It's not even 7 a.m. on a Sunday morning and Neihu's Bishan Park is already filling with people out for some exercise. Laughter rings out from the group of a dozen or so people gathered near the path by the lakeside pavilion. They're getting their whole bodies into the act, making faces and flailing about, raising a ruckus that carries all the way across the lake.

"Next we're going to imitate a leaping gazelle," says Hwang Kwei-shuai. "Pull out your horns and place your hands next to your ears." Dressed in a white T-shirt emblazoned with the words "Laughter Club," Hwang leads the group in its gazelle impression, laughing as he bounds ahead.

Their laughter takes many forms. There's the "greeting laugh" they use when they meet and shake hands; there's the "milkshake laugh," which involves raising an extended thumb to the mouth as if drinking milk; there's the roaring laugh in which they open their mouths wide and stick out their tongues in imitation of a lion; there's the laugh of someone rushing towards the finish line in the hundred-meter dash; and many, many more. The 20-some members of the Laughter Club stretch a bit to warm up before diving into an hour-long laugh fest. Once they've filled their minds and bellies with laughter, they're ready to joyfully raise the curtain on the rest of their day.

Patients at Xizhi's Cancer Friends New Life Association become as happy as children practicing "laughter kungfu" under Gao's tutelage.

Awakening your inner child

One club member says, "A big laugh brings tears to my eyes, which alleviates my dry-eye syndrome. I don't have to use drops anymore." Another says, "I have a problem with sometimes being short of breath. When I need air, I laugh three times, which causes sweat to bead on my forehead. The effect is like drinking ginger tea on a cool day."

"You don't need any reason to laugh," says Laughter Club volunteer Hwang Kwei-shuai, an obstetrician at Tri-Service General Hospital. "And it's easy to be happy. It all depends on your willingness to laugh. Laughter awakens your inner child. Regaining a childlike outlook makes it easier to deal with workaday stresses."

Hwang began promoting laughter as exercise after discovering its power for himself.

Three years ago, catastrophe struck his family. His father-in-law was diagnosed with stage-three nasopharyngeal cancer after swelling was noticed in the lymph nodes around his neck. Following Hwang's advice, he immediately entered the hospital for radiation- and chemotherapy.

His treatment program was grueling. In addition to experiencing nausea, vomiting, and loss of appetite, he developed oral ulcers and swollen vocal cords. It was torturous for both patient and family. The family was naturally expecting him to recover after the completion of his therapy, but he instead suffered an extremely rare complication-septicemia. He passed away just two weeks later, less than six months after the discovery of his illness.

Even Hwang, long accustomed to dealing with matters of life and death, crumbled under the blow. "I blamed myself every time I remembered that my father-in-law had only been willing to undertake this painful treatment because I was a doctor. What made it worse was that I knew that, medically speaking, nasopharyngeal cancer wasn't among the most deadly of cancers. I never imagined his treatment would fail." Hwang had a hard time facing his family or even himself. He sobbed uncontrollably when alone, and soon fell into an intractable despair.

One day, a patient he was examining remarked: "Doctor, you seem depressed. You look more like the sick person here!" It was a wakeup call. Hwang realized he needed to buck up.

Patients at Xizhi's Cancer Friends New Life Association become as happy as children practicing "laughter kungfu" under Gao's tutelage.

A global movement

Hwang recalled a trip he'd taken to the US for advanced training a few years previously, where he'd attended the tai chi, yoga, meditation, and massage classes that the University of Texas' M.D. Anderson Cancer Center offered to its patients. He also read an article entitled "Humor Power," and began wondering if laughter might indeed be the best medicine.

He began searching for information online, and discovered that Taiwan had its own Laughter Club that promoted "laughter yoga" and a locally developed "laughter kungfu." He tracked down Chen Dacheng, head of the Laughter Club, the month after his father-in-law passed away, then joined the club's workouts in front of the earth-god temple on Mt. Wujiutong in Taoyuan County.

