How to get through the pandemic: Try a little laughter

Possessing a healthy sense of humour is also associated with living longer. PHOTO: AFP

NEW YORK (NYTIMES) - Some enlightened doctors, nurses and therapists have a prescription for helping all of us to get through this seemingly never-ending pandemic: Try a little laughter.

Humour is not just a distraction from the grim reality of the crisis, said Dr Michael Miller, a cardiologist at the University of Maryland School of Medicine in Baltimore. It's a winning strategy to stay healthy in the face of it.

"Heightened stress magnifies the risk of cardiovascular events, including heart attacks and strokes," he said. "Having a good sense of humour is an excellent way to relieve stress and anxiety and bring back a sense of normalcy during these turbulent times."

Laughter releases nitric oxide, a chemical that relaxes blood vessels, reduces blood pressure and decreases clotting, Dr Miller said. An epidemiological study of older men and women in Japan confirmed that those who tend to laugh more have a lower risk of major cardiovascular illness.

Possessing a healthy sense of humour is also associated with living longer, an epidemiological study from Norway reported, although the correlation appears to be stronger for women than for men.

Armed with this growing body of research, Dr Miller prescribes "one good belly laugh a day" for his patients. It's not just going "ha, ha," but a "deep physiological laugh that elicits tears of joys and relaxation".

While the long-term impact of such a practice remains unknown, neuroscientist Sophie Scott of University College London said laughter has been shown to reduce the stress hormones cortisol and adrenaline and increases the body's uptake of the feel-good endorphins.

Watching a funny video was tied to improvements in short-term memory in older adults and increased their capacity to learn, research by Dr Gurinder Singh Bains of Loma Linda University found.

Perhaps most relevant today, possessing a sense of humour also helps people remain resilient in the face of adverse circumstances, said George Bonanno, a professor of clinical psychology at Columbia University. In one study, he interviewed young women who had been sexually abused and noted their facial expressions.

"Those who managed to laugh or smile at moments during their interview were more likely to be doing better two years later than those who had not," he said. "Humour keeps negative emotions in check and gives us a different perspective, allowing us to see some of the bad things that happen to us as a challenge rather than a threat."

Humour and tragedy may be more intimately connected than one would think. "Charlie Chaplin once said 'In order to truly laugh you need to be able to take your pain and play with it,'" said Mr Paul Osincup, the president of the Association for Applied and Therapeutic Humor.

"Write down all of the most difficult and annoying things about quarantine," he recommends. "Play with those. See if you can find any humour in your situation."

Increasingly, humour is being integrated into mainstream medical practice with a similar goal, said Dr Kari Phillips, a resident physician at the Mayo Clinic in Rochester, Minnesota. She observed over 100 clinical encounters and discovered that humour typically surfaces about twice during a half-hour doctor visit. It is initiated in equal measure by doctors and patients, often to break the ice between them or to help to soften the impact of a difficult medical conversation.

"We found that introducing humour results in better patient satisfaction and empowerment, and it helps people feel more warmth in their connection with the doctor," she said.

Dr Peter Viccellio, a professor of emergency medicine at Stony Brook University Hospital on Long Island, has seen many Covid-19 patients during his hours in the emergency room. A touch of playfulness and kindly humour, he said, has helped to ease a painful situation for both his patients and members of the overburdened hospital staff.

"If you are empathetic with the person, your humour tends to fit them, it's not forced. If you are not emotionally connected to them and force a joke it can go very wrong."

Other kinds of joking that are potentially destructive, he said, are the in-group humour that mocks patients or other members of the hospital staff, and the gallows humour. And one needs to be careful not to appear to be making light of somebody else's pain.

Despite these potential pitfalls, some hospitals have initiated formal humour programmes, making funny books and videos available and inviting clowns in to interact with younger patients.

Some caregivers are also bringing humour into their own practice. Ms Mary Laskin, a nurse case-manager at Kaiser Permanente in San Diego, has been working with her chronic pain patients online, teaching them laughter exercises alongside practices to develop other positive mental states like gratitude and forgiveness.

"This pandemic is like a tiger creeping toward us, a huge slow-motion stressor that makes the experience of pain worse. Humour helps my patients relax and release their grip on pain," she said.

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