Is there a link between laughter and tolerance of pain?

November 12, 2012

Is there a link between laughter and tolerance of pain?

A study investigating laughter and how it affects the individual’s role when bonding socially has recently been carried out. The association between laughter and the release of endorphins was also part of the study. Although the BBC news reported that,” Study reveals laughter really is the best medicine”, the study did not investigate the link between laughter and pain relief in a medical sense. In addition to the BBC, several newspapers reported, with varying degrees of accuracy, on the limited study of laughter and any relation it may have to pain relief.

The study, which was published in the scientific journal, Proceedings of the Royal Society B, was peer reviewed and the research was carried out by the University of Oxford who worked with other European and US organisations. The funding was provided by the British Academy Centenary Research Project.

The rigorousness of the study is questionable because the pain measurement methods were weak. The study was small scale and its design and method used had limitations. The way participants’ pain thresholds were assessed may not hold up to scrutiny within the academic world. Further larger scale studies, incorporating more accurate and measurable methods will have to be used when dealing with pain and pain tolerance if these findings are to be confirmed.

It was found that people who were in a group and watched funny videos had a higher pain threshold immediately after watching than before watching the video. This effect was not seen when they watched the funny video alone. The group who watched the funny video also had a higher pain threshold than the pain threshold of groups of people who had just watched a serious factual video.

The media reported the study in a relatively honest fashion. But some news reports indicated that the findings medically are more important than they actually are.

What was the Research?

In order to examine the association between laughter and feelings of comfort and security relating to the social interaction between individuals a series of laboratory and natural tests were devised. They involved six experimental studies, some were carried out in a laboratory setting, and others were in much more natural surrounding such as going to see a comedian on stage. The participants had tests to measure their receptiveness to pain both before and after the performance or video show.

The link between social wellbeing and laughter in a relaxed situation and how it relates to social interaction was being investigated. In particular, the researchers were trying to find out if stress free laughing encourages a feeling of wellbeing, and if so, then what is the biological reason for this.

The theory being tested was that of “feelings of wellbeing associated with laughter are caused by the release of chemicals called endorphins”. It is already known that endorphins are released during exercise and pleasant excitement. Researchers have found that the raised levels of endorphin can make people less responsive to pain. In monkeys, researchers have seen that raised endorphin levels may be crucial to social bonding.

In this study no direct recording of endorphin levels took place. It was measured indirectly by subjecting participants to pain and measuring their responses.

The study consisted of five experiments where people either watched a comedy video or a factual, non funny video. These experiments were sub divided into groups of people who watched the video or others who watched it individually. There was a sixth experiment where people were in the audience at an Edinburgh fringe festival performance. Those who took part varied from 16 to 62 people, all were adults and excluded anyone who was suffering from a medical condition, was pregnant, diabetic, or who had taken alcohol or smoked in the two hours previous to the test. In some tests the main group was broken down into sub groups.

The number of times people laughed was recorded when they were watching the video. This information was collected if the person was in a group or watching alone. Those who went to the stage performance were asked to fill in a questionnaire giving their opinion on how many times they laughed during the show. This was recorded on a scale of 0 to 5.

The method used to measure endorphin levels was indirect. Participants were tested before and after the video or performance for their resistance to pain. The threshold before the show or video was then compared to the one afterwards. A -16° C wine cooler sleeve was held on the forearms of the participant and the time was noted before the pain was too great. This was originally used but was found to be inadequate for the job. It could not stay cold enough as testing continued.

It was then decided that the inflatable collar used when checking blood pressure could be used if the pressure was built up until the participant found it unbearable. The pressure measurement was then taken as a record. The researchers found that using the inflatable cuff gave less varied results than the wine cooler sleeve leading them to believe that it could be a more consistent test.

Those who went to the stage performance were required to bend their legs to ninety degrees and lean against a wall. The time was recorded before they found the pain too much. This was recorded before and after the show.

In all, sixteen different scenarios were tested. The researchers looked for differing pain thresholds from before and after the show or video. These included individual screenings and groups shows.

What did the researchers find?

It was discovered that after watching comedy shows in a group, the pain thresholds were significantly higher than those who watched the factual show. However those who watched the comedy show alone did not increase their pain threshold.

As a further test the researchers showed a group videos that made them feel good, but were not funny. These included pleasant nature scenes and wildlife documentaries. This group showed no difference to their pain thresholds. This led the researchers to believe that the act of laughing is associated with the raised endorphins and change in pain threshold rather than just feeling good.

The participants who did the most laughing were those at the live comedy shows and they experienced the greatest increase to their pain threshold after the show. Those who watched live, non funny dramas did not change their pain threshold in any way after watching the performance.

Conclusion

The researchers believe that their study proves that when someone laughs in a natural fashion then that person’s pain threshold increases considerably, but when no natural laughter is elicited then the pain threshold remains the same. The study indicates that the act of laughter is the key to raised levels of endorphins, just feeling good is not enough to increase the levels.

The researchers have drawn a conclusion that the increased pain threshold is a direct effect of natural laughter, which then releases endorphins.

However there may be some issues concerning the data collection and interpretation in this study. The methods used to measure how receptive someone was to pain were very subjective. Those conducting the study admit that the wine cooler method was not very reliable and by switching to the blood pressure cuff may have caused an inaccuracy in the results. Additional research is required to confirm the findings and to produce a reliable way to measure pain.

This was a small scale study, the maximum number of people taking part in any phase was 62, and sometimes they were broken down into sub groups. This means that further study must take place to ensure that these small groups reflect the population. Larger scale testing must occur to confirm that the findings are representative within society.

This was an indirect study, meaning that levels of endorphin were not actually measured, only the perceived effects of endorphins. The ideal test would measure endorphin levels and pain levels in some way that proves an association between them both.

Because the researchers took the sensible step of excluding those suffering from medical conditions, or who were pregnant or had smoked or had a drink within the last two hours the effect of laughter on these groups could not be analysed. The effect of natural laughter on these groups is indeterminate and requires testing to prove if they are similar to those tested.

The limitations seen in this small scale study were caused by its design and the way it was executed. The pain measurement aspects of the survey would not stand up to scrutiny and will need to be readdressed in any further study. It is accepted that larger scale studies are required with methods of pain measurement being able to withstand academic scrutiny.

Endorphin levels were not measured during this test so to test the theory that a higher pain threshold is due to higher endorphin levels must be tested. Further tests must include more reliable pain measuring and endorphin level testing.

However we must remember that the objective of this research was not to understand if laughter was useful for pain relief in a medical sense. The aim was to examine the association between social bonding and laughter.

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