The Power of Laughter

“When do you think people feel like laughing?”

The public’s impression of “clowns” is often associated with comedy and humor. But in the work of Dr. Red Nose, the meaning of “laughter” goes far deeper than what is visible on the surface. It is not merely an emotional response, but also a finely tuned physiological and psychological mechanism.

Why do we laugh? How does a sense of humor arise? By drawing on science, psychology, and history, we can rediscover this most remarkable human instinct from four different dimensions.

The “humor” we commonly refer to today actually has a winding history.

According to Dr. Red Nose’ internal training literature, 《Humor and Laughter》, the Chinese term “幽默” first appeared in Qu Yuan’s 《Chu Ci》, where it meant “silent and still.” It was not until 1924, when the writer Lin Yutang was searching for an equivalent Chinese term for the English word “humor,” that he transliterated it as “幽默,” giving it a whole new life.

Interestingly, the English word “humor” has also evolved. It derives from Latin and was originally a medical term for “bodily fluids.” In ancient Greek medical theory, the proportion of different fluids in the body determined a person’s temperament. In the 16th century, English playwrights extended this “theory of humors” and created a comedic genre based on the clash of different personality traits. From then on, “humor” gradually transformed from a medical term into a behavioral and aesthetic concept that brings people pleasure.

Centuries later, Dr. Red Nose brought this “art of making people laugh” back to hospitals. Humor moved from medicine to aesthetics, and now, in a unique way, it has returned to the medical setting.

From an evolutionary perspective, human laughter is the product of a long journey through time. When humans evolved from moving on all fours to walking upright, the rhythm of breathing was liberated, giving us the capacity to produce language as well as the sound of “ha ha ha.”

Physiological laughter is not only the “dispersal and release” of neural energy, but also a genuine process of bodily restoration. Taiwanese scholar Chen Hsueh-chih once aptly described it this way: “Humor is like the brain going for a jog.” From receiving a stimulus to bursting into laughter, the brain’s entire neural circuitry participates.

This not only activates the brain, but also relieves stress through endocrine changes. According to a 2023 international meta-analysis of “spontaneous laughter,” laughter can significantly reduce the body’s stress hormone cortisol by approximately 30 percent. At the same time, as German scholars concluded in their review of the benefits of medical clowns: “Laughter can stimulate and regulate the immune system by releasing endorphins (that is, endogenous morphine).” These mechanisms can help hospitalized children and their families effectively relieve the high levels of stress and fatigue accumulated over time.

In psychological research, one mechanism behind laughter comes from “comparison.” When we see an absurd, comical, or flawed situation and realize that we are in a relatively superior position, our sense of security and satisfaction makes us laugh. This is an inner defense mechanism that releases stress and reduces anxiety.

This is also why Dr. Red Nose are often “clumsy” in hospital wards.

In hospitals, children are usually in an extremely passive state: they must undergo examinations, receive injections, and take medicine at any time. When a Medical Clown enters the ward, accidentally bumps into the door, cannot find something, or messes up a simple magic trick, the child suddenly becomes the “smarter” one. This psychological reversal temporarily returns the power of control that the child has lost.

This kind of psychological support has also gained clinical evidence. In 2023, Taiwan published a quasi-experimental study titled 《A Quasi-Experimental Study on the Emotional Impact of Medical Clown Services on Parents of Children Receiving Cancer Treatment》 (published in the Journal of Pediatric Nursing). The study clearly indicated that medical clown services can significantly reduce parents’ psychological distress and anxiety during the process of accompanying their children through cancer treatment by improving the children’s emotional state.

The creation of humor often requires one key condition: “benign violation.”

When the “normal” that we are accustomed to is disrupted, we become afraid if it feels threatening; but if breaking with convention also creates enough distance to establish a sense of safety, we find it humorous. Cognitive psychologists also point out that laughter is a “communication signal” in human evolution, used to convey to the group that “it is safe here; there is no threat.”

Hospitals are spaces filled with rules, quietness, and seriousness. When Dr. Red Nose play ukuleles in the ward corridors, use IV stands as parade props, or engage in exaggerated “silent gunfights” with children, they are actually “gently” violating the conventions of the hospital.

Because all of this takes place in a context of understanding and goodwill, this unexpected “difference” instead breaks through the sense of isolation in the ward. Laughter creates new social connections among children, family members, and medical staff, conveying the signal that “it is safe here” and allowing everyone to briefly forget the weight of reality within a shared play situation.

In summary, the power of laughter has never been limited to “happiness on the surface.” It is a sophisticated process that begins with neurons in the brain, passes through the endocrine system, and ultimately builds trust and a sense of safety between people. In the anxiety-filled space of a hospital, a sincere smile is actually a small but tangible revival of life.

What Dr. Red Nose bring into hospital wards is precisely this professional companionship grounded in physiological, psychological, and social mechanisms. We do not issue prescriptions, nor do we provide medical treatment in the conventional sense, but through the performing arts and humor, we try to firmly return to children the right to play and the agency that originally belong to them, allowing laughter to become the gentlest yet most resilient force with which to face a lengthy course of treatment.

Red Nose Clown Association Taiwan, R.O.C. Dr. Red Nose and Dramatherapy: Creating a People-Centered, Friendly Healthcare Environment Through Clown Performance. Official Dr. Red Nose website. https://drn.org.tw/dramatherapy/

Tseng, Ching-Wen (2024). Humor and Laughter. Red Nose Clown Association Taiwan, R.O.C.

Wu, Wei-Wen et al. (2023), 《A Quasi-Experimental Study on the Emotional Impact of Medical Clown Services on Parents of Children Receiving Cancer Treatment》 (Medical clowning influences the emotions of parents of children undergoing cancer treatment: A quasi-experimental study), Journal of Pediatric Nursing.