Laughter: The Best Medicine

By Susan B. Epperly

I’ve always been fond of the old Irish proverb that says, “A good laugh and a long sleep are the best cures in the doctor’s book.” And I joke with my massage clients that if that long sleep takes place on a massage table, then that’s even better!
I’m the artist behind the massage therapy-themed comic “A Touch of Humor,” so it probably comes as no surprise that I’m a vocal advocate of incorporating humor into one’s massage practice. I believe that one of the most important anatomy lessons is familiarizing ourselves with the funny bone.
But while it may seem intuitive that humor can be an effective tool for enriching our practice, it can be difficult to understand exactly how to introduce humor into a therapeutic environment without offending, patronizing, or insulting clients and coworkers.
Of course, there are no hard and fast rules about to how to implement humor appropriately in a health-care setting (and some of us are more comfortable with employing humor than others). But considering some general guidelines can be helpful.

Inherent Optimism
The use of humor, or being known as a person who exhibits good humor, is inextricably intertwined with optimism. And it certainly seems reasonable to assume that the presence of optimism in a health-care setting has the potential to contribute to a positive and beneficial therapeutic outcome.
Craig E. Matthews, LMT, a massage therapy instructor in Austin, Texas, agrees that humor and optimism go hand-in-hand, and shares that they contribute to success in both his personal and professional life. “Noticing humor contributes considerably to an optimistic outlook, and I choose to be an optimist because it is so much more enjoyable than pessimism. I don’t like being unhappy all the time; there are enough tribulations already in our lives,” he says. “Besides, others don’t like being around unhappy people and nobody wants to be massaged by a grump.”
But if we can use humor, does that necessarily mean that we should? And if so, why?
In a Southern Medical Journal article, Howard J. Bennett, MD, advises that, “Some patients do not appreciate humor, and it can be counterproductive to use it in their presence.”1 The piece goes on to caution that if a patient or client is ill, distressed, or angry, humor should be avoided.
The degree to which this advice may seem like common sense to a particular practitioner probably directly correlates to that practitioner’s “emotional quotient” or “emotional intelligence.” According to Andrew Colman’s A Dictionary of Psychology (Oxford University Press, 2009), emotional intelligence is defined as “the ability to recognize one’s own and other people’s emotions, to discriminate between different feelings and label them appropriately, and to use emotional information to guide thinking and behavior.”2 Generally speaking, then, a higher emotional intelligence likely corresponds with one’s ability to successfully and appropriately employ humor, both in personal and professional interactions.
This is certainly not meant to impose judgment on anyone based on their level of emotional intelligence, their proficiency with humor, or their preferred communication style. Some people are more proficient with certain languages than others, and similarly, some people are more fluent in the use of humor than others. This doesn’t mean that any one language is superior to another, or that one’s worth should ever be determined by one’s ability (or inability) to speak a language (or one’s ability to employ humor).
Practitioners who feel challenged by the use of humor in their work should not feel inadequate, but rather (should they desire to polish their skills), commit to practicing the use of humor to become more proficient. While some may seem to have been born with an inherent sense of humor, the use of humor, like the use of language, is something that can be learned and incrementally mastered if one so desires.
Regardless of a practitioner’s emotional intelligence or proficiency with the use of humor, an important precursor to the implementation of humor as a therapeutic intervention should involve assessing a client’s appreciation of humor. As massage therapists, we’re all quite accustomed to reading clients’ emotional states, physical postures, and body language. Similarly, it’s important for us to use these same perception skills to assess clients’ receptiveness to humor and to ensure that its use will enhance, rather than undermine, our therapeutic encounter.
One of the questions that we must consider is, “How can we bring humor into our therapeutic practice?” There are many creative ways to do so, and most of them don’t necessarily involve cracking jokes.

