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"Research Critiques Incite Words of Mass Destruction"

by Ron Berk, PhD CNN MTV DNA

What were they thinking?
How could they be so critical of the well-known health benefits of laughter?
"I have no clue what you're saying."
Maybe we should back up.
Okay, let's begin this article with the next paragraph.  

Over the past four years, humor researchers Martin (2001, 2002), McGhee (1999, 2002), and Provine (2000) performed in-depth autopsies of nearly 50 studies on the physiological effects of laughter. [ Confession: Admittedly, I even updated and affirmed their critiques in my review (Berk, 2002).]

After ripping the methodology of each study to smithereens, the researchers reached a consensus: Much of the research to date is sparse, weak, inconclusive, and absolutely putrid. In other words, the enthusiastic claims about many of the physiological effects (Clay, 1997; McGuire, 1999; Zand, Spreen, & LaValle, 1999; Ziegler, 1995) are premature and exaggerated. These three researchers delivered presentations at the 2002 and 2003 annual AATH Conferences, a credit to conference organizers Patty Wooten and Ed Dunkelblau for using the conference as a forum to air important research issues. However, at the 2003 conference in Chicago, one of these researchers was particularly provocative.

Considerable negative discussion ensued, and a few attendees actually invested in riot gear. Perhaps that's a slight exaggeration, but you can intuit the emotional trajectory these responses took. Over the past year, various communications by AATH members indicated confusion over the researchers' conclusions and misunderstandings about the state of our art.

My quest here is to clarify the issues and propose a strategy we can all use in our work and presentations. Why is this so important? Research furnishes the scientific foundation for why we do what we do as humor professionals, what we can do with our clients, patients, students or audiences, and how we can extend our work in new directions. In other words, the research not only circumscribes boundaries for our current practice, but also provides a springboard for diving into untested waters.

The increased sales of riot apparel at our annual conference only weaken our organization and its mission. Our ability to thrive hinges on our unity, our growth, and the scientific research base that adds to our credibility. The remainder of the article is presented in this spirit of professional responsibility and reconciliation.

Research on Humor and Laughter
The psychophysiological research domain is considerably broader than many practitioners might imagine. ( Digression Alert: You remember that Chris Columbus rented 3 ships to sail to the New World: The Nina, the Queen Latifah II Royal Caribbean, and the Goodship Lollipop. End of Digression ) Consistent with this number of ships, there are - you guessed it - two streams of research: the psychological and the physiological.

Psychological Effects
The psychological effects relate primarily to humor as a coping mechanism and, to a lesser extent, its enhancement of interpersonal relationships. The former use is based on the role of detachment, derived from two Latin root words: de , meaning remove , and tachmentus , meaning this tire iron from my skull . Humor enables one to distance oneself from professional and personal problems, that is, to detach or disengage mentally to put those situations into a proper perspective. The notion of humor as an adaptive coping mechanism underlies the limited behavioral research in this area and has been adopted by psychological theorists such as Sigmund Freud, Gordon Allport, Rollo May, and Frasier Crane.

Using humor involves a cognitive shift that allows one to separate from an immediate threat or aversive stimulus in order to view it from a different perspective. Thereby, one reduces the "normal" emotional responses, which might include feelings of shame, embarrassment, anxiety, tension, stress, depression, loneliness, helplessness, escape, anger, frustration, hostility, low self-esteem, grief, and incontinence. By jolting us out of our habitual frame of mind, humor might decrease or even eliminate those negative feelings. In this case, being "out of your mind" can promote a sense of control, self-protection, empowerment, and superiority OVER the problem. In other words, you rule. You da man or woman. You're Rambo or Ramboette!

These hypothesized and, in fact, highly desired effects of humor are somewhat supported by available quantitative (correlation) and qualitative research evidence (Lefcourt, 2001). Most of these studies, using existing self-report humor measures, yield consistent, although relatively weak, correlations with various mental health variables, such as anxiety, tension, stress, depression, and loneliness (Martin, 2003). Controlled laboratory studies, however, indicate that humor improves mood and reduces negative emotional consequences of experimentally induced stress. Further, researchers are currently investigating what types or styles of humor (e.g. self-deprecating, sarcastic, disparaging) are effective in coping with different threatening situations.

This area of psychological research extends to the effects of humor on interpersonal relationships. If you're a successful "coper," you should be more socially competent and adept at attracting and maintaining relationships. Mounting evidence demonstrates humor's effects on social support and interpersonal relationships, such as non-romantic friendships and dating, but none on marriage as yet (Martin, 2001, 2002).

Physiological Effects
In contrast to emotional responses, the physiological effects relate to laughter's impact on the entire body. ( Dedication: This paragraph is goes out to the college men and women who unselfishly contributed their spit and blood for chemical analysis, as well as their heart rate, blood pressure, temperature, respiration, brain, skin, and liver in the name of laughter research.) These effects involve the central nervous, muscular, respiratory, circulatory, endocrine, immune, and cardiovascular systems. Some minor effects have been noticed on gums, lips, tongue, hair, eardrums, and toenails.

