Studies of People Who Have a Good Sense of Humor
The second major approach to assessing humor's capacity to help cope with life stress involves correlating a measure of sense of humor with the level of stress or negative emotion experienced. If watching a comedy video in a research laboratory or exposure to some other form of "outside" humor can help reduce feelings of anger, anxiety or depression, or otherwise help cope with life stress, then people who find or produce a lot of humor in everyday life should receive this stress-reducing benefit on a daily basis.
Three different types of research have been conducted using sense of humor measures to study the relationship between humor and stress. The first (and strongest) approach uses same experimental procedure to induce stress among different participating subjects. The expected finding is that subjects with a stronger sense of humor will experience the stressful event as being less stressful than those with a weaker sense of humor. A variation of this approach requires subjects to actively produce humor in some way following a procedure designed to generate stress.
The second approach is to assess the number and level of stressful events going on in people's lives and determine the relationship between sense of humor and measures of negative emotion at different stress levels. The expected finding here is that if humor does serve to moderate (reduce) the level of stress experienced in the midst of negative life events, then negative emotion should increase among low sense of humor individuals as life stress increases. This relationship should not be present, however, among high sense of humor individuals. Sense of humor would be serving as a "buffer" to protect them from the usual negative emotional impact of negative life events.
The third (and weakest) approach is to simply correlate scores on a sense of humor test with a measure of stress, anger, anxiety, or depression. In this case, there is no consideration of the level of stress participating subjects are under. The expected finding here is that people with a better sense of humor will score lower on these measures of stress. That is, if they really are actively using their sense of humor on a regular basis, this should produce the same lowering of stress and negative emotion that experimental studies have demonstrated.
Experimentally-Induced Stress
Some researchers have asked participating subjects to actively produce humor in their lab settings. There is evidence that exposure to a stressful film causes less mood disturbance (less negative affect) among individuals who actively produced humor while watching a film than among those who did not produce a humorous narrative to accompany the film.51 It is especially interesting to note that this effect was strongest among individuals who did not habitually produce humor in their everyday life. This is consistent with the idea that people who do not normally actively initiate humor on their own can benefit (in terms of stress reduction) from any form of help that gets them engaged in humor - whether it be watching a funny video or responding to a request to generate humor.
In another important study, subjects were led to believe that they would receive an electric shock a bit later in the experiment.52 This is a clear anxiety-generating situation, since no one enjoys electric shocks (although it was a mild shock). Watching a funny video prior to the anticipated shock significantly reduced the level of anxiety experienced at several points prior to the expected time of the shock (the shock was still some time away at all of these points). This occurred for individuals who scored both high and low on a sense of humor measure. In this case, then, having a good sense of humor offered no particular advantage in managing anxiety at the early stages of the study - when the anticipated shock was still some time away. But as the anticipated time of the shock became immanent, those having a stronger sense of humor showed less anxiety than the low sense of humor subjects. This suggests that a good sense of humor may well serve to protect us against elevated stress right when we need it the most. The problem for most of us, of course, is that this is precisely when our sense of humor usually abandons us.
Stress in Current Real-Life Situations
Many studies have now shown that people who score higher on sense of humor measures - especially measures that directly assess the extent to which you use humor as a coping tool in everyday life - experience less stress-related negative emotion during the stressful event than those who score lower on the tests. These findings again suggest that a good sense of humor serves as a kind of buffer, helping to protect against stress. In the earliest (now classic) study like this Rod Martin and Herb Lefcourt, at the University of Western Ontario in Canada, found that among individuals who did not often use humor as a coping tool, the amount of anger, anxiety, depression, and fatigue all increased as the amount of stress in their life increased. This is the general outcome we expect when people are faced with stress. Increased stress did not occur, however, among people who frequently used humor as a coping tool.53
This finding was replicated for five different ways of measuring sense of humor, several of which measured sense of humor in a general sense, rather than focusing specifically on the use of humor to cope. So there is something about having a better sense of humor that helps keep people from suffering the depression, anxiety and anger that most of us experience when our stress levels go up. The ability to keep from being overcome with negative emotion when under stress is a crucial component of personal and emotional resilience.
