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Feb. 10, 2023

Natalie Dattilo - The Power of Laughter

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Natalie Dattilo, PhD is a clinical psychologist who treats patients with depression. Her treatment approach is based on wellness science. We chat about mental health in general and specifically about the importance of playfulness and laughter in our daily lives. Natalie and I discuss the scientific effects of laughter both spontaneous and self-initiated laughing and why we older adults should dismiss the ageist trope "We must act our age" and include play in our daily routines.

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Disclaimer: Unedited AI Transcript

Announcer (00:06):

You are connected and you are listening to specifically for seniors, the podcast for those in the Remember When Generation. Today's podcast is available everywhere you listen to podcasts and with video at specifically for seniors YouTube channel. Now here's your host, Dr. Larry Barsh.

Larry (00:40):

My guest today on specifically for seniors is Dr. Natalie Dillo. Natalie received her PhD in clinical health Psychology from the University of Florida and completed her residency at the Indiana University School of Medicine, where she was on the faculty for nine years. She then served as director of psychology in the psychiatry department at the Brigham and Women's Hospital in Boston, and is now instructor at Harvard Medical School. She is an expert in cognitive behavior therapy, acceptance and commitment therapy, and mindfulness-based stress, retype reduction. She has appeared on Good Morning America, cbs b S News, N B C, Boston, and in the Washington Post, New York Times, wall Street Journal and Forbes. Welcome to specifically for seniors. Natalie, we are thrilled to have you on.

Natalie (01:45):

Aw, thank you for inviting me to be on.

Larry (01:49):

The pleasure is mine. Let me ask you, as a clinical psychologist, what kind of problems do you deal with

Natalie (02:00):

As a clinical psychologist, I've been prac, I've been been in practice for about 14 years and I treat depression. And it's sort of all the various sort of forms. So recurrent depression primarily. So people who are prone to recurrent bouts of depression, I work with them to eliminate their symptoms and also prevent re recurrence.

Larry (02:27):

Do you find that problems differ in senior adults than people still working?

Natalie (02:36):


Larry (02:38):

In what way? I would

Natalie (02:39):

Say yes, <laugh>. Oh okay. So in, oh, I mean our, just the, our lives are just so very different as we you know, live our lives across like the lifespan and developmentally things just change so much from when we are adolescents to young adults. Those issues are different than those working ages when we are working and, and starting families and raising families, and then families leave, <laugh> children leave and then we're then what do we do? Right? So there's a lot of transitions that we go through in life. You can either experience those transitions as, as gaining something new. So some people will experience those transitions as some, as something to gain and some people experience those transitions as something to lose. So, and it's usually a mix of both. And so by the time you've had so many life transitions you get pretty good at them actually. You actually get better at these things. And, and we call this resilience over time.

Larry (03:50):

So I said you were an expert in cognitive behavior therapy acceptance and commitment therapy and mindfulness, best based stress. Mm-Hmm. <Affirmative> reduction. What's your treatment approach? How do you go about this?

Natalie (04:09):

This is a great question. So all of those different types of therapy are what we would call or label skills based therapies. So I think it's important for people to understand that there are different types of therapies out there depending on a person's preference, depending on their goals, and depending on their needs. And so when you hear people talk about like talk therapy or traditional talk therapy, that is one type of therapy, but it's not the only type of therapy out there. I would call that I would sort of put that in the bucket of what, what's happening in my life. And you meet with somebody to talk with them about that and maybe get some support, a little bit of advice, but it's mostly just c you know, centers around what, what is going on in my life and what is the problem.

Natalie (04:58):

The next bucket of therapy, I would call the why bucket, and these are insight based therapies. These are psychodynamic psychotherapies. These tend to be longer term types of therapies, a little bit more analytic. And the goal is to help people develop insight and self-awareness. And usually it's, you know, it's going back to the origins of some of these issues. It's a little bit more like childhood focused. You might hear, you know, or think about therapy in that way as well. So so there's the what bucket, there's the why bucket. So not just what is the problem, but why is this problem happening or why is this problem happening to me? And then the last bucket, this is the skills-based bucket. So this is where you're gonna find C B T, cognitive behavior therapy, acceptance and commitment therapy, and the mindfulness-based therapies. The, this is, this answers the question, how, so not just what problem am I running into?

