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Benefits of Smiling and Laughter Yoga

Children are seen to laugh over 300 times a day, but as adults we typically laugh no more than 15 times. What is it that happens to us, as we grow older? Where does that spirit of playfulness and joy disappear?

Nicholas Cohen reminds us of the chemical and hormonal changes that occur in the body and brain when we are stressed or unhappy. If this is the impact (or sometimes consequence) of feeling unease, can it not also work in reverse? Perhaps engaging in positive mood states, through smiles and laughter, can bring about positive changes in our blood and neurochemistry? There are findings to suggest this is very much so, and I’d like to share them with you.

Two leading figures in this field have been Norman Cousins, author of the book “Anatomy of Illness as Perceived by the Patient” and Dr Madan Kataria, the founder of Laughter Yoga. It was in 1979 that Norman Cousins was battling a connective tissue disease and working out how he may manage the pain and debilitation his illness caused. He documented the fact that 10mins of “genuine belly laughter” had an analgesic effect, affording him almost 2hrs of pain free sleep.

Dr Kataria, a medical doctor in his own right, started lunch time comedy clubs in green areas of the city of Mumbai. Initially, the group would tell jokes, but when these dried up, Dr Kataria developed the novel idea of pretend laughter. He developed silly games, funny gestures, child-like eye contact and “ho-ho, hah-hah-hah” type chants! There were a host of playful games, such as pulling your pockets out and laughing (‘no money laughter’) or pouring milk between two imaginary jugs, and drinking from the jug tipped down towards the mouth (‘milk-shake laughter’). Dr Kataria puts it well, when he says “Laughter is a choice. It is a connector of people with no barriers and no language”. Those who participated in his exercises discovered that the body could not distinguish between pretend and real laughter, as both had the same positive effects, with planned laughter becoming spontaneous laughter within a few short minutes.

Research Findings

The outcomes from research into Laughter Yoga is promising. In one study, Kaur and Walia engaged Nursing students in daily laughter sessions for 15-20 mins, over 10 days. They reported on statistically significant and positive reductions in stress levels. A 2012 study by Prof Robin Dunbar and his team at the Experimental Psychology Department (University of Oxford) found that laughter triggers the release of endorphins, which are the body’s natural anti-depressants. The same study found a 10% increase in pain thresholds within subjects, which they attributed to engagement with laughter sessions.

There are similar studies with adults over the age of 65yrs, who were assigned a laughter therapy group once weekly for 4months, where 48 participants had significantly better outcomes on depression and sleep scales, together with improved results in mini-mental state examinations, as compared to 61 adults who were not offered the laughter session (a control group).

In a randomised control trial in an oncology setting, 62 cancer patients were randomly split between a laughter therapy group (a total of 33 patients), and a waiting list for laughter therapy group (a total of 29 patients). The therapy group were given 3 laughter sessions, lasting 60mins a time. The laughter therapy group made beneficial gains in mood and self-esteem (Kim et al 2015).

There are a host of studies that additionally show couples who can laugh through stressful conversations with one another, cut through the tensions they feel. These couples are also more likely to be those who report greater relationship satisfaction and longevity to their partnership. Indeed, there are more studies that show smiling and laughing with one another in social contexts leads to a sense of greater connectivity, attraction and sense of support network, such that we do not feel alone with our problems and also have a sense that as a collective, we will get through. After all, as the Neuroscientist Sophie Scott says, laughter communicates more than words can say – "a sense of agreement, shared experience, affection and affiliation".

How Laughter Helps

We all know the saying, when things are tough – “if you don’t laugh, you’d have to cry!” Laughter seems to be a de-escalator of stress, and a way of releasing tension. In the vein of Mindfulness philosophy, which is becoming so popular today, laughter is incredibly 'present moment focussed' – just consider that when you are laughing, you really can’t do or think about anything else!

In the context of CBT (Cognitive Behaviour Therapy), much emphasis is placed on reframing difficult situations, and looking at them with a less negative set of assumptions and mental filters. Because laughter can make us feel things are less serious than they may seem, this can be a powerful re-frame. Otherwise, being serious and anxious easily steals away our hope and joy. We begin to subscribe to the point of view that we have so much to manage that we have no time to laugh. We begin to sink into our problems, as if they were quicksand.

Family based and Systemic/Organisational Therapies say much about the benefits of “Serious Play” – how to learn and tackle problems that are serious, with a playful and light-hearted attitude. Previously blocked and untapped resources can be found, just by lightening up! Laughter can literally move us from distress and pain, to fun and carefreeness! We are always more creative and open, when we are having fun.

Try it now – just smile, for no reason. Feel the smile in your lips, in your eyes, on your forehead and even in your heart. Most people who are asked to do this, connect immediately with a sense of happiness and positivity. It’s as though smiling (and in greater concentration laughing) is infectious, spreading through us just as surely as reaching out to anyone who may be in our midst. You will find that when you smile, others begin to smile with you. What’s more, the more people smile, the more positive they feel, and positive feelings are known to enhance wellbeing.

