Humor as Diagnosis

"Laughter is the best medicine." We now have laugh therapy, laugh yoga, laugh workshops, and laugh lessons. Homage must be paid to Ed Wynn in Mary Poppins singing "I Love to Laugh". All of these refer to laughter as a treatment, which does work wonders.

However, laughter, and its parent, humor as a diagnostic tool has been overlooked. As an extremely funny physician, I have noticed that the best-healing, most intelligent patients get my jokes, while the dumb, hopeless ones do not! (HAHA). No, really, the ability to laugh is more than intelligence. In fact some of the most intelligent patients have no sense of humor. I usually resort to puns, punch lines, slapstick, and funny voices just to engage them in the healing process. Sometimes it works, sometimes it results in very awkward silences, even without fart jokes. As I told my kids, it has to be funny enough to get away with it. I’ve had to purchase special malpractice insurance to cover the damage I have inflicted with my humor. Good thing my mother told me to keep my day job as a doctor. I could never be an oncologist—starting to tell a patient about a dismal prognosis with "A funny thing happened on the way to the morgue" is just not good.

One of the best treatises on humor was written by the father of psychoanalysis, Freud, in the early 1900’s. Humor requires a recognition of contradiction; as simple as someone looking or moving silly, to abstract contradictions which fuel political satirists such as Jon Stewart. Even non-humans can appreciate humor (contradiction) at a basic level.

Smiling and its bigger version, laughter are the expression of that recognition, which has a role in social cues. Indeed, humor smiling and laughter usually require a certain social skill set, which some of us have more or less of. This "intelligence" is one of several different types. High intelligence in one sphere, such as theoretical physics, does not imply intelligence in another, such as humor—as evidenced by Sheldon Cooper on the Big Bang Theory.

On a physiological basis, there are specific areas of the brain, and functions of the mind, that participate in humor. Because humor always occurs in a context, the ability to perceive what’s funny in its context requires the integration of several neurological functions, including visual, auditory, linguistic, moral, and memory processes. On the other hand, the inability to appreciate a joke (such as mine, which are always funny), implies that there is some dysfunction (such as depression, anxiety, social issues or early dementia).

The sum of our mental functions is in part a reflection of the various neuro-chemicals floating around our body. The purpose of humor is in part to release chemical antidotes to the molecules of stress and dis-ease. Laughter usually occurs in a safe environment; we marvel at heroes who can laugh in the face of death.

We live in a stressful world; how much more or less compared to 10,000 years ago is subject to debate. However, with lifestyles that are disconnected from the solar, lunar, and seasonal cycles, as well as each other, we are subjecting ourselves to stressors previously unknown to our physiology. We are born with naturally corrective mechanisms, which include laughing often in the context of socializing, story-telling, singing, dancing and praying. These activities, tending toward marginalization in school budgets and family schedules are probably essential.

If we define a nutrient as something that we need on an ongoing basis to grow, repair, and maintain optimal health of body, mind and spirit, then humor is a nutrient. The exact dose, like other nutrients, is highly individual and dependent upon multiple factors. However, we all need some. Making the investment in watching comedy and being downright silly will pay off! LOL!

What do you find funny? What don’t you find funny? Why? How often do you smile during the day? What makes you laugh? How often do you laugh during the day? When confronted with a challenge, do you see and/or look for the humor? Do you make jokes with your family, friends, colleagues and clients? How do you react when you are teased or the subject of a joke?

2. These contents are ©2014 by Michael Cheikin MD and may not be reproduced in any form without express written permission.

3. Dr. Cheikin’s website has related articles and references such as "Yoga and Truth", "Listening to Your Pain" and others.