Dr. Lee Berk, associate professor at Loma Linda University, is a pioneer in mirthful or happy laughter research.
In two landmark studies, published in 1989 and 2001 in the American Journal of the Medical Sciences and the Journal of Alternative and Complementary Medicine, respectively, Berk found that mirthful or happy laughter produces very tangible, physical benefits.
In a conversation with Spectrum, Berk explains the importance of understanding mind-body connectedness and why happiness is not ethereal.
Question: Can you tell us a little bit about why a medical professional and researcher like yourself would spend time studying laughter?
Answer: The classic healthcare model has used a biomedical approach. “What is your disease? Let me try to cure it.” There is a physical or somatic orientation when we look for the causes and consequences of disease. We discover penicillin.
But we now know many factors beyond physical ones are important. Lifestyle behaviors, diet, activity, and things like spirituality, attitude, gratitude, and forgiveness and so on also play roles in health and disease outcomes.
We are all familiar with the scenario where when one elderly spouse dies, the other soon dies or comes down with a debilitating disease. We now know that in mourning the immune system can be compromised and suppressed. Depressed people have a greater propensity to have a compromised immune system. The question is how do we rebound? The main point here is that there is no behavior we have that does not have biological translations.
Once we start realizing that, we then see that all aspects of thinking positively have ramifications. We can drag in biblical concepts, like the Proverbs text: “A merry heart doeth good like medicine.” That is not just nice verbiage, but it is the medical science of psycho-neuro-immunology being stated in biblical terms.
Psychoneuroimmunology is a term that denotes a bi-directional relationship between the mind/brain, the neuroendocrine system and the immune system. They intercommunicate incessantly with one other. They talk back and forth (communicate) with each other at a molecular level. It was discovered that immune cells have a huge number of receptors for hormones and neuropeptides. So diet, behavior, and activity have the capacity to modulate various responses of immune cells.
If I think a certain way, my body will respond. Depression causes physical anomalies. Happiness is a variable in and of itself, as important as cholesterol or saturated fats in determining morbidity or mortality in any given group.
Happiness is not ethereal. There is not one thought process that you or I have that does not have biological consequence — whether for better or worse. This is the reality of wholeness.
The science of neurology brings the scientific evidence for this reality — the precursor for mind-body medicine.
In general in medicine and health care, we have compartmentalized education and teach in silos. This has been done for convenience. We have physiology over here, endocrinology over there, and biochemistry in the other corner. We don’t typically connect them. But the whole human organism tells us that we had better start thinking more “interconnectedly.” If you have plans for a nice dinner in the evening, you start thinking about that dinner throughout the day. Your mouth waters and your physiology changes in anticipation. You are already bio-translating it, and you feel better and happier in expectation. For many individuals. shopping lifts their spirits. That’s not “nothing.” It’s real neurochemistry.
So hope is important?
To get a patient to have hope has potential psycho physiological benefits — it’s real!
We can even see this in the Bible. Remember the woman who came after Jesus, but the crowds pushed her away? She touched the hem of his garment, and he said: “Who touched me?” She said that she did and asked him to heal her. Jesus said: “Your faith has made you whole.”
It bio-translates. Hope is a very real word physiologically. Anticipation and expectation are synonyms in the English language.
Are you the first researcher to look at laughter in a medical context?
The real interest in this subject began when a gentleman called Norman Cousins, editor of The Saturday Review back in the 1960s and 1970s, was diagnosed with an autoimmune disease: degeneration of the connective tissue in the spinal cord. He had a life of massive stress and distress, and he came to the conclusion that things were not going to go well with his prognosis, so he thought he would try good stress (eustress) to see if it would make him well.
He thought, “Laughter makes me feel good,” so he started watching Laurel & Hardy and humorous films he enjoyed. He eventually said that after watching a half-hour of comedy, he could get two or three hours of pain-free sleep. He also took large doses of Vitamin C, now known to have anti-inflammatory properties. He eventually wrote a book, which became a number one best-seller, as Cousins was a very well-recognized person. He was asked to write an article for the New England Journal of Medicine — almost unheard of for a non-medical professional. Cousins profoundly influenced a large number of people, including the owner of the McDonalds food chain, who wrote him a check for several million dollars to help fund this new field of study.
I was fooling around with researching and studying laughter, and somehow Cousins heard about it. He came down to Loma Linda University, and asked me what it would take to show whether there was any physiological effect and benefits from laughter.
I was focusing on the positive aspects of laughter, and had found that the hormone system was benefiting. Laughter is a good kind of stress (eustress), and it decreases bad stress (distress). It reduces blood levels of detrimental stress hormones cortisol, epinephrine, and other substances. And surprisingly, when those stress hormones are reduced, numerous immune system components are allowed to re-optimize and function more normally.
We are finding and understanding about more and more areas of interconnectedness. For instance, the part of the body with the most receptors for neuropeptides of emotion is not the brain, but the gut. There is a very intimate communication between emotion and the gut — which, by the way, is the largest immune organ.
