Motivation and emotion/Book/2016/Laughter yoga and emotion

Overview
Laughter yoga is a relatively new method of promoting laughter as a form of psychological and physical therapy (Krebs, Herodez, & Pajnkihar, 2014). Originating in India, laughter yoga has spread to over seventy other countries around the world (Krebs et al., 2014).

Research shows that laughter yoga can positively impact our emotions. It can help everyday people such as students, (Yazdani, Esmaeilzadeh, Pahlavanzadeh, & Khaledi, 2014) to those suffering from chronic illnesses such as Parkinson’s disease (DeCaro & Constantine Brown, 2016). These are promising results as laughter yoga is easy to implement, is cost-effective, and is a strength-based, positive approach to therapy (DeCaro & Constantine Brown, 2016).

This book chapter explores laughter yoga and its effect on emotion. The information is intended to provide insight about how laughter yoga can be used to understand and improve our emotional lives based on psychological theory and research.

What is laughter yoga?


Laughter yoga is a form of laughter therapy that has both physical and psychological benefits (Bennett et al., 2015). It was developed by an Indian doctor named Madan Kataria during 1995 (Bennett et al., 2015).

Laughter yoga involves simulated self-induced laughter and yoga breathing techniques (Bennett et al., 2015). Simulated laughter in this case does not rely on understanding humour or responding to jokes or comedy (Krebs, Herodez, & Pajnkihar, 2014; Shahidi et al., 2011). It essentially involves laughing for no reason (Bennett et al., 2015). This is based on the idea that laughter has a range of benefits to the body whether it is fake or genuine (as the body cannot tell the difference) (Shahidi et al., 2011). In saying this, it is noted that fake laughter quickly transitions into natural laughter during laughter yoga sessions (Krebs et al., 2014; Yazdani et al., 2014).

Laughter yoga is typically done in group sessions (Bennett et al., 2015) that are run by trained laughter yoga instructors (DeCaro & Constantine Brown, 2016). These sessions generally run for about 30 to 45 minutes (Bennett et al., 2015). Along with laughing and breathing exercises, laughter yoga also incorporates childlike playfulness (Prakash, 2013), clapping, stretching, chants, and other body movements (Bennett et al., 2015).

Explanation of laughter yoga by Dr Madan Kataria

Laughter Yoga Session at Washington National Cathedral

What is emotion?
In order to explore how laughter yoga may affect emotion, it is important to understand what emotion actually is.

Emotion is an ill-defined term in the literature (Izard, 2010). Cabanac (2002) describes it as a mental state that is often associated with feelings such as joy, sadness, anger, fear, disgust, and surprise. Reeve (2015) describes emotion as being a multidimensional term that is a combination of feelings and bodily responses. Emotions are also goal-directed and expressive (Reeve, 2015). These functions are said to help us adapt to situations (Reeve, 2015).

What is laughter?
Laughter is an emotional reaction that can influence both the self and others (Farifteh, Mohammadi-Aria, Kiamanesh, & Mofid, 2014). It has a distinct repetitive vocal sound, along with particular facial expressions and the contraction of muscles (Louie, Brook, & Frates, 2016).

There are five types of laughter (Louie et al., 2016). These include spontaneous (genuine) laughter, simulated (self-induced) laughter, stimulated laughter such as a reaction to tickling, induced laughter such as the result of drugs or laughing gas, and pathological laughter which may be the result of a disorder (Louie et al., 2016).

People tend to laugh during various emotional states (Szameitat et al., 2009). They laugh when they are happy, nervous, and sometimes even when they are feeling sad (Szameitat et al., 2009).

Emotional benefits of laughter

 * Laughter is a component of human happiness (Mora-Ripoll, 2011) where it increases positivity while decreasing negativity (Prakesh, 2013).
 * It is associated with stronger interpersonal relationships and psychological well-being (DeCaro & Constantine Brown, 2016).
 * Laughter can improve mood (short-term and long-term) (Bennett et al., 2015; DeCaro & Constantine Brown, 2016).
 * It can help in alleviating stress (DeCaro & Constantine Brown, 2016; Farifteh et al., 2014; Yim, 2016).
 * It can also help in reducing depression (Yim, 2016) and improving life satisfaction (Bennett et al., 2015).

Yoga breathing and emotion
Laughter yoga utilises both laughter and yoga breathing exercises (Bennett et al., 2015). Some yoga breathing exercises involve breathing deeply into the abdomen, and altering breathing patterns by holding and releasing the breath during different parts of the breath cycle (Brown & Gerbarg, 2009).

Emotional benefits of yoga breathing:
Yoga breathing is a form of meditation that aims to reduce stress by focusing the mind on the present (Brown & Gerbarg, 2009). This is based on the premise that stress is the result of constant mind shifts such as worrying about the future and reflecting on past mistakes (Brown & Gerbarg, 2009). Yoga breathing involves taking the mind away from these negative emotions (Brown & Gerbarg, 2009). By focusing on the present, positive emotions such as calmness and joy replace the negative emotions associated with stress such as anger, fear, and sadness (Brown & Gerbarg, 2009).

