Can 'prescribed' laughter help people recover from trauma?

What are the mental health benefits of laughter?

This year, a six-week pilot scheme called Comedy on Referral may see patients write their own jokes and perform them with the help of established comedians. The sessions will be delivered through the NHS Bristol Wellspring Settlement Social Prescribing Team. Social prescribing, which helps people access activities and support in their local community, is a holistic approach to improving people's health and well-being.

Although comedy sessions may seem like an unusual approach to psychological treatment, research suggests laughter can improve symptoms of depression, anxiety, and stress. Spontaneous laughter - or genuine laughter - has been shown to reduce the stress hormone cortisol and trigger the release of mood-boosting neurotransmitters called endorphins.

Humour therapy or laughter therapy has even been used as a form of 'medication' to treat patients with dementia, with one study suggesting subjects experienced a decrease in agitation. With this in mind, laughter may be able to help those living with trauma.

"Laughter releases mood-boosting hormones," says Counselling Directory member Dee Johnson. "Using laughter in a healing capacity can be really constructive and effective. Being able to let out your emotions is vital when so much has been suppressed. For many, pushing down painful emotions means that by default you shut down the good feelings too. This can contribute to low mood."

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Laugher can also help us connect with others, which can help with feelings of isolation. Often, trauma can lead people to withdraw socially and avoid people, places or activities they once enjoyed. Some people find it challenging to engage with others without feeling uncomfortable or overwhelmed.

"Laughing with others is a great activity to ease into reaching out and connecting with people," says Johnson. "Bonds are formed and it becomes easier to start communicating more and asking for help. It may be the first time someone has been able to feel joy in a long time, so it brings a sense of hope and trust that things can and are changing for them."

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Research has also shown that humour allows people to frame problems with a different perspective, which may help to reduce distress. "Finding appropriate humour in something can help people get a different perception of things or events that have disturbed them. It can also provide a sense of control over a problem," says Johnson.

"I work with inpatients with acute mental health disorders and it's both common and fantastic to see and hear when they start to share jokes and humour together. Some may have forgotten how to even raise a smile - and their confidence and shedding of trauma are visceral."

Humour can also help people to process difficult feelings, emotions and experiences. Comedy can also help to shift some of the stigma associated with trauma and mental health problems too.

"Mental health processing does not have to be all heavy, hard and laden with doom," says Johnson. "All our emotions are valid and a way of expressing what's going on for us. Embracing joy should be as much of a focus as having the right nutrition, sleep and general self-care. Being negative can be automatic, so sometimes we may need help to access happiness."

Can 'prescribed laughter' have a negative impact on people with trauma?

It's important to remember that laughter is often used as a defence mechanism. Many people use false laughter or dark humour to help them bear the burden of suffering or misfortune. Although recognising the positives when facing adversity can be helpful, using laughter as a defence can lead people to block out painful feelings rather than process them in a healthy way.

Knowing whether laughter and comedy are appropriate is also crucial. "It is about not causing offence or diminishing someone's experiences," says Johnson. "Even if this is unintended, this will cause more harm to someone suffering from trauma. It is also more likely to prevent them seeking help as it can affect their confidence.

"It's not uncommon for a trauma sufferer to carry shame and guilt about not being able to cope - and misguided humour would certainly exacerbate that," she adds. "Trauma experiences are unique. It is really about understanding people's personal experiences."