Natalie (05:55):

Why am I running into this problem, but how do I fix it? That's a really long answer to your question. So I'm working with people on solutions. So what is it that's getting in your way? And if, if depression or symptoms of depression show up in your life on a frequent basis, we do wanna understand why that's an important part of the process. But that's not where we stop. We know why enough and we have ideas about why this happens or keeps happening. And then we get to apply solutions. And the solutions are kind of one of two types. The first is thinking solutions. So I'm, I'm listening for people to tell me what they're thinking about themselves, what they're thinking about their lives, about the situations that they find themselves in. And the way that people talk is a reflection of how they think. And sometimes the way that they're thinking about something is, is biased <laugh>. So we bring a lot of bias into the situations that we find ourselves in, in, in life, and sometimes we can correct those biases, and that's part of my job and correct those biases in many ways through new behavior. So doing things differently than you've done them before. If you want to feel differently than you did before,

Larry (07:24):

You've said that our mental health is in a crisis. What do you mean by that?

Natalie (07:33):

Our mental health sort of collectively as a culture has been in crisis for a while. It's been in crisis for a while, and I think it, it, it's been going in the wrong direction for too long. If anything if anything positive came out of this pandemic, it was that the recognition that mental health is important and that no one is immune, is immune from that, from the consequences of that, right? That we can all be affected by things that happen to us in life. And so, you know, the fact that we're talking about anxiety more than ever before, and the fact that we're talking about things like depression and wellness and mental wellness, it's been a re i in, I've never heard so much attention be paid to mental health in my life, in my entire career as I have now. So these are good things. So are we in a crisis because we're paying more attention to these issues? Or are we in a crisis because things are actually getting much, much worse? That's hard to say. And maybe it's both.

Larry (08:38):

I'm glad you mentioned wellness. You base some therapy on wellness. Science.

Natalie (08:45):

Sure, yes. There's a science to wellness, right? So in some branches of psychology, which is the scientific study of behavior, and we look to see which behaviors which can include <laugh>, which include the, the way we think about things and what we do. There are some best practices when it comes to wellness, right? So, and I, you know, I work with people on self-care and developing self-care plans, which is really designed to promote wellness. So staying healthy, getting healthy and staying healthy, whether that's physical health or mental health. And so wellness is really the promotion of good health. And, you know, there's a lot of information out there. There's a lot of potential misinformation out there. And when it comes to self-care, self-care, I'm in the business of trying to identify and promote best practices in self-care as prevention. So, and there's an evidence base to this.

Natalie (09:46):

There are things that we know work, and when I ask questions and I give them a survey about their self-care practices, I ask them like, what are their, your attitudes towards self-care? What do you think about when you think about that? And what barriers do you run into? And people will tell me that it's not a matter of time. People will think, I don't have enough time for self-care. What people tell me is, the major barrier to those practices is energy, that I have the time, and I even have the motivation, but I don't have the energy cuz I'm exhausted. And the second is, I don't know what to do. If I had an hour or half an hour of time and I wanted to do something that would promote wellness in me, what should I be doing? And so we've identified the sort of the six top things that people can do that we know work when it comes to promoting our wellness and our wellbeing. Do you wanna,

Larry (10:46):

And <laugh>, and those are,

Natalie (10:49):

So it's okay. So it's easy to remember. I use the acronym escape to help people remember what they are. And so the first one is e it's exercise. So physical activity is always gonna be if you're able to move your body, move your body, it will give you the most bang for your buck when it comes to feeling better and staying well, feeling well and staying well. And it doesn't have to be a lot, but you do want to feel like you've done something. So that could take just a few minutes actually to feel like you've exerted yourself and walk away from feeling like, okay, I did something. There's different types of exercise, there's different types of physical activity, but physical activity for this purpose needs to feel a little effortful. The next is sleep. So good quality, sleep quality over quantity. The next is connection.

