Hektoen International

A Journal of Medical Humanities

Warning: laughter can be hazardous to your illness

Bharata Wingham
Buckingham, Virginia, United States



Photography by Chris Keiss

A cheerful heart does good like a medicine: but a broken spirit makes one sick.
—Proverbs 17:22


Laugh for the health of it!

When is the last time you had a good laugh? This was a question I used to ask myself from time to time. If I needed a chuckle, I would make up my mind to go see a funny movie or attend a party hoping to find a few laughs. This seemed a normal way to think about laughter—as a reaction to stimulus.

When I became proactive in maintaining my own health, I heard that intentional laughter, like jogging and a healthy diet, was beneficial. Choosing to laugh independent of mood or emotional state was a new idea to me. Yet there is mounting scientific evidence that large doses of laughter, like vitamins taken in conjunction with a healthy dietary regime, can be effective in promoting healing and health.1 And much like any other practice, time and space must be made for it.


Laughter and health

The recommendation for a healthy heart may one day be: exercise, eat right, and laugh a few times a day.2
Michael Miller, MD, Center for Preventive Cardiology, University of Maryland Medical Center

Society has intuitively known about the regenerative power of laughter long before science began to validate its positive physiological benefits. This is evidenced in common expressions such as “Laughter is the best medicine,” and even in Irish folk wisdom, “A good laugh and a long sleep are the best cures in a doctor’s book of remedies.”

Validating our intuitive appreciation for the benefits of laughter, we now have gelotology—the study of humor and laughter and its psychological and physiological effects. To sum up the last 50 years of scientific research on the benefits of laughter very simply . . . it’s good for you!

University of Virginia Doctor Randolph Canterbury says it is no joke: “When people go through the motions of laughing, there is a feedback mechanism from their brain to the muscles involved in laughter, so there is feedback to the mood regulator in the brain. It improves the mood.”3 Poor emotional health can predispose us to lower immunity against disease. Author Deepak Chopra has stated that when we laugh, we feel happy, and “happy people are healthier than unhappy people. It appears that happiness, which simply means having happy thoughts most of the time, causes biochemical changes in the brain that in turn have profoundly beneficial effects on the body’s physiology.”4

Recently, more people have been turning their attention to natural health remedies. Laughter is the most natural remedy for emotional pain, loss, sadness, fear, and anger. It is also a remedy for seriousness, which our society seems to have in abundant supply. Perhaps the first person to draw public attention to the practice of intentional laughter for healing was Norman Cousins in his landmark book, Anatomy of an Illness, where he describes his struggles with arthritis, using laughter for pain relief and his healing process: “I made the joyous discovery that 10 minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep,” Cousins reported.5


How it works

Laughter is a stressor, providing what pioneering biologist Hans Selye has called “eustress” (“eu” meaning “good” in ancient Greek) or pleasant stress.6 This is distinctly different from distress, the unpleasant and damaging stress. Hans confirms that stress in life is unavoidable, even while fully relaxed and asleep. “Complete freedom from stress is death,” he states.6 A certain amount of tension (tonus) in our bodies is good, but hypertension can be damaging if prolonged.

The increased physical stress on the body through prolonged laughing spikes tension upward because the body produces endorphins (eustress). This action lowers the production of cortisol, which is the hormone produced in a “fight or flight” experience (distress). The endorphins, combined with an increase in oxygen intake, shift the body’s physiology, resulting in a positive mood change. As the laughter subsides, the tension falls precipitously, creating a peaceful, relaxed, and mentally alert state.

Positive emotions and activities have been found to increase our Happiness Quotient (HQ), which, in reality, is more important than our IQ—because no matter how smart we are, if we aren’t happy, it matters little.


Reconnecting with laughter and life

As anticipated by the Greek physician Hippocrates, positive emotions and healthy outcomes may be linked through multiple pathways.7

Now we know laughing is good for us, both through research and personal experience. So what can we do to bring laughter back into our lives? One powerful approach is to use laughter deliberately to promote good health and healing, rather than just as a reaction.

