MEN'S HEALTH I

The role of humour in men’s health

Using humour as a tool to get serious health messages across can be beneficial when faced with reluctant male patients

Dr Finian Murray, Men’s Health Development Officer, Health Service Executive,, Kells, Co Meath

May 1, 2012

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  • A lot of articles about humour tend to be humourless. Funes1 writes: “Psychologists tell us that children laugh 400 times a day whereas adults only laugh 15 times. Those 385 laughs, where do they go?” In this paper I will not attempt to answer that question but will begin a discussion on whether humour and laughter have any health benefits. I will give a brief outline of men’s health and argue that including humour in the delivery of health messages can have a beneficial role in promoting health. 

    Theories of humour 

    The danger of examining humour has been highlighted by the American writer EB White, who once remarked: “Analysing humour is like dissecting a frog. Few people are interested and the frog dies.” Everyone’s sense of humour is as different and can be as unique as their fingerprint. However, some theories about humour have emerged.

    From the time of Plato hundreds of philosophers, linguists, psychologists and sociologists have theorised about comedy,2 and in the whole of that 2,500-year period, they have come up with no more than three basic theories: the superiority theory, the incongruity theory and the release theory. 

    The superiority theory argues that jokes work by being aggressive towards a third party. Rather than physically attack someone, humour allows a person to symbolically kill their victim or, if you prefer, to ‘put them down’. The incongruity theory argues that humour involves some kind of a mismatch of ideas or a confusion about the meanings of words. 

    Freud,3 in his book Jokes and their Relation to the Unconscious, was the first to put forward the release theory. He took the view that jokes exist to allow the harmless release of anti-social emotions. Murray4 explains that we will laugh at the shock of hearing things that haven’t previously been said, or which shouldn’t have been said – taboos. 

    Each of the theories contains a grain of truth. The theory best suited to our purposes here, and my own favourite, is the incongruity theory because there are some jokes which have not a whiff of aggression or release about them. If all humour is predatory, it doesn’t explain how we can laugh at the absurd, or indeed ourselves. Take, for example, this joke by Spike Milligan5:

    “There’s this auction at Christie’s and there is this Monet painting with an asking price of £1 million. 

    The auctioneer asks, ‘What do I hear?’ 

    This voice from the back shouts, ‘You can hear the traffic in Bond Street.’ 

    ‘Any advances on the traffic in Bond Street?’ goes the auctioneer. Someone else shouts, ‘I can hear the buses going up Dulwich Hill!’”

    Does humour have any health benefits?

    Positive outlook

    Looking at the research, there are two schools of thought. On the positive side, some scientists say that when you laugh your brain and body produce ß-endorphins – the body’s natural feel-good chemicals. A recent study by Dunbar6 found that laughter raised people’s pain thresholds. Shared social laughter causes an endorphin rush and the release of oxytocin in the brain – the same chemical reactions that we have to human touch. Endorphins are natural opiates. They make us feel relaxed, encourage social and sexual interaction and increase levels of trust. 

    Laughter decreases stress hormones like cortisol and increases immune cells and infection-fighting antibodies, which improves our resistance to getting a disease. Granek et al7 tell us that positive psychological and physiological responses to laughter have been shown in a variety of settings, and include stress hormone reduction, mood improvement, increased creativity, pain reduction, improvement in immunity and reduction in blood pressure. 

    He adds that neurophysiological studies found that viewing a humorous video significantly reduced allergen-induced wheat reactions and decreased saliva cortisol, and that mirthful laughter reduced serum concentrations of cortisol, dopamine, adrenaline (epinephrine) and growth hormone. 

    Drs L and D Berk’s8 study claims to prove that people who laugh more have healthier immune systems. Increase in heart rate produced by a good laugh had health benefits equivalent to 15 minutes on an exercise bike. Miller9 warns, however, “we don’t recommend that you laugh and not exercise, but we do recommend that you try to laugh on a regular basis. Thirty minutes of exercise three times a week and 15 minutes of laughter on a daily basis is probably good for the vascular system.”

    Negative effects

    On the negative side of the argument, researchers say that there is no evidence people live longer because of laughter. It is only a placebo effect. The comedian Steven Wright once quipped: “I’m addicted to placebos. I’d quit but it wouldn’t make any difference.” Robert Provine10 argues that “the much vaunted health benefits of laughter are probably coincidental, a consequence of the primary goal of laughter, ie. bringing people together. In fact, the health benefits of laughter may result from the social support it stimulates.” He continues: “Laughter did not evolve to make us feel good or improve our health. Certainly, laughter unites people, and social support has been shown in studies to improve mental and physical health. Indeed, the presumed health benefits of laughter may be coincidental consequences of its primary goal: bringing people together.” The famous American humourist Jack Handey once joked: “Dad always thought laughter was the best medicine, which I guess is why several of us died of tuberculosis.”

