October 29, 2004

Laughter helps patients in therapy sessions

Laughter may be the best medicine, but the role laughter plays in psychotherapy has
been disputed since the days of Freud. While theories have ranged from laughter being harmful to its supporting the therapeutic partnership, none have been based on objective data. In the October issue of "The Journal of Nervous and Mental Diseases," MGH researchers report the first physiologic evidence of the role of laughter during psychotherapy.

As part of a larger ongoing study of psychophysiology and empathy, the researchers videotaped therapeutic sessions and took physiologic measurements of both members of 10 unique patient-therapist pairs. Physiologic response was gauged by skin conductance, a measure of the activity of the sympathetic nervous system, which previous research has associated with increased empathy. Following the sessions, the videotapes were reviewed by independent observers who identified each laugh episode according to who was speaking prior to the laughter and whether the other person laughed as well.

The researchers found that patients laughed more than twice as often as therapists did and were most likely to be laughing in response to their own comments. Physiologic measurements suggested that patients use laughter to communicate emotional intensity to psychotherapists, much like an exclamation point, and that patients' and therapists' laughing together magnifies that intensity and may contribute to feelings of rapport.

"Laughter is an indication that a subject is emotionally charged," says Carl Marci, MD, director of Social Neuroscience in MGH Psychiatry and the paper's lead author. "Taken with the current understanding of laughter outside of psychotherapy, our findings suggest that the patient who is laughing is trying to say more than has been expressed verbally to the therapist." Marci's MGH co-authors are Erin Moran and Scott Orr, PhD.