How does laughter yoga affect emotion?
Laughter yoga positively impacts various emotions in different ways. This section will cover key laughter yoga research findings in the literature and theories of emotion in relation to laughter yoga.

Summary of laughter yoga research findings
Research shows that laughter yoga is effective in reducing negative emotional symptoms and increasing positive emotional responses in various circumstances.

Laughter yoga and Parkinson’s disease
Parkinson’s disease is a degenerative disorder that is often associated with negative mood (DeCaro & Constantine Brown, 2016). DeCaro and Constantine Brown (2016) exposed Parkinson’s disease patients to a laughter yoga session that ran for 45 minutes by a trained instructor and tested them on their well-being before and after. Well-being measures included scales of enthusiasm, energy level, mood, optimism, and stress level (DeCaro & Constantine Brown, 2016). They found statistically significant improvements in all well-being measures except for optimism (DeCaro & Constantine Brown, 2016). As these measures were collected straight after the yoga session, it appears that laughter yoga directly influenced emotion in this study.

Theories on how laughter yoga impacted emotions in this study:
 * Amygdala stimulation: Laughter is said to stimulate the amygdala which is found to be defective in some Parkinson’s disease patients (DeCaro & Constantine Brown, 2016).
 * An increase in dopamine: Laughter is also said to increase dopamine levels and this could have increased the Parkinson’s disease patients’ mood in this study (DeCaro & Constantine Brown, 2016).
 * Physical exercise benefits: Laughter is said to have similar benefits to physical exercise (DeCaro & Constantine Brown, 2016).

Laughter yoga for haemodialysis patients
Haemodialysis is a process that involves removing waste from the blood for people with kidney disease (Martin, 2015). Bennett et al. (2016) measured haemodialysis patient’s quality of life, subjective well-being, mood, optimism, control, self-esteem, depression, anxiety, and stress before and after a laughter yoga intervention. Patients went to sessions three times a week for four weeks and each session ran for 30 minutes (Bennett et al., 2016). Results showed an increase in happiness, mood, and optimism (Bennett et al., 2016). It also showed a decrease in stress. These results were not significant; however, the nurses who were exposed to the patients during the study noted that laughter yoga positively impacted the mood of the patients (Bennett et al., 2016).

Theories on how laughter yoga affected emotion in this study:
 * The positive effects of laughter could have given patients a break from the negative emotional effects associated with haemodialysis (Bennett et al., 2016).
 * Laughter could have acted as a coping strategy to deal with stress associated with haemodialysis (Bennett et al., 2016).
 * The relaxation components of laughter yoga could have contributed to increases in positive mood and happiness and decreases in stress and anxiety in this study (Bennett et al., 2016).

Laughter yoga versus group exercise on elderly depressed women
In a study by Shahidi et al. (2011), elderly depressed women either underwent ten sessions of laughter yoga with a trained instructor, ten exercise sessions, or no intervention. They found that laughter yoga was just as effective as exercise in reducing depression (compared to the control group) (Shahidi et al., 2011).

Theories on how laughter yoga affected emotion in this study:
 * The benefits of laughter as described in the literature include muscle relaxation and changes in mental parameters (Shahidi et al., 2011). Depression may have been one of those mental parameters that changed as a result of laughter in this study.
 * Yoga has been shown to be an effective treatment for depressive disorder (Shahidi et al., 2011). The yoga breathing techniques in laughter yoga may have contributed to the decrease in depression in this study.

Laughter yoga and stress in cancer patients
Stress is associated with negative emotions such as depression and anxiety (Wang, Cai, Qian, & Peng, 2014) and it can inhibit cancer treatment (Farifteh et al., 2014). Farifteh et al. (2014) found that laughter yoga can decrease stress in cancer patients prior to chemotherapy treatment.

Theories on how laughter yoga affected emotion in this study:
 * Laughter may have decreased stress-making hormones in the blood (Farifteh et al., 2014).
 * Laughing and crying is said to reduce tension in the body and this could have lead to decreases in stress in this study (Farifteh et al., 2014).
 * Laughter may have decreased stress by releasing endorphins in the brain (Farifteh et al., 2014). Endorphins relax the mind and body (Farifteh et al., 2014).

Laughter yoga on general health among nursing students
Yazdani et al. (2014) exposed nursing students to eight sessions of laughter yoga. These sessions were held twice a week and ran for one hour each (Yazdani et al., 2014). It was found that laughter yoga positively impacted the student’s general health in this study (Yazdani et al., 2014). This included a decrease in anxiety and depression (Yazdani et al., 2014).

