How Laughter Helps

laughter, funny, humor, hilarity, merriment, mirth

Laughter eases hospital pain

Sometimes laughter can release tension

The old adage "laughter is the best medicine" has proved its worth among children coping with pain, research suggests.

Medical experts in the USA found laughter helped children relax, which had a major impact on how they dealt with and accepted pain.

They believe the healing power of humour can reduce pain and stimulate immune function in children with cancer, Aids or diabetes and in children receiving organ transplants and bone marrow treatments.

Their study reinforces practices adopted by UK hospitals, where laughter is used as a tool to make hospital wards a friendlier place.

Dr Margaret Stuber, who led the US research, said: "We think laughter could be used to help children who are undergoing painful procedures or who suffer from pain-expectation anxiety."

"In the future, patients watching humorous videos could become a standard component of some medical procedures."

The US study, Rx Laughter, is a collaboration between the entertainment industry, paediatrics and psychiatry.

They asked 21 children aged eight to 14 to put their hand into cold water and found the whole group tolerated the temperature longer while watching a funny video.

Those who laughed most remembered less of the pain and hormone tests on their saliva showed their stress levels were lower after laughing.

Clown doctors

Dr Stuber said: "Rx Laughter's goal is to ease ill children through some of these medical procedures and minimise the traumatic effects that children experience.

"In some instances laughter may even reduce the amount of anaesthesia necessary."

Hospitals in the UK have recognised the power of laughter and some use "clown doctors" to go into children's wards and inject a bit of fun.

The clown doctors are provided by The Theodora Children's Trust charity and entertain children on a one-to-one basis.

Theodora director Joanie Speers said: "The clowns are not doctors or therapists, but very well trained artists.

"Their job is simple, but they have a very big impact.

"Some of these children are so traumatised they don't want to know.

"The clown doctors get them to laugh and they respond better."

Distraction therapy

The team of 10 clown doctors visit about 30,000 children and their families every year at hospitals in London, Manchester and Cambridge.

The clown doctors' role is endorsed by Sylvia Buckingham, principal lecturer in child health at London's South Bank University.

She said: "They make children laugh. It can be used as distraction therapy.

"When the clown doctors are there, the children can relax and know it's going to be fun.

"Laughter is such a good tool, if you can make someone laugh and forget the pain, it's a bonus."

Humorous videos, especially cartoons, are already used in anaesthetic rooms at Manchester Children's Hospital.

They have found the videos help the children relax before going into theatre.

Frances Binns, a therapeutic play consultant at Manchester Children's Hospital said: "Laughter and humour come out as a way of helping children cope with pain.

"I call it the balloon syndrome, to put a little bit of air in to help everyone relax."

Laughter may be the best medicine

The old adage that laughter is the best medicine may be true according to doctors.

Research carried out in the US suggests that laughing and having a good sense of humour can protect against heart disease.

The study by doctors at the University of Maryland has found that people who fail to raise a smile in stressful or uncomfortable situations may be more likely to develop heart problems.

The authors suggest that a daily dose of laughter - by watching a funny video for instance - should be recommended by doctors alongside exercise and a low-fat diet as a way of staying healthy.

The researchers interviewed 150 people who had either suffered a heart attack or had undergone bypass surgery. Their attitudes were compared with 150 healthy people of the same age.

Embarrassing situations

Each participant was asked how they would react to a number of uncomfortable everyday situations.

These included arriving at a party to find somebody else wearing the same outfit and having a waiter spill a drink over them at a restaurant.

The researchers found that people with a history of heart problems were more likely to get angry or hostile rather than laugh or use humour to overcome the embarrassment of the situation.

People with previous heart conditions were also less likely to laugh even in positive situations.

The doctors who carried out the study believe the differences are significant. However, they are unable to explain why laughter may protect the heart against disease.

'The best medicine'

Dr Michael Miller from the University of Maryland said: "The old axiom that 'laughter is the best medicine' appears to hold true when it comes to protecting your heart.

"We don't know yet why laughing protects the heart but we know that mental stress is associated with impairment of the endothelium, the protective barrier lining our blood vessels.

"This can cause a series of inflammatory reactions that lead to fat and cholesterol build-up in the coronary arteries and ultimately to a heart attack."

Speaking at an American Heart Association Conference in New Orleans, Dr Miller suggested that doctors should perhaps consider "prescribing" laughter.

"We know that exercising, not smoking and eating foods low in saturated fat will reduce the risk of heart disease.

