This article first appeared in Personal Wealth, The Edge Malaysia Weekly, on Dec 21 - 27, 2015.

PEOPLE are used to saying that laughter is the best medicine. They trot it out like a cliché, but has there been any documented proof? The popular “proof” that most advocates of laughter as therapy espouse would be Norman Cousins, the US journalist who claims to have healed himself of ankylosing spondylitis (a painful degenerative disease of the spine) through a combination of at least an hour of belly laughs a day and high doses of vitamin C.

He wrote several best-selling books based on his experience, most notably Anatomy of an Illness: A Patient’s Perspective, which was published in 1979. Cousins’ books sparked interest in the subject, causing medical researchers to delve into the matter to assess his claims. 

Among them was Dr Berk Lee who, together with his colleagues, published a paper on “Neuroendrocrine and stress hormone changes during mirthful laughter” in 1989. The researchers did a study on 20 high-risk diabetic patients with high blood pressure and high concentration of fats or lipids in their blood. The patients were divided into two groups; one was only given standard medications while the other group viewed 30 minutes of laughter-inducing videos on top of the medications. 

After following both groups for a year, the research team saw significant improvement in the second group, which showed better cholesterol levels, lower inflammatory response and lower stress levels. This led the researchers to conclude that real laughter (belly laughs rather than silly giggles) could have a positive impact on certain diseases.

Dr Madan Kataria of Bangalore, India, read these studies and thought of a novel way of using them. He organised a small “laughter club” with just five members in 1995. At first, Kataria used jokes to try and induce laughter, but all of them soon ran out of jokes. After a while they got bored and didn’t want to attend the club, so he put on his thinking cap and came up with the idea of using special exercises to induce belly laughs. And thus, Laughter Yoga was born.

Laughter Yoga proved effective and soon word spread about the club. Kataria found himself in demand, and began training and certifying Laughter Yoga teachers from all over the world so that they would be able to start their own laughter clubs.

Twenty years later, there are thousands of laughter clubs in more than 60 countries. In Malaysia, there are several Laughter Yoga teachers, leaders and clubs that hold community laughter sessions in public parks. The teachers were trained and certified by Kataria himself.

Laughter Yoga is an exercise routine aimed at inducing prolonged voluntary laughter. Karen Sze Tho (picture), a certified teacher, explains that when a person laughs long enough, his body registers the forced laughter as real laughter and triggers the feel-good hormone known as endorphins to help participants relax. 

“Motion creates emotion, which is why if we laugh long enough, our mind will actually think it is real and we will start to feel happy. Therefore, to get the health benefits of laughter, you have to laugh loudly and heartily from the belly for at least 10 to 15 minutes. After that, your heart rate will go up very quickly,” she says.

Instead of relying on jokes or comedy, Laughter Yoga integrates childlike playfulness into the exercise to make the participants laugh for a long time, she adds. “If you depend on jokes, then you will just laugh for a few seconds and that’s it. So with this, we laugh as long as we want because it is an exercise. What happens is that during the exercise, there will be clapping, chanting and playfulness. It is also very important that we have eye contact with each other.” 

The Johor Baru Happy & Joyous Club’s teacher, Lee-Jean Fung, says that although it is called Laughter Yoga, there are no yoga movements involved. Only yoga breathing (deep diaphragm breathing) is used. 
“It is a combination of laughter exercise and some yoga breathing. I would like to point out that Laughter Yoga is non-religious, non-racial and non-political. Some people do not like the word ‘yoga’, so we use the term laughter therapy. It does not matter because the concept is still the same,” says Fung, who is the former director of My Pharmacy (M) Sdn Bhd.

Sze Tho’s Ara laughter club holds community laughter sessions every Tuesday morning at 7.30am at the public park along Jalan PJU 1A/20, while Fung’s club holds community laughter sessions according to its schedule, which is at different locations and times around Johor Baru every morning except Thursdays. The places and times are available on its website, www.laughteryoga.com.my.

Benefits and values

After a laughter session, the participants will immediately feel a difference, says Sze Tho. “They will experience an instant mood change. It is great cardio, it builds a positive attitude and it helps you to face challenges better if you practise laughter regularly.”

