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Smile therapy: the benefits of laugh

“Laughter can have the same effect as a painkiller: both act on the nervous system by anaesthetising it and convincing the patient that there is no pain.”

(Patch Adams)

Smile therapy, or gelotology (from the Greek γελὸς), is now increasingly widespread in popular culture as well as in hospital practice. Among its many branches is known to all the clownterapia, made famous by the 1998 film by Robin Williams on Patch Adams. In actual fact, this particular approach has more ancient roots: in fact, in Italy, we find an example ante litteram provided by the Carmelite priest Angelo Paolo (1642-1720), who used to dress as a “jester” to make the sick and suffering laugh. In addition to the better known Gesundheit! Institute founded by Patch Adams, we find in the history of clowtherapy two other important figures, born in parallel and independently: Karen Ridd in Winnipeg, Canada, and Michael Christensen in New York.

Today, gelotology is applied in many countries around the world, taking many forms:

– clowns in hospital wards;

– refresher courses for nursing doctors;

– refresher courses for teachers;

– educational interventions in problematic class groups;

– interventions in the company and company updating;

– establishment of itinerant comic mini libraries;

– Establishment of outpatient clinics or clowtherapy/gelotology ambulances.

The well-known case of Norman Cousins, who demonstrated the therapeutic properties of laughter between the seventies and eighties, is also an example. Famous American journalist and teacher, suffering from ankylosing spondylitis, decided to treat himself with laughter: he took 25 grams of vitamin C daily via drip and watched for 3-4 hours daily comedy films (especially of the Marx brothers). Against all odds, Cousin healed within a year. A recent Canadian study then scientifically confirmed that good mood defends against infections. The studies on the subject are really numerous, we will summarize two to give our readers an idea of the potential that can be hidden behind a laugh.

The first, conducted in 2009, is entitled “Clowns for the prevention of preoperative anxiety in children: A randomized controlled trial“. The aim was to determine whether specially trained professional clowns could calm down preoperative anxiety with respect to the use of midazolam or no intervention in front of them. This is a study conducted on children aged between 3 and 8 years, under general anesthesia. The patients were assigned to one of the following three groups: group 1 received neither midazolam nor clowns; group 2 received 0.5 mg of oral midazolam 30 minutes prior to surgery, up to a maximum of 15 mg; and group 3 had two specially trained clowns available, present at the arrival of the preoperative room and in the operating room, during the entrance and application of the mask for inhalation of the anesthesia. The resulting effect of the clowns on the reduction of anxiety was present and continued when the children entered the operating room, but at this point it was equal to the group to which the midazolam had been administered. No significant differences between the groups were found when the anaesthesia mask was applied. This study concluded that the use of clowns for children undergoing surgery can significantly alleviate preoperative anxiety.

“Laughter is the tonic, the relief, the remedy for pain.”

(Charlie Chaplin)

The benefits of laugh, as reported in the article “Laughter prescription” of 2009, are many and demonstrated by many studies: have been reported in geriatrics, oncology, critical care, psychiatry, rehabilitation, rheumatology, home care, palliative care, hospital care, terminal care and general care for patients. These and other reports constitute sufficient evidence to support what is experiential evidence: laughter and humour are therapeutic allies in healing. The study continues by introducing an area where questions remain open, namely the effect of laughter on the so-called stress hormones: epinephrine, noradrenaline and cortisol. This is very important because it has been theorized that if laughter can decrease the stress hormones. It would be a mechanism that could explain the connection between laugh and immune function, and from there to better health outcomes.

Finally, there are real courses and groups of laughter, with specific programs and guides to follow, meetings where to express joy in the company. In this case it speaks of Laughter Yoga, a practice where the laugh is deliberately forced and prolonged for many minutes if not hours. For example, one of the group programs of the American Daily Laughers Association offers the following benefits for its participants:

– Laugh more easily, be more playful and less serious and have more fun;

– Less stress, anxiety and overthinking, more joy, calm and clarity;

– Be more confident and successful;

– Deepen the embodied understanding of the thought/sense (mind/body) connection;

– Strengthen the immune system and general health;

– Win the fight with shyness, insecurity and fear of looking stupid;

– Be part of a safe space to meet people who go beyond their comfort zone;

– Create more quickly deep and peaceful ties with people;

– Develop a more creative and resilient attitude without reciting statements;

– Exit the head, enter the body;

– Practice a gentle and fun cardio exercise to do anywhere and anytime;

– Improve your ability to breathe deeply and easily;

– Spend more time enjoying the present moment.

Even in Italy, this practice has now developed into real clubs of laughter:

“Club della Risata is the name given to every group that meets to laugh for no reason with Laughter Yoga. This exercise can be done outdoors, as in the parks in India in the morning, or indoors (houses, gyms, etc.).

There are now thousands of laughter clubs in over 70 countries around the world, and if you think that Dr. Kataria began his “adventure” in March 1995 with only 5 people in a park in Mumbai, you can see how successful his idea was!

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Written by

Graduated in Literature at the University of Eastern Piedmont, he's now studying anthropological and ethnological science at the University of Milano-Bicocca. Journalist and writer, he collaborated with many local newspapers and in the 2015 he published his first book "Qui non arriva la pioggia". In the 2017 published "Il peccato armeno, ovvero la binarietà del male".

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