"Perhaps regular hearty laughter should be added to the list. We could perhaps read something humorous or watch a funny video and try to find ways to take ourselves less seriously.

"The recommendations for a healthy heart may one day be exercise, eat right and laugh a few times a day."

'Comfort foods'

A spokeswoman for the British Heart Foundation said the findings made sense.

"Depression, anxiety and social isolation can hinder patients recovery after heart attacks, so it does follow that laughter and a positive attitude could play some part in relieving stress and improving outcome for patients with heart disease.

"Perhaps people who laugh a lot are less likely to be stressed.

"Stressed, anxious or depressed people may also be more likely to smoke, be physically inactive and rely on high fat 'comfort foods' and alcohol as part of their coping strategy.

"And unfortunately these are likely to increase the risk of heart disease further. We should all learn to laugh more. Perhaps it's good for our hearts - it definitely makes you feel better."

Humor was the last thing on Sharon's mind. She had recently undergone a double mastectomy, and was trying to get used to her prosthetic breasts. As usual, she had gotten up, put the coffee on, and went out to get the morning paper. But when she bent over to get the paper, one of her breasts popped out, and fell to the porch. Her dog, always on the lookout for a new toy, grabbed it and ran out into the yard for a game of "catch me if you can." Sharon ran after him, chasing him back and forth across the yard, shouting, "You let go of my breast! Come back here with my breast!"

Realizing what the neighbors must be thinking, she suddenly stopped and looked around. No witnesses. Then it hit her-the silliness of the whole situation-and she began to laugh. She convulsed with laughter for what seemed like several minutes, laughing so hard that tears were streaming from her eyes. When she finally stopped, she realized that it was the first time she had laughed since her surgery. And it felt great! She determined that from that point on, she would never again be without humor and laughter in her life-no matter how tough the days.

On June 2, 1996, I found myself in Binghamton, NY doing a program for cancer survivors and their families on National Cancer Survivors Day. A woman came up to me after the program and told me about her struggle against brain cancer during the previous two years, and that her doctors were continually amazed at how well she was doing. While some who were close to her seemed to be preparing for her death, she was very full of life and planning her future. She attributed her success to the fact that she had a good sense of humor, and always tried to find a light side of things- even on the toughest days.

My friends, who know I earn a living by talking to people about how humor helps cope with life stress-while contributing to physical health and wellness at the same time-are always puzzled when I tell them I'm speaking to cancer survivors about humor. "My God!" they say, "How can you laugh at cancer? There's nothing funny about getting cancer." And, of course, they're right. There's never anything funny about the fact that one has cancer. But learning to find a light side of things that happen as a result of your cancer, and keeping your sense of humor about the everyday things that have nothing to do with cancer, give you a powerful tool in coping with all the tough days you face. Your sense of humor also helps bring back some joy into your life.

There's no evidence that humor and laughter add years to your life, but they certainly add life to your years. The reason so many hospitals provide programs on humor for their Cancer Survivors Day program is that shared laughter reminds us better than any other experience that the day is really devoted to a Celebration of Life!

After virtually every program, someone comes up to me and says, "You know, what you said is so true. If it hadn't been for my sense of humor, I would never have gotten through the treatments, let alone the disease." They note that finding a light side of things was essential to maintaining hope and determination to fight the disease. In the March/April, 1996, issue of Coping, Steven Barish noted how important humor and a positive attitude were in his own recovery from non-Hodgkin's lymphoma. Gilda Radner (Saturday Night Live) and Michael Landon (Bonanza ) were models for us all as they showed the power of humor and laughter to boost the quality of life while battling cancer.

Of course, you don't want to use humor to deny the reality of the disease. You expect to go through a period of shock and denial when you receive your diagnosis. If you use a lot of humor during this early period after getting the news, chances you're probably not using it in a healthy manner. One woman, upon learning about her own cancer, spent the next couple of weeks telling people, "The bad news is, I have cancer. The good news is, I'm biodegradable." The constant joking, in her case, was probably a sign that she was refusing to come to grips with the reality of her disease.

Once you've reached the stage of acceptance, and are ready to move on and battle the disease as effectively as you can, humor is a powerful tool to help you cope on a day-to-day basis. If you haven't yet learned this lesson, perhaps a little information on the latest exciting research on the coping and health benefits resulting from humor will give you the incentive you need to make the effort to build more humor into your life.

