When my mother was diagnosed with cancer, she faced the illness with a matter-of-fact stoicism. She scoffed at the “terminal” diagnosis, as Simone de Beauvoir might prescribe, vanquishing the dangerous potency of the word. Toward the end, her candid acceptance morphed into bullish humor, which she used to disable the emotional rollercoaster and to reassert agency over a life that was no longer on her terms. She found delight in disabling the boundaries of what was socially acceptable in joking about cancer, despite her warts-and-all humor eliciting sighs of incredulity from friends and her doctors. The audacity to find humor in the face of despair wields power to reshape the habitualized experience of suffering and provides a form of catharsis for oneself, and for family and friends. The patient who dares to be a comedian and laugh along with the audience, also discovers relief in the physiological release of internalized tension.
Laughter therapy pioneer, Robert Provine, notes that laughter is produced through the modulation of outward breath, as is the case with speech production. Breath regulation is the foundation of the yogi practice of pranayama, and an essential ingredient of laughter yoga practices first introduced in India in 1995 by Dr. Madan Kataria, with the help of his wife, Maduri, a practicing yogi at the time. The physiological benefits of laughter, as a regulation of breath, were captured by relief theories in the early decades of the 20th century. Freud, for one, proposed in Jokes and Their Relation to the Unconscious that laughter, jokes, and humor enabled the dissipation of psychological and physiological tension. Today, laughing therapies and laughter yoga contribute to an ever-growing basket of alternative wellbeing therapies.
Researchers (Kafle, et al. 2023) caution that the focus on eliciting laughter may inadvertently hide affordances attached to humor and comedy interventions that do not rely on the elicitation of laughter—affordances commonly found elsewhere in art and music therapies. Indeed, there is a meaningful distinction to be made between the physiological benefits of having a good belly-aching laugh and the psychological and social affordances that emerge from both laughter and humor/comedy interventions. Perhaps the old adage, “laughter is the best medicine,” should be interpreted more broadly to incorporate the kind of humor that does not elicit physical response.
Michael Christensen, a pioneer in healthcare clowning, highlights the potential impact of alternative humor practices for patients, families and service providers. In “Humanizing Healthcare through Humor,” Christiansen documents the history and worldwide success of medical clowning practices over the past three decades.
Today, the scope for application of laughter and humor intervention covers a broad spectrum of ages: from pediatrics to gerontology (Gonot-Schoupinsky & Garip, 2018) and pathologies: including depression and mental health disorders (Kafle, et al. 2023), eating disorders (Declercq, Dieter, et al., 2024), neurological disorders (Memarian & Bahari, 2017), cancer patients (Lee, Kim, & Park, 2020), and those waiting for an organ transplant (Dolgoff-Kaspar, et al, 2012). Laughter and humor approaches are also reshaping the way illness is experienced and dealt with across institutional, familial, and social settings, from patient-staff relations to online support forums (Demjén, 2016).
The chameleonic moods, forms and uses of laughter and humor are widely deployed as a response to illness. Nervous laughter wards off discomfort, anxiety, awkwardness, or the embarrassment one feels for being a burden on others; contemptuous humor mocks and ridicules with a disdain for the absurdity of life; resigned or futile laughter and self-deprecating humor releases physiological tensions within and reveals a level of humility; maniacal and hysterical laughter walks a tightrope over madness and topples into social or pathologically abnormality. Championing nuanced clinical research that casts an imaginative eye toward ever-richer tools for alternative health practices, there is value in adopting a transdisciplinary approach that gathers together the expertise of comedians, clowns, and artists, alongside researchers from the health and social sciences and the humanities.
Literature and film is replete with characters who adopt laughter and humor as a means to subvert or reorder the world in which they are diagnosed ‘ill.’ In Ken Kesey’s One Flew Over the Cuckoo’s Nest (1962), laughter represents resistance and an unwillingness to play a part in the madness of institutional confinement. Jack Nicholson’s portrayal of McMurphy presents a disturbing, maniacal laughter, reminiscent of Zarathustra’s “laughter of the heights,” a holy and redemptive overcoming of life’s inherent meaninglessness (99). Nicholson’s career was a veritable showcase of subversive characters facing adversity with humor and maniacal laughter. His portrayal of the Joker in Tim Burton’s Batman (1989) foreshadowed Heath Leger’s and Joaquim Phoenix’s gloomier treatment of the character, their laughter becoming a symptom of disturbing pathological illness, highlighting the darker psychological dimensions of humor and its power to dismantle social order.
Laughter and humor operate in a liminal space, what Mikhail Bakhtin calls the “carnivalesque;” a space of play that is both free and entangled in the norms and expectations of how one might respond to illness. Philosopher and enactive cognitivist, Alva Noë, employs the term “entanglement” to refer to the ways in which human experience entails a complex relation between habitually organised activity and an artistic or philosophical reflective reordering of that activity (24). Laughter and humour takes its place between aesthetic intuition and philosophical reflectivity and disrupts, disorders, and resists the disempowering effects of illness.
The physiological and psychological benefits of laughter and humor are interwoven with one’s vulnerability, existential being, sense of agency and empowerment, as well as one’s spiritual and social connectedness. By employing a candid humor, my mother disrupted social norms and ensured there would be no pity party. Aware of the effect humor had on those around her, my mother’s final moments were a celebration of her own resilience, which made her smile. A fitting exit, as Batman proclaims, “if you gotta go, go with a smile.”
Image Credit: The Death of Socrates (1787). Metropolitan Museum, of Art, New York. Photograph by Jacque-Louis, David.
Works cited
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