Hwang recommended that the group extend its movement to the pressure cooker of Taipei and soon established a laughter yoga seed class. Over the next four years, Laughter Clubs spread to Taoyuan, Taipei, and Yonghe in the north, and to Tainan and Pingtung in the south as membership grew to more than 10,000 people.

The laughter yoga practiced by the club was developed by Madan Kataria, a Mumbai cardiologist. A practicing doctor for 25 years, Kataria had noticed that Mumbai residents rarely smiled. In 1995, he decided to bring some laughter into the lives of the city's residents. He and a friend kicked off their campaign by taking turns telling jokes in a park. When they ran out of jokes 10 days later, their audience was growing and more of them were laughing. "Why can't laughing be made into a kind of exercise?" wondered Kataria. He and his wife, a yoga instructor, began studying the matter and soon developed laughter yoga.

Laughter yoga's movements are very simple. Practitioners begin by clapping to warm up and stimulate pressure points in their hands. They then move on to simulating laughter, inhaling while making a "ho ho" sound and exhaling while making a "ha ha ha" sound. This is accompanied by belly breathing, which creates vibrations that deliver oxygen to the organs and achieve the exercise's objective-relaxation.

When Chen Dacheng, who runs a medical devices business, saw a program about laughter yoga on the Discovery Channel in 2004, he became curious about the exercise, which requires no facilities and is accessible to people of all ages. Chen contacted Kataria, spent NT$100,000 to attend a seven-day seed class in Switzerland, then began actively promoting the exercise in Taiwan.

Chen has taught laughter yoga classes in Taipei yoga studios and admits, "99% of the people who've studied yoga don't think this is yoga." He explains that proper yoga contains a number of movements that require a great deal of practice to perform, whereas laughter yoga is so simple even a three-year-old can do it. It is not well accepted among yoga practitioners because many find it to be lacking in challenge and therefore uninteresting.

"The key is attitude," says Chen. "You have to let go of long-standing bad habits and rediscover your inner child." Chen is adamant that laughing really is that simple. When you can crack a smile and change your attitude, it begins to transform your world.

Gao Ruixie developed Taiwan's own "laughter kungfu," a simple exercise regimen that includes stretching, yawning, and breathing exercises. The routine takes only about five minutes and helps practitioners clear their minds.

"Laughter kungfu"

In addition to the laughter yoga from abroad, there's also a locally developed "laughter kungfu."

Gao Ruixie is a volunteer who teaches laughter kungfu at Xizhi's Cancer Friends New Life Association every Thursday morning.

The association's 6,600-square-foot facility includes offices, a kitchen, a little library, and classrooms large and small, but has a homey feeling about it. Its many physical fitness classes, which run from morning to evening, include rotation, laughter kungfu, massage, yoga, meditation, and lectures on mind, body, and spirit.

At 11, the patients and volunteers sit in a circle on the wooden floor of a large classroom. Gao, leading them, has them spread their legs and let their hands fall naturally, which makes them look like children sitting by the front door of their homes. He then has them stretch their hands upward, slowly open their mouths, and make a long yawning sound. They then relax and repeat the move three times, gradually warming up their bodies.

For the second move, Gao has them suck in their abdomens, which causes their heads to drop. They then open their mouths again while gradually raising their heads, and making a "ha ha ha ha" sound from their bellies which they draw out into a laugh. They continue laughing until they are lying down or even rolling around the floor. By this time, most have tears in their eyes, and possibly even a little phlegm in their throats.

For the third move, Gao has them stand in a relaxed posture, inhaling while raising their hands, then drawing their hands into their abdomens. They slowly squat, then raise themselves into a position between squatting and standing, extend their hands and their fingers, open their mouths wide, and make a "wa" sound.

Laughter kungfu consists of eight basic moves, which Gao changes around as the mood strikes him. There are 20-some patients in the class today. When Gao notices someone new, he reminds them that they shouldn't force themselves to laugh hard if they've had surgery in the last three months, or suffer from severe hemorrhoids, glaucoma, or epilepsy. Otherwise, they run the risk of opening their wound or having a flare up.

