By Ingrid E., Ed. Wells

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However, there are limits to the adequacy and the success that can be expected from such an intervention. A limit is definitely exceeded, when the current emotional state is distinctly disturbed. The training of cheerfulness primarily has potential for improvements in the future. It is appropriate when one aims at achieving sustainable changes in the long run. It is not suitable as a quick help in a crisis. In a crisis, cheerfulness does only help, if one is already able to draw on helpful personal resources, that is, if one already has a sufficiently high degree of trait cheerfulness.

It is known by now that even in diseases with a clear somatic cause, psychological factors can influence the severity of the disease or the likelihood of a flare-up and can substantially co-determine the severity of pain. Thus, patients with a certain disease may vary in their illness expression from asymptomatic to severely disabled, despite comparable objective medical findings. Moreover, it is assumed that diseases and complaints do never exist exclusively in the mind (or "in one's imagination"), but that complaints that cannot be explained by a distinct somatic cause, too, are related to "real" physiological disorders (disorders of function).

Perhaps this may even be more obvious than the first possibility. Third, it might neither be true that joking causally influences cardiac health, nor that cardiac disease is the cause for less frequent joking. Nevertheless it is possible that it is observed that frequent joking and healthy hearts often co-occur, that is, if there is a third variable that influences both the frequency of joking and cardiac health. In the given case, membership in a well-functioning social group could be such a third variable, which is accompanied by convivial gatherings increasing the likelihood of joking, and also by social support that can play a part in staying healthy and feeling healthier.

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