April 1, 2021

Laughter – What is It Doing for Our Health?

Show Notes

On this episode, Chuck Gaidica is joined by Dr. Bernard DiCasimirro, Chief Medical Officer for New Directions Behavioral Health. Together, they discuss the health benefits of laughter.

In this episode of A Healthier Michigan Podcast, we explore:

  • How health professionals are taking more notice of the effects of laughter and our health.
  • What laughter is doing for us physically and mentally.
  • The short and long term benefits of laughter.
  • Why we’re drawn to laughter.

Transcript

Chuck Gaidica:
This is A Healthier Michigan Podcast, episode 77. Coming up, we discuss the many benefits of humor to overall well-being.

Chuck Gaidica:
Welcome to A Healthier Michigan Podcast, the podcast dedicated to navigating how we can all improve our health and well-being through small, healthy habits we can start implementing right now. I’m your host, Chuck Gaidica. Every other week we’ll sit down with a certified health expert to discuss topics that cover nutrition, fitness, and a whole lot more. And on this episode, we’re going deep into the connection between laughter, humor, and our health. With us today is Chief Medical Officer for New Directions, Behavioral Health, Dr. Bernard DiCasimirro. Good morning, how are you doctor?

Dr. Bernard DiCasimirro:
I’m doing well. Thank you, Chuck.

Chuck Gaidica:
Well, it’s good to have you with us. And I know prior to your position there at New Directions, you were Medical Director for Perform Care, behavioral health arm of AmeriHealth. And you’ve got a lot of experience in psychiatry as well as other regimens within medicine. So give us this idea of the connection points between laughter and good health.

Dr. Bernard DiCasimirro:
Okay. Well, first off, I think it’s important for us to recognize that emotional well-being has become a major part of the way that we take care of patients across the board. 30 years ago, when I was in medical school, mental health and physical health were very separate things. And now, thankfully, we’ve moved well beyond that. We get better every day, I think. More and more we recognize the importance of taking care of the whole person, including people’s emotional well-being. People who are doing well emotionally are also people who tend to take better care of themselves physically. And so they’re both very, very interconnected. And laughter is really a vital part of emotional well-being. And therefore it’s a vital part of good health in general.

Chuck Gaidica:
So you don’t normally think of a doctor walking in to see a patient in an examining room or otherwise. And you hear out of the doctor’s mouth, “A doctor and a podcast host walk into a bar…” So we understand that laughter is the best medicine, but how do you get into it? Is it just natural for some?

Dr. Bernard DiCasimirro:
Well, I think you’re exactly right. Yeah. Nobody wants to go for their annual physical and have a stand-up comedian in the room with them. I think for the most part, humor and the seed of the laughter comes from our patients. I think what’s important is that for doctors and nurses to be open to that seed, if you will, to allow themselves to laugh with their patients, to encourage their patients to laugh with them. So I think that’s what’s important. It’s not so much a performance. It’s more being in tune with what’s happening in the room and being relaxed enough to acknowledge the fact that no matter what situation we’re in, including an annual physical, there are moments that are funny and we should allow ourselves to capitalize on.

Chuck Gaidica:
So part of the humor I suspect is disarming. I mean, we’ve all been there for an annual physical and some of it is pretty embarrassing and you just feel ill at ease. And if your doctor puts you at ease, or you do as a patient, oftentimes that takes the edge off the entire half hour you’re there and all is well. You really do feel like, well, this is just okay, it’s fine. Everybody goes through it.

Dr. Bernard DiCasimirro:
It seems pretty silly not to take advantage of sitting in a paper gown without a back.

