Over a century ago, William James—an American physician, philosopher, and educator, who many consider the father of modern psychology—wisely said, “We don’t laugh because we’re happy. We’re happy because we laugh.”
This week, a new study from Georgia State University (GSU) reported that incorporating voluntary laughter into a physical activity regimen focused on strength, balance, and flexibility improved older adults' mental health, aerobic endurance, and their levels of confidence regarding exercise. Associating laughter with working out helped participants make exercise a habit. Having fun and laughing at the gym led them to seek regular physical activity, instead of avoiding it like the plague.
The Septemeber 2016 study, “Evaluation of a Laughter-based Exercise Program on Health and Self-efficacy for Exercise,” appears in The Gerontologist. This new research is one of a few studies that have evaluated the potential of simulated laughter to improve health outcomes among older adults. It’s also the first evaluation of a finely-tuned physical activity program that incorporates simulated laughter.
Long ago, Indian yogis intuitively struck upon the physiological and psychological benefits of spontaneous voluntary laughter and developed Hasya yoga. The basic premise of Hasya yoga is that self-initiated, simulated laughter done in a group quickly turns into genuine and contagious laughter.
The benefits of laughter are believed to be rooted in our nervous system. By putting the cart before the horse with self-initiated laughter, you tap into an innate feedback loop. Any type of laughter stimulates diaphragmatic breathing, activates the parasympathetic nervous system, and triggers the “tend-and-befriend” response linked to healthy tone in your vagus nerve. Just ten minutes of laughter is sufficient to trigger mental and physical health benefits.
In the 1970s, my father, Richard Bergland, M.D., became friends with Norman Cousins, who wrote a book called Anatomy of an Illness as Perceived by the Patient: Reflections on Healing. To the best of my knowledge, this was one of the first books to popularize the correlation between laughter and well-being with a mainstream audience.
Norman Cousins was interested in my dad’s empirical, science-based research on the neurobiology of emotions that he conducted in his laboratory; my dad was drawn to Cousins’ first-hand account of healing himself from what appeared to be a terminal illness by having a sense of humor and forcing himself to laugh.
In the early '70s, Cousins was blindsided by the sudden onset of an unidentified and crippling illness. His self-discovered strategy for regaining his health involved the prescriptive use of laughter as medicine. Cousins describes how he stumbled on the health benefits of laughing,
"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. When the pain-killing effect of the laughter wore off, I would switch on the motion picture projector again [to watch Marx Brothers movies] and not infrequently, it would lead to another pain-free interval."
The new GSU study was founded on the hypothesis that your body can’t differentiate between simulated laughter techniques and laughter that results from something that is genuinely funny. According to the researchers, self-initiated laughter (such as practicing Hasya yoga or watching slapstick comedy) and spontaneous laughter both elicit powerful health benefits.
In their recent study, the GSU researchers worked closely with older adults residing in four assisted-living facilities. Study participants were coached on the techniques of a moderate-intensity group exercise program called LaughActive. This program incorporates playful simulated laughter into a strength, balance, and flexibility workout.
During the simulated laughter exercises, LaughActive participants initially choose to laugh and go through the all the motions of pretending to laugh. Much like Hasya yoga, the group exercises facilitate eye contact and playful behaviors between participants. Once the simulated-laughter ball is in motion, the silliness of the situation tends to snowball and create a chain reaction that leads to uncontrollable laughter throughout the group.
When was the last time you had an uncontrollable fit of laughter? Sadly, I hadn’t completely lost control of my body with a laughing attack for months, until just a few days ago. Having a laughter attack made me feel really happy and high on life for at least an hour or two after just a few minutes of intense belly laughter.
Last Saturday, I was ordering a coffee and almond croissant from my friend, Kathy, at East End Market. There was a very long line at the time. For some reason, the two of us started to giggle. Before we knew it, we were both convulsing and bent over with laughter to the point that we momentarily couldn’t finish our sales transaction. The more irritated the people in line became...the harder we laughed. After composing myself, I apologized to everyone in line. As I walked away, I realized that I felt as if I was on cloud 9. Of course, this sensation reminded me of Norman Cousins and the universal ability of laughter to make us feel good.
Along these lines, for six weeks during the GSU study, participants attended two 45-minute physical activity sessions per week that included eight to 10 laughter exercises lasting 30 to 60 seconds each.
A laughter exercise was typically incorporated into the workout routine after every two to four strength, balance, and flexibility exercises to encode the sensorimotor association. The study found significant improvements amongst participants in mental health, aerobic endurance, and outcome expectations for exercise (for example, perceived benefit of exercise participation) based on assessments completed by the participants.
After the study was complete, participants were surveyed about their satisfaction with the LaughActive program. The feedback is encouraging: 96.2% of the people found laughter to be an enjoyable addition to a traditional exercise program, 88.9% said laughter helped make exercise more accessible, and 88.9% reported the program enhanced their motivation to participate in different exercise classes or other physical activities.
The researchers note that the health benefits associated with combining laughter and exercise include lower mortality and a reduced risk of a number of chronic conditions, such as: coronary heart disease, high blood pressure, stroke, type 2 diabetes, metabolic syndrome, osteoporosis, colon cancer, breast cancer, anxiety, and depression.
Regular physical activity also reduces the impact of age-related declines in aerobic endurance, the incidence of falls and hip fracture, and the degenerative loss of muscle mass, quality and strength. All of these health benefits are of paramount importance for older adults to maintain independence and sustain their ability to perform regular activities of daily life.
Adding laughter to an exercise program creates positive associations on a psychological and neurobiological level. This double whammy triggers an upward spiral in your mind and body that is linked to positive emotions that will make you want to exercise regularly. As I’ve said many times before, because all animals seek pleasure and avoid pain, if there’s any way to make exercise seem like an enjoyable and agreeable experience, you're more likely to make it a long-term habit.
In a statement, Celeste Greene, lead author of the new study and a master's degree graduate from Georgia State's Gerontology Institute, summed up her work by saying,
"The combination of laughter and exercise may influence older adults to begin exercising and to stick with the program. We want to help older adults have a positive experience with exercise, so we developed a physical activity program that specifically targets exercise enjoyment through laughter. Laughter is an enjoyable activity and it carries with it so many health benefits, so we incorporated intentional laughter into this program to put the fun in fitness for older adults."
Voluntary, self-initiated laughter is a terrific way to make people of all ages and walks of life feel better. Combining laughter and exercise is an especially effective way for older adults—who might have functional or cognitive impairment—to improve mind, body, and brain function.
One of the benefits of self-initiated group laughter is that there's no need to rely on cognitive skills to "get the joke" because there is no joke beyond the absurdity and ridiculousness of the situation.
More research is needed to better understand the underlying mechanisms of how laughter improves well-being. Also, future studies will help to identify an ideal dose-response of how different levels of exposure to laughter are associated with various health benefits. Stay tuned!
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