Knowing that some cancer victims suffer from negative feelings and wonder why the disease struck them, Gao often has his classes shout out, "I don't accept this! I really don't accept this! I really genuinely don't accept this!" They then extend their hands to the heavens, relax, and shout one more time, and in so doing, cast aside their stress and pressure.

Responses to the exercise routine are diverse. Some people say it relaxes their bodies and makes them feel as if all their cells are laughing. Others say their jaws and bellies ache from the unfamiliar exertion. Still others find the guffaws of classmates who are falling down laughing to be contagious, while others cackle until the tears come.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

The qi of laughter

The 56-year-old Gao was once the vice chairman of Juei Fong Paper, the company that makes Sunti brand toilet paper. He began promoting laughter kungfu a decade ago and retired from his job three years ago.

Gao, whose honest guffaws are contagious, takes on a benign expression reminiscent of the Maitreya Buddha when he laughs. But he says he was a terrifying beast of a boss when he was younger. Gao used to organize "monster training camps" to boost the discipline, efficiency and morale of his employees. (The camps were hugely popular with Taiwanese companies a decade or so ago.) A typical morning for campers might involve a very early wake-up call for cleanup duty followed by morning calisthenics, during which they would be required to shout, "We must succeed!"

In those days, "monster boss" Gao didn't have any time for his family, and didn't communicate well with his wife. Dragged to couples counseling by his wife, he then began undergoing individual counseling, taking "personal growth" classes, and actively working to develop previously untapped potentials in himself.

Gao then traveled to Canada's famous The Haven for personal growth courses. From there, he went on to study the meridians of Traditional Chinese Medicine, and disciplines such as tai chi and qigong that involve breath control and abdominal breathing. After three or four years of work putting it all together, he came up with his laughter kungfu.

During this period, he also persuaded his company to fund a radio program called The Growth Train, which advocated for a spiritual revolution. On retiring, he devoted himself to the promotion of his "martial art," bringing it to drug rehabilitation centers, psychiatry wards, patient-support organizations, and other places where smiles are few and far between.

"Laughter kungfu puts the qi into chuckles, and the chuckles into qi," says Gao. He explains that there are many schools of qigong practice, and notes that the Daoists, Buddhists, and martial artists all have their own approaches. Laughter kungfu builds on Buddhist qigong, which focuses the practitioner's attention on the lower abdomen, doesn't attempt to direct the qi, and doesn't require memorization of the meridians. In that respect, it resembles the Baduanjin style of qigong.

Because it's so hard for people today to find an hour per day to practice, Gao shrank laughter kungfu's workouts into a three-part routine that takes just five to 10 minutes to complete and leaves practitioners feeling great.

The movements are like those of an early-morning stretching routine: dangling your arms, intertwining your fingers, and pushing the palms out, then extending your hands above your head and slowly lifting them skyward. When they reach their highest point, you separate them and open your mouth in a yawn. You then let your arms relax and naturally trace a circle.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

The miracle of laughter

Granny Mei, who is 87 and suffers from sciatica, long depended upon her husband to get by because she often hurt too badly to walk. Tragedy struck in 2001 when her husband went to the hospital for an enema to treat constipation. Somehow, while undergoing this minor, normally risk-free procedure, he contracted pneumonia, and died just nine days later. Unable to bear her loss, Granny Mei wished only to join her husband in the afterlife. She became severely depressed and stopped eating.

Sometime later, her family heard about the patient-support center in Xizhi from a friend of her grandson's, and they took her there for classes. At the outset, she had trouble smiling and sometimes alternated between tears and laughter. Eventually, however, she caught the laughter bug. She now works at the center as a volunteer, and has even represented it on trips to introduce laughter kungfu to New Zealand and Canada.

Gao has learned from his work with patients in the psychiatric wards at National Taiwan University Hospital and at the Songde Branch of the Taipei City Hospital that each responds differently. Sometimes, out-of-work middle-aged individuals suffering depression or emotional trauma are able to let go and laugh in their first class. Other times, depressed older women with no interest in life and middle-school girls bullied at school remain downcast and unable to make eye contact with others even after an hour's class.