Chuck Gaidica:
Yeah. Well, I have to tell you, this is a personal story, but I want to share it. We have a son who, when he was in his mid-teens broke his femur and this is pretty serious stuff. So Susan and I are at the ER, he’s getting a rod placed in his leg. We’re sitting in the collective waiting room, not a private space. This is where everybody’s waiting for their loved one and words from the doctor. And our doctor walks in, sees us and yells out loud so everybody can hear, “It’s a boy.” And we start laughing. And of course, he’s laughing. Now, let me tell you that outside of the importance of what happened, and my son is fine now, but outside of describing the actual incident and that your teenager gets a break and it’s dramatic and traumatic. That is the thing that has stuck with our family since that time, that bit of humor.

Dr. Bernard DiCasimirro:
Of course. I’ll tell you a funny story that happened to me as you know I’m a psychiatrist and I was treating a young man who had a delusion and part of his delusion was that he was very frightened of people of Italian extraction. And I remember meeting him for the first time and introducing myself and he looked straight at me and he said to me, “I mean, really they’re bringing me a doctor named DiCasimirro?”

Chuck Gaidica:
And then things went okay from there?

Dr. Bernard DiCasimirro:
Things went okay from there, we acknowledged the irony and we got beyond it. So even when we’re treating folks who have psychiatric problems, humor can be an active part of what happens.

Chuck Gaidica:
So tell us about the training for doctors, because when I think back into my lifetime, I mean, there have been doctors that have been kind of funny and interesting, and some are smart and wonky and some are like Patch Adams and they walk into the room and yell, “It’s a boy.” You know, I mean there’s always that. But in recent time, our doctors and nurses and other healthcare providers, a therapist, is there any training that is overt that people would go into that would help them get through this? Because not everybody is funny, let’s face it.

Dr. Bernard DiCasimirro:
That’s true. Not everybody is funny. I don’t know that there is training per se in humor. Not that I’m aware of anyway, but again, there’s this whole push to make sure that we are actively engaged with our patients in a way promotes their best mental health, in a way that promotes their emotional wellness for patients, I think is the key here. And of course we’re fortunate in medicine in that we train in various ways, and with many people. Hopefully by the time that you’re out in practice, you’ve worked with a lot of different physicians. You’ve worked with a lot of different nurses, a lot of different therapists. And along the way, the hope is that you encounter people who really model what we’re talking about here. Model the idea of taking good care of the whole person and being open to those moments where humor and laughter are going to be a really positive part of the treatment.

Chuck Gaidica:
Yeah. And I do know from some regimens like motivational interviewing and things like that for coaches and therapists, one of the very first things that you’re encouraged to do is to engage. And that would seem to me to be the first place where a little humor could help you get to know someone and vice versa. Because oftentimes doctor, we do that with our very own buddies, don’t we? That’s the way we start a conversation with a joke, literally.

Dr. Bernard DiCasimirro:
Yes, absolutely. And I think it’s important that while it’s a professional environment and while there are serious topics that have to be discussed, it doesn’t prevent us from being human in those situations. And I think that’s always important when we’re trying to take care of folks.

Chuck Gaidica:
So outside of the connection and the, I guess it’s more an emotional connection, but that’s important all by itself. What are the physical things that you could say that you could actually point to? Are there releases of hormones? I mean, what’s literally happening to our bodies when we find that we’re in the midst of a bit of humor with someone else? What’s happening to us physically?

Dr. Bernard DiCasimirro:
Well, let’s start with the simple stuff. The stuff that makes practical sense to everybody. And that is a good hearty laugh brings in more oxygen into our body. We’re breathing deeper. And so we have more oxygen rich blood that is being provided to our lungs, and to our heart, and to our muscles. There’s also a tremendous release of tension with laughter. And so people are able to relax after a good hearty laugh. So I think that’s the seed kind of where the benefits come from. From there, researchers have found that indeed endorphins are released. Those are the chemicals in our brain that bind to the opiate receptors. They cause a reduction in pain. They cause an increase in relaxation, a sense of euphoria. And so there’s hard science behind the fact that laughter is helpful, that laughter helps us be healthier people.