Natalie (11:42):

This is social connection, the value of our relationships, we know that's important. Again, quality over quantity. Okay. The next is appreciation, a which is cultivating positive emotions. So that could be gratitude, appreciation, awe, curiosity, optimism hope it's the active and intentional cultivate cultivation of those feelings that if we're not practicing them on a regular basis, we tend to not have them as much. And the last two is play, which is where some of the laughter work comes in. And the last E is exhale. So practicing breath work and recognizing the relationship between the way that we breathe and how we feel.

Larry (12:25):

You mentioned laughter, and that's one of the reasons I invited you to come on. You've been quoted as saying, in order to feel good, we have to practice feeling good. And laughing is one of the most cost effective ways to do that. Mm-Hmm. <Affirmative>, what's so good about laughing?

Natalie (12:45):

Oh, <laugh>. <Laugh>. Oh, how good do you feel after you've had a good laugh? It's just you know, in, in this day and age, there are very few things that work so well, <laugh> so reliably costs so little. And in this day and age where we want to feel better fast, it has all of those ingredients. Those are, its it's key ingredients in the, I guess the mechanisms of action. So I think it's the best drug out there if you wanna feel better al almost immediately now, how long do those effects last? Well, it maybe depends on how often you're actually flexing those muscles. But the more joy we feel, the more we practice feeling good. Whether that happens through lack, whether that happens through play, through music, through anything that really uplifts you even if it's for a moment allows us to preserve the ability to access that emotion again, like in the future. So we want that, this again is thinking about these, this long-term wellness plan where like like exercise that you might do to build muscles or gain strength or endurance you know, it, it gets a little, it gets easier over time. So this is more like, this is like an emotional fitness kind of practice.

Larry (14:15):

This scientifically how does laughter make us feel? Good.

Natalie (14:22):

Mm-Hmm. <Affirmative>,

Larry (14:23):

Let's mm-hmm. <Affirmative>, let's get down to the hormones.

Natalie (14:25):

Okay. So laughter is, so, laughter is so interesting, and it's defined as the physiological response to humor. Now humor is interesting because humor differs and it's subjective. So something that one person finds funny, the next person might not. So, so, so studying laughter a spontaneous laughter presents some challenges. But in the studies that have been done with both spontaneous laughter, which is that sort of involuntary reaction that we have to things we find funny, there's also simulated laughter. So like forced laughter. And you can just force yourself to laugh by just creating laughter on purpose in your body and in your body. We notice that it can't tell the difference. Your body and brain can't actually tell the difference between laughter that is spontaneous and laughter that is simulated. Now, if you've ever tried to force yourself to laugh at something that's not funny or just something that's neutral, what you might notice is that it's funny, like, like when you laugh and you hear yourself laughing it kind of makes you laugh.

Natalie (15:33):

If you hear other people laughing, it can sometimes make you laugh as well. So there is this sort of contagion effect, but I think that's part of the reason why the body experiences both types of laughter very sim similar is because there's a lot of overlap between the two. So when we laugh we know that a couple things are happening in the body. One is the release of endorphins. So endorphins are our body's natural painkillers. And so laughter is associated with pain reduction, or at least perception of pain reduction. Okay. and the other is it, it it's oxytocin. So it's yeah. So oxytocin is the love drug and it makes you feel more closely connected to people. So you have the endorphin, the the, the pain reducer and the connector all in one. So we do feel more socially connected. We feel a greater sense of belonging even when you're laughing by yourself. You don't have to be laughing with a group of people to experience that sense of connection to others through laughter

Larry (16:52):

When you're treating a patient or a client. Mm-Hmm. <affirmative> how do you work laughter into your treatment approach?

Natalie (17:01):

That's a great question. I, I carefully <laugh> sometimes, sometimes carefully, inappropriately. And

Larry (17:12):

Probably the way you're communicating right now,

Natalie (17:16):

Ab absolutely. I, I do try to, when it's appropriate, keep the work that we're doing, which can be very difficult and can involve painful emotions, painful conversations, but not all the time, not all the time. There is room and space for all of that in the conversations that I have with people when I'm doing therapy. But there is also room for lightheartedness. And I actually think it is so important to maintain a little lightheartedness, especially when the content of the conversation is so heavy and a little levity, and it's, it does, it sort of diffuses the power of the heaviness that might be in the room during a session. So what does that look like? Well you know, it's usu I'll tell you, it's usually at my expense. I will usually say something that's goofy about me or something that, you know, I can relate to this because I, I could tell you what happened the other day. And the way in which you can tell the story can add some elements of levity and lightheartedness. And I think it does go a long way.