She says joining a Laughter Yoga session also helps the participants to have social interactions with one another, which builds relationships and promotes camaraderie. “Before I started this laughter club, everybody at the park was exercising on their own. Sometimes, they would greet each other and say ‘Good morning’, but that’s it. There was no social interaction. But now, with the laughter club’s sessions, the bonding is great.”

Fung says because Laughter Yoga provides an immediate effect, first-timers will always want to return for another session. “After attending a session, the participants love the exercise and feel that the 30 minutes of laughing had gone too fast. They sweat so much and feel very happy. That’s why they want to come back again and again.” 

Laughter Yoga is important because nowadays, it is difficult to find reasons to laugh, says Fung. “If you read the newspapers or listen to the news, how to laugh? So, if you want to find a reason to laugh, there are not many. Of course, sometimes we just giggle and laugh for a few seconds, but this is nervous laughter or just laughing to entertain people; it’s different.”

She believes that laughter can be a very good coping mechanism for individuals who are depressed or even suicidal. “I feel that laughter is one of the coping mechanisms nowadays because there’s a lot of stress and tension in our country. Laughter can help prevent suicide because it can help change your mood. If the person has joined Laughter Yoga sessions for a certain time, they might have second thoughts when they have a suicidal urge or use laughter to break that negative state.” 

As Laughter Yoga uses exercises and stomach movements, Sze Tho says it is not suitable for those who are quite advanced in their pregnancy or those who have had major surgeries, especially if they still have stitches on their body. 

“They have be aware and know themselves better. We always tell our participants, ‘If you feel you are not comfortable, then it is best that you do not participate’. That’s the only guideline we give,” she says.

Fung says sometimes, it can be challenging to get people to laugh, which is why group dynamics are important. “Usually people will laugh if it is in a group setting. If they want to laugh but cannot, then they should join a laughter club. Because if they join us, they will definitely laugh.”

She adds that it is quite difficult to get men to join their laughter sessions even though they may need it more, as women can mix around more easily. “In countries like India or the US, men laugh along with women. Here, it is difficult to get men to laugh. During our sessions in the park, we encourage the guys who are doing exercises to join in. Only one or two will do so.” 

Many of these eventually drop out because they are teased by their peers for being part of such a group, says Fung.

For introverts or those who are unable to join the sessions at the park, there are other alternatives, such as Skype laughter clubs. Anyone can join and laugh with people from different countries. Sze Tho says the only barrier for people to laugh on this platform is the time difference.

“You can always google Skype laughter clubs. But [whether you can participate] depends on the time difference. If you are willing to join them and laugh with them, then there is no problem.”

Laughter Yoga services

To get certified as a Laughter Yoga teacher, one will have to participate in a five-day training conducted by Kataria or the other master trainers. The certified teachers will be able to train and certify Laughter Yoga leaders. 

Besides conducting laughter sessions in public parks, companies do invite the teachers to conduct sessions at their corporate events. Sze Tho says for freelance work, she charges RM10 per head with a minimum of 20 participants, but it is more about generating publicity for Laughter Yoga.

“After I did the course and got certified, I did a lot of community and charity work, such as laughing with seniors at old folks’ home and laughing with cancer patients at hospices. I also get invitations to do sessions for wellness and health programmes such as World Health Day, World Alzheimer’s Day and World Diabetes Day,” says Sze Tho.

Fung says her club also gets invitations from the Johor government to participate in its events. “When it has events, it asks us to go and lead the ice-breakers. Recently, it organised an event and rather than asking people to do Zumba or aerobics, it asked us to conduct a laughter session for 15 minutes to kick off the event.”

She adds that whatever they make from the companies is used to run the club. Fung believes that if anyone wants to make money from Laughter Yoga, they must use some of it to contribute to the community.

“If you just use it to make money, then it is not in the nature of Laughter Yoga, because it is about the inner spirit of laughter. It makes people develop an attitude of forgiveness, generosity, compassion and helpfulness, actively seeking happiness for themselves and others. Laughter Yoga goes beyond the physical. It also involves a lot of self-improvement and self-development,” she says.

As someone who had been in the pharmaceutical industry for more than 30 years before retiring early this year, Fung fully believes in the power of laughter. “Even though I am a pharmacist, I can still say laughter is the best medicine,” she says.

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