Laughter Leaves Me Lighter: Coping With COVID-19 | Humanities | JAMA | JAMA Network
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A Piece of My Mind
June 23/30, 2020

Laughter Leaves Me Lighter: Coping With COVID-19

Author Affiliations
  • 1Department of Radiology, University of Michigan, Ann Arbor
JAMA. 2020;323(24):2476-2477. doi:10.1001/jama.2020.9283

In the midst of the coronavirus crisis, a friend’s email arrived. She’s well known for sending funny notes. I was home alone and opened it. It was a black and white photograph of a youngish Robin Williams, arm extended in front of a giant statue of Rodin’s The Thinker offering up a roll of toilet paper. And it instantly made me laugh. I may even had said “That’s great!” to the only person present—me. Waves of laughter brought ease, and a big smile spread across my face. I felt noticeably lighter and energized. Immediately, I began thinking: “Who can I send this to—they’ll get a kick out of it!” As the ripples of fun spread across the country, I received their enthusiastic replies.

You’ve probably experienced something similar—maybe even sent around the very same picture. I’m reexperiencing it again, as I write this. Is it just a meaningless anecdote, or does humor really help us cope? Researchers of humor have applied some serious study to this very topic. The short and soothing answer: Humor really can help us cope, and we can actively increase the humor in our lives to increase our well-being.

The “hows” and “whats” of using humor for coping are surprisingly profound. In the above story, humor researchers would be quick to note the positive effect on individual coping and on the larger social impact of strengthening bonds of friendship. Social connections are essential for our sanity and fundamental for combating the negative health effects of loneliness and social isolation.1,2

Of course, not all humor is helpful. Researchers have described specific types of humor that stand out as generally unhelpful. These include highly aggressive forms like insults and sarcasm. A self-defeating humor style, ie, those who make fun of their own weaknesses as a way to ingratiate or avoid issues, can also be maladaptive.2,3 I am not advocating or supporting racial, sexist, or other forms of humor that demean individuals or groups. A high level of tact, sensitivity, and consideration is called for when using humor. Primum non nocere applies. The intent here is on benign humor and its potential to boost coping, well-being, and social bonding.

In multiple studies across cultures, higher levels of humor correlate with more well-being, and less depression, anxiety, and negative emotions.2,3 Of course, correlation is not causation. If humor really helps, then humor interventions should generate more happiness and better coping.

I did a 2-year “humor intervention” of sorts— the improv conservatory training program at Second City. By helping me bring more humor to everyday life, it boosted my well-being. My family, friends, and colleagues noticed as well—a playful shift for the better.4 A few years later our medical school teamed with Alan Alda and the Alda Center for communicating science to offer improv workshops for our students at the University of Michigan. Our students cracked themselves up—and each other, too. They rated the workshops to be highly relevant, valuable, and fun.5

Although you can’t exactly sign up for an improv or stand-up comedy class these days, robust research indicates that there are simple and effective ways to boost the humor in your life. For sure, you can tune in for a funny movie or sitcom. Research indicates this is associated with a reduction in anxiety and an increase in positive emotions.3 Because approximately 70% of humor occurs spontaneously in everyday life, let’s focus on the everyday.2

Wellenzohn et al6 conducted the most systematic and rigorous study of humor interventions to date. They used a randomized, placebo-controlled, clinical online trial involving 632 adults to assess the value of 5 different interventions. Participants focused on 1 of 5 exercises for 7 consecutive days. Their study had a power of 0.80 or more, with 100 or more participants for each of the 5 humor intervention groups. A pretest, prior to initiation of the study, excluded those with elevated depressive symptoms. An analysis of covariance showed statistically significant effects on happiness (P < .05 to P < .001) for 4 of the 5 humor exercises. Three of the 5 exercises showed a statistically significant difference in self-reported happiness at 1, 3, and 6 months.

Their interventions are surprisingly simple. “Three funny things,” sums up the first one—just write down the 3 funniest things you experience during the day, and your feelings during these experiences.6 I’ve found it to be a quick and easy way to raise my “humor awareness.” With the daily check-in, I’m more likely to remember to add some fun to texts, emails, and daily conversations. Some days I’m pleasantly surprised to discover how much humor is showing up in my life—and on the pages of my journal. In writing about it, I get to reexperience it—a humor boomerang that’s right on target. When I don’t have much to write down, it motivates me to find—and bring—more humor the next day. The “Three Funny Things” portion of the study by Wellenzohn et al also affirmed and extended prior work by Gander et al.7 So the evidence is solid: a humor journal can help build more skills and well-being.