The key, according to Pert, is found in complex molecules called neuropeptides. "A peptide is made up of amino acids, which are the building blocks of protein. There are twenty-three different amino acids. Peptides are amino acids strung together very much like pearls strung along in a necklace." Peptides are found throughout the body, including the brain and immune system. The brain contains about 60 different neuropeptides, including endorphins. Neuropeptides are the means by which all cells in the body communicate with each other. This includes brain-to-brain messages, brain-to-body messages, body-to-body messages, and body-to-brain messages.

Individual cells, including brain cells, immune cells, and other body cells, have receptor sites that receive neuropeptides. The kinds of neuropeptides available to cells are constantly changing, reflecting variations in your emotions throughout the day. The exact combinations of neuropeptides released during different emotional states has not yet been determined.

The kind and number of emotion-linked neuropeptides available at receptor sites of cells influence your probability of staying well or getting sick. "Viruses use these same receptors to enter into a cell, and depending on how much of the natural peptide for that receptor is around, the virus will have an easier or harder time getting into the cell. So our emotional state will affect whether we'll get sick from the same loading dose of a virus."

This kind of conclusion from a researcher at the cutting edge of research on the mind/body connection should give you all the motivation you need to undertake the 8-Step Humor Development Training Program. Your sense of humor helps assure that these chemical messages are working for you, not against you. "The chemicals that are running our body and our brain are the same chemicals that are involved in emotion. And that says to me that . . . we'd better pay more attention to emotions with respect to health." (Candace Pert)

It was noted earlier that preliminary research suggests that humor/laughter stimulates the production of helper T-cells, the cells attacked by the AIDS virus. If humor was to help the body battle AIDS (there is presently no evidence that it does--or does not), it probably wouldn't be as a mere result of the production of more helper T-cells, since there would be every reason to expect these new cells to also be invaded by the virus. Rather, it would probably be due to the neuropeptides produced by the positive emotional state that goes along with humor and laughter.

Along these lines, Pert has noted that "The AIDS virus uses a receptor that is normally used by a neuropeptide. So whether an AIDS virus will be able to enter a cell or not depends on how much of this natural peptide is around, which . . . would be a function of what state of emotional expression the organism is in."

"This I believe to be the chemical function of humor: to change the character of our thought." (Lin Yutang) 

This research will not be exhaustively reviewed here, but some of the major studies will be presented to show you that there is no longer any doubt that your daily mood or frame of mind makes a significant contribution to your health--especially when the same mood or emotional state persists day after day, year after year. Anything you can do to sustain a more positive, upbeat frame of mind in dealing with the daily hassles and problems in your life contributes to your physical health at the same time that it helps you cope with stress and be more effective on the job.

Your sense of humor is one of the most powerful tools you have to make certain that your daily mood and emotional state support good health, instead of working against it. Humor also helps you maintain a healthy lifestyle in general, a practice that is increasingly being recommended by health care professionals as the country shifts toward an emphasis on preventive medicine.

(Excerpt from Chapter 1, Health, Healing and the Amuse System: Humor as Survival Training)

Most important: People suffering from a variety of diseases have been benefited in some way or the other but we don't claim to having cured long-standing ailments with Laughter therapy. Laughter is more of a supplementary and preventive therapy. so far we have not done any research, but we are starting clinical research very soon .It will take a couple of years before we publish research data on laughter therapy. Based on the interviews of hundreds of people in India and research done all over the world, we have found that laughter has helped many people.

What Happens During a Laughter Therapy Session ?

All the members of the Laughter Club gather at a fixed time in the morning and stand in a circle or a semi-circle with the anchor person in the middle. He/she gives commands to initiate various types of Laughter and deep breathing exercises.

Breathing Exercises

The session starts with deep breathing exercise, 5 times, where people take a deep breath simultaneously raising their hands up towards the sky keeping their elbows straight. The breadth is held for a few seconds while stretching the body. The breath is then released slowly taking double the time than that of inspiration. This breathing exercise resembles pranayam or Talasna in Yoga.

