The Healing Power of Laughter

“Always laugh when you can, it is cheap medicine” -Lord Byron

I woke up tired again today. For me, waking up tired is one of the hardest feelings in the world. When this is combined with steroids, stress, and an inability to meet my responsibilities the days feel incredibly long. Yesterday, I yelled at my partner for cutting potatoes for French Fries into rectangles as opposed to using the cheese grater to make round potato chip like French Fries. Of course, this yelling resulted in my second crying meltdown of the day.

They say that people with Crohn’s ought to avoid stress. But, when the Crohn’s is resulting in decreased economic earning power, the difficulties of meeting basic life functions i.e. being awake long enough to do things like dishes, laundry, and showering, and there is the added guilt of not being physically able to spend time with a dying parent the emotional devastation gets to be a bit much. When daily pain is thrown in, and our diets become so restricted that even a simple meal becomes a challenge of extraordinary proportions it can be incredibly hard to focus on the big picture, hold onto to hope, or hell even smile at the insane. But, laughter truly is the best medicine and in these moments finding something to laugh at can make all of the difference.

Yesterday, my thing to laugh at was the need to be institutionalized. I felt as if my grip on reality was slipping, my emotions were a yo-yo of anger, frustration, grief, and fear which led to more than one moment of me crying while my partner kept telling me it was going to be okay, and while I knew that it was going to be okay in the moment I did not feel like it was going to be okay.

In response to a desperate plea for help my sister unknowingly made me laugh so hard I cried. After texting her that I was losing my grip on reality and that I felt as if I needed to be admitted to a psychiatric facility she replied with “well start with finding out if you can wean a little? And then get a referral to an institution.” For some reason, I just started laughing- perhaps there was nothing else I could do? But, in laughing, I finally had a little bit of relief from the emotional agony I had been walking through.

The Power of Laughter

Laughter has a myriad of benefits. Among these benefits are: stress reduction, immune system boosts, decreased physical pain, and improved mood.

Stress Reduction

High levels of stress are linked to decreased health. When we experience stress our hearts race, our breathing becomes faster, and our muscles prepare for action. During the time of stress, our adrenal glands release both adrenaline and cortisol which have negative impacts on our health. In fact, high stress has been linked to cardiovascular problems, headaches, stroke, body aches, and harmful behavior such as overeating and alcohol and drug abuse. But, when we laugh our bodies have increased oxygenation and our brain releases endorphins and neurotransmitters. The increased oxygenation can decrease the risks of cardiovascular problems as well as reducing the other negative impacts of stress on the body. Laughter also decreases the presence of stress hormones which lower immune response and lead to harmful behaviors.

Immune System Boost and Pain Relief

Endorphins are the bodies plain relievers. Like opiates, Endorphins attach to our brain receptors which can reduce pain as well as improve our overall mood. Not only does laughter result in decreased physical pain, but it also has been linked to immune systems boosts. Stress results in a chemical reaction in the body which lowers our immune response. In contrast, laughter releases neuropeptides which can fight stress and illness. Laughter also increases the efficiency of T-cells which gives a person an additional immune boost. Finally, the decrease of stress hormones that comes with laughter has its own immune-boosting effect.

Mood Enhancement

With the increase in endorphins that it provides laughing has a natural mood-boosting effect. We also can’t be angry or anxious when we are laughing. The Mayo Clinic says that laughter can also lessen depression and anxiety which will lead to us feeling happier. Laughter also helps us to shift our thinking from negative to positive. Through laughter, we can gain perspective on the situations and gain psychological distance from the depression, anger, or anxiety. With this psychological distance comes balance and a better ability to think positively about the situation at hand.

Health Benefits of Laughter by Jenny

How to Find Humor

For those of us living in hopeless or defeating circumstances, it can be challenging to find something to laugh at. Finding ways to find humor in the absurd can help to increase the presence of laughter in our lives. But, even if we are not in a place where we can laugh at the situation, we can find others ways to obtain the health benefits of laughter

  1.  Watch a comedy special or a funny movie. Netflix and Hulu both offer a range of options for comedy. If I don’t have time for an entire comedy special or movie, youtube has countless funny videos that can make me laugh in under five minutes. Start with a search for your favorite comedian, or terms such as “funny.”
  2. Spend time with funny people. My brother is one of those people who have zero ability to self-filter which leads to him saying the things everyone is thinking, but no one says. As such, whenever I spend time with him, I find myself laughing more than not. When I need a mood boost, Luke is always someone I can count on.
  3.  Fake it! Some Yoga gurus have already caught onto the healing power of laughter and in some practices fake laughter and breath work go hand in hand. Even though we might feel a bit ridiculous faking our laughter, eventually the mood boost of faking it and the absurdity of it will lead to real laughter.

