Essay, Research Paper
Laughter can be a powerful therapy for most patients and the caregivers. There are many benefits from the effects of humor and laughter on the body, mind, and spirit; the patient during recovery from illness; and the health professional during delivery of care. Most experienced caregivers have discovered that attention to only the physical body during treatment will render a partial or temporary recovery. The patient’s emotional responses, belief system, and support network may effect compliance of treatment and ability to cope with fear, pain, and loss.
Medical studies indicate that laughter boosts levels of endorphins, the body’s natural painkillers, and suppresses levels of epinephrine, the stress hormone. (3) The ability to laugh at a situation or problem provides a feeling of superiority and power. Humor and laughter can foster a positive and hopeful attitude. Humans are less likely to have feelings of depression and helplessness if we are able to laugh at what is troubling us. Humor gives us a sense of perspective and may allow for refocusing thoughts during times of difficultly. Laughter provides an opportunity for the release of those uncomfortable emotions, which, if oppressed, may create changes that are harmful.
Caregivers, as well as patients are in need of the therapeutic effects of humor and laughter. Healthcare providers may experience feelings of failure when their efforts are ineffective. They may feel anger and frustration when a patient rejects care or is noncompliant with treatment. They may feel grief when patients die or families mourn. Caregivers are at risk physically too (e.g., exhaustion from long shifts with inadequate staffing, exposure to infectious organisms and physical abuse from combative patients.) Ability to see the humor in a situation and to laugh freely with coworkers can be an effective way to take care of the body, mind and spirit.
Illness, either acute onset or exacerbation of a chronic illness can be a stressful event. Hospitalization, separation from family, invasive procedures, complex technology, or unfamiliar caregivers can all create feelings of anxiety, loneliness, discomfort, anger, panic, and depression for the patient. These emotions are known to produce physiological changes that are harmful to the body; changes which the use of humor and laughter can ease.
Situations where humor and laughter made a significant difference in a patient’s response to care, but none as profound as this story. Fred was 60 years old and recovering from a mitral valve replacement. During his immediate postoperative recovery, Fred experienced a mild psychosis and severe depression. The acute psychotic episode resolved prior to discharge, but the profound depression continued for many weeks. Fred lacked enthusiasm for anything. He refused to eat, to walk, and even refused to wear anything but pajamas. His surgeon referred him to an outpatient cardiac rehabilitation program.
Upon entry into the program, Fred walked with a shuffling gait, responded to questions with one or two words, and was unable to make eye contact. His wife was exhausted and discouraged. For several weeks Fred had little improvement in his depression, in spite of antidepressant drugs and psychological counseling.
One day, about a month after beginning rehab, he was walking on the treadmill; his 25 lb. weight loss noticeable as his sweat pants hung loosely over his hips. After about 6 minutes of walking, his sweat pants suddenly fell down around his ankles, revealing bright red boxer shorts. The nurse hit the emergency stop button in time to prevent his falling and went to assist him. He was looking down at his dropped drawers and when he lifted his head we could see a big grin starting and he began to laugh. We smiled and joined him in the laughter, grateful for the permission to respond by laughing at the ridiculous situation. From that moment on Fred’s depression continued to resolve, he became involved in his recovery process and was able to regain his strength and he eventually returned to an active involvement in his church and community. (1)
Doctors and nurses in the Child Life Program, St. Luke?s hospital in Cincinnati, Ohio use a humor cart to help cheer up sick children. Built in the shape of a house with a big foot popping out of a chimney on top; the cart is decorated with pictures of animals and staff members. Inside are goofy props such as fake vomit, a battery-operated chicken, books and videos. The cart makes fun of some of the scariest parts of the hospital, the staff and their instruments. The director of the program, Robyn Hart, feels that this helps to boost the social and psychological development of children with illnesses. ?Humor helps to defuse their fear,? she states. (1)
Humor gives us perceptual flexibility and thus can increase our cognitive control. One nurse used her perceptual flexibility to help her cope with a demanding patient who frequently interrupted the nurse’s busy schedule with minor complaints and requests. The nurse’s patience and tolerance were wearing thin. It was lunchtime and the patients were eating when again the nurse was called to this patient’s room. Upon entering, the patient indignantly pointed to her tray and told the nurse, “This is a bad potato!” The nurse then picked up the potato and began spanking it, saying “Bad potato! Bad potato!” The patient and nurse both laughed and the tension of the moment was dissolved. (1)
The appreciation of humor is highly individual; therefore caregivers must be observant to the patient’s response. Sometimes the response may be subtle, a glistening of the eyes or flushing of the cheeks. Of course one would hope for the big smile, chuckle or playful retort; but if suspected that the patient feels insulted or misunderstood the providers intention, it would be helpful to say something like: “Gee, I sure hope you weren’t offended by that. I was just trying to lighten up the situation and help you to relax. I didn’t mean to upset you, sorry.” If the humorous attempts aren’t working with that patient, the caregiver should quit. Healthcare providers should remember never to use sexual, ethnic, or racial material with patients or their families. It is unprofessional and they risk offending the patient or losing rapport and respect.
The effect of humor to reduce stress and improve health by producing changes in the immune system has been the topic of many articles and workshops. The effectiveness of humor in moderating the effects of stress on the immune system remains unknown at this time. (2) Laughter and humor are two powerful tools, helping people cope and get through threatening situations. Looking at life’s situations with a sense of humor and laughter provides perspective and helps keep things in balance when life seems unfair.
Resources and References
1.Wooten, P. (1997) Laughter as Therapy. PULMONARY REHABILITATION.
2.Klein, A. (1989) Healing Power of Humor. Los Angeles, CA: Tarcher. Jacksonville,
FL: Headwaters Press
3.Lefcourt, H. (1990) “Humor and immune system functioning”. International Journal
of Humor Research, Vol.3, No. 3
4 Lefcourt, H. (1986) Humor and Life Stress. New York, NY: Springer-Verl