Laughter creates an adaptive response to stress by increasing the psychological distance from whatever may be disturbing us. In Dialectical Behaviour Therapy (DBT), often used with Personality Disorder, such a process is known as ‘thought dispersal’. The greater the gap between our thoughts and ourselves, the more space and freedom we feel – the thoughts no longer 'have us in their grip'. Of course we can’t go through life laughing away all our troubles, because there will be times we have to face issues more directly, and resolve them. If we resist our negative feelings and thought processes, these difficulties can begin to persist. But respite from stress is sometimes just what we need, just like a holiday that allows us to recuperate from the trials and tribulations of working life, allowing us to return refreshed and more resourcefully able to manage.

Lastly, but perhaps most importantly, the ability to laugh when things go wrong in life builds resilience. When we make mistakes, and can laugh at ourselves, it means we are open to forgiving ourselves. It’s not too big a step then, to be able to forgive others too. How much stress and tension do we hold onto when we beat ourselves up, or are unhappy with others for what they may have done or said to us? Laughter can help let things go, releasing us - and others - from the imprisonment that has been imposed. It might just be the key that unlocks the door to greater happiness.

Invite More Laughter into Your Life

If you want to enjoy the benefits of laughter and smiles, surround yourself with joyful people. Find some space each day to step out of seriousness and have some fun. Offer the gift of laughter to those you love -deliberately if necessary. Try to consciously smile more. Make more playful eye contact, with people you admire, live or work with. When the opportunity arises, tell a joke that has tickled you, or share any funny stories you might have captured through radio, TV or social media. Post a funny anecdote or video on your Facebook or Instagram page. If nothing else, just Google videos of babies laughing for no reason whatsoever, and pets getting up to silly antics. Tune into more classic comedy, stand-up or satirical news shows to literally top up on your daily dose of laughter. The more you have, the more you will have to share. Smiles can be collected, like precious pearls.

If you want to try out Laughter Yoga, Solihull Well Being Clinic is hosting free evening sessions, online, especially during the COVID-19 period where many of us are more available and at home, whilst also making regular journeys into the “worry zone”!

You may also wish to benefit from a video blog on the subject of this article, which is in two parts - the first offers a verbal commentary on the science of joy and laughter, and the second part focusses on a guided meditation exercise, which will help you experience the joy and laughter that is being spoken of. This, and many other video blogs, are available on the Solihull Well Being Clinic's Youtube Channel, to which you may subscribe so as never to miss a video update.

The following quote carries deep meaning for me, and is a nice way to conclude;

“Of all days, the day on which one has not laughed is the one most surely wasted”


Anatomy of an Illness as Perceived by the Patient: Reflections on Healing and Regeneration by Norman Cousins, ISBN No. 9780393038873

Letter from India : The Laughing Guru. Madan Kataria’s prescription for total well-being.By Raffi Khatchadourian, August 23, 2010 Link for article :

Effect of laughter therapy on level of stress: A study among nursing students : Lakhwinder Kaur, Indarjit Walia : Nursing and Midwifery Research Journal, Vol-4, No. 1, January 2008

Social laughter is correlated with an elevated pain threshold. Dunbar RI1, Baron R, Frangou A, Pearce E, van Leeuwen EJ, Stow J, Partridge G, MacDonald I, Barra V, van Vugt M. Proc Biol Sci. 2012 Mar 22;279(1731):1161-7. doi: 10.1098/rspb.2011.1373. Epub 2011 Sep 14.

The Effects of Laughter Therapy on Mood State and Self-Esteem in Cancer Patients Undergoing Radiation Therapy: A Randomized Controlled Trial. So Hee Kim, Jeong Ran Kook, Moonjung Kwon, Myeong Ha Son, Seung Do Ahn, and Yeon Hee Kim April 2015

Sophie Scott, TED Talk Exeter April 2018

Thank you for taking the time to read this article. If you feel anything can be improved, do please get in touch. Otherwise, do feel free to share it with friends and colleagues who may benefit. In the period of social distancing, we have a range of remote therapy and counselling sessions available. Feel free to get in touch if we can be of ay help 0121 777 1675 or

Dr Bobby Sura

Consultant Clinical Psychologist and Psychotherapist

Dr Bobby Sura is a Consultant Clinical Psychologist specialising within the field of lifespan and family based mental health needs. He has over 20yrs NHS experience and 16yrs in the private sector, being the founder of Clinical Psychology Direct and Director for Solihull Well Being Clinic. Bobby is Chartered with the British Psychological Society (BPS), Division of Clinical Psychology (DCP), Health and Care Professions Council (HCPC) with eligibility for registration with the United Kingdom Council for Psychotherapy (UKCP) and Association of Family Therapy (AFT). He manages a large service in Hall Green, Birmingham, with a range of Counsellors, Psychotherapists and Psychologists who offer their services on a private, fee paying basis.

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