Is laughter really the best medicine?

Is laughter really the best medicine?

Therapeutic humor is revered as an essential component of healthy aging. Find out more about the health benefits of this phenomenon
by Marge Coalman, EdD


The health and wellness industry boasts an arsenal of tools to help us deal with the stresses of daily life. These tools include breathing exercises, time management techniques, aerobic exercise regimens, and muscle relaxation, to name a few. But we often forget to take advantage of 2 coping mechanisms we have available to us— humor and laughter.


Although used interchangeably by most people, the words humor and laughter represent different facets of well-being and refer to separate phenomena. This article looks at the differences, research findings, positive qualities and benefits of both, and how to apply them in the world of physical activity programming for older adults.


Pathways to health
Mental health clinician and humorist Mark Darby has written a book about therapeutic humor, entitled Use It or Lose It: Humor and Treatment of Mental Illness. Darby insists that “humor is the most underrated pathway to health.” Author Norman Cousins, the most frequently quoted and recognized name in the field of humor intervention, coincidentally promoted laughter with that well-known quote from his book Anatomy of an Illness as Perceived by a Patient: “I made the joyous discovery that ten minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.”


Distressed by early reports of the above quote being taken out of context and attributing him with “curing himself with laughter,” Cousins attempted to clarify his position in a later book, The Healing Heart. “The newspaper accounts had made it appear that I had laughed my way out of a serious illness,” he said. “Careful readers of my book [Anatomy of an Illness], however, knew that laughter was just a metaphor for the entire range of the positive emotions. Hope, faith, love, will to live, cheerfulness, humor, creativity, playfulness, confidence, great expectations—all these, I believed, had therapeutic value.”


How do laughter and humor differ? Research is clarifying the distinctions between these 2 phenomena. Interestingly, on a scientific level, the research is much more specific than the popular literature indicates.


Laughter: a physical experience

Laughter is a physical phenomenon, which is spontaneous in origin most of the time. Scientists have looked long and hard at the commonly held belief that we produce endorphins when we laugh—particularly the deep belly laugh that often seems uncontrollable and is almost always out loud. Endorphins are chemicals that transmit signals between brain cells. These chemicals are released as a result of pain or stress and result in feelings of euphoria, such as the runner’s high. To date, researchers have found no scientific evidence that laughter produces this chemical response.


However, laughter does cause individuals to enter a positive emotional state called eustress, a condition opposite to distress. Eustress is a pleasant or curative stress that boosts the immune system by elevating antibody levels in the body.


According to Lee S. Berk, DrPH, an associate research professor of pathology and human anatomy at Loma Linda University in California, researchers have mapped brain activity during joketelling. These investigators found that laughter involves the entire cerebral cortex, he says, not just a specific area in the brain.


Moreover, Berk’s research has shown that the experience of laughter appears to increase the number of natural killer cells (or NK cells), which help the immune system fight infection and defeat immune system diseases and cancers. Funding for Berk’s work came from the late Norman Cousins.


Humor: a broader construct

While laughter has a physical nature, humor is constructed in the mind. This phenomenon is defined as a stimulus that causes amusement and a response to the stimulus (Mahoney, 2000). It is fundamentally the ability to see that things that at first appear incongruous need not be, if viewed differently—if life hands you lemons, make lemonade.


According to the currently accepted research, humor provides mental stimulation and a kind of distraction that differs from laughter (Suls, 1972). Mirthful humor improves mood, an effect sometimes lasting a prolonged time. When it comes to illness, a shift in perception produced by resolving humor’s incongruities lets people see their situations from a different angle. Individuals feel a greater sense of control when they can spontaneously create humor about the things they face. And they may even obtain benefits simply from believing that humor and laughter are beneficial.


The Mayo Clinic, Harvard Medical Clinic, and national research programs of the US Centers for Disease Control and Prevention have all studied the positive impact of laughter, humor and positive thinking on curative outcomes for those with cancer, heart disease and other potentially terminal illnesses. Also, many hospitals and cancer treatment programs have clown doctors and nursing specialists who endorse and practice “the joy of service and healing” (AATH, 2005).


In truth, laughter and humor are among the best and most holistic medications we can use to stave off illness, reduce stress, and increase positive immunesystem response to the hazards of living in a stress-filled world. These interventions have no side effects— unlike the popular prescription drugs for low mood, despondency, anxiety and stress. While not recommended as replacements for medications prescribed to treat specific conditions or diseases, humor and laughter can produce dramatic and therapeutic outcomes through the supplemental effect of hormone and brain responses. Additional physiological benefits include increasing oxygenation and circulation throughout the body, according to Mark Darby. But the psychological benefits of affording perspective in difficult times, enhancing quality of life by adding enjoyment, and providing greater socialization and communication are also important to life enjoyment and wellness (Darby, 1997).