One intentional laughter practice being taken up around the world is Laughter Yoga. Laughter Yoga combines prolonged laughter with deep breathing. The concept of Laughter Yoga is based on a scientific understanding that the body cannot differentiate between fake and real laughter, giving us the same physiological and psychological benefits. In a Laughter Yoga class, laughter is simulated as a body exercise in a group—we start off “faking it,” and through eye contact and childlike playfulness, it soon turns into real and contagious laughter.

Having lead Laughter Yoga sessions for 14 years, I have noticed that new participants tend to enter with one of three basic attitudes: 1) Eagerly looking forward to the fun, 2) Unsure of what to expect, or 3) Asking themselves, “What am I doing here?”

Through brief introductions, I get a sense of the participants’ emotional states prior to the session. I can’t wait to see their transformation. The first thing I explain is that there is no right way to feel at the beginning and no right way to do the laughter games and practices. In fact, real laughter is not even necessary. We use the principle of “Fake it until you make it!” Just going through the motions of laughter induces the release of endorphins.

We don’t use comedy or jokes to get people laughing, though I must admit it does sneak through the back door at times. Instead we use brief laughter games to stimulate and trigger the laughter. The laughter games are brief improvisational activities done to encourage and stimulate the laughter. They engage in the process of “acting as if” something is funny. (In fact, as a side note, actors who have attended a session have told me that these are great exercises to practice for learning to react spontaneously in theatre.)

Literally hundreds of such exercises can be done seated or standing and moving around. The idea is to take a familiar action or movement, such as sneezing, and add laughter to it. Things that we normally take very seriously, like writing checks for our bills, can be used as well. Or pretending to be walking around in a crowded airport or shopping mall listening to your cell phone and acting as if the caller is telling you the funniest joke you’ve ever heard. The length of the laughter depends on the group—whether they are the general public, disabled, elderly, etc. I tell newcomers that even hearing people laugh can have a beneficial effect on us and to do the best they can with the games and laughing meditation.

Laughing meditation is a good way to allow participation for those unable to do the more physical laughter games. It can be done sitting or lying down. As the leader, I announce that I will laugh for the next five minutes, and the participants can join in and laugh as much of that time as they feel it is comfortable. The most important part is that the leader continues on, providing a very permissive environment for the participants to experiment with their laughter.

We encourage closed eyes during the meditation, which allows them to be more focused on their own experience. Even giggles are good, no pressure to perform with loud and long guffaws. The two principles we use are, “Stretch, but don’t strain,” and “No new pain.” If they feel a strain or pain they can stop for a few moments or however long they feel necessary to release the strain. They can either start in again or stop entirely. They need to go at their own pace. The most important outcome is to let go, relax, and have fun with the experience. This triggers the “feel good” chemicals to release into the body.

After the laughter, it is very beneficial to allow all the good feelings to be absorbed into the body. This is accomplished by allowing at least three to five minutes of relaxation after the laughter stops. In yoga we refer to this as Yoga Nidra, or deep relaxation, where the body can readjust to its normal state with the mind calm. This usually brings a deep state of rest and repose. A very desirable state in our stressful world today.

By the time the session ends, gratitude flows out as if from a bottomless, living fountain of youth and vitality. The anxiety, stress, and burdens of the day all dissolve in the peals of laughter and fun. They feel the release and so do I. How could there be a better way to spend an hour, a real “happy hour”?

If people only knew how much fun it is to lead the sessions, there wouldn’t be any way we could keep up with the demand to train them. If there were ever an exchange that was more rewarding and fulfilling, I’ve never come across it. I am often awed by the transformations that have occurred. I don’t know how many times participants who had the “what am I doing here” look have approached me after class and expressed gratitude for being introduced to such a wonderful experience. They often tell me of the way they got there—even sometimes being “dragged” there by their friend or relative.

I understand their initial reluctance to attend a session. Frankly, there are times when I don’t feel like doing it. For me, beginning the practice of Laughter Yoga was much like beginning to jog regularly. Often I would feel too lazy or pulled toward something more “fun.” But after developing the habit of jogging, I could not imagine doing anything else. Someone once said to me that how you feel at the beginning of the practice is not how you will feel at the end. With Laughter Yoga, it is much the same. Over the years I have come to see that the “me” that enters the session is not the same “me” that leaves it. And that helps to set aside any reluctance I may have at the start. At the end I always feel revitalized, transformed into the person I truly wanted to be.