Ho-Ho, Ha-Ha Exercise

1. All the members start chanting Ho-Ho, Ha-Ha with their hands slightly raised and bent at the elbows. The sound should come from the naval with the mouth half open. It is better to do this exercise in a rhythm, swinging their body as if one is enjoying the exercise. Slowly the speed of the Ho-Ho, Ha-Ha is increased, under the guidance of the anchor person, who bursts into loud laughter with arms thrown up in the sky. All the group members follow suit and laughter continues for about 10-15 seconds or more, depending upon the capacity of the individual

2. Every member would raise his hands up towards the sky while laughing, which is an easier position to laugh in and makes one feel less inhibited. Each laughing session starts with deep breathing exercise, where members stretch their hands upwards and take deep breaths hold their breaths for some time and then release their breaths. This breathing exercise is similar to Pranayam in Yoga, which helps in increasing the vital capacity of the lungs and helps in producing laughter.

3. After deep breathing everybody starts chanting Ho, Ho, Ha, Ha. Slowly increasing the speed of the chant, they slowly burst into hearty laughter by stretching their hands up and looking at each other's faces. Each laughter lasts for about 20-30 seconds and sometimes 45 seconds. This Ho-Ho, Ha-Ha exercise is called 'Kapalbhati' where there is a rhythmic movement of the diaphragm and abdominal muscles. It helps to facilitate the lungs in order to initiate the laughter. When a large number of people gather and chant Ho-Ho, Ha-Ha, it charges the whole atmosphere with laughter.

4. All the members were instructed to laugh at the same time following the instructions of an anchor person who conducts the session. The anchor person gives the command 1..2..3. If all the members start laughing at the same time the effect is good. While laughing the participants are instructed to look at each other's faces, as everyone has a peculiar style of laughing. This helps to enhance the stimulus and generate natural laughter.

5. Over a period of 15 days a few more types of laughter were created like laughing with mouth wide-open, no-sound, laughing with lips closed and little humming sound, medium laughter and cocktail laughter where every member tries laughter in five different ways like Ho-Ho, Ha-Ha, Hee-Hee, Ooh-Ooh etc. In a nutshell it is not at all difficult to laugh without jokes if laughter is practised in a group.

At five in the morning every Sunday, joggers in New Delhi's parks can expect to be greeted by masses of chirping birds, jogger’s wheezing and the chuckling of their fellow outdoor exercisers.

Oblivious to the fact that it was World Laughter Day, the group was busy with its regular exercise - laughing. For over two minutes the group, ranging in age from 12 to 75, guffawed hysterically for no obvious reason.

Seventy-one-year-old Diljeet Singh is one of the cacklers. Head of an advertising agency in New Delhi, the grey-bearded Sikh is an amiable personality.

"Laughing is a complete exercise for lungs, heart, vocal chords and the entire nasal tract," says Singh.

A yoga enthusiast since 1972, Singh believes morning yoga exercises, including belly laughs, cured his angina.

Group instructor Puran Singh Rawat, 33, took up practising yoga when afflicted with a severe backache at a young age, when the word spondylitis was still unknown to him.

He says the morning laugh has not only relieved his back pain but keeps the smile on his face the whole day.

"Modern-day stress can have a devastating effect on your health. The laugh therapy leaves you feeling light at heart, free of all worries and tensions," beams Rawat.

Adherents believe the health benefits of laughter therapy are many, including gastritis relief, lower blood pressure and less severe diabetes, and they say laughter therapy benefits corporate power-suit types too.

Dr Madan Kataria, founder and president of Laughter Clubs International, says the technique reduces inhibitions, boosts self- confidence and develops leadership qualities. Starting the day on a positive note improves performance.

Kataria says group laughter therapy removes negative influences like guilt, anger, fear, jealousy and ego problems and redirects practitioners toward forgiveness and better understanding of human relationships.

To laugh without any reason is considered to be foolish. One who laughs alone is a stupid fellow. Laughing loudly is against etiquette. Because of the above self-imposed restrictions in society, a mental blockade against laughing has resulted. To add to that are the modern stress and the strains of life, people have forgotten to laugh.

When we do the act of laughing, we are doing only one act, that is act of laughing, nothing else but laughing. The mind is full of happiness, full of positive vibrations. There is absolutely no entry for the negative vibrations.

What does a simple emotion like laugher and a universally acclaimed form of exercise such as yoga have in common?

Yoga has always been distinguished as a classic system of Hindu Philosophy because of the marvels of bodily control it instills by its practice. A regular exercise of yoga produces such a unique physiological balance in the human body that it is incomparable to any other form of exercise. Laughter on the other hand is a cognitive, affective and behavioral response familiar to every one of us. So what is common between laughter and yoga?