Is Loma Linda known in the medical field for your research on the physiological effects of laughter?
I am a humble person, and a little embarrassed to say that we are probably the world’s authority on mirthful laughter and humor, and their psychoneuroimmunological effects and health benefits.
Do you prescribe laughter for yourself? How?
On the top of my desk and around my office, I have signs that say laughter is life’s best medicine, and laughter is an instant vacation, as well as a picture of prescription goggles with “Rx laughter,” and a bowl of “laughter pills.”
The purpose is for all of us to remember that stress can be deadly. We live a lifestyle predominantly of stresses, and that has consequences. It is important for us to get off the merry-go-round and break that psychophysiological stress cycle. And, not surprisingly, this is also what we are encouraged to do from biblical wisdom.
One can accomplish this in many ways. Music for me is critical. I will crank up Eric Whitacre’s virtual choir on YouTube — amazing! Or watch and listen to Andrea Bocelli sing the Lord’s Prayer with the Mormon Tabernacle Choir. For me listening to that is a transitional brain gamma frequency moment.
You recently presented a paper abut a pilot study investigating the neuropsychological effect of differences in brain state from the use of mental visualization that results from the conditioning of prior exercise behaviors. Can you put that in simple terms? What did your study find? Is this a departure from your laughter research?
Yes, and no. You must realize that this all fits under the construct of “wholeness” and the scientific validation of our interconnectedness.
In one of our humor studies, we had the subjects watch humor of their choice, like America’s Funniest Home Videos, but different people find different things funny. To see their brains in distress, researchers watched the first 20 minutes of the movie Saving Private Ryan. The brain states are very different. We have become very interested in what the brain visualizes and hears and translates in all the brain frequencies for delta, theta, alpha, beta and gamma (0 to 40 Hz).
So if one visualizes success, a golfer might see the ball going in the hole. We see a difference in brain state between athletes visualizing that they are exercising or that they are resting. You can put your brain to a state of rest if you visualize resting. If you visualize exercising, does your brain move to a brain frequency state of exercise? The answer is yes!
With digital technology, we are in a whole new arena to be able to look at brain state and frequency changes.
There are different levels of cognitive processing.
Delta is when we are basically asleep.
Next is theta, which is also subconscious.
Next comes alpha, which is a state of rest.
Most of the time we are in beta, when we are working, writing and thinking.
The highest level of cognitive processing is the gamma state which is associated with great memory and recall.
Gamma frequency is something we don’t yet totally understand in the world of neuroscience relative to the potential health benefits. Long-term meditators and mindfulness mediators would appear to achieve this brain frequency with practice.
In neuroscience, a term associated with gamma frequency is “binding”; what this means is the brain is in greater synchrony and, if you please, is talking or communicating with itself to a great extent.
There are biblical implications there. We are told by Christ that if we are burdened and heavy laden, we should come for rest. That happens to be much like alpha frequency. After you achieve “rest,” your brain can more readily move into a gamma state and thus be more effective and “better” at problem resolution (remember brain synchrony).
We don’t really know very much about the brain yet, do we?
Right now our research is not the tip of the iceberg, but just a little ice crystal at the top of the top of the iceberg.
The medical community must accept your research about laughter and the brain?
In 2011 we were very fortunate to have been invited by National Institutes of Health to give a presentation on science of laughter. At first I declined the invitation to go among the elite of the research world. There was not much of an appreciation at that time for the reality that human behavior and lifestyle had any profound effects on morbidity or mortality. Especially not positive lifestyle behaviors such as mirthful laughter/humor — or for that matter “a merry heart.”
How long have you been at Loma Linda?
Except for a short four-year hiatus when I helped to run the Susan Samueli Center for Integrative and Complementary Medicine in the School of Medicine, with Dr. David Felten, at UC Irvine, I have been at Loma Linda since 1969.
I have a passion for this journey, and teach six courses on lifestyle medicine/health and wholeness, like Lifestyle Health, Managing Stress, Therapeutic Humor for Health Care Providers, Introduction to Psychoneuroimmunology, Music Therapy and Wholeness, etc.
These courses are taught at a mechanism modulatory level so as to understand evidence-based practice and appropriate clinical application.
All of my academic courses are evidence/science-based. The response we have gotten from our students on these lifestyle subject materials and mechanisms are absolutely amazing. They are not very knowledgeable on the influence of lifestyle on health. Managing Stress is one of my courses that even faculty take.
However, surprisingly, funding is not easy. I am not studying and researching something that can be sold. Mind, body, and spirit, relative to lifestyle are not part of the classical research funding area that will provide substantial research monies. You would think there would be some interested Christian or Adventist donors who would want to support this kind of research in the 21st century. But we have not seen this kind of support yet. Other secular academic institutions seem to be leading the way. I find this quite a paradox.
It has been a long wholeness research journey but we are beginning to start seeing pieces of the puzzle fit together, and a true picture of the science of “wholeness” is beginning to emerge.
Dr. Lee Berk