Just Laugh

June 21, 2013

Ricky Gervais as David Brent in The Office, BBC, 2001

From The American Scholar:

In my neuropsychiatric practice, I often use cartoons and jokes to measure a patient’s neurologic and psychiatric well-being. I start off with a standard illustration called “The Cookie Theft.” It depicts a boy, precariously balanced on a stool, pilfering cookies from a kitchen cabinet as his sister eggs him on, while their absentminded mother stands drying a plate, oblivious to the water overflowing from the sink onto the floor. Though not really a cartoon—in that nothing terribly funny is taking place—it allows me to begin assessing various things: abstraction ability, empathy, powers of observation and description, as well as sense of humor. I am especially curious to see how patients process the image, whether they perceive only a portion of it or take it in as a whole. Some people notice only the boy, others only the mother.

Next, I show a series of cartoons, starting with examples from a newspaper comics page and working up to more sophisticated drawings from The New Yorker. I then ask for an explanation of what’s going on in each of them. Over the years, I’ve learned that you can’t fake an understanding of a cartoon; you either get it or you don’t.

Finally, I tell a few jokes set out in increasing levels of subtlety and complexity. Patients don’t have to find the jokes funny (humor is too heterogeneous for that), but they should be able to explain why other people might find them funny. Why am I interested in my patients’ ability to appreciate humor? Because humor impairment may point to operational problems at various levels of brain functioning.

Charles Darwin referred to humor as “a tickling of the mind.” We speak of being “tickled pink” at a funny joke, and tickling often leads to laughter, so the analogy is apt. At the physiological level, humor reduces levels of stress hormones such as cortisol and is thought to enhance our immune, endocrine, and cardiovascular systems. Laughter also provides a workout for the muscles of the diaphragm, abdomen, and face. A joke can raise our spirits, or ease our tension. If we’re able to laugh during a stressful situation, we can put psychological distance between ourselves and the stress. Norman Cousins, editor of The Saturday Review for more than 30 years, chronicled in his 1979 bestselling book, Anatomy of an Illness, how he attempted to cure himself of a mysterious and rapidly progressive inflammatory illness of the spine by engaging in hours-long laughing sessions while watching Marx Brothers films and reruns of the then-popular Candid Camera. Though Cousins’s claims could not be scientifically confirmed, even the most skeptical researchers agree that humor provides an antidote to some emotions widely recognized to be associated with illness—for example, the feelings of rage and fear that can precipitate a heart attack.