Other studies have produced similar findings in connection with depression,54 anxiety,55 the perceived stressfulness of an exam,56 and negative emotion in general.57
A separate group of studies has looked at the relationship between measured sense of humor and the extent of negative emotion or stress among groups of people dealing with specific diseases or other highly stressful circumstances. For example, more frequent use of humor as a coping tool has been shown to be associated with lower levels of depression and anxiety among older patients suffering from chronic obstructive pulmonary disease,58 lower distress levels among breast cancer patients,59 fewer depressive symptoms among both chronic arthritis patients60 and older widows who recently lost their spouse,61 better adaptation among the elderly to being moved to a new residential care facility (relocation to a new living situation is a major stressor for most elderly people),62 and reduced stress during dental surgery.63
Studies Not Considering Current Level of Life Stress
Some measures of sense of humor specifically measure the extent to which one uses humor to cope with stressful situations, while others assess other aspects of sense of humor not specifically related to stress. People who more often use humor to cope have been shown to have lower levels of depression64 and anxiety,65 worry about things less often,66 and experience less stress in life generally.67 That is, people who actively use their sense of humor to cope tend to be less depressed and anxious and less stressed out generally than those who do not use it to cope. The problem with this kind of research, as we've already noted, is that there is no way to determine which is the cause and which is the effect. People who are less stressed, depressed, or anxious in everyday life may use humor to cope with problems more often because they are in a better frame of mind to do so from the beginning. Or the opposite may also be true; they may be less stressed, depressed, and anxious precisely because they use humor to cope. There is no way of knowing what is responsible for the negative relationship between humor and stress with this kind of study - which is precisely why psychologists generally try to resolve such issues in laboratory studies, where they can draw firm conclusions about cause. However, these findings are consistent with those experimental studies which have demonstrated humor's power to cause a reduction in stress and negative emotion.
A Key Distinction: Positive (Adaptive) vs. Negative (Maladaptive) Humor
The above discussion of the research on sense of humor and coping presents a somewhat rosier picture than actually exists in the research findings. I've focused on the studies which document humor's power to help cope with stress. In each of the areas discussed, however, other research has produced findings that were inconsistent with the positive outcomes presented here, or which required a more qualified statement of the benefits of humor than I've provided. The discussion to this point does, however, capture the general thrust of the findings.
A major cause of the lack of consistent support for humor's coping power can probably be attributed to the fact that virtually all of the research relating sense of humor to stress and mental health has used measures of sense of humor that failed to make the crucial distinction between positive and negative forms of humor. We all know from our own experience that some people initiate a great deal of humor - even in stressful situations - but their humor is often sarcastic, rude, or simply inappropriate in some way. Such humor almost certainly was not the basis for the longstanding survival of the familiar phrase, "Laughter is the best medicine."
Two separate measures have recently been developed which distinguish between positive and negative forms of humor.68 Both of these new measures have been related to a number of measures of psychological well-being, showing that positive and adaptive forms of humor were associated with higher self-esteem and interpersonal competence and lower depression and anxiety. Negative and maladaptive forms of humor were associated with poorer self-esteem and interpersonal competence and higher levels of depression and anxiety.69 These findings make it clear that simply having a well-developed sense of humor is not enough to obtain the mental health benefits humor offers, since a well-developed negative sense of humor appears to actually interfere with good psychological health and effectiveness in social interaction.
Positive forms of humor were also associated with a skilled use of humor. Thus, the positive humor users were good at producing humor that helped them cope, got others to laugh, and strengthened social relationships. Some of their humor tended to be self-enhancing, but not at the expense of others. Their humor helped them deal with difficult situations, while still maintaining a realistic perspective on life. People using such humor tended to have a humorous outlook on life in general. Other positive forms of humor were more focused on building social relationships, serving to "raise group morale, identity, and cohesiveness by reducing conflicts and increasing others' feelings of well-being. This non-hostile use of humor involves joking and banter to reduce interpersonal tensions and facilitate relationships with others."70
Several types of negative humor were distinguished in these measures. Rude and aggressive humor included humor that was coarse, vulgar, sarcastic, ridiculing, teasing, or otherwise putting others down. Self-defeating humor involved efforts to disparage oneself - often in an effort to gain the approval of others. Continued use of this kind of humor seems to occur at a high personal cost in terms of one's own self-image.
Each of these negative forms of humor was found to have a detrimental effect on psychological well-being, while the positive forms were supportive of well-being. This basic finding helps make sense out of the failure of measures of sense of humor to be consistently associated with either physical (as discussed in Humor and Nursing I) or psychological health and well-being (as discussed above) during the past 20 years of research on this topic. From this point on, researchers will obviously have to distinguish between these two types of humor if we are to fully understand just how (and how much) humor and laughter contribute to physical and emotional well-being.
It is also worth remembering that the commonly accepted wisdom that the ability to laugh at oneself is a good sign of a healthy sense of humor, as well as of good mental health generally. Taken as a whole, the existing research on humor continues to support this view. The key, however, is that it is the capacity to laugh at yourself and the occasional use of this capacity that is good for your mental/emotional health. This new evidence suggests that you can go too far with such humor.
Finally, it should be noted that some people (mainly those not submitted to the emotional ordeals nurses go through every day) might consider the typical black or sick humor shown by nurses to fall within this negative category. It certainly appears to them to be inappropriate and harmful. I am convinced, however, that most nurses are very aware that this humor that they share with each other is NOT to be shared with patients or others lacking a nurse's daily exposure to serious injury/illness and risks to survival among patients. Nurses know that this humor is very adaptive - and that it is crucial to their well being (as discussed below).