Laughing and Breathing

A crucial element which is shared by both yoga and laughter is that of "breathing – a respiratory response". The specific pattern of inhalation and exhalation that is practiced in a few yoga exercises is also performed when the individual is laughing.

More so when this laughing is done in a specific fashion as in laugher therapy. Various forms of exercises are done which incorporate different kinds of laughter. These laughing exercises stress the different organs and muscles providing benefits, which are similar to that of yoga. Yoga has been and still is a philosophy that believes in ‘Emotional Control’. And laughter is on the other end of the continuum being a response, which defines an emotion, we all go through in our daily lives. And though balance of emotion is what is preached in yoga, a happy and laughing attitude is what is practiced, explains Ashrafi Baker who has been a yoga instructor for 28 years.

Though we would find it difficult to believe, they do share common assets. The two categories of yoga exercises that share these common physiological benefits with laughter are that of ‘Asanas’ focusing on the Digestive system and the Respiratory system. The organs involved in the process of digestion are the stomach, the small intestine, the pancreas and the liver; all of which are situated in the abdominal cavity. The incredible in-built mechanism that we have, to keep the function of these organs healthy is normal respiration. With every exhalation and inhalation our body provides a 24-hour massage to these organs. This gentle and automatic massage keeps the digestive organs healthy. Yoga provides certain exercises that enhance this regular respiratory pattern and hence focuses totally on increasing the strength and elasticity of the abdominal muscles.

Specific exercises, ‘Bhujangasana’, ‘Salabhasana’ and ‘Dhanurasana’, are done to maintain the strength and elasticity of the muscles. This massage not only keeps the abdominal muscles healthy but also keeps the abdominal organs in proper positions in the abdominal cavity. Normal respiration is also enhanced when an individual laughs. The respiratory pattern of laughter completely replaces that of the usual regular rhythmic respiration. According to William Fry Jr., "laughter with its complexity and multiformity appears to precipitate utter respiratory chaos."

This leads to physiological benefits. And it is this change in the respiratory pattern that bears resemblance to the breathing exercises followed in yoga. Also individuals respond to humor differently and thus there are a variety of styles that we laugh in. When we laugh with the mouth closed which is practiced as silent laughter, the strain is applied on the abdominal muscles. It is this specific movement that provides exercise to the abdominal muscles.

Internal Massage

Anecdotal evidence is the common response of "stomach aching with laughter" which illustrates the use of the abdomen in the process of laughing. In a recent interview study it has been found that when individuals laugh, the pressure which gets applied on the abdomen helps relieve constipation.

 And hence this simple response of laughter is also an aid for effective removal of waste from the body, providing benefits similar to that of yoga breathing techniques. But not all benefits can be incurred by laughter. According to Ravi Dixit, a yoga instructor at the Kaivalyadham, laughter and yoga can share a few similarities such as exercises of abdominal muscles. But he further elaborates by saying that this effect can be obtained by emotions of laughing and crying, and so it is a scientifically difficult task to prove that the effects can be compared to that of yoga.

The second system of exercises in which yoga and Laughter share common benefits is the respiratory system. An important nourishment for the body is oxygen, which is taken from the respiratory system, and the principle organ for respiration is the lungs. Breathing is not dependent only on lungs but also on the respiratory muscles. Similar to the abdominal muscles, respiratory muscles also must be strong and healthy for satisfactory breathing. For the body to get the required amount of oxygen there are three important criteria to be satisfied.

The lungs must be healthy The respiratory muscles must be strong The respiratory passage must be clear. Yoga provides specific asanas to fulfill the above-mentioned criteria. Asanas such as ‘Salabha’ and ‘Mayura’, which involve deep inhalation and retention of breath, are just a couple amongst others. Moreover when the individual laughs heartily he uses the lungs similarly where in the muscles are stretched to their full extent, thereby maintaining their elasticity.

Even the respiratory pattern is no longer rhythmic and therefore in the process of laughing an individual also provides more than the adequate supply of oxygen, which is very essential to the circulatory system. Furthermore, in the study mentioned above, it was found that individuals who regularly laugh as for example in a Laughter Therapy club, a reduction in asthmatic attacks and bronchial problems has been reported.

Laughter has been shown to lower the level of stress hormones (epinephrine, cortisol, dopac, and growth hormone) in the blood, (temporarily) lower blood pressure, and reduce pain. As Groucho Marx put it, "A clown is like an aspirin, only he works twice as fast." Laughter also provides an excellent source of cardiac exercise-especially important for senior citizens or non-ambulatory patients-and triggers a peculiar breathing pattern that offers significant respiratory benefits. It lowers the amount of residual air in the lungs, replacing it with oxygen-rich air. This reduces the level of water vapor and carbon dioxide in the lungs, thereby reducing the risk of pulmonary infection.

