Can laughter actually heal? Funny truths in your therapy space

There are moments I have experienced more times than I can count. A client sits across from me, holding something heavy: grief, fear, shame, confusion and then, unexpectedly, one of us says something that catches us both off guard. A small moment of shared absurdity. A wry observation that lands perfectly. And suddenly, we are laughing.

Not laughing to escape the difficulty. Not laughing because the pain is not real. But laughing because, in that precise moment, something shifts. A wall comes down. Breath returns to the room. And sometimes, often, that moment of laughter becomes the very thing that makes it possible to go deeper.

After many years of clinical practice as a person-centred psychotherapist and trauma specialist, I have come to understand that laughter is not the opposite of healing. In many instances, it is part of it. This article explores why, through the lens of neuroscience, psychology, sociology and culture, and invites you to consider that the therapy space can hold both tears and laughter, sadness and happiness, and that this is not a contradiction. It is, in fact, profoundly human.

The weight we are carrying and why this matters now

Mental health difficulties are not a minority experience. According to Mind (2024), approximately 1 in 4 adults in England will experience a mental health problem each year. The Mental Health Foundation reports that mixed anxiety and depression is Britain's most common mental disorder, affecting 7.8% of the population (Mental Health Foundation, 2024). Among young people aged 17 to 19, the proportion with a probable mental disorder rose from 10% in 2017 to 23% in 2023 (NHS Digital, 2023). The cost of poor mental health in England is estimated at £300 billion per year (Centre for Mental Health, 2024).

These are not simply statistics. Each number represents a person, a human being who may be struggling to get out of bed, to feel connected, to find meaning, to simply breathe. And in this context, the question of what genuinely helps, what creates the conditions for recovery, resilience and renewal, matters enormously. One answer, supported by a growing and compelling body of evidence, is laughter.

The doctor who dared to laugh: Patch Adams and the birth of healing humour

Many of us will remember the 1998 film Patch Adams, in which Robin Williams portrays Hunter 'Patch' Adams, a medical student who becomes convinced that laughter, play and human connection are as vital to recovery as any pharmaceutical intervention. Based on the true story of Dr Adams and his Gesundheit! Institute, the film captured something that the medical establishment had long struggled to quantify: that joy is medicinal.

Dr Adams famously brought clowning, humour and unconditional positive regard into hospital wards, challenging a medical culture that had become disconnected from the full humanity of its patients. His philosophy was rooted in the belief that treating the person, their spirit, their capacity for joy, their need for genuine connection, was as critical as treating their disease.

What seemed radical in 1998 now has a substantial evidence base. A 2023 systematic review and meta-analysis published in PLOS ONE found that laughter significantly reduced cortisol levels, the body's primary stress hormone, across multiple interventional studies (Kramer and Leitao, 2023). The same year, a landmark systematic review in Frontiers in Psychology confirmed that comedy and humour interventions produce measurable improvements in mental health outcomes across a range of presentations, including depression, anxiety and psychological distress (Kafle et al., 2023). Patch Adams was ahead of the science. But the science caught up.

Sean Maguire and the power of a therapeutic relationship that can breathe

Robin Williams appears again in the second film I want to draw your attention to, and perhaps this is no coincidence. Robin Williams, who experienced significant mental health challenges throughout his life, had an extraordinary capacity to hold both warmth and pain simultaneously. In Good Will Hunting (1997), he plays Dr Sean Maguire, the therapist assigned to Will Hunting, a young man from South Boston with a genius IQ and a deep wound of abandonment, shame and trauma.

What is remarkable about Sean's therapeutic relationship with Will is that it is never clinical in the cold sense. It is warm, irreverent, fiercely honest and at times genuinely funny. Sean uses gentle wit not to deflect from Will's pain, but to disarm his defences, to communicate safety, acceptance and unconditional positive regard in a language Will can receive. The lightness in their early therapy sessions creates the container in which the hardest moments become possible.

This is something I recognise deeply in my own clinical practice. Carl Rogers, the psychologist and founder of person-centred therapy, wrote extensively about the core conditions of therapeutic change: empathy, unconditional positive regard and congruence, the therapist's authentic presence in the therapy space (Rogers, 1957). A therapist who laughs genuinely with a client is, in that moment, deeply congruent. They are not performing neutrality. They are present, human and real. And that realness can be profoundly healing.

