Resilience: it’s hard to feel like a victim when you’re laughing

by Carolyn Thomas  ♥  @HeartSisters

Somebody recently described my presentations on women’s heart disease as “part stand-up comedy and part serious cardiology talk!” I think she was right. I now believe, in fact, that some parts of my own heart attack story are downright hilarious. In hindsight, of course.

They weren’t one bit amusing when they were actually happening.

Authors Drs. Steven J. Wolin and Sybil Wolin would likely say that this ability to see humour in a catastrophic health crisis can be a key ingredient in healing resiliency. In their book The Resilient Self, they describe creativity and humour respectively in this way: “they turn nothing into something and something into nothing.”  

But for some of us caught in the midst of adversity, the Wolins explain, even the thought of being resilient during such struggles can seem an impossibility:

“There is a whole industry that would turn you into a victim by having you dwell on the traumas in your life. In reality, you have considerable capacity for strength, although you might not be wholly aware of it.

“Sometimes it is easier to be a victim. And sympathy can feel sweet; talk of resilience can make some feel that no one is really appreciating exactly how much they have suffered.”

The Wolins also observe that you can’t feel like a victim when you’re laughing about your situation and creating new ways of being.  For example:

“When we notice the humor in a situation, we are in an observant role. It takes a little bit of psychological distance in order to see the humor in ourselves and our circumstances.

“We are standing beside our painful situation when we can laugh at it. This can give us a chance to stick a pin in negative emotions and choose actions that are coping and positive. It is hard to wallow or ruminate in negative emotions when you’re seeing the absurdity in your situation.

“Humor has helped people through some of the darkest times imaginable. As psychiatrist Victor Frankl wrote in ‘Man’s Search for Meaning’ about surviving Nazi concentration camps:

“Humor was another of the soul’s weapons in the fight for self-preservation. It is well known that humor, more than anything else in the human makeup, can afford an aloofness and an ability to rise above any situation, even if only for a few seconds.”

“At the same time, humor isn’t exactly escapist; it doesn’t deny the awfulness of adversity.

“For example, people who have shared a difficult experience often share a gallows humor: jokes and wit about their suffering that are only appropriate to be told by and among those who have shared the adversity. This in-group humor can help acknowledge and dispel negative emotions and strengthen social support among people who have come through trauma and challenges. It can also be a way for people who have survived a difficult experience to mentor and encourage those who are still going through it.”

An illustration of gallows humour is a popular post published on WomenHeart‘s online support community forum for women living with heart disease. It was called “You Know You Have Heart Disease When….” and the topic attracted hundreds of sentence-completions from survivors, such as:

• “…..you’re not sure if your phone’s set on ‘vibrate’ or you’re in AFib!”

I know, I know. The inside jokes may represent high hilarity to us heart patients, but likely don’t even register on the laff-o-meter of regular people.

Dr. Steven Wolin once told a Psychology Today interviewer that he defines resiliency during painful experiences as the capacity to rise above adversity and forge lasting strengths in the struggle.

“Resilient people don’t walk between the raindrops; they do have scars to show for their experience. They struggle – but keep functioning anyway. Resilience is not the ability to escape unharmed. It is not about magic.”

In fact, noticing the humour in adversity may actually aid our resilience on a cellular level.

Dr. Michael Miller from the University of Maryland in Baltimore found that when people laugh, their major blood vessels dilate, allowing for easier blood flow, which is considered a surrogate marker for a reduced risk of cardiac events. He presented his findings at the latest European Society of Cardiology press briefing on how psychological wellbeing influences cardiac-related outcomes.

In 2006, researchers at Loma Linda University in Loma Linda, California, found that two hormones (beta-endorphins, which help to alleviate depression, and human growth hormone, which helps support immunity) increased by 27 and 87 percent respectively when study participants even anticipated watching a funny video.  Just simply anticipating laughter seems to boost health-protecting hormones and chemicals.(1)

These potential benefits gained widespread interest with the 1976 publication of Norman Cousins‘ article Anatomy of an Illness in the New England Journal of Medicine. In that article, and later in a book of the same name, Cousins described how laughter and vitamin C helped his recovery from ankylosing spondylitis. According to Cousins, 10 minutes of laughter resulted in two hours of pain-free sleep and a redction in his erythrocyte sedimentation rate. Despite criticism that later appeared in the medical literature, Cousins’ famous account has worked its way permanently into popular consciousness.

In one early observational study(2), humour and laughter were commonly witnessed among hospitalized patients, who used fun as a coping mechanism to reduce the anxiety and frustration associated with:

• being in the hospital
• the insecurity of being sick
• having to deal with hospital routines
• submission to authority figures
• loss of control over bodily functions

Consider this real-life dialogue between an Australian heart patient and a cardiologist in an Intensive Care Unit, shared with me by the woman herself, who says she was too groggy to remember much of this conversation, but her hubby swears it actually happened.  She’d been admitted to hospital for congestive heart failure and familial dilated cardiomyopathy, and needed surgery to have an ICD implanted.

• Cardiologist: ” And what brought you to hospital?”
• Patient:  “An ambulance.”
• Cardiologist: “No, why are you here?”
• Patient:  “Isn’t this the Hilton?”
• Cardiologist to other cardiologist: “We have a live one here!”
• Patient:  “Gosh, I hope so. Let’s try and keep it that way.”

Surgeon and author Dr. Bernie Siegel once wrote:

“Show me a patient who is able to laugh and play, who enjoys living, and I’ll show you someone who is going to live longer. Laughter makes the unbearable bearable, and a patient with a well-developed sense of humor has a better chance of recovery than a stolid individual who seldom laughs.”

Timing of course is everything when it comes to seeing the funny bits, no matter what our diagnosis, as cancer survivor Sydney Love reminds us:

“When you are first diagnosed, there is no such thing as humor.

“But once you have learned to live with your diagnosis and with your treatment, you can actually benefit from humor. A good laugh relieves stress for everyone, which researchers are beginning to demonstrate. The relief of laughter can be especially beneficial for patients, who already have more than enough stress to deal with.”

And in their book No Time for Nonsense: Self Help For The Seriously Ill, Dr. Ronna Jevne (who also wrote a book with the fantastic title of Hoping, Coping and Moping: Handling Life When Illness Makes It Tough) and Alexander Levitan write:

“Of course serious illness is serious! Why else would they call it ‘serious?’ That is all the more reason to avail yourself of every advantage — including laughter.”

♥.

(1) Cortisol and Catecholamine Stress Hormone Decrease Is Associated with the Behavior of Perceptual Anticipation of Mirthful Laughter. L. Berk, S.Tan, D. Berk, Loma Linda. Presented at the 121^st Annual Meeting of the American Physiological Society, 2008.

(2) Coser RL. Some Social Functions of Laughter: A Study of Humor in a Hospital Setting. Human Relations 1959; 12: 171-182.