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Book Reviews

The Health Benefits of Humor and Laughter

By Dwenda Gjerdingen, MD, MS

Dr. Dwenda Gjerdingen is a family physician and professor at the University of Minnesota Medical School in Minneapolis.

A good laugh is a wonderful thing. It refreshes, relieves stress, generates positive emotions, promotes communication, strengthens group identity and cohesion, and benefits both the giver and receiver.1 In addition to these significant benefits, there is also evidence that laughter and humor promote good health.

There is evidence that individuals with chronic or terminal illnesses ... use humor to promote healing, and that humor does have health benefits, such as improved pain tolerance and improved immune response.

Humor is defined as a stimulus that helps people laugh and feel happy, while laughter is a response to humor that involves positive physiological and psychological reactions.2 The positive emotions associated with laughter and humor involve the dopamine system of the brain. The neurological pathways are different, though, depending on whether one’s laughter and smiling are intentionally generated, or whether they are evoked by humor. During laughter, various muscle groups are activated, but the period after the laugh is characterized by general muscle relaxation, which can last up to 45 minutes. Greater relaxation is seen with true laughter, compared to simulated laughter.3

Humor is a complex phenomenon and is thought to involve three stages: 1.The listener encounters incongruity (the punch-line); 2. The listener tries to resolve the incongruity between the punch-line and the expectation shaped by the joke (surprise and coherence); and 3.The listener concludes that what actually makes sense is pleasant nonsense (appreciation). Functional imaging during laughter reveals that different areas of the brain are involved with each of these stages.4 Interestingly, men and women often perceive jokes differently, as indicated by gender differences in both behavioral response and functional brain imaging during a humorous event.5

The possible medicinal benefits of humor were brought to our attention by Norman Cousins’ experience, as described in his article, “Anatomy of an Illness.”6 Here, he relates how laughter and vitamin C were keys to his recovery from ankylosing spondylitis. Only 10 minutes of laughter, brought on by viewing comedy films, resulted in 2 hours of pain-free sleep.

But is Cousins’ experience supported by science? Is it really true that something as basic and free as a good laugh can promote healing? Although the research on humor is limited, and the methodologies used in some studies have been criticized, there is evidence that individuals with chronic or terminal illnesses not uncommonly use humor to promote healing, and that humor does have health benefits, such as improved pain tolerance and improved immune response.

One small study of cancer patients in the rural Midwest found that over 87 percent were using at least one complementary intervention to cope with the stress of cancer, with the most popular intervention being prayer and the second most popular humor.7 In another cancer study, participants identified humor as an important factor for coping with cancer and cancer treatment, and they believed that humor played a role in their spirituality and their perception of the meaning of life.8

In one review on humor in medicine,9 the most promising results with the use of humor is patients’ response to pain. In studies that evaluated patients’ pain after their exposure to comedy videotapes, the videos improved pain tolerance and reduced the need for pain medications. Similarly, patients’ exposure to humorous videos increased salivary IgA levels, a measure of immune function.10 Humor may also have positive effects on heart disease, diabetes, blood flow, and depressive symptoms.11

In the field of medicine, humor has been used not only to improve patients’ symptoms, but also to enhance physician-patient communication and medical education. Both of these areas are fraught with stress, so it makes sense that humor might help to relieve the tension that results from ill health or the demands of training, provided it is used with consideration and appropriate timing.

In my work with medical students and residents, I find that humor often comes unexpectedly and unsought, in the midst of a busy, stressful day. Recognizing the blessing of this type of unplanned humor, and its capacity to lighten the load, I found myself recently praying as I drove to the hospital, “God, help me to see the humor in this day.” During the morning as I was meeting with our residents for teaching rounds, one of the residents told about how MRSA, a difficult-to-treat skin infection, had shown up on a patient’s chin in the form of a pimple-like eruption. He said that it was thought that the infection had been transmitted from some exercise equipment at a fitness center. I interjected, “Oh yes, there is a weight machine that has one of these little chin rests on it. Of course, when I use it, I hold my chin above the chin rest.” A rather innocent comment, I thought, but not so to the team of residents, who all burst into laughter. I’m not sure if it was my description of the “little chin rest,” or my being a graying woman in my late 50’s, talking about my personal experience with weight machines. But it so delighted me that they were all laughing, that I joined the merriment. The rest of the day was brighter — a change that no pill could have accomplished.

So, I say, let the laughter roll! So what if it runs health providers and pharmacists out of business!


1. Taber KH, Redden M, Hurley RA. Functional Anatomy of humor: positive affect and chronic mental illness. Journal of Neuropsychiatry and Clinical Neurosciences 2007; 19:359-362.

2. Bennett MP, Lengacher CA. Humor and laughter may influence health: II Complementary therapies and humor in a clinical population. eCAM 2006; 3(2):187-190.

3. Ibid.

4. Taber, Redden, Hurley.

5. Wikipedia:

6. Cousins N. Anatomy of an illness (as perceived by the patient). New England Journal of Medicine 1976; 295:1458-1463.

7. Bennett and Lengacher.

8. Ibid.

9. Bennett HJ. Humor in medicine. Southern Medical Journal 2003; 96(12): 1257-1261.

10. Bennett and Lengacher.

11. Taber, Redden, Hurley.