Setting Boundaries

Boundary work is just as much about negotiating and asking for what we want and need as what we don’t want and don’t need. To this end, if we are working towards not just our own individual safety but towards changing the conditions in which people are not safe or are harmed, boundaries are about imagining radical possibilities as much as responding to events in the present.” -Cristien Storm

Every caregiver has their limits. My limit was toes. I had no problem helping Mom in the bathroom, hand feeding her, or helping her get dressed. But, trimming her toenails was my line, and I was not going to cross it. Until I did. Mom had her toenails painted through a loving act of kindness from an LNA, and a month later the polish was chipping and bothering her. So, she asked me to get nail polish remover and get rid of it. So, one sunny afternoon I sat on my Mom’s hospital bed, her foot in my hand and removed her nail polish. Once I got that all done, I figured why not, I’ll trim her toenails. With the Red Sox spring training game playing in the background, the spring sun shining through the window, I crossed my caregiving line.

I don’t know why trimming mom’s toenails was my line. For whatever reason, it was just the thing I decided I was not going to do. Kate, or an LNA, or anyone else could do it. It was not for me. But, in crossing my line, I connected with Mom in a powerful way. Somehow, sitting in her bed with her, listening to the game, and doing her toenails was comforting.

Boundaries

When we set a boundary, it is our way of telling others (and ourselves) what is and what is not acceptable to us. These boundaries can be physical, emotional, mental, spiritual, and sexual. The PsychCentral article, “What Are Personal Boundaries? How Do I Get Some?  highlights the fact that “love can’t exist without boundaries.” In caregiving, knowing my limits and boundaries has helped me to avoid burnout and fatigue. But, these boundaries also have been harmful when they have been so rigid as to block me from being open to new possibilities.

Examining Boundaries

Some of my boundaries are critical and help me to not only stay safe but also maintain my emotional health. But others come from misconceptions or lines I draw for arbitrary reasons. I don’t know why my limit was toes. But, by having this arbitrary boundary I was limiting the acts of love I did for mom, and in setting this arbitrary limit, I was avoiding an experience which ultimately connected me with my mom in a way that we both needed.


Who?

Just like we have varying levels of intimacy with different people, we have different boundaries for different people. For example, my physical boundaries allow for hugging close friends and family but not acquaintances. Asking ourselves what our comfort level and needs from the various people in our lives can help us to determine the “who” of boundary setting.

What?

When we clearly define what the limit or boundary is for ourselves, we can then communicate this more clearly to others. Asking ourselves what we need is a good first step in determining the “what” of boundaries. In addition to understanding what we need we can also ask ourselves “what else?” For example, if we are uncomfortable with hugging, we could ask for a handshake instead. As a caregiver, I at times have had to set boundaries with people in my life so that I can have the needed time to take care of me.

Where?

Just like we have different boundaries for different people, different places will require difference boundaries. Our boundaries are work look different then those boundaries we employ at home. Determine where difference boundaries are needed allows us to determine the location for each of the boundaries we set.

When?

Asking ourselves, “when do I need to set this boundary” is helpful for us to determine the timing of the boundary. For example, when my mom was at home, I had to set boundaries with work about contacting me when I was with her. While I was available to respond to texts, and emails on most days the days I was with her I found the influx of email notifications to be undue stress and pressure. I found that sending an email to my clients explaining that I not available on certain days helped to keep the extraneous emails at bay.

Why?

Understanding why we need certain boundaries can help us to determine what purpose the boundary poses. In my life, the boundary of “no toes” served to protect me from something which I had no need to be protected from. I was intimidated by mom’s feet for no other reason than my own misconceptions and personal feelings about feet which had no basis for my reality. When I stepped back and asked myself “why” this boundary was in place I was able to see that instead of protecting me from a true threat this boundary was keeping me from experiencing closeness.

 How?

In some cases, a boundary needs to be communicated verbally whereas in other instances actions can set a boundary. When we ask ourselves how we plan to set the boundary, we can choose the communication method that is most appropriate.

In setting boundaries, assertive communication is the most effective. Rather than telling someone what they should do, it is essential to focus on “I” statements and one’s own feelings. When setting a boundary with someone else, there is no need to apologize or over-explain our positions. Instead, we can keep it simple with an “I” statement such as: “I am not comfortable with hugging, can I shake your hand instead?” In other cases, we don’t have to communicate verbally. For example, if someone seeks to hug when we are not comfortable, we could use an assertive statement, or we could simply take action such as putting out hand out to intercept the hug and turn it into a handshake.

Putting it all together: Boundaries in Action

Once we understand the Who, What, Where, When, Why, How of our personal boundaries we can work to communicate these boundaries with others in our lives. Setting these boundaries with others allows us to work towards preserving our emotional and physical well-being.

Hold On Pain Ends

“Hope is the thing with feathers That perches in the Soul” -Emily Dickinson 

When faced with hopeless situations it can be tempting to give up. In those moments, an acronym for hope comes to my mind: Hang On Pain Ends. When I was growing up one of the pieces of advice, my Mom often gave me was, “don’t make a permanent choice in response to a temporary situation.” In moments of despair, profound grief, and well hopelessness it can be tempting to throw in the towel and give up. But, it is precisely in those moments when sometimes all one has to do is hold on.