What laughter does to your brain and body

The idea that laughter is good for us is ancient; Proverbs 17:22 tells us that "a merry heart doeth good like a medicine", but modern neuroscience is now giving us the biological mechanisms to understand exactly why.

When we laugh, our brain's reward circuitry activates, triggering the release of endorphins, endogenous opioid peptides that produce feelings of pleasure, reduce pain perception and promote a sense of well-being (Nummenmaa et al., 2017).

A landmark study published in The Journal of Neuroscience demonstrated that social laughter specifically triggers endorphin release in the thalamus, caudate nucleus and anterior insula, brain regions associated with arousal, emotional awareness and social bonding (Nummenmaa et al., 2017). The researchers, led by Professor Lauri Nummenmaa of the University of Turku and Professor Robin Dunbar of the University of Oxford, concluded that laughter-induced endorphin release may be a primary mechanism through which human beings form and maintain social bonds.

Critically, this is not simply a pleasant byproduct of laughter. It is biologically functional. Research by Dunbar et al. (2021), published in PLOS ONE, confirmed that shared laughter enhances feelings of social bonding even among strangers, operating through the endorphin system in ways that parallel other bonding behaviours such as singing and communal feasting. In the therapy space, this means that moments of shared laughter are doing neurobiological work, deepening the therapeutic alliance, signalling safety and activating the brain's reward and attachment systems.

Laughter also directly lowers cortisol. The 2023 PLOS ONE meta-analysis by Kramer and Leitao demonstrated that spontaneous laughter interventions produced significant reductions in cortisol levels compared to control conditions, meaning that laughter actively downregulates the stress response at the neuro-hormonal level. For clients who are living in a state of chronic hyperarousal, as is often the case with anxiety, depression and trauma, this is not trivial. It is therapeutic in the most literal sense.

Research published in Brain and Behavior (Zarei et al., 2022) further examined how laughter activates large-scale brain networks associated with affect regulation, suggesting that neural circuits involved in laughter may have genuine relevance to the remediation of depressive symptoms. Meanwhile, a 2024 systematic review in SAGE Open demonstrated that laughter interventions produced significant improvements in stress, depression, anxiety and quality of life in clinical populations (Olympiou and Ahmed, 2024).

Key neurobiological effects of laughter at a glance:

• Endorphin release – activates the brain's natural opioid system, reducing pain and promoting pleasure.
• Cortisol reduction – actively lowers the stress hormone, calming the nervous system.
• Social bonding – strengthens the therapeutic alliance through shared neurobiological experience.
• Affect regulation – engages brain networks implicated in the management of mood and emotional distress.
• Immune enhancement – may enhance natural killer cells and release immunoenhancers, supporting overall health. 

Laughter, authenticity and the therapeutic alliance

All emotions have their place, and genuine mental health and well-being is not the absence of painful feelings, but the capacity to move fluidly between them. Laughter and lightness in the therapy space function in precisely this way.

They are not an avoidance of pain. They are part of the emotional palette that makes human experience whole. When a client laughs in a therapy session, at themselves, at life's absurdities, at the sheer improbability of their situation, they are demonstrating something remarkable: the capacity to hold pain and joy simultaneously. This is what psychological integration looks like.

From a person-centred perspective, the therapeutic relationship is not a neutral container for interventions. It is the intervention. Rogers (1957) argued that the core conditions, empathic understanding, unconditional positive regard and congruence are both necessary and sufficient for therapeutic change. When I laugh genuinely with a client, all three of these conditions are active simultaneously.

Empathic understanding is present because shared laughter requires attuning to the client's experience, finding what is amusing or wry or absurd in precisely the way they do. Unconditional positive regard is present because laughter communicates acceptance: "I am not here to manage or fix you; I am here with you". And congruence is present because genuine laughter cannot be performed. It is, by definition, authentic.

Research in the sociology of humour and therapeutic relationships supports this. A systematic review by Kafle et al. (2023), published in Frontiers in Psychology, examined comedy interventions across a range of mental health presentations and found consistent evidence for benefits aligned with the CHIME framework of personal recovery, specifically in the domains of connectedness, hope, identity, meaning and empowerment. These are not minor outcomes. These are the foundations of a life worth living.