Infusing Humor
One great way to incorporate humor into human interactions is to build it into the environment in which those interactions will take place.
Art is one way to infuse a space with humor, whimsy, and lightheartedness, which can put visitors at ease. Whether it’s a clinic space we welcome clients into or a classroom inhabited by students, any professional space can be improved by the incorporation of humor.
Humor can help your clients relax and make them more receptive to you and your practice. Humor can also break down barriers, help people learn, and help distract them from their pain, problems, or other hardships. And showing clients a little glimpse of your personality in the form of what you find to be humorous can help them develop a fondness and affinity for you and your practice.
Tanya Chaney, LMT and owner of Chaney’s Natural in Monongahela, Pennsylvania, understands the value of humor in a therapeutic environment. “Humor is a great way to break the ice and make people comfortable in your office space. It is also a great way to find a common ground or to connect.”
As I look around my own massage space, I see many small, humorous, or whimsical touches that clients have found to be charming and endearing. Whether it’s a poster instructing clients to “embrace messy hair,” or a set of sculptural hands spelling out the word massage in American Sign Language, my massage room is populated by plenty of delightful touches of levity. I’ve collected and framed pages from antique massage textbooks that feature charming instructional illustrations, as well as various plaques and prints with messages like, “It doesn’t get much better than this—Relax!”
The key is for you to find and embrace your own voice and sense of humor regarding whimsical decorative elements. And, of course, one of the secret ingredients of good art, good design, and good humor is the element of surprise. Refreshing and unexpected associations (whether between colors, shapes, textures, or ideas) are hallmarks of creativity, wit, and humor.
A few guidelines or best practices for choosing humorous elements for your massage space include the following:
• Don’t incorporate anything that might be considered crude, vulgar, or gross. Err on the side of caution here. Even though something may be hilariously funny to you, some of your clients might find it to be offensive and off-putting.
In our profession, we tend to be fairly comfortable with bodily functions and nudity. But remember that something we encounter every day and are very used to can potentially make others uncomfortable. And it’s not worth losing a client over something that may be interpreted as a crude joke.
• Keep the humor related to massage. I have displayed a number of décor items that feature my “A Touch of Humor” massage therapy comics throughout my massage space. They keep the humorous element centered on massage and don’t stray into anything that might stir up strife (politics, religion, race, gender, sex, sexual orientation, etc.).
• When in doubt, sometimes it can be safer to not aim specifically for humorous or funny, but rather for cute or charming. Humor can be lost on someone who doesn’t share your sense of it, whereas something that’s just cute or charming can be appreciated by most everyone.

The Science Behind Humor
Another question we should ask ourselves is, “What are some of the reasons for bringing humor into our therapeutic practice?” There are actually many, some more scientific and some more intuitive, but all of them are equally legitimate motivations for embracing humor. In a 1996 paper “Humor in Medicine,” R. C. Wender asserts that, “Humor helps individuals narrow interpersonal and cultural gaps, communicate difficult messages, express frustration and anger, and cope with anxiety.”3
Wender also suggests that “primary care providers need to be able to interpret humor used by patients and can learn to use humor to create a healing environment.”4 While Wender’s paper focuses on the use of humor by physicians, it can be reasonably assumed that the implementation of humor in a massage therapy practice is similarly advantageous.
Capitalize on the fact that humor eases pain and relieves stress. Oxford researchers conducted a series of experiments to better understand the effect of laughter on people’s ability to withstand pain.5 They discovered that authentic, heartfelt laughter causes endorphins to be released in the brain. Endorphins, of course, are chemicals that cause us to feel less pain and fewer negative effects of stress. Endorphins offer pain-killing and euphoria-producing effects. The researchers found that viewing laugh-inducing, humorous content therefore led to an increased pain tolerance.
These study results, along with many similar emerging research findings from equally well-regarded institutions, suggest that we would be ignoring a powerful pain relief technique by neglecting to incorporate humor into our therapeutic practice. By fostering an environment that encourages and embraces laughter, we are creating a habitat where healing is all the more likely to take place.

Humor as Marketing Muse
Throughout our nearly decade-long career, my husband and business partner, Shane, and I have implemented a variety of humorous ad campaigns. One of our favorite projects is a web series titled “Trigger Point Ninja.” The show follows our hero as he travels the globe to obliterate members of a far-reaching terrorist organization of myofascial trigger points. You can see episodes at From giggle-inducing business cards to funny postcards and stickers, we’re always looking for ways to infuse our promotional materials with some sass and spunk. It’s not at all uncommon for one of our clients to pick up a few of our tongue-in-cheek business cards and tell us that they love handing them out to their friends and colleagues. Just the other day, a client told me, “Your business cards are so funny that when I hand one to someone, it’s like I’m giving them a greeting card.” When one of our current clients and a prospective client can share a chuckle as part of the referral process, then we’ve already made headway toward developing a promising professional relationship.
Finding your own voice when injecting your marketing with humor can take some trial and error. It can be helpful to run your ideas past a few clients and colleagues before committing to ordering your funny business cards, postcards, or stickers. These trusted confidants may indicate some clients might take the humor the wrong way, or spot unintended (and perhaps inappropriate) messaging that you hadn’t noticed.
And an important thing to remember when crafting your own humorous promotional materials is to be original! There’s nothing humorous about simply hijacking someone else’s joke, idea, or marketing campaign.