Larry (18:32):

This podcast is primarily directed at those of us in the, I like to say remember when mm-hmm. <Affirmative> generations. And this is where we ourselves, I guess must assume some ages, tropes, and believe that we should act our age.

Natalie (18:52):


Larry (18:56):

Why is playfulness important for those In my generations?

Natalie (19:03):

Mm-Hmm. <affirmative> mm-hmm. <Affirmative> playfulness. Oh gosh. Playfulness and play is so important. For, again, these for wellness, I think as a wellness pillar is one of the things that I would consider a wellness pillar is play. Oh, play is associated with so many benefits and it is so good for your brain. So there's that aspect to it as well. It's not, it's not just fun to, to play. Play in of itself is fun and presents opportunities for laughter. We know the benefits of laughter play gives us the opportunity to connect play signal safety. So there's all these great psychological benefits to play, but it's also just really good for your brain and it keeps a brain youthful. And I do link it to depression or the prevention of depression through one of the key features of depression. And one of those key features of depression is a symptom called anhedonia.

Natalie (20:06):

Anhedonia is the inability to feel pleasure. It, it sort of just that a part of the brain just kind of goes offline unless it is regularly generating. So this is why the regular and planned activation of the pleasure and reward centers of the brain is so important to feel good and as a prevention tool for depression. So that's it in my mind. It's also just, it has a very practical application that play in some ways is like exercise where you, you do it because it's good for you to do it. It also makes you feel better. And if there are these proven psychological and physical benefits, why not do it <laugh>? Why not do it <laugh>, just like there's no, and you know, it's, there's no, as, you know, negative side effects. It's it's, it's generally, you know, harm free. And again, in our search for these things that kind of meet that criteria available to everybody, low cost, no known side effects, feels good and is reliable, then I think we should just do it. I think just do it.

Larry (21:16):

But how do we do it as senior adults?

Natalie (21:21):

Uhhuh, <affirmative>.

Larry (21:22):

I mean, how do we get over

Natalie (21:23):

This feeling?

Natalie (21:25):

Okay, so this is a good question too. Play is an attitude or a mindset more than any particular activity. So there are things that some of us would consider play that others would not. There's some great work by Stuart Brown who wrote a book called Play, kind of breaks down the different types of play that he's studied, and there's different types of play and also different play personalities. So if you were to think back in your life to a time when you were a kid or a teenager, young adult, what types of activities did you find fun then? Okay. some of those activities would probably still be fun now. But there might've been something if it was creative if you were a creative type of player if you were a collector, if you liked, if you were very active with play and you played sports or you were very creative with your play and you used a lot of imagination, that tells us something about our play type, our play style, or our play personality. And those are really good places to start. Things you used to enjoy. Start with those, see if they still bring that same level of enjoyment and, and, and go from there. Start from there

Larry (22:55):

And get over the feeling of self-consciousness, that it's all right to play as an adult.

Natalie (23:03):

Absolutely. Yes. I mean, get silly. I mean silly is silly again, is a, is a mindset and this idea that we should be a certain way or shouldn't do this and shouldn't do that. I mean, who says <laugh>? I mean, who, who wrote those rules?

Larry (23:24):

That's such good advice. Your science advisor to a group called laugh.events that offers comedy focus, I guess corporate events. Yes. Is is there anything like that for seniors?

Natalie (23:41):

I don't know, but I think it's a really great idea.

Larry (23:45):

And why not?

Natalie (23:47):

Mm-Hmm. <affirmative>? I don't know. I think it's a good question. I think it's Tyler. I mean,

Larry (23:53):

More than just listening to a comedian Right. Which is great fun too. Yes. But how do we involve ourselves? Mm-Hmm. What techniques i, i, are there techniques that we can be taught

Natalie (24:08):

Mm-Hmm. <Affirmative>,

Larry (24:09):

Would a group like this be of help to us?