Chuck Gaidica:
And so do you see something that extends from what we may call short-term? Some of those sound like it could just be short term effects that extend into long-term effects. Are we seeing anything besides just the next five minutes that’s actually beneficial to us?

Dr. Bernard DiCasimirro:
Absolutely. There was a very interesting study that came out of the University of Maryland that suggests, not clear about the mechanism, but the indication is that those who are good humored, those who tend to laugh on a consistent basis, end up with a protective factor for their hearts. They end up being more heart healthy, if you will, because of the amount of laughing that they do in their lives. There are also studies that indicate that serotonin, which is another chemical that’s released in our brain that it’s optimized with laughter. And so those of us who have a good belly laugh on a consistent basis are likely to have a better mood, have a more consistent mood.

Dr. Bernard DiCasimirro:
As most people realize serotonin is one of the ways that we treat depression, one of the chemicals that we try to adjust. There’s even a study that came out of Norway I believe, indicating that longevity is connected to people who have a more reasonable sense of humor. People who are able to laugh on a consistent basis. So there are absolutely long-term health benefits that we get out of laughter.

Chuck Gaidica:
And it’s interesting that you’re talking about these immediate effects because there’s also this thing that I used the phrase buddies, or the words buddies, but it can also be with family members. There’s a friend of mine who’s a comedian, I’ve got a few friends for whatever reason, are comedians in my lifetime that I’ve come to know. And he said, one day he’s driving with his son up near Auburn Hills with one of the recycled Mount Trashmores, we have them everywhere. Northville has them, Wayne has, on the way to the airport, you see them, the giant hills of trash from all of our garbage. And he’s driving with his son and his son says to him, “Dad, just think about that.” He said, “That didn’t even exist when I was born.”

Chuck Gaidica:
His dad said, “You’re right, but think about this, your diapers are at the very bottom of that trash heap.” And his son immediately looked at him and said, fired back, “Yeah dad, think about this. Your diapers are going to be at the top of the trash heap.” And so here’s this, now this is not an easy topic to discuss with… You’re aging, and his kid must be as quick as he is in wit. And the guy he said, “This was the funniest thing my son has ever said to me.” And I thought, what a moment between a father and son, it’s not always the moments of just everything is fine and we’re just driving along. It’s that moment that has stuck with him that is now like the moment I described with my doctor in our son’s situation, it sticks with you for a lifetime. So there are long-term effects that could even make you chuckle 10 years later.

Dr. Bernard DiCasimirro:
Of course. I think almost everybody has a story of some time where whatever the situation was, there ends up being a moment of really pure humor between family members. All of those situations are important and they all help us be healthier, frankly.

Chuck Gaidica:
Well, it’s no accident that this podcast episode is launching on April Fool’s Day. So not everybody is into that. I’ve been working that deal with, we have five kids, our five kids know every year that there was going to be some kind of April Fool’s joke because they were either headed for more at school or otherwise, or I was going to get one at work. So it’s always a time for us to be a little playful. We get an excuse.

Dr. Bernard DiCasimirro:
Yes, absolutely.

Chuck Gaidica:
Do you, as a doctor ever tell someone purposefully to go seek out laughter and comedy. I mean, I know you’re not going to write a prescription to Mark Ridley’s Comedy Castle or are you? I mean, do you tell someone, go find your favorite comedian on a podcast and listen to them as you’re working out or anything?

Dr. Bernard DiCasimirro:
Well I think the important part of this is to remember that good emotional health is not an accident any more than good physical health is an accident. And so the expectation is that we get enough rest. We get up every day and move our bodies and exercise. We eat a well-balanced diet. And that activity that we put into being physically healthy is also very important for us to put that same amount of energy into finding ways of being emotionally healthy. And that includes relaxation. It includes seeking out connections with people, good friends, family, and it also includes finding ways to laugh on a regular basis.

