ANCHORAGE - Jennifer Fielder's rosy cheeks bloomed like begonias as she led AhLAFska Club members through exercises designed to incite mirth.
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The group of six, ranging from preschooler to grandfather, cackled through the Wicked Witch Laugh as they ground invisible weeds beneath their heels into the carpet. They hopped and scratched and hooted their way through the Monkey Laugh. They giggled through the Penguin Laugh, their waddling feet akimbo. They sang "Happy Birthday" using only the words ho, ha and hee.
Through it all, they personified Fielder's advice - make the motion and the emotion will follow. Laughter started out forced, then grew genuine. Between exercises, they breathed deeply and stretched to release the day's tension.
"After leaving, I feel like I do after I run or exercise," said Anchorage attorney Kathleen Harrington, who joined the club last month. "I feel physically better and can give more attention outward. I'm not stuck in my own stuff."
The club mantra - "Ho! Ho!, Ha! Ha! Ha!" - trailed out the door and down the hallway, causing hospital workers to smile as they peeked in or joined the group for a few workday chuckles.
"My club is different than most others, because people come and go throughout," said Fielder, a registered nurse who works as a care coordinator at Alaska Regional. "When just a few people show up, I yank people in from the hall."
Fielder is one of more than 800 people in the United States certified to lead laugh groups through World Laughter Tour Inc., founded in 1998 by Steve Wilson, a psychotherapist and counselor from Ohio.
Because of laughter's health benefits, these clubs have been embraced by recreation therapists, social workers, psychologists and support group facilitators.
At the very least, laughter exercises lungs, oxygenates blood, works abdominal muscles, massages internal organs and releases tension. But medical studies have shown it can also increase tolerance to pain, improve the immune system, adjust blood sugar in patients with type II diabetes and aid digestion.
A University of Maryland School of Medicine study released in March showed laughing helps blood vessels function better, improving cardiovascular health.
Wilson touted a new study in Japan that indicates laughter improves the quality of breast milk in nursing mothers during a phone interview while driving to his office in Gahanna, Ohio. The study showed infants with eczema had fewer or less intense episodes if the mother was exposed to systematic laughter. But physical benefits are not what intrigued Wilson when he first learned of laughter clubs.
"For those who need it, the science is there. But I've been a mental health professional for 40 years, and the two most certain indicators of good mental health are a good sense of humor and an easy laugh."
India became the birthplace of laugh clubs after Dr. Madan Kataria, a Bombay physician, started the laughter yoga movement there in the 1990s.
Dr. Kataria toured the United States in the late 1990s with Wilson to see if laugh clubs would jibe with the Western mentality.
"We wanted to see if people would take laughter seriously," Wilson quipped.
It's hard to say exactly how many clubs are meeting regularly in libraries, churches, offices, hospitals, nursing homes and schools countrywide but Wilson estimates at least 600. WLT has trained 4,000 laughter leaders across the globe and there are clubs in 40 countries yukking it up.
Fielder, a breast cancer survivor, started AhLAFska to aid fellow employees at the hospital, although most who attend this haven of hilarity hail from the wider community.
"Cancer support groups are excellent for some people, but I found them to be kind of a downer," she said. "This is a positive way to let emotions out, and a great stress reducer."
"Besides, how goofy is it to be a certified laugh leader? It's just so out there."
Sandy Outwater, who works for Anchorage's municipal street maintenance department, visited for the first time June 21.
"Just the idea of laughing, just remembering what it felt like to laugh freely like we did as children, that was my big draw. I thought, I want to recapture that."