed to allow the patient to fight back during the rigorous oncology treatment. Patient assessments document the effectiveness of the humor intervention and offer the recreation staff and volunteers continuity of interventions. Over the last nine years, Hamilton has assisted dozens of hospitals nationwide to implement humor programming patterned after the Duke Humor Project. The Laugh Mobile is also manufactured by Carolina Ha Ha and has been sold nationally. Medical staff report Laugh Mobile programs build morale and endorse the value of the sense of humor.

Ruth Hamilton and Frank Jeffreys may be contacted at (919) 544-2370 for consultation or presentations. Carolina Ha Ha offers monthly community mini-seminars and also clowning classes and the Certified Humor Presenter series. Their web site URL is

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