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Guest Editorial

JOAN JACOBSON

It is really true that laughter is some of the best medicine for staying well and healthy. And, there is even simple scientific evidence. When you laugh endorphins are released, they are the body’s natural painkillers, and they suppress epinephrine, the stress hormone.

Twenty-seven years ago, in 1979, Norman Cousins wrote "Anatomy of an Illness" after having a life-changing experience. He was stricken with a crippling and life-threatening collagen disease. Collagen is the fibrous protein in the bones, cartilage, tendons and other connective tissue. Cousins was treated by his physicians who predicted that he didn’t have long to live. He decided to take matters into his own hands. He followed a regimen of high doses of vitamin C and positive emotions that included daily doses of belly laughter. This strategy gave him an additional hour pain-free sleep. Eventually he got well using his strategy. He said, "Laughter may or may not activate endorphins or enhance respiration, as some medical researchers contend. What seems clear, however, is that laughter is an antidote to apprehension and panic." Fifteen years later, he had a heart attack. He recovered once again using his laughter strategy, and wrote "The Healing Heart." He died in 1990, following cardiac arrest, at the age of 75. He lived years longer than his doctors had predicted, more than once. He calculated 10 years after his first heart attack, 16 years after his collagen illness, and 26 years after his doctors had diagnosed heart disease.

Cousins was invited by the Dean of Medicine, Sherman Mellinkoff, to join the faculty at the University of California at Los Angeles (UCLA) in 1978. He was designated an adjunct professor of medical humanities. What brought him to UCLA was the quest for proof that a patient’s psychological approach to illness could have an effect on biological states. Cousin was particularly interested in the impact of positive emotions and attitudes, such as purpose, determination to live and festivity. He wondered if the brain played an active, conscious role in the healing process. What would the implications of such findings be on the treatment of serious illness? Could a good vehicle for making such discoveries be the emerging field of psychoneuroimmunology? At UCLA, he appointed a task force of high-caliber scientists. Out of these efforts grew the UCLA program that was subsequently named the Cousins Center for Psychoneuroimmunology (UCLA-PNI Cousins Center).

Presently, the center is studying the psychological and behavioral and immune factors associated with environmental factors, allergy, autoimmune disease, inflammatory disease, genetic factors, cancer, infectious diseases, cardiovascular disease and stroke.

The research on laughter continues. In the January 2006, issue of the University of Maryland Magazine an article entitled "Laughter: Good Medicine for the Heart" describes the laughter research work of Michael Miller, M.D. It was shown that laughter has a therapeutic effect on the body specifically, on the endothelium, the protective lining of the blood vessels. Laughter actually caused the lining to expand allowing for increased blood flow to the heart. The study, supported by the National Institutes of Health and the Veterans Affairs Merit Award, involved 20 healthy volunteers. Their blood flow was measured before and after they watched a funny movie or a stress-inducing movie.

Prior to the study, the researchers performed a baseline test to measure how the subjects blood pressure reacted to increased blood flow under normal every-day circumstances. Each subject in the study was invited to watch a 15-minute segment of either a funny or emotionally disturbing movie. The opening battle scene of "Saving Private Ryan" was chosen for its "stress-inducing quality," and "King Pin," a zany comedy about a professional bowler was the laughter-inducing segment, according to Dr. Miller.

Following the viewing of each segment, the researchers measured the subject’s blood pressure. A sonogram was also used to measure constriction or dilation inside of the vessels in the arm. The subjects were tested on two separate days; one for the funny segment and the other for the disturbing segment.

The study participants’ blood pressure was dramatically affected by both films. In 14 of the 20 volunteers who watched "Saving Private Ryan," the blood vessels constricted and the diameter was decreased by an average of 35 percent. This is remarkable, says Miller, "because even some of those 14 subjects who had a reaction had previously seen the film." The decrease in diameter is called "vasoconstriction" and can be a potentially unhealthy development. "Over time, impairment in the endothelium (that lines the blood vessels) may be associated with a greater tendency to fat and cholesterol build-up in the coronary arteries. This can lead to heart attack," Miller explains. Conversely, after the funny movie, the blood vessel diameter (or vasodilatation) was increased in 19 of the 20 volunteers by an average of 25 percent, according to the researcher.

It was shown by the researchers that a good hearty laugh releases endorphins from the brain, which then produces euphoric feelings and wellness. Miller says, "At the very least, laughter offsets mental stress and the release of chemicals, such as cortisol that lead to a breakdown in nitric oxide, which causes vasoconstriction."

It is suggested that laughter strategies be incorporated into the treatment of heart disease as well as its prevention. The study by Miller was published in Heart in 2005, and received global attention. This is probably because it is something everyone can understand and even practice without a prescription. As Norman Cousin would suggest, I leave you with the adage: "End today and begin tomorrow with laughter."

Park City resident Joan Jacobson, PhD, RN, is an adjunct professor for the University of Utah College of Nursing. She is the author of Midlife Women.


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