Easing Awkwardness
Those of us who practice massage know it’s only a matter of time before the inevitable need arises to confront some awkward and uncomfortable conversations. Whether those exchanges are with clients, colleagues, or employers, humor can provide a valuable social lubricant that can help us ease the friction involved in some of these uneasy, but necessary, confrontations. Boundary issues, professional disagreements, and the discussion of inappropriate behavior, of course, must be tackled, but humor can sometimes help soften the blow involved in delivering a tough message.
Of course, when using humor in an attempt to defuse an uncomfortable interaction, it’s important to avoid the possibility of coming across as flippant, irreverent, facetious, or unconcerned with the other person’s concerns and feelings. This can prove to be a tricky obstacle course to maneuver. We never want to risk hurting anyone’s feelings or making anyone feel picked on or disrespected. It can be helpful to direct the humor away from the person with whom we’re communicating, and rather focus it on the situation, or even ourselves. Self-deprecating humor, for those of us who are comfortable using it, can serve as a kind of peace offering in some interactions, wherein we demonstrate our own humility and our willingness to be vulnerable for the sake of levity and harmony.
And, even if we don’t feel comfortable incorporating humor into our face-to-face interactions with clients and coworkers, infusing it into written policies on our websites, brochures, and other materials can provide a more restrained and strategic use of humor.
On our website, Shane and I have attempted to soften some of the more serious, straightforward explanations of our policies with some lighthearted comments. Our diversity policy is an example: “We are proud to provide a hospitable environment that embraces diversity. We welcome clients from all walks of life, regardless of gender, gender identity, race, religion, sexual orientation, weight, age, fitness level, political affiliation, alma mater, paper or plastic preference (you get the idea). We do not, however, tolerate the abuse of alcohol, drugs, or massage therapists!”

The Last Laugh
Those of us who practice massage therapy are a very fortunate bunch. We get to work in lovely, peaceful environments, and we have the privilege of making a very real and lasting impact on our clients’ lives. Many of us feel we have truly found our life’s work in practicing massage, teaching massage, and spreading the word about the myriad benefits of massage. In a joyful career such as this, why on earth shouldn’t we be laughing? And why wouldn’t we want our clients, students, and colleagues to laugh right along with us?

When Humor Makes Sense
Humor can play a vitally important role in one’s massage practice in a variety of ways:
• Humor can make clients feel more comfortable and receptive to their therapy.
• Humor can help break the ice and put clients at ease about an encounter in which they may otherwise feel somewhat vulnerable and apprehensive.
• Humor can help give clients a respite from their pain and stress.
• Humor is a great teaching tool. It can help convey educational concepts when we are informing our clients about the therapies we offer and the therapeutic mechanisms of action at work. And humor can help students more easily grasp concepts in the classroom.
• Humor is a wonderful way to ensure that our marketing messages stand out from the crowd.
• Humor can offer a social buffer when the need arises to engage in awkward or uncomfortable conversations about boundaries, policies, and disagreements.
• Humor can humanize us as practitioners and teachers, and endear us to our clients, colleagues, and students.
• Humor can help us maintain an upbeat, relaxed work environment that can relieve our own stress and guard against burnout and compassion fatigue.

1. Howard J. Bennett, MD, “Humor in Medicine,” Southern Medical Journal 96, no. 12, 2003, accessed March 2017,
2. Andrew Colman, A Dictionary of Psychology (Oxford University Press, 2009).
3. R.C. Wender, “Humor in Medicine,” Primary Care 23 (1996): 141–154.
4. Ibid.
5. R. Dunbar, et al., “Social Laughter is Correlated with an Elevated Pain Threshold,” Proceedings of the Royal Society B (2011), accessed March 2017,

Susan B. Epperly works with her MT husband, Shane, in their East Austin clinical massage therapy practice, Tiger Lily Studios, LLC. Susan and Shane (both massage instructors) also create a variety of educational products in both digital and physical formats (ebooks, audio books, videos, and more) for other wellness practitioners. For more information, visit