There is no doubt that humor helps you sustain a more positive, optimistic daily attitude. It nurtures hope and determination to overcome your cancer. Dr. Bernie Siegel has been reminding us for years that emotional factors can play an important role in battling disease, and a growing body of evidence from the new field of medical research called "psychoneuroimmunology" confirms this view. By sustaining a more positive mood, and reducing the amount of time spent in a state of anger, anxiety, or depression, you are playing an active role in mobilizing your body's own health and healing resources. Your emotional state begins working for your health, rather than against it.

So you have every reason to humor your tumor. It builds some joy into your life during a period when it seems like all you know is anxiety, anger, depression, and pain. It gives you an energy boost on the days when you have none. And it helps assure your body is fully committed to battling your disease.

Remember, "They who laugh, last."

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A Funny Way to Lose Weight: 
Laugh It Off

By Don Oldenburg
The Washington Post
Published on: 04/17/05 

Weight loss is hardly a laughing matter here in the Obese Nation, where two-thirds of adults are overweight or worse. But the newest aha! breakthrough in the battle of the bulge just might prompt a snicker — and maybe make you healthier.

One can lose weight by laughing.

No joke.

Instead of yo-yo dieting, try ho-ho dieting.

Before guffawing at the notion that mirth reduces girth, be aware that purposeful laughing is gaining a following. Thousands of laugh clubs worldwide now invite people to, well, laugh out loud together. A hybrid branch of psychology called "laughter therapy" is finding its way into hospitals and nursing homes with mood-lifter activities.

A new exercise movement called Laughtercising has created guidebooks and laugh-track CDs of nonstop hooting and howling to get the yuks started. Even scientists are examining the good laugh in clinical studies.

"When it comes to the weight-loss arena, I ask myself: Is laughter a gimmick or a gift?" says Katie Namrevo of Bellevue, Wash. "Some people don't take this seriously."

But she does. On the back cover of her 2004 book, "Laugh It Off! Weight Loss for the Fun of It," is a "before" photo showing her as a frumpy 50-year-old and an "after" photo as a 54-year-old who says she laughed off 35 pounds.

Namrevo was a "stress eater" who had tried all the diets and pills, she says. They only added stress and she didn't lose an ounce.

One day, after watching a TV program on laughter therapy, she headed to the fridge to "medicate" and decided to try laughing instead. Loud, long and hard, like a lunatic.

Giving new meaning to the phrase "belly laugh," Namrevo says she found that laughing 30 seconds to five minutes as often as 10 times a day, she no longer craved food. She began losing weight and she had more energy and a desire to exercise. "Laughing is a happy and healthy thing to do," she says.

Which may mean it's only a matter of time before Robin Williams and Chris Rock join the ranks of fitness trainers.

Laughing exercises "will definitely become a part of all the fitness clubs and yoga centers," predicts Thomas Varkey, a business consultant who two years ago founded the Laughter for Life club in Boston. Members meet for 25 minutes twice a month for yoga-inspired, roll-on-the-floor laugh-o-ramas.

Varkey's laughter club is one of about 1,000 in the United States and 3,000 worldwide. Most clubs are founded by "laughter leaders" trained and certified by either of two laughter-advocacy organizations, Laughter Club International, based in Mumbai, India, or the World Laughter Tour, based in Gahanna, Ohio.

"It gives a lot of exercise to our body and a kind of well-being," says Varkey. "The well-being helps us not to eat too much. When we are depressed, we tend to eat more. Laughing is antidepressant medicine."

When Chicago public relations professional Betty Hoeffner decided last year to make a CD of uproarious laughter, friends thought she was crazy. But she had been using concerted laughter to reduce stress for years and was convinced that laughing 10 minutes a day would reduced stress for others. So she founded the Laughtercising program that gradually builds up people's ability to laugh hard for 10 minutes at a time.

"It's just laughing, but you have to work up to the 10 minutes just as you would in any exercise program," says Hoeffner, who sells the $10 recording through online retailers and at her Laughtercising and HeyUgly Web sites, the latter dedicated to increasing self-esteem in teens. Sales are "picking up," she says. "It has just been word of mouth — ha! ha!"