Theories on how laughter yoga affected emotion in this study:
 * Laughter yoga provides a distraction from negative thoughts (Yazdani et al., 2014). This may have lead to decreased anxiety and depression in this study.
 * Laughter yoga promotes positivity (Yazdani et al., 2014) which may have also resulted in a decrease in negative emotions in this study.

Theories of emotion and laughter yoga
The following theories can help in understanding the research findings of laughter yoga and its positive influence on emotions.

Motion creates emotion theory
Laughter yoga is basically based on the motion creates emotion theory. The motion creates emotion theory proposes that the body cannot tell the difference between fake (intentional) laughter and real (instinctual) laughter (Louie et al., 2016). This means that both spontaneous and self-induced laughter provide a similar physiological response and therefore result in the same benefits (Louie et al., 2016). No humour is required (Louie et al., 2016).

James-Lange theory
The James-Lange theory proposes that emotional responses are initially based on bodily changes (Northoff, 2008). In other words, we interpret our feelings based on physiological reactions (Northoff, 2008). For example, our body’s response to laughter may result in us thinking/believing that we are happy or in a good mood. In this theory, simulating a body reaction that is known to create an emotional response should result in that particular emotional response (Dzokoto, Wallace, Peters, & Bentsi-Enchill, 2014). This supports the motion creates emotion theory of laughter yoga in the sense that simulated laughter creates the same emotional response as genuine laughter.

Cannon (as cited in Dzokoto et al., 2014) believed that bodily changes did not create emotional responses, but rather, facilitated emotional responses. In this case, simulated laughter in laughter yoga may help in facilitating positive emotional responses, rather than specifically causing positive emotional responses.

Facial feedback hypothesis
The facial feedback hypothesis proposes that there is a connection between facial expressions and emotional experience (Dzokoto et al., 2014). Specifically, the theory supports the idea that facial muscle activity can have a direct impact on emotion (Dzokoto et al., 2014). Darwin (as cited in Dzokoto et al., 2014) insinuated that the stronger the facial expression, the more intense the subsequent emotion is. This could explain the impact of laughter yoga on emotion. Laughter yoga involves laughing for no reason in a group setting (Bennett et al., 2015) and as fake laughter becomes more genuine throughout the session (Shahidi et al., 2011), the laughter generally intensifies. This means that all participants get exposed to happy expressions that intensify as the laughter yoga session goes on. This form of happy face exposure could explain the positive emotions that appear after participating in laughter yoga. The facial feedback hypothesis has been well supported in the literature (Dzokoto et al., 2014).

Arousal theory
The arousal theory can explain how laughter yoga decreases stress. Stress increases arousal and tension in the body (Yim, 2016). The arousal theory proposes that laughter relieves stress by easing arousal and tension (Yim, 2016). The human response to this is to feel as though their stress is not that bad after all (Yim, 2016). This could explain the decreases in stress in some of the laughter yoga research findings. The arousal theory recognises that there is a complicated interaction between mind and body and cognition and emotion when it comes to laughter (Yim, 2016).

Laughter as a mechanism
Freud (as cited in Yim, 2016) proposed that laughter can act as a coping mechanism. This is because it can reduce negative emotional responses and unpleasant feelings (Yim, 2016). Perhaps laughter yoga acted as a coping mechanism in some of the laughter yoga research findings.

Relief theory
According to the relief theory, laughter is proposed to be a release of pent-up nervous energy (Morreall, 2014). Laughter in laughter yoga may therefore help to let go of negative emotions. This explains some of the laughter yoga research findings.


 * Sarah was feeling quite sad after a recent breakup until she came across this book chapter on laughter yoga and emotion. Inspired, yet sceptical of psychological theory and research on laughter yoga, Sarah decided to engage in aspects of laughter yoga therapy. Although she felt a little silly at first, she started laughing out loud for no reason. This soon turned into real laughter. Sarah then changed her composure and engaged in deep breathing. After this, she felt really relaxed and happy. Sarah was aware that she was going to miss her ex, yet somehow she felt positive, at least for the time being, that she will get through.

Conclusion
Laughter yoga appears to have a lot of benefits on our health both physically and mentally. It also has an impact on our emotions. Laughter yoga increases positive emotions such as happiness and it also decreases negative emotions such as sadness and stress (Bennett et al., 2016). The best part about this is that anyone can laugh and laughter yoga research shows that we do not even need a reason to do it. Breathing exercises are also beneficial to our health (Brown & Gerbarg, 2009). This is another activity that anyone can take part of. Many theories such as the motion creates emotion theory help to explain how laughter yoga works.

Laughter yoga is well recognised around the world (Krebs et al., 2014). Perhaps there is a laughter yoga club near you. All it takes is a quick search on the internet. Even if this is not the case, laughing and breathing exercises can be easily incorporated into our daily lives in order to positively impact our emotions.