Have 2 Chuckles and Call Me in the Morning

New research says humor helps kids cope with pain

THURSDAY, Feb. 21, 2002 (HealthDayNews) -- Maybe Patch Adams has been right all along. Maybe laughter is a great medicine.

Doctors at the University of California at Los Angeles said today that they have some evidence that TV shows like "I Love Lucy" and "Abbott and Costello" provide more than just yuks -- they ease pain in children.

Dr. Margaret Stuber, a psychiatrist at UCLA's Jonsson Comprehensive Cancer Center, reported that healthy school children who watched the funny videos with their arms submerged in ice water were able to keep their arms in the water longer when they were laughing at the shows. Submersion in ice water is a standard study technique for pain measurement.

"They said that the pain didn't bother them as much," Stuber said during an American Medical Association conference on pain in New York City.

Stuber said her study results are very preliminary and still being analyzed. But they are encouraging enough to continue the research in hopes of helping sick children better withstand the pain and anxiety of treatments for diseases like cancer or procedures like organ transplants.

"We would like to be able to help kids who are the most susceptible to pain," she said. "Laughter and humor can be helpful for children in dealing with pain."

Of course, some would say this is a no-brainer.

"I can't imagine when humor would not be valuable," Dr. Patch Adams said yesterday in a phone conversation.

Adams, who runs the Gesundheit! Institute in Arlington, Va., was immortalized by comedian-actor Robin Williams in the 1998 film "Patch Adams," the story of a physician who touts the benefits of laughter in treating illness.

His reaction to the new findings?

"I'm taking 22 clowns from six continents to Afghanistan, but not because of a scientific study that says humor is good in a war zone," he said.

"The absurdity of spending all that money for a study is beyond my comprehension," Adams added.

But Stuber said the more you know about pain management, the better you can treat patients.

"Understanding the mechanism of the way laughter works is essential to designing appropriate intervention," she said. "Nothing works for everyone in the same way, and we can target treatment."

The study, called "Rx Laughter," is being done in conjunction with other UCLA psychiatrists and pediatricians, and with television executive Sherry Hilber. It is being funded by a gift from the cable-TV network Comedy Central.

For the study, Stuber and her colleagues selected 21 healthy children, ages 8 to 14, and compared their pain responses when they watched the funny videos to when they didn't watch them. The "pain" was created by asking the children to hold their arms in tubs of cold water for as long as they could, with three minutes the maximum time allowed.

Before, during and after their arms were submerged, the children watched funny videos.

At each juncture they were asked to rate their pain. While they were rating their pain, the doctors also measured the children's levels of cortisol in their saliva. Cortisol is a hormone released by the adrenal gland to help the body handle stress. In addition, the doctors noted how each child responded to the videos. They measured how much they laughed, and they also asked the children how funny they thought the videos were.

Stuber said the children's cortisol levels all decreased while watching the videos, whether their arms were submerged or not.

However, the therapeutic benefits of the videos were most effective when the children watched them while their arms were submerged, and not when they watched the videos before or after submerging their arms.

Christopher L. Coe is a University of Wisconsin psychologist and president of the Psychoneuroimmunology Research Society, which studies the relationship between the mind and body. He believes the jury is still out on the therapeutic value of laughter.

"I have no doubt that laughter does help reduce pain. But, at least academically, does laughter act as just a distraction, getting rid of the negative? Or is laughter a unique state that has therapeutic value beyond balancing out the negatives" brought on by anxiety and pain? he said in an interview.

Stuber acknowledged there are many questions to be answered about laughter's medicinal benefits.

"Does it help because the video is funny or because it's a distraction [from the pain], allowing you to focus on something else? Is there a separate pathway in the brain that has to do with pain perception? Does laughter change the way you think? We don't have the answers to these questions," she said.

But she feels the research is worthwhile and practical.

"It's one of the few things we've found that isn't expensive," she said.

Some effective methods of reducing pain, like behavioral therapy, are expensive and often not covered by health insurance.

"Also, this is so intuitively obvious and acceptable that we can slip it into a medical program easily," she said.

What to Do: To locate a pain management facility near you, visit The American Academy of Pain Management. For advice for those suffering pain from cancer, see this American Pain Foundation Web site. To visit Adams' Web site, click here.

SOURCES: Interviews with Margaret L. Stuber, M.D., professor in the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles; Patch Adams, M.D., Arlington, Va.; Christopher L. Coe, Ph.D., professor of psychology, University of Wisconsin, Madison, and president of the Psychoneuroimmunology Research Society; American Medical Association pain management conference, Feb. 21, 2002, New York City
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