The research in this area can be lumped into seven physiological effects:
    (1) Improved mental function
    (2) Muscle exercise and relaxation
    (3) Improved respiration
    (4) Stimulation of circulation
    (5) Decreased stress hormones
    (6) Increased immune system defenses
    (7) Increased pain threshold and tolerance

Criticisms of the studies' quality have focused on (4) - (7). The problems identified pertain to (a) internal design flaws, (b) invalid results, and/or (c) lack of generalizability of results.

The internal flaws include the following:
    . Small sample size (as few as 5-10 subjects)
    . No randomized design
    . No control group
    . Lack of appropriate controls to isolate independent variable
    . No standardized baseline measurement
    . Unreliable measures of blood and saliva assays
    . Low statistical power
    . No statistical tests, or too many

Due to some of these flaws, the results from several studies proved to be statistically insignificant, opposite the hypothesized direction, or attributable to uncontrolled factors. Further, small and/or unrepresentative samples and artificial or laboratory-based procedures resulted in the inability to generalize many of the studies' results.

The corpus of research in all seven areas suffers from the dearth of well-designed studies that draw valid conclusions about the health-enhancing changes produced by laughter. The highest-quality studies showed strong evidence of increased pain tolerance due to the effects of comedy - not merely because of distraction. This tolerance continued for at least a half an hour, even after the subjects' moods had returned to baseline. Unfortunately, though, we still lack empirical evidence that hearty laughter has pain-killing effects or that laughter stimulates the production of endorphins. The weakest investigations dealt with stress hormones and the immune system.

Results proved to be inconsistent, contradictory, or inconclusive because of the aforementioned flaws. In fact, methodological weaknesses in these studies may have actually prevented the desired physiological "benefits" from being detected.

Where Do We Go From Here?
Obviously, tankers of bodily fluids need to be collected and analyzed in a bazillion methodologically rigorous studies before we accumulate sufficient scientific evidence to substantiate existing health benefit claims. ( Possible Excuse: The deficiencies in previous research may be due, in part, to the lack of adequate research funding.) The research reviews cited in this article contain specific directions for those studies. The paucity of quality research on the physiological effects is our Achilles' heel or, maybe, 12EEE-size foot.

Given this faulty and rather inadequate research foundation; as humor professionals, what should we do? Take down our shingles (or cardboard signs)? Incinerate our props and costumes? Stop advertising in this newsletter? Find a job in homeland security? Maybe all of the above? Get real. Evidence-based practice in education, psychology, business, government, and healthcare is an ideal. Such is the case with humor and laughter, as well. Although we should be relentless in our pursuit of the "Gold," my professional motto has always been: "Go for the Bronze!"

In presentations on humor and laughter, I recommend introducing your audience to the list of possible psychological and physiological effects. However, the cardiac approach - "I know in my heart these effects are real" - won't fly. Instead, consider this:

The evidence for the psychological benefits is much stronger than the evidence for the physiological health benefits . The latter are suggested , not conclusive, effects based on current research findings. Much work needs to be done in all of these areas.
Conveying the state of our art accurately to the uninformed and less informed is our professional obligation and responsibility. Any misrepresentation of that state is irresponsible for you and AATH.

- Ron Berk, PhD CNN MTV DNA
(January 2004)
 author 
References
Berk, R. A. (2002). Humor as an instructional defibrillator: Evidence-based techniques in teaching and assessment. Sterling, VA: Stylus Publishing. (Chapter 2).
Clay, R. A. (1997). Researchers harness the power of humor. APA Monitor, 28 (9) , 1.
Lefcourt, H. M. (2001). The humor solution. In C. R. Snyder (Ed.), Coping and copers: Adaptive processes and people ( pp.68-92 ). New York: Oxford University Press.
Martin, R. A. (2001). Humor, laughter, and physical health: Methodological issues and research findings. Psychological Bulletin, 127, pp.504-519.
Martin, R. A. (2002). Is laughter the best medicine? Current Directions in Psychological Science, 11, pp.216-220.
Martin, R. A. (2003). Sense of humor. In S. J. Lopez & C. R. Snyder (Eds.), Positive psychological assessment: A handbook of models and measures (pp.313-326). Washington, DC: American Psychological Association.
McGhee, P. E. (1999). Health, healing and the amuse system: Humor as survival training (3 rd ed.). Dubuque, IA: Kendall/Hunt.
McGhee, P. E. (2002, February). Comprehensive review of humor research. Paper presented at the annual meeting of the Association for Applied and Therapeutic Humor, Baltimore, MD.
McGuire, P. A. (1999). More psychologists are finding that discrete uses of humor promote healing in their patients. APA Monitor, 30 (3), 1.
Provine, R. R. (2000). Laughter: A scientific investigation. New York: Viking Penguin.
Zand, J., Spreen, A. N., & LaValle, J. B. (1999). Smart medicine for healthier living. Garden City Park, NY: Avery Publishing.
Ziegler, J. (1995). Immune system may benefit from the ability to laugh. Journal of the National Cancer Institute, 98, pp.342-343.

Ron BerkOriginally published in The Humor Connection by AATH
(reprinted online at http://aath.org/art_berkr01.html),
Copyright, 2004, Ron Berk.

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