The 2 additional potent interventions in the study by Wellenzohn et al are also straightforward: Count all the funny things that happened during the day and note the total every night, and notice the humor experienced during the day and add new humorous activities like reading comics, jokes, and watching funny movies.6 I can attest that tracking and recording definitely helps nudge humor to a higher place on one’s radar. It takes a little effort and it packs a potent punch and proffers a pleasurable payoff.

The authors speculate that the effectiveness of these interventions may relate to the savoring of present-time positive emotions rather than ruminating about the past or feeling anxious about the future. Perhaps they’re gently nudging me toward a “positive rumination” about the fun stuff in my life.6 Whatever the mechanism, I know I’m signing up for more.

Additional humor interventions have been validated as well. A structured 7 Humor Habits Program created by McGhee3 is especially noteworthy. His interventions include “cultivate a playful attitude,” “create your own verbal humor,” “find humor in the midst of stress,” and give yourself permission to laugh more frequently, deeper, and longer. In McGhee’s program, each of the habits is addressed sequentially for a week at a time using specified interventions and reflective or journaling practices. An additional week is dedicated to integration of all 7 habits.

So go ahead! Pick a specific intervention that tickles your curiosity. Practice it, and journal about it for at least a week. And beware—increased humor and well-being are likely to show up in your world.

Perhaps you’d rate your sense of humor as already above average. In one study, 94% of participants did.2 Even if you’re in that top 94%, it’s likely you can make room for more humor. Especially in this challenging time, let yourself lean on humor. Know humor can “take it.” Like a muscle, it gets stronger the more it’s used. Similar to creativity and courage, humor often generates more of itself. Reuse and recycle, but don’t reduce it.

Although it’s definitely not a cure-all, there’s strong evidence that humor interventions can help us cope. Done well, they leave us lighter. And more connected, too. Undoubtedly, there’s lots to be sad about in our current world. I miss Robin Williams, too. He would have a lot to say about this pandemic—in his intuitive and manic style. So let the tears flow. Perhaps some of them will even be from laughter. Fortunately, we have control over how much humor we create and bring to our world. So let’s get the humor factories humming. Carry a double dose in your pocket. Share the playful sparks, and let the smiles spread. Ahhh, yes—I’m hearing the sounds of laughter and feeling the lightness.

Section Editor: Preeti Malani, MD, MSJ, Associate Editor.
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Article Information

Corresponding Author: David Fessell, MD, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (fessell@umich.edu).

Conflict of Interest Disclosures: None reported.

References
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Martin  RA, Ford  T.  The Psychology of Humor: An Integrative Approach. Academic Press; 2018.
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Ruch  W, McGhee  PE. Humor intervention programs. In: Parks  AC, Schueller  S, eds.  The Wiley Blackwell Handbook of Positive Psychological Interventions. John Wiley & Sons; 2014:179-193. doi:10.1002/9781118315927.ch10
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Gunderman  RB.  Education in professionalism: improvisation.   Acad Radiol. 2016;23(5):655-657. doi:10.1016/j.acra.2015.12.022PubMedGoogle ScholarCrossref
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Fessell  DP, McKean  E, Wagenschutz  H,  et al.  Medical improvisation training for all medical students: 3-year experience.   Med Sci Educ. 2020;(30):87-90. doi:10.1007/s40670-019-00885-0 Google Scholar
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Wellenzohn  S, Proyer  RT, Ruch  W.  Humor-based online positive psychology interventions: a randomized placebo-controlled long-term trial.   J Posit Psychol. 2016;11(6):584-594. doi:10.1080/17439760.2015.1137624 Google ScholarCrossref
7.
Gander  F, Proyer  RT, Ruch  W, Wyss  T.  Strength-based positive interventions: further evidence for their potential in enhancing well-being and alleviating depression.   J Happiness Stud. 2013;14:1241-1259. doi:10.1007/s10902-012-9380-0 Google ScholarCrossref
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    1 Comment for this article
    Funny!
    Lucia Ferraro, M.D. | MemorialCare Long Beach Medical Center in Long Beach, California
    I am going to try the suggested humor habits. You already have me laughing!
    CONFLICT OF INTEREST: None Reported
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