Guest Blog: Creating Therapeutic Laughter for Brain Injury

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Creating Therapeutic Laughter for Brain Injury

By World Laughter Tour Special Guest Blogger Saundra C. Maisey, Certified Laughter Leader-Expert Level (CLL-E) & Trailblazer, Newfields NH

This summer (2015) I had an opportunity to present six laughter circle sessions at Krempels Center in Portsmouth, NH.


Their mission: “Krempels Center is a nonprofit organization dedicated to improving the lives of people living with brain injury from trauma, tumor or stroke. In partnership with universities and community volunteers, we offer programs that engage our members in meaningful and productive experiences and provide ongoing support and resources to survivors and their families.”

They got in touch with me because they already had some awareness of the benefits of laughter. I was apprehensive about accepting the assignment because I had never worked with people with brain injury. Before I committed, I attended a couple of their community sessions and watched the interaction with the staff and the members, and decided this was something I could do. I consulted with Helen Bzdel, MSW, CLL-E, Saskatoon, to pick her brain about what kinds of activities I might do and what I could expect with this population. She was very encouraging that this population would enjoy and benefit from a therapeutic laughter program.


One of the things I do at almost all of my laughter sessions is talk about who was born on this date, what happened in history on this date, and any special holidays. Lo, and behold, they were doing the same thing at their community sessions first thing in the morning. I knew I could keep that activity and expand on it.


The first two sessions, I just talked about what had happened, or whose birthday it was. By the third session, I had put together a PowerPoint slide show to go along with this part of the laughter circle. My theory was that seeing pictures might help members connect with the topic. I feel it was very beneficial to do that. Imagine my surprise when I showed a picture of Steve Wozniak (because it was his birthday that day), and there were a couple of people who knew who he was before I mentioned his name. That was very encouraging.


The number of participants changed every week. One week I had 15, the next week, 2 people came to the session. Their abilities varied widely, from those who functioned at a good level physically and mentally, to those who were confined to wheelchairs and had very little ability to communicate. All who attended participated at whatever level they could manage. By my staying flexible, it all worked.

We did a variety of laughter exercises. I quickly learned which worked best and which did not work at all. I was surprised when they were able for the most part to do the “Macarena laughter exercise.” I downloaded the song onto my computer and played it for them a couple of times. That resonated with some of them.

10 one metre laugh-Orr

It didn’t matter that I repeated laughter exercises from one week to the next because it was almost always a different audience, and the few that attended multiple sessions did not remember from one week to the next what we did. Using an egg timer, we tried laughing for 1 minute together; some just managed to smile, while others laughed for as long as they could.

The first week, toward the end of the session, one of the members went into a seizure. He was a tall muscular man in a wheel chair and wearing a helmet (that should have been a tip-off to me). The only thing I could think to do was to stand behind him holding onto his shoulders so he wouldn’t fall out of the wheelchair. I had an intern with me during the session, and went to get help. By the time staff arrived, his seizure stopped. They wheeled him out of the room, and we carried on. Fortunately, I was ready to wrap up the session with a meditation, and it seemed like the appropriate activity after what had just happened.

The staff at Krempels was very concerned about how I was impacted, asking me several times to be sure I was alright. They said that although this didn’t happen often, it was the nature of brain injury and assured me it had nothing to do with what I had been doing with the group. They followed up with me later in the week to make sure I was still OK and would be back, and to let me know that the gentleman was fine. They had called paramedics and he had a trip to the hospital that afternoon. Actually, the same man returned uneventfully to a later session in the six-week period.

A couple of highlights for me: The program manager sat in on one of the sessions, and as we were putting the room back together after it was done, she talked to me about one of the women who was there that had responded during the laughter activities. She told me that this woman always had a “flat” facial expression, rarely showing any type of emotion, but here she was smiling and laughing with the rest of us. The program manager was impressed with that. That woman attended the next week, and I watched her closely, and she seemed to be having a good time and there was lots of happy expression on her face as we laughed together. That was a high point for me.


Another highlight was in the last session. I had been watching one particular couple for the past 5 weeks. He was a stroke patient, still having speech issues, and was partially paralyzed on his right side. She used a walker, and accompanied him to all of the sessions he attended. She always sat at the back of the room on the seat of her walker, and didn’t participate. They showed up at the last session, and when we were ready to start, she wheeled her walker into the circle beside him, and joined us in our activities. They both were laughing and smiling a lot, something I hadn’t seen from them during the other community sessions that I had attended each day I was there.


He was very responsive, and did his best to give answers when we were discussing birthdays, and such. At the end of the session, I went to do the meditation – and realized that I hadn’t brought the one that I had intended to do. I did have the one that I use at almost all of my laughter circle sessions, but had been reluctant to use with this group. It is Janie Jasin’s “Golden Mirror Meditation”. I had a sense that it would be okay to go for it.

The end of the meditation calls for everyone to examine their hands. I say things like, “these are the hands that do the dishes, that cook the meals, etc.” And, “these are the hands that hold your sweetheart, your children, your grandchildren.” As I made these statements, I looked over and saw this couple holding hands. I almost burst into tears! It was such an affirmation about the difference we make with therapeutic laughter programs. This experience sure made a difference for me!

I remember being apprehensive going into the first session. I think that is normal for anyone who is conscientious. But, when it was over, I was on such a high.

I thought working with TBI folks might be depressing, but I left each afternoon feeling such joy that I had made contact with these people.
The Center is such a positive place. I’m looking forward to working with them in the future.

This was a summer “filler” program, but I’ve talked with them about creating more of these opportunities. For instance, three days a week they have an “Early Bird” morning session where they are in a circle tossing a ball back and forth. What a great time to do some laughter! I think occasional laughter sessions for the caregivers would be a great idea, too.

Good stuff!


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