Natalie (24:13):

I actually think it's a great idea. I actually do, I think that, I think broadening the scope of audience, targeted audience would be great for a company like laugh.events to teach, to teach people how to bring more laughter into their life. So primarily what this, what this group does is bring comedy shows you know, standup comedy shows to corporate settings. And they've been doing this virtually since the pandemic started, and they've started to resume some of those in-person shows. But I can think of gatherings around the country for people who might want to participate in a sort of customized comedy show, cuz that's the other element that they bring. They, they know a little something about the audience and they bring some of that material into the show, these very talented standup comics. But then there are other things that this group offers, like improv. So I don't know if you've ever taken an improv class or participated in an improv situation, but there's some really great benefits to that too. And it's one of the best ways to eliminate that sense of self consciousness, cuz it's, you gotta, you gotta let it go. You gotta let it go to be any good. I,

Larry (25:38):

I mean this is so important to my age group, especially in times like these with political and global crisis. I mean, we sit down and the first thing we talk about in a new group mm-hmm. <Affirmative>, is what pills are we taking? What surgery have we had, what doctor appointment we're going to mm-hmm. <Affirmative> we worry about gun violence for our grandchildren. It would seem to me we need direction, not all the time, not all of us, but

Natalie (26:18):

I think maintaining an outlook of, I think laughter and lightheartedness and silliness is one of the things that allows us to maintain a sense of optimism and hope. And so I think it is critically important, especially during times challenging times and times of crisis to bring a little bit of that back into our lives so that we can just go on <laugh>, right? That we can just continue to, you know, look forward to a time when it won't be like this. Hopefully, like hope. It's such a, such an important, powerful and important tool for just living. And I think during times of crisis it's even more important to maintain some levity, some lightheartedness. But there's room for both. That doesn't mean that you'd forget that there's other things going on in the world and other things that we should be concerned about.

Natalie (27:24):

And if we have the opportunity to do something, then do something. I think there's room for both. I don't think it has to be either or. I don't think we have to be complaining all the time about the things that aren't going right in order to fix them. In fact, I think for our, for our, you know, our ability to sort of regulate our own emotions, maintain resilience, think clearly about what needs to happen next, that we can't be sort of mired in the misery all the time and see a way out of it. So I, I think there's room for balance. I, and I think that's, that's really at the end of the day, what we're striving for. And when we talk about happiness,

Larry (28:01):

Thanks for bringing that to us. Anything we missed that we should talk about?

Natalie (28:07):

I don't know. We covered a lot of ground. I, I do love this conversation. I could talk about laughter and, and happiness for hours. <Laugh>.

Larry (28:18):

Wanna do it?

Natalie (28:19):

<Laugh>? Sure. I gotta come up with jokes. Don't <laugh>.

Larry (28:26):

This has been great. Natalie, thanks so much for coming on. We really appreciate your input.

Natalie (28:33):

Larry, thank you so much for inviting me. It was a pleasure.

Larry (28:36):

Thanks again.

Announcer (28:42):

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Natalie DattiloProfile Photo

Natalie Dattilo


Dr. Natalie is a licensed clinical psychologist and personal wellness advisor who specializes in the treatment and prevention of depression. She has been helping humans find happiness for a decade and a half using a personalized, structured, and scientifically-supported approach. She is passionate about translating cutting-edge research from psychology, neuroscience, and medicine into practical strategies for health and wellness, personal fulfillment, and success.

She is a regular media contributor and a public education spokesperson for the American Psychological Association appearing on Good Morning America, CBS News, NBC Boston, Washington Post, New York Times, The Wall Street Journal, and Forbes.

Dr. Natalie received her doctorate in clinical health psychology from the University of Florida and completed her residency in psychology at Indiana University School of Medicine where she served as a member of the faculty for over 9 years before relocating to the Boston-area. Currently, she provides psychological consultation for the Physician Wellness Program at Brigham & Women’s Hospital and is an Instructor of Psychology at Harvard Medical School. In 2016, she founded Priority Wellness, a mental health consultancy specializing in lifestyle wellness programs for individuals and organizations. In 2022, Priority Wellness began offering hybrid (virtual and in-person) services for clients nationwide and globally, with offices located in Boston and Carmel, Indiana.