Hoeffner breaks into a big raucous laugh as a spontaneous demonstration of proper technique. "You just keep going and going and you work up such a sweat and your abs are aching," she says. "You get so much energy you'll be vacuuming your house at 10 o'clock at night. Just try it!"

"The laughter industry is really funny to me," says physician Patch Adams, an alternative-medicine advocate and the icon of the health benefits of laughter, who returned last week from taking 32 clowns, a third of them high school students, on a tsunami relief trip to Sri Lanka.

"The clearest connection (of laughter to weight-loss) is that depression, boredom and loneliness are the gigantic reasons why people eat gigantic quantities of trash and fatness," says Adams, who founded the Gesundheit! Institute in suburban Washington and West Virginia, which works to bring fun and creativity to health care. "It's not really laughter that is a great power, but the life that leads to laughter and the readiness to laugh at things."

Jacki Kwan, a Bethesda, Md., clinical social worker and laughter club leader, says if there's weight loss from laughing it's because people feel better about themselves. "If laughter would help you lose weight, then I would be very thin and I am not. But in conjunction with other things, exercise and eating right, yes."

Kwan leads her "Ha!Ha!logy" therapeutic humor program twice weekly with elderly residents at the Hebrew Home of Greater Washington. The 15-to-30-minute sessions start with breathing exercises, move to "ho-ho-ha-ha-ha" chanting and clapping, then a closed-mouth humming laugh exercise and finally the open-mouth-tongue-out lion laugh.

"When they begin to focus on the physical exercise of laughing, people tend to forget what's wrong," Kwan says. "Laughter brings you into the moment where there is no pain, fear and anger — only joy and love. The tendency is to feel better about who you are — which might lead someone to take better care of themselves and make better food choices and do exercise."

Science is finding that laughter alone produces biological benefits. A study from the University of Maryland School of Medicine in Baltimore, presented last month to the American College of Cardiology's annual conference, showed that daily hearty laughing increases the flow of blood by expanding vessels constricted by stress.

"A belly laugh is internal jogging," says William Fry, associate professor emeritus of clinical psychiatry at Stanford University. Laughing involves "a great deal of physical exercise and muscular behavior" — 15 facial muscles plus dozens of others all over your body that flex and relax. Your pulse and respiration increase, oxygenating the blood.

"Laughing 100 to 200 times per day is the cardiovascular equivalent of rowing for 10 minutes," Fry calculates.

How often do people laugh per day? "Far more than they realize," he says, adding that any kind of laughter sets the respiratory apparatus and its muscles into motion.

Which means even brown-nosers who laugh too hard and too long at the boss' jokes are getting healthier, if not ahead.

Other studies have found that laughter bolsters the immune system, regulates abnormal heartbeat related to stress, improves the respiratory system and relaxes muscle tension.

Lee Berk, associate research professor of pathology and human anatomy at Loma Linda University and a pioneer in studying the physiological effects of laughter, says regular "happy or joyful laughter" in the right doses decreases detrimental hormones and increases beneficial ones.

"That we have proven," he says. "The biological changes we see with moderate, routine exercise is very similar to the changes we see with the constant use of mirthful laughter."

But can laughter make an ounce of difference in that midriff bulge? That hasn't been proved but can be extrapolated, Berk says. "We know the mechanisms," he says, explaining that stress increases cortisol, the hormone that causes craving for food, and laughing reduces it.

Berk figures that one day doctors will tell overweight patients to eat right, exercise regularly and get 15 minutes a day of good hearty laughter. "I'm doing it now with my patients," he says.

Robert Provine, professor of psychology and neuroscience at the University of Maryland Baltimore County, thinks that would be a little premature, scientifically. In 2000, he wrote the book "Laughter: A Scientific Investigation." He says that for laughter to produce the same benefits as aerobic exercise it would require a long, sustained bout of hysterics.

"If we were treating laughter as a drug and it had to go for review before the FDA," he says, "it wouldn't pass because we really don't understand its physiological correlates and consequences."

He pauses to chuckle. "Having said that, a life with laughter is certainly more fulfilling than one without."

Of Namrevo's story of shedding pounds with laughter, Provine says: "If it works for her, that's fine. ... If you're laughing, you aren't eating."

But Namrevo thinks there's more to it than that: "I have to believe that it will work for anybody. The gift of laughter is available to everybody. It is amazing. And the side effects are all good."

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