Chuck Gaidica:
So we’ve talked about some physical improvements that can happen with laughter and humor. You’ve talked a bit about the emotional health associated with it. What about the social benefits? We’re coming out of this time, where we haven’t been able to hug people, kiss the people we know and love. We’re fist bumping, maybe instead of handshaking, and the connection with people… We can’t even go to our favorite places, whether it be your favorite bar or church, it doesn’t matter, some of those places have not been available. What are the benefits of laughter relative to the social setup of our lives?

Dr. Bernard DiCasimirro:
Well, we’re drawn to laughter I think, as people. I think if you walk into a room and there’s a crowd of people there, you’re going to head to the corner where people look like they’re having fun, where people are smiling and laughing. And so I think we’re drawn to people who are good humored. We’re drawn to people who are open and able to laugh. And that’s how we connect with one another. Getting back to the brain, there are actually studies that indicate that when we hear laughter our brains become more reactive, there is a greater connection between the parts of our brains when we hear the sound of human laughter.

Dr. Bernard DiCasimirro:
There was also an interesting kind of social science study that went on and involve that concept of speed dating. Where you sit in a room with a number of people and somebody rings a bell every few seconds and you jump from table to table. And so they surveyed people after one of those experiences and the most important thing, the thing that drew one person to another was a sense of humor, was the ability to sit down and laugh with one another. So it’s so important, it’s the way that we connect with one another, for the most part.

Chuck Gaidica:
And this has to go back eons. I mean, we’ve heard the phrase court jester. So I don’t know, that must be like medieval times. We know the phrase stand up comic, but even professionally I can tell you from a television standpoint, they don’t start recording a game show like Wheel of Fortune or Steve Harvey Show or whatever it is, Family Feud. They don’t start those shows until somebody walks out and warms up the audience. In other words, gets them laughing, gets them smiling, part of what you’ve now described, which makes perfect sense. We’re breathing in deeply, we’re now ready, we’re on the edge of our seats and we’re ready for a show. And then the hosts walk out and boom, they record for half an hour. That’s no acc.

Dr. Bernard DiCasimirro:
Right. And the hosts that we’re attracted to, the hosts that stay around for a long period of times are the ones that I think often the ones that can laugh a little bit at themselves. And the ones that are open in those situations to helping us all to laugh.

Chuck Gaidica:
Isn’t that a skill that, I guess it’s a trickle up. It can go all the way up to the leaders of our country and beyond where we tend to find the self-deprecating humor or taking a moment with reporters where, it’s just a humanizing thing when somebody makes a gaff or a slip that they go, “Oh brother, am I an idiot?” I mean, it’s just, you look at that person, you think, well, we would all do that too. We would all be embarrassed, crack a joke and move on. It’s okay.

Dr. Bernard DiCasimirro:
Yep. I absolutely agree.

Chuck Gaidica:
So we’re also coming out of this time, coming out, I mean, not all of us are out of it yet where there has been some great depression, anxiety because of the pandemic. So if people have found themselves in some kind of a fog or funk, what are your suggestions for putting themselves back into a good place with laughter? How can we all look for places to go?

Dr. Bernard DiCasimirro:
Well, first off, I want to be careful with your question and make sure that people understand that when depression or anxiety becomes a part of your life, and it’s really interfering with your daily functioning, it’s really interfering with your ability to take care of your children, connect with your spouse, spend time with friends, when we’re at that point, it’s really time to reach out for help. And there are a lot of options to find health. You can reach out to your primary care physician. You can call the number that’s on the back of your insurance card, if you have health insurance. There are local universities and community mental health centers that will offer people help. So I think, I want to make sure that we cover that aspect of it as we talk about it, because this has been a tremendously difficult year for people.

Dr. Bernard DiCasimirro:
I will say that I think one of the pieces of silver lining, if you will, in this past year, is that we’re talking a whole lot more about emotional well-being and about mental health. It’s become a topic because it’s become a significant need for so many people. The more that we talk about these things, the better it is for people who have been struggling for a long time, and for people who are new to these types of feelings and these types of problems. So there’s certainly that piece of it that help is available. And we should encourage anybody who is struggling to reach out.