The review also highlighted an important nuance, that laughter that arises naturally within the therapeutic relationship, as opposed to structured laughter exercises, operates through its social and relational dimensions. In other words, what matters is not the laughter itself in isolation, but the shared, attuned, safe relational experience that laughter creates. This is precisely what person-centred therapy, at its best, provides.

When laughter can signal something else

In the spirit of clinical honesty, it is important to acknowledge that laughter in the therapy space is not always a sign of healing. Experienced therapists will recognise laughter that functions as a defence mechanism, the client who laughs off their most painful disclosures, whose humour keeps intimacy at arm's length, whose consistent joking is a way of saying don't come too close.

In person-centred practice, the response to this kind of laughter is not to confront it or interpret it prematurely, but to stay present with what is beneath it, to gently, warmly, hold the space for whatever the client is not yet ready to name. Sometimes the laughter itself needs to be received before the tears beneath it can be trusted.

The therapy space, at its best, is big enough to hold all of it, the grief and the laughter, the fear and the warmth, the pain and the absurdity of being alive in this world, in this body, in this particular moment in history.

The evidence is clear: laughter has measurable neurobiological, psychological and social benefits. It reduces stress hormones, releases endorphins, deepens relational bonds and opens the door to emotional territories that more serious approaches can sometimes leave closed.

But beyond the evidence, there is something more elemental, the simple truth that to laugh together with your therapist is to be, briefly and beautifully, fully human together. And that is often where the real healing begins.

References

Centre for Mental Health (2024). The Big Mental Health Report 2024. London: Centre for Mental Health. Available at: www.mind.org.uk.

Dunbar, R.I.M., Frangou, A., Grainger, F. and Pearce, E. (2021). 'Laughter influences social bonding but not prosocial generosity to friends and strangers', PLOS ONE, 16(8), p. e0256229. https://doi.org/10.1371/journal.pone.0256229.

Kafle, E., Papastavrou Brooks, C., Chawner, D., Foye, U., Declercq, D. and Brooks, H. (2023). 'Beyond laughter: a systematic review to understand how interventions utilise comedy for individuals experiencing mental health problems', Frontiers in Psychology, 14, p. 1161703. https://doi.org/10.3389/fpsyg.2023.1161703.

Kramer, C.K. and Leitao, C.B. (2023). 'Laughter as medicine: A systematic review and meta-analysis of interventional studies evaluating the impact of spontaneous laughter on cortisol levels', PLOS ONE, 18(5), p. e0286260. https://doi.org/10.1371/journal.pone.0286260.

Mental Health Foundation (2024). Key facts and statistics about mental health. London: Mental Health Foundation. Available at: www.mentalhealth.org.uk.

Mind (2024). Key facts and statistics about mental health. London: Mind. Available at: www.mind.org.uk.

NHS Digital (2023). Mental Health of Children and Young People in England, 2023 Wave 4 Follow Up to the 2017 Survey. London: NHS Digital.

Nummenmaa, L., Manninen, S., Tuominen, L., Hirvonen, J., Kalliokoski, K., Nuutila, P. and Sams, M. (2017). 'Social laughter triggers endogenous opioid release in humans', Journal of Neuroscience, 37(25), pp. 6125–6131. https://doi.org/10.1523/JNEUROSCI.0688-16.2017.

Olympiou, A. and Ahmed, S. (2024). 'Laughter interventions to improve psychological well-being/QoL in cancer patients: A mini systematic review', SAGE Open Medicine, 12. https://doi.org/10.1177/21582440241300561.

Rogers, C.R. (1957). 'The necessary and sufficient conditions of therapeutic personality change', Journal of Consulting Psychology, 21(2), pp. 95–103. https://doi.org/10.1037/h0045357.

Yim, J. (2016). 'Therapeutic benefits of laughter in mental health: a theoretical review', Tohoku Journal of Experimental Medicine, 239(3), pp. 243–249. https://doi.org/10.1620/tjem.239.243.

Zarei, S.A., Yahyavi, S.-S., Salehi, I., Kazemiha, M., Kamali, A.-M. and Nami, M. (2022). 'Toward reanimating the laughter-involved large-scale brain networks to alleviate affective symptoms', Brain and Behavior, 12(7), p. e2640. https://doi.org/10.1002/brb3.2640.