Hold On

Holding on for me means doing the best I can with the situation in front of me. Some days, the best I can is merely showering, eating three meals, and not entirely losing my shit. Other days, the best I can is being present for the people in my life and giving back to the universe around me. When life happens, and I have to confront a hopeless situation it is the latter, not the former that sets in. But, in the confrontation of hopelessness, simply putting one foot in the front of the other can be enough.

There is a reason the saying, “it is always darkest before dawn” is a cliche. From states of hopelessness can come great joy and beauty. But, in our journey to the other side of pain, we have to hold on and face the pain.

Pain Ends

Think back to the last time your heart was broken, eventually with time, distance, and contemplation the pain left. Pain heals, ends, and changes. The worst pain we are experiencing today will eventually end.

One of my favorite stories comes from an alcoholic in recovery that I know. For this person, we will call him Joe, every day for over a year he was miserable sober. Not unhappy, not discontent, straight-up miserable. Then suddenly, one day, he wasn’t miserable. He was so shocked he called both his twelve-step sponsor and his professional therapist, he just had to check and ask what he was feeling. Joe had no idea when his misery would end. All he knew was that every day he was absolutely miserable. But, he had hope that someday maybe it would get better, so he held on and eventually after months of not giving up Joe was no longer miserable. This is not to say that some misery came back from time to time. But, as Joe recounts those time became less and less and less until eventually one day he simply couldn’t remember the last time he had felt miserable.

For me, HOPE is the acknowledgment that eventually pain ends (even if just for a moment), and healing is possible.

HOPE

Fatigue and I

“When we are tired, everything seems so very much worse” -Jane Green

The other day I woke up with negative spoons. For some Crohn’s patients, my reference to spoons is an all too clear reminder of Christine Miserandino’s article, “The Spoon Theory” written about her journey with Lupus. Miserandino’s story of spoons is her attempt to explain to her non-sick friend what living with Lupus is like. In the story, Miserandino compares her daily journey to spoons. In this compelling story, Miserandino says that people without illness have unlimited spoons to do whatever they wish with while those of us who have illness have a limited amount of spoons with which to navigate daily life. I absolutely hate, detest, loathe, and can’t stand when I have limited or negative spoons. For me, it is the absolute worse part of managing illness and one that I would much rather do without.

In completing research for this post and reading about fatigue and IBD, I became increasingly agitated and pissed off the best solutions to deal with fatigue are 1. Manage IBD, 2. Check for Anemia, 3. Manage psychological symptoms, 4. Improve the quality of sleep, and 5. Investigate medication side-effects as a potential for causing fatigue. While it is important that people with IBD pay attention to all five of the aforementioned recommendations, as someone who deals with persistent and at times debilitating fatigue, I will say that none of them have done much to alleviate mine.

The reason why fatigue makes me so angry is that it is the one Crohn’s symptom that I cannot push through. It is the one Crohn’s symptom that stops me in my tracks. I live in with daily pain, and I have learned how to work through the pain. I can have a partial bowel obstruction and still function as a participating member of society. However, when fatigue hits there is absolutely nothing I can do to make it go away besides stop, and the last thing I want to do is stop. For me, having to cancel plans, not do something I am looking forward to, and having to choose how to spend my limited energy is mentally and physically exhausting. I equate fatigue with my body failing me, and I hate how I feel when I want to do something but just can’t. I also hate that for me I have to make choices every day about the tasks that I want to complete- do I want to do laundry today or shower? Do I want to spend time with my family today or work? Do I want to cook dinner and save money or do I order out so I can clean my bathroom? Sometimes, my house is a mess, and there is a daunting tower of laundry staring me down, and I don’t want it to be that way, but, I had to make choices to either work, see family, clean the house, do laundry, get groceries, etc. and I just didn’t have anything left over to put into the mess or the laundry. When I cannot do something because my body has decided that it has reached its limit I just want to scream. Especially, when that something I want to do is at 10 am, and I cannot believe that I am already so exhausted.

I highly doubt anyone likes having limitations and I know my general detest for fatigue does not help me cope well with this symptom. I know that my own emotional process with fatigue makes me more likely to be cranky when I have it, and I also know that for me, some days will be easier than others and I must allow myself to throw the fatigue-related hissy fit so that I can then manage it. I am a big believer in stomping my feet and just getting the anger out.

I do not have to like dealing with fatigue, but I also have zero choices in the matter. So, I spread my energy out through the course of the day, take a nap in the afternoon, and consume copious amounts of coffee (I know coffee is bad for IBD and fatigue is bad for paying my bills!). I also manage my fatigue through letting others in my life know when my spoons are running a bit low. Even though I (like most people) do not always like asking for help, I also know that asking for help allows me to live my best life. When I alone do not have to manage it all by myself life becomes better.