Dr. Bernard DiCasimirro:
On a lighter side. I think it’s really important on a daily basis for people to find their funny, to seek out whether it’s a book, or a movie, a television show, a favorite comedian, or probably best of all that friend that makes you laugh, just makes you have a good hearty belly laugh. Seeking some time, whether it’s virtually, by telephone or if you’re lucky enough to be able to be face to face with that person and allowing yourself just that time to relax and enjoy some great laughs with a friend. So my advice to folks, as they try to get through these hard times, or just try to stay emotionally well is to find your funny on a daily basis.

Chuck Gaidica:
That’s such great advice and finding your funny can also be when you’re talking about the people in your life, sometimes the funniest people are the littlest people. We now have grandchildren and some of the greatest laughter that’s contagious comes out of little kids. I mean, you don’t even know why they’re laughing and it just tickles you and you get going, and it’s just a joy to get a video or to see something online from a kid you don’t even know.

Dr. Bernard DiCasimirro:
Well, children haven’t learned to be inhibited yet.

Chuck Gaidica:
Yeah.

Dr. Bernard DiCasimirro:
Yes. And so they’re full on, they’re out there. And obviously as adults, we can’t live our lives completely like that, but there are lessons to be learned there. I mean, and what we talked about in the beginning, the idea for people in the healthcare field to be open to those moments of humor and laughter. Maybe the idea is to have a child’s eye when we look at those situations.

Chuck Gaidica:
That’s also some great advice. Well I think out of this pandemic is coming a lot of great stuff. And one of the things I’ve seen and I’m sure you’ve seen this behind the scenes and it’s been going on for a longer time, this turn of phrasiology from mental illness to mental health, to emotional health. And I think you’re right, this is a time that so many people have had to concentrate on that. And it’s delightful to see that some are finding ways to navigate this space that I think will be long lasting habits that will benefit them forever.

Dr. Bernard DiCasimirro:
Absolutely. We’re learning a great deal from this time as painful and as difficult as it is. We’re learning a great deal I think about how to take better care of one another. And maybe that’s the lesson that we’re going to carry away from this.

Chuck Gaidica:
Yeah. Yeah. Well, doctor, I really appreciate your time. It is so much fun to talk to you, and give me the phrase again, what should we be trying to do every day?

Dr. Bernard DiCasimirro:
Every day we should find our funny.

Chuck Gaidica:
That’s great. That’s wonderful. And I think finding our funny can lead from just being happy for the moment to joy, which I think is a little deeper and longer lasting. And we need some of both right now. But it’s good to talk to you.

Dr. Bernard DiCasimirro:
Same here, Chuck, I appreciate this time so much.

Chuck Gaidica:
Well, I’ve learned a lot about you in a way about the Italian heritage of your name. And I didn’t understand until this podcast that Norwegians were so funny that they could do we’re study on longevity and laughter. That’s funny all by itself. Doctor, have a good rest of your day.

Dr. Bernard DiCasimirro:
Thank you.

Chuck Gaidica:
That’s Dr. DiCasimirro Who’s been with us for this podcast. We’re talking about ways you can find your funny every single day. The doctor is in a position at New Directions as the Medical Director. And we’re so glad that he was with us. We’re glad you’re with us as well on this April Fool’s Day or whichever day you’re catching us. Thanks for listening to A Healthier Michigan Podcast, it’s brought to you by Blue Cross Blue Shield of Michigan. If you like our show, you want to know more, check it out at ahealthiermichigan.org/podcast, or you can leave a rating or review on Apple Podcast or Stitcher. You can always get new episodes, old episodes on your smartphone or tablet. Be sure to subscribe to us on Apple Podcast, Spotify, or your favorite podcast app. I’m Chuck Gaidica, be well.