    Men’s health

    In recent years there has been a growing awareness and concern about the burden of ill health experienced by men. The National Men’s Health Policy11 tells us statistics on men’s health in Ireland confirm that men die on average nearly five years younger that women do, and have higher death rates at all ages, and for all leading causes of death. Men experience more accidents than women during sporting activities and in the workplace; they are more likely to engage in risk behaviours such as speeding, drink-driving and not wearing seatbelts. 

    Men have less healthy diets than females, are more likely to be overweight or obese, drink more alcohol and are more likely to become involved with substance misuse. Men are also more likely to experience considerable mental health problems. Of particular concern in recent years has been the increase in the number of young male suicides. Men see health as ‘important but not urgent’. Research suggests men take fewer preventive measures and are less willing than women to seek medical help. 

    Can humour promote men’s health?

    There is an argument to be made for using humour in delivering health messages to men. Armstrong12 informs us that men have a dearth of knowledge regarding how their bodies work. He continues: “Some men don’t know their epididymis from their elbow.” Numerous studies in the field of advertising have noted that humour is the most effective tool for enhancing recall of advertisements. This knowledge is beginning to be recognised in education. Humour strengthens the relationship between student and teacher, reduces stress, makes a course more interesting, and, if relevant to the subject, may even enhance recall of the material. 

    Korobkin13 found that classroom information is retained for longer when presented in a humourous manner. Berk14 claims that humour has the ability to decrease students’ anxiety, improve the ability to learn and boost self-esteem. This, in turn, can encourage a more receptive learning atmosphere. In the words of humourist Virginia Trooper: “It’s not what’s taught, but what’s caught. And if we can get our students’ mouths open for laughter, we can slip in a little food for thought.”

    How would this work in practice? 

    Given that men are not likely to talk or read about their health problems or go to the doctor, Dr Ian Banks15 found that one way to get around this was to introduce humour into publications and presentations on men’s health. Men generally see health as women’s business. When you manage to get men to attend a course or talk about health, they tend to make their minds up beforehand that they will not enjoy the experience. Taking the lead from Dr Banks, in my work as Men’s Health Development Officer I gradually introduced humour into my courses and talks. This, I found, made the courses and presentations more enjoyable for the participants. I learned quickly that when participants are laughing, they are paying attention and picking up on the health messages. At the end of each course I give each of the participants an evaluation sheet. In response to the question, ‘what did you find most useful about the training and why?’, ‘humour’ is frequently quoted as the number one answer. 

    Health messages don’t have to be boring, eg. along with telling people to eat less, you could add the slogan: ‘Little pickers wear bigger knickers!’ To encourage men to perform testicular self-examination you could use the strap line: ‘Keep your eye on the ball.’ Feel free to come up with your own ideas.

    Conclusion

    If done incorrectly, humour can be a disaster but, executed correctly, it lightens the load, eases the burden, releases tension and helps get the message across. Avoid extremes of glibness or being overly serious. Respectful humour can sometimes help set the right tone, one in which everyone can feel comfortable. All humour has a target; you have to make sure the target deserves it. It’s a tricky balance to strike, but you can do it. Are there health benefits to laughter? The jury is still out. But while we’re waiting for the answer, let’s have some fun along the way.

    Reference

    1. Funes M. Laughing Matters: Living Creatively with Laughter. Newleaf, Dublin, 2000
    2. Double O. Stand-up: on being a comedian. Methuen, London, 1997: 89-91
    3. Freud S. Jokes and Their Relation to the Unconscious. Penguin Books, London, 1976
    4. Murray L. Teach Yourself Stand-up Comedy. Hodder Education, London, 2008: 7-11
    5. Milligan S, Clare A. Depression and How to Survive It. Arrow Books, London, 1993: 139
    6. Dunbar R. Cited in Carr J, Greeves L. The Naked Jape. Penguin Books, London, 2007: 22-23
    7. Granek-Catarivas M, Goldstein-Ferber S, Azuri Y et al. Use of humour in primary care: different perceptions among patients and physicians. Postgrad Med J 2005; 81: 126-130
    8. Berk L, Berk D, Tan S et al. Immune system changes during associated laughing. Cited in Carr J, Greeves L. The Naked Jape. Penguin Books, London, 2007: 23
    9. Laughter helps blood vessels [homepage on the internet] University of Maryland Medical Center 2005 [updated 9 March 2009; cited 18 January 2012]. Available from: http://www.umm.edu/news/releases/laughter2.htm
    10. Provine R. The science of laughter [psychologytoday.com] Psychology Today 2000 [updated 25 May 2011; cited 18 January 2012] Available from: http://www.psychologytoday.com/articles/200011/the-science-laughter?page=2
    11. Department of Health and Children. National Men’s Health Policy 2008 –2013. Government Publications, Dublin, 2008: 1-7
    12. Armstrong, J. Men’s Health: The Common Sense Approach. Gill & Macmillan Ltd, Dublin, 1999: 11
    © Medmedia Publications/Modern Medicine of Ireland 2012