Humor and Laughter for Health with Sherry Hilber (cont.)

Dr. Zeltzer: I think that what is interesting, and what has not been studied, is the content of what the distraction involves, and the impact of the content. For example, is it thinking about somewhere fun or nice? Does it have the same effect as just a pleasant image, or watching something interesting versus something really funny? That is going to be a really exciting component of the Rx Laughter research, to look at the kind of emotions elicited during a distracting event, and looking at how the content of the distraction affects the nervous system differently.

Hilber: I'm reminded of a tape that was sent to me by one of the members on the advisory board of Rx Laughter, Madelyn Pugh Davis, who was an original writer of I Love Lucy. She sent me a tape of the sitcom "Ellen" in which Ellen goes for a mammogram and it's painful for her and she's told beforehand that if she thinks of a funny episode in a sitcom, it will help. While she's having the mammogram, she thinks about a Lucy episode and she keeps repeating it and visualizing it and it does help her get through the procedure. I thought that was very funny.

Dr. Zeltzer: Sherry, what you just described reminds me of one of the goals of the Rx Laughter project, which is to show the ways in which humor and laughter influence pain. For example, especially medical procedure pain, we can think about creative ways in which medical treatment rooms might be designed differently to provide a more therapeutic environment that might actually have a physical effect on pain.

Hilber: Absolutely. One of the goals of Rx Laughter is that therapeutic component. We could even take tapes geared to that particular treatment area, sitcoms that have been on that have addressed other areas and use them, absolutely. And that's the large ultimate goal of the therapeutic component.

Dr. Zeltzer: Yesterday, we went with Sherry and Dr. Stuber on a tour of the children's hospital at UCLA with some of the members of the board of advisors for Rx Laugher, and I was really struck by a young boy in the dialysis unit, and he was sitting there quietly. Two of the former writers from "I Love Lucy" had come up to him and asked him if he ever watched the show. He said he loved the show, and they asked what his favorite episode was, and he immediately remembered the "Lucy" episode where she was going on an airplane and trying to hide a huge cheese she was bringing on board, so she put it under her blouse and pretended she was pregnant. He was laughing as he was describing the story. The writers began to tell him how they got the idea for that episode, and the child was laughing. Watching this boy, who was in his teens, and these writers, who were probably in their late 70s or early 80s, laughing hysterically while he was in the middle of hemodialysis made me think of the power of laughter.

Hilber: I remember that, and I remember thinking how wonderful the connection was and the additional aspect from the child's point of view. These people care enough to be here to do this, to laugh with me. The hospital, the doctors care enough, and I think that's another aspect of what Dr. Stuber, Dr. Zeltzer and I are trying to do with this project.

Moderator: Are you familiar with the recent research on Child Life Science?

Dr. Stuber: We read that research, and we actually work with the Child Life and Child Development Services at the Children's Hospital at UCLA. Child Life Specialists are in most pediatric hospitals. These are people who have specific training at either a bachelor's or master's level in child development. Their area of expertise is really what children of different ages need and how they develop in normal development. Their job in a pediatric hospital is to provide an environment for children to be able to live and grow and develop normally while they're in the hospital having medical care. Child Life Specialists are an essential part of any children's hospital. They help the pediatricians to remember they have this child they need to be considering. They also coordinate the many people in the community who want to help and they make sure there's an environment within the hospital that includes places to play and learn. Certainly, as the studies have shown that distraction helps children cope with pain, the child life specialist helps children become distracted, provide activities for children while they are hospitalized and help prepare children for medical procedures by helping them practice coping strategies, what to expect so the event doesn't feel as threatening and unknown, and really play a role in helping children cope with pain through a variety of distractions and interventions. Certainly both of us are very indebted to many years of research that's been done with a number of interventions with some of our colleagues like Susan Jay. What we're trying do is actually ask a slightly different question about the specific content of the distraction. Is it really just thinking about something else other than what is happening to you, or is it feeling more control of the situation, or is really there something additional and special about humor and laughter that adds another dimension that makes it more powerful than simple distraction?

I'm not sure all of what I could say to you about what's involved with laughter. We know that it involves breathing differently. We know that it's essential for people to periodically sigh when they breathe, that it's not enough to just breathe at same rate all the time. Certainly the kind of deep breaths that happen when you have a belly laugh makes adifference. It makes a difference if you're breathing by using your abdominal muscles and that is the essence of a belly laugh. What is interesting to me is that probably the less obvious aspects of laughter may be even the more important ones, that is, that it probably changes the chemistry in your brain and when it changes chemistry in brain, that changes way you perceive things around you. You're less irritable, you're happier, things don't bother you as much, you feel less anxious, less pain. That could be evaluated physiologically. I suspect it changes a lot of aspects of the chemistry in the brain and hormones in the body.

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