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Neurotheology (Intro) (Sayadmansour 2014)
Neurotheology, a branch of neuroscience recently coined by Alireza Sayadmansour in 2014, seeks to merge neurology with theology in order to understand how the human brain responds to religious/spiritual thoughts and actions (Sayadmansour 2014). Multiple studies throughout the past two decades have shown evidence that religious beliefs and actions can have positive (Azari et al. 2001; Newberg and Iversen 2003; Hill 2006) and negative (Halpern et al. 2008; Chatters et al. 2017) effects on the physical and psychological states of the