The philosophy

I absolutely love watching peoples’ faces bloom into the most radiant smiles during Laughter Yoga, and I am always amazed at how people who were complete strangers at the beginning of the session talk over lunch as if they’ve known each other for years.

Mary Tadokoro, Laughter Yoga leader in Japan

Occasionally someone will ask, “What is the connection between laughter and the spiritual discipline of Yoga?” My answer is that Yoga is a practice and a philosophy with the guiding principle of regaining unity of mind, body, and spirit. It is to help us rediscover or uncover our true nature, our true selves. The practice of Laughter Yoga is in keeping with that principle. In Indian spiritual circles it is called Hasya Yoga. Hasya is the Sanskrit term for laughter.

Laughing brings in more oxygen, which promotes clear thinking. This a direct connection to the yogic practice called pranayama. The purpose of pranayama is to regulate breathing so that we maintain a wide-awake, energized state, which is accomplished by increasing oxygen.

Another practice in Yoga is called Maitre, a Sanskrit word meaning unconditional friendliness to ourselves and others. When we practice proactive laughter, it gradually shifts our mood to one of warmth and camaraderie. We not only renew a sense of unity within ourselves, but with others as well. As we flow through the games, the mind lets go, the body relaxes, and the spirit can soar.


Laugh on demand

Laughter is the best remedy, no matter the illness.
Sri Swami Satchidananda

Laughter Yoga is about opening up and stretching the dimensions of our “laugh-ability” that we have shut off. Proactive laughing is about increasing our zones of fun and promoting new levels health and vitality. We need not wait to increase the amount of laughter we can experience in our lives—we can dive in and explore for ourselves. Join a Laughter Yoga class, a Laughter Club, just start laughing at home for no reason! Feel the differences before and after. We can bring profound benefits to ourselves, our friends, coworkers, and families as soon as we commit to simply letting go and laughing!



  1. Welsh, Jennifer. Why Laughter May Be the Best Pain Medicine. Scientific American. 2011 Sept 14 [cited 2011 Oct 25]. Available from: http://www.scientificamerican.com/article.cfm?id=why-laughter-may-be-the-best-pain-medicine&WT.mc_id=SA_DD_20110914
  2. Levitt, Ellen Beth. University of Maryland School of Medicine study shows laughter helps blood vessels function better. University of Maryland Medical Center. 2009 March 9 [cited 2011 Oct 25]. Available from: http://www.umm.edu/news/releases/laughter2.htm
  3. Youtube. Available from: http://www.youtube.com/watch?v=5MCWhslUd-o
  4. Chopra, Deepak. Creating health. Houghton Mifflin Company; 1991.
  5. Cousins, Norman. Head first. Penguin Books; 1989.
  6. Selye, Hans. Stress without distress.Signet Books; 1974.
  7. Peter Salovey, Alexander J. Rothman, Jerusha B. Detweiler, Wayne T. Steward. Emotional states and physical health. American Psychologist, Vol 55(1), Jan 2000, 110-121.


Books and web links

  1. Franzini, Louis R. Kids who laugh: how to develop your child’s sense of humor. Square One Publishers; 2002.
  2. Kataria, Madan. Laugh for no reason. India: Madhuri International; 1999.
  3. Laughter: http://en.wikipedia.org/wiki/Laughter
  4. Laughter Yoga exercises: http://laughteryoga.org/index.php?option=com_content&view=category&layout=blog&id=300&Itemid=603
  5. Laughter Yoga International: http://laughteryoga.org/



BHARATA WINGHAM has been leading Laugh-a Yoga® and laughing meditations in Yogaville, Virginia since 1997 and is trained and certified by Dr. Madan Kataria, founder of the worldwide laughter clubs. He offers Laughter Yoga Leader certifications twice a year for Integral Yoga Programs at Satchidananda AshramYogaville. His books Laugh-a Yoga: Combining the Joy of Laughter and the Bliss of Yoga and An Ancient New Idea are available by request. To register for the certification go to: http://integralyogaprograms.org/2011/11/18/laugh-a-yoga%c2%ae-leader-certification-2/.


Highlighted in Frontispiece Winter 2012 – Volume 4, Issue 1
Winter 2012  |  Sections  |  Doctors, Patients, & Diseases

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