Humor and mirth: implications for programming

What do the health benefits of humor and laughter mean for professionals who seek to enhance health and quality of life for people ages 50 and older? Coupled with research showing that socialization and strong social networks contribute to heart and brain health in older adults, findings about humor and laughter reveal the enormous value in providing environments that promote positive well-being.


Professionals can encourage and enhance positive well-being by introducing humor and laughter into activities and class offerings. And they can embrace humor and laughter as vital components of any class that focuses on traditional physical activity formats, such as cardiovascular exercise, strength training and stretching.


In most cases, the leader’s personality and approach will determine the mood of a class and the opportunity for humor and laughter to occur. These elements make the critical difference for many older adults who have to overcome the barriers of low selfesteem or self-efficacy, mobility and transportation challenges, and in many cases unremitting, long-term pain, to attend.


A shared view of humor that empowers participants to perceive their strengths, skills and remaining abilities, rather then their losses, creates a general sense of well-being for the group as a whole. The opportunity for individuals to learn optimism and positive thinking about their losses and limitations is more apt to be provided in the appropriate exercise class, than in the physician’s waiting room or office.


Most successful program leaders have a level of intimacy with attendees that allows them to know the boundaries for humor and mirth in a group. For example, ethnic and cultural differences are inappropriate topics for humorous reference. In fact, sarcasm and irony are generally best avoided in any group of individuals with a range of abilities in cognition and language comprehension. Dark or gallows humor is also more appropriate for other environments and audiences.


Instructors will find that, in many cases, the spontaneous antidotes and jokes shared by participants may be more caustic or age-phobic than those any trained professional would offer. But in the supportive context of a class of friends and peers, these incidents often evoke laughter and goodwill.


How humor and laughter benefits the industry

High on the list of positive characteristics of both humor and laughter are 2 things:

  • They are literally free.
  • They can be used an unlimited number of times throughout the day.


Health and wellness professionals must usually select and purchase equipment and materials to support a specific class format. In contrast, the social construct that promotes therapeutic humor is in the internal toolkit of the instructor and the class participants.


One key finding of behavior change research done by J. O. Prochaska, a developer of the stages-of-change model and related process strategies, is that the individual must experience positive benefits to lead to long-term commitment to change. As an industry, we have also learned that people need to have fun at the gym to return. In light of this information, including socially appropriate humor and laughter in programs is important to achieve consistency and commitment among participants. Humor and fun can also make participation of greater value to each person in small or large group programs, particularly those new to physical activity and lifestyle change.



Marge Coalman, EdD, is president/owner of Coalman Consulting in Portland, and a regular contributor to the Journal on Active Aging. She is also the national director of wellness and programs for Touchmark Living Centers, Inc., a provider of quality senior housing in the United States and Canada.




  • Association for Applied and Therapeutic Humor (AATH). (2005). The Humor Connection, Fall 2005. Retrieved from
  • Christie, W., & Moore, C. (2005). The impact of humor on patients with cancer. Clinical Journal of Oncology Nursing, 9(2), 211. Available from
  • Cousins, N. (1979). Anatomy of an Illness as Perceived by the Patient, p. 39. New York NY: Norton & Company, Inc.
  • Cousins, N. (1983) The Healing Heart: Antidotes to Panic and Helplessness, p. 50. New York NY: Norton & Company, Inc.
  • Darby, M. (1997). Use It or Lose It! Humor and the Treatment of Mental Illness. Omaha NE: Surprise Press.
  • Mahoney, D. L. (2000). Is laughter the best medicine or any medicine at all? Eye on Psi Chi, 4(3), 18–21. Chattanooga TN: The National Honor Society in Psychology.
  • Mayo Clinic Staff. (2004). Manage life’s stresses. Retrieved from
  • Moore, M. (2004). The healing power of laughter. Retrieved from
  • Prochaska, J. O., & Velicier, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(2), 38–48.
  • Rendell-Smock, S. (1998). Humor and health, part 2: What the experts say. The Sideroad, Go to Health, Issue 10; January 6. Retrieved from
  • Suls, J. M. (1972). A two-stage model for the appreciation of jokes and cartoons: An information-processing analysis. In J. H. Goldstein & P. E. McGhee (Eds.), The psychology of humor: Theoretical perspectives and empirical issues, pp. 81–100. New York NY: Academic Press.
  • White, L. (2004). Nation Celebrates Humor Month in April. Retrieved from


This article is provided courtesy of the International Council on Active Aging