"Anxious and depressed patients often hold their negative feelings inside and often experience chest pain," says Tang Hwasheng, a doctor at the Songde Branch. "The laughing exercises cause them to stretch out their chests and shout, which is very helpful." Tang says he asks patients not to dwell on negative things, but in many cases negative, worried thoughts are a long-term habit. Casting them aside isn't easy; patients need techniques to help them.

"The neural network keeps what it uses and discards what it doesn't," says Tang. "If you laugh every day, your pessimistic neural pathways are gradually going to atrophy and new optimistic pathways are going to develop, building, in effect, a highway to happiness."

"In Taiwanese, we say hioh-chhoan, which means 'take a breath,'" explains Gao. "The idea is similar to the Buddhist Shurangama Sutra's notion that by casting aside our greed, anger, etc., we can approach our Buddha nature. Both ask us to calm our emotions for a moment." Gao admits that exercising and practicing laughing kungfu regularly offer no guarantee that a cancer won't recur. He recalls a cancer patient who became terrified of death and began to break down when the cancer came back after three years. Addicts suffering from withdrawal at rehabilitation facilities also suffer terribly. Gao doesn't ask people in these kinds of situations to deny their suffering. Instead, he has them focus for a time on breathing, laughter, and the cleansing tears that flow from laughter. These, he says, deliver oxygen to their bodies and provide them with a momentary respite.

"How about this?" asks Gao. "Let's spend 10 minutes breathing and yawning, then you'll have the strength to go back to your worries." By putting it in those terms, Gao gets the patients to listen to what he has to say. And there's always a patient who ends up feeling better for having laughed, who becomes able to say, "I'll take things as they come. Worrying isn't helping anything!"

Smiles may be the most contagious kind of happiness there is. And laughter is both free and good for you. Why not spread some around?

When we see someone smiling, we can't help but smile in return. And laughter is surely the best medicine for stress relief. Make it a point to enjoy a little bit every day!

Hwang Kwei-shuai (left), an obstetrician at Tri-Service General Hospital, leads Laughter Club members on a weekend workout in Neihu's Bishan Park. Their early morning impressions of gazelles leaping and elephants stretching out their trunks burn away stress with roaring laughter.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Gao Ruixie developed Taiwan's own "laughter kungfu," a simple exercise regimen that includes stretching, yawning, and breathing exercises. The routine takes only about five minutes and helps practitioners clear their minds.

Hwang Kwei-shuai (left), an obstetrician at Tri-Service General Hospital, leads Laughter Club members on a weekend workout in Neihu's Bishan Park. Their early morning impressions of gazelles leaping and elephants stretching out their trunks burn away stress with roaring laughter.

Gao Ruixie developed Taiwan's own "laughter kungfu," a simple exercise regimen that includes stretching, yawning, and breathing exercises. The routine takes only about five minutes and helps practitioners clear their minds.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Gao, a retired businessman, and Lin Yuhua, a volunteer with the Care Cardiac Children's Association, bring laughter to drug rehabilitation centers, psychiatric wards, and patient-care associations.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.

Patients at Xizhi's Cancer Friends New Life Association become as happy as children practicing "laughter kungfu" under Gao's tutelage.

Gao Ruixie developed Taiwan's own "laughter kungfu," a simple exercise regimen that includes stretching, yawning, and breathing exercises. The routine takes only about five minutes and helps practitioners clear their minds.

Gao Ruixie developed Taiwan's own "laughter kungfu," a simple exercise regimen that includes stretching, yawning, and breathing exercises. The routine takes only about five minutes and helps practitioners clear their minds.

Gao Ruixie developed Taiwan's own "laughter kungfu," a simple exercise regimen that includes stretching, yawning, and breathing exercises. The routine takes only about five minutes and helps practitioners clear their minds.

Throw your concern with appearances to the wind and let those hearty guffaws fly. Laughter exercises fill you with "laughing qi" and get your day off to a boisterous beginning.