The Medieval scholastics observed that risibility, the propensity to laugh, is intrinsic to man. In other words, to be human is to experience the humor of reality and respond physically. Yet, how often can we go days without a serious, side-splitting episode of hearty laughter? The effects of neglecting the lighter side are perhaps no laughing matter.
Laughter in Response to Illness
Norman Cousins—editor, writer, peace activist—offered a thrilling account and study of the effects of laughter on health in his 1979 book Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration. Cousins offers no snake oil or quick fixes. Rather, he begins with his personal experience being diagnosed with ankylosing spondylitis—arthritis of the spine—“which would mean that the connective tissue in the spine was disintegrating.”
As one would expect, someone in such serious condition wound up with round-the-clock care. Cousins observed, “I had a fast-growing conviction that a hospital is no place for a person who is seriously ill.” Anyone hospitalized for any length of time understands the maddening inhumanity of technologically advanced, life-saving hospitals. While they preserve your physical body, there is an antiseptic chill that threatens to obliterate your weary soul with endless protocols and procedures administered with seemingly little regard for your individual needs.
Instead of staying in the hospital and accepting a slim chance of recovery, Cousins took matters into his own hands, with the support of a doctor, and moved his room from the hospital to a hotel next-door where he set up a regime of regular belly laughs and high doses of Vitamin C. With a nutritious diet for body and mind, Cousins moved toward wellness. His recovery was in no way guaranteed; the circumstances of his remission are open to question. What his story has demonstrated for many people is how powerful the will to live is and the remarkable power of the human body to regenerate.
More than Placebo
Cousins did not claim to know how or why his condition improved. He indicated it may have been largely the placebo effect: when an inert medicinal induces the mental disposition necessary for the body of its own powers to return to homeostasis. His discussion of includes companionship with fascinating people around the world, a lengthy aside about leprosy and why pain is not the enemy, and endearing anecdotes about the people he came into contact with through publicizing his recovery.
Rather than trying to identify exactly why laughter and Vitamin C made such a difference, Cousins takes a broader view of what makes life worth living. He notes that the incredible power of the placebo is not tied to the little sugar pill most often administered. He writes, “In the end, the greatest value of the placebo is what it can tell us about life. Like a celestial chaperon, the placebo leads us through the uncharted passageways of mind and gives us a greater sense of infinity than if we were to spend all our days with our eyes hypnotically glued to the giant telescope at Mt. Palomar.”
Cousins continues, “What we see ultimately is that the placebo isn’t really necessary and that the mind can carry out its difficult and wondrous missions unprompted by little pills. The placebo is only a tangible object made essential in an age that feels uncomfortable with intangibles, an age that prefers to think that every inner effect must have an outer cause. Since it has size and shape and can be hand-held, the placebo satisfies the contemporary craving for visible mechanisms and visible answers. But the placebo dissolves on scrutiny, telling us that it cannot relieve us of the need to think deeply about ourselves.”
Cousins could not have predicted the grotesquely mechanistic view of health our culture has adopted in which we think our brain chemistry needs to be tweaked to feel better about ourselves. Cousins could not have imaged an age in which the elderly were isolated against their will and healthy people kept in their homes to protect each other against an illness which many of them would get without noticing. These developments in our culture have made Cousins’ exhortation all the more needed.
Finding Hope
Cousins’ starting place was the observation that negative emotion can lead to deleterious physical effects; could, then, positive emotions have equal and opposite positive effects? In the years since Cousins’ writing, empirical evidence has confirmed the age-old wisdom: laughter really is the best medicine. In the emerging field of psychoneuroimmunology, “[t]he research flowed quickly, and showed that nonphysical things like thoughts and emotions affect our bodies at the cellular level, just as surely as do genes or lifestyle or the medicines we take. Emotions — particularly depression and stress — are linked to heart attacks. They suppress the immune system as it tries to fight the flu. One’s thoughts and attitudes affect the course of cancer, and the recovery from breast cancer. Emotions even affect how long one is plagued by the skin condition psoriasis.”
Anatomy of an Illness does not offer a playbook for getting over an illness or a manual for clean-living. From the perspective of a layman, the book offers a commonsense approach to life and illness. What has made the book an enduring fascination among certain people is the spark of hope it ignites. Could something so simple really work? It certainly isn’t a cure-all, but hope does, in the end, make life worth living.
Where Cousins may fall short is addressing those who are dying. He hints at the unique considerations in his discussion of a young woman suffering from a degenerative illness and a doctor foregoing aggressive cancer treatment in order to live fully in the time he has. Not every illness will be turned around, no matter how positive one’s emotions and salutary one’s diet. On the other hand, it is those people who have a reason to live who die a beautiful death. It is not that the sadness and disfigurement of death is beautiful but rather that for the living to be in the presence of someone who suffers well and dies convinced of his ideals and life’s purpose is a profound gift. That final, world-changing act of a good death is only possible with the disposition toward living that Cousins illustrates.
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