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Laughter really is the best medicine

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Could humour be the key to a healthier society? Comedian and pelvic physiotherapist Elaine Miller certainly thinks so.

Have you heard the joke about the Scottish pelvic physiotherapist-cum-comedian who makes people laugh so hard that they, well, wet themselves?


The punchline is that Elaine Miller then treats them for their problems "down below".

Comedian Elaine Miller truly believes laughter is the best medicine.

Comedian Elaine Miller truly believes laughter is the best medicine.

But seriously, new research has revealed laughter may very well be the best medicine for a healthy life.

Published online in the Australian and New Zealand Journal of Public Health, the research, A systematic review of humour-based strategies for addressing public health priorities, found that humour could influence people's behaviour and intentions around their health.

It was conducted by the Scottish comedian and women's health physiotherapist, who is a Fellow of the Chartered Society of Physiotherapy, in collaboration with a team of Monash University researchers led by Monash Warwick Alliance Professor Helen Skouteris.

"I have seen comedy used to address the most taboo subjects on stage," Ms Miller said. "My field is incontinence, which is often very embarrassing for people to talk about, but because laughter is universal it has the potential to reach people broadly.

"This robust, systematic review analysed 13 studies over the past 10 years whereby humour had been used to communicate serious messages covering topics such as mental health, breast and testicular cancer self-examination, safe sex, skin cancer and binge drinking.

"What we found is that humour can act as an effective vehicle for delivering messages people might find fear-inducing or threatening. Humour, if used well, can be an emotional buffer that breaks down some of that fear so the underlying messages reach the intended audience and influence their behaviours and attitudes."

The study highlighted a number of factors that could impact the effectiveness of a humour-based message, including the level and type of fear or perceived threat, the taboo nature of the topic and an individual's taste in humour.

"It's definitely not a one-size-fits-all approach," Ms Miller said. "A poorly judged joke can ruin a health campaign's message, a therapeutic relationship, a gig; or all three of those at once. "Humour is very complex and further research to examine humour and public health promotion is certainly warranted.

"What this study also highlighted is, there's a lot of us who work in health promotion who can learn from commercial advertising and public safety campaigns, such as road and rail safety where humour has been shown to attract attention, promote the memory of and positive attitudes towards an advertisement, brand or message."

The Scotland-based pelvic physiotherapist and winner of the Comedy Award at Fringe World in 2020 is passionate about pelvic floors and most of her clinic days are spent elbow deep in leaky ladies.

Her comedy show, Gusset Grippers, was written in a fit of temper because so many people with troubles "down below" do not seek help.

"People think leaking is an inevitable consequence of ageing or parenthood, and that's just not true," she said. "Making people laugh about something embarrassing means they will talk about it, and talking is kryptonite to taboos".

Prof Skouteris, Head of Monash University's Health and Social Care Unit within the School of Public Health and Preventative Medicine, said the study was an "encouraging first step" towards implementing humour-based messaging more broadly across public health.

Professor Helen Skouteris.

Professor Helen Skouteris.

"Humour is enjoyable. People are drawn to it - they want to look at it and be part of it," Prof Skouteris said.

"Importantly, this review highlighted that humour can be utilised as a tool to encourage conversation and sharing. It's not just a way to send a message but actually encourages people to talk about it and be open with others, which we believe can lead to influencing society's perceptions and behaviours around important public health prevention messages."

Prof Skouteris said further research was necessary to examine how humour worked specifically in public health settings.

"Most of the research done to date has focused on humour and health outcomes in clinical settings so it's important we look more broadly at how humour may influence behavioural intentions and public health outcomes out of those acute health settings," she said.

If all goes well, Ms Miller hopes to take some of this research on the comedy circuit.

"I'm interested in sub-clinical women, those who have incontinence but who don't seek help. I'm planning to tour my show and survey the audience to establish prevalence of pelvic health conditions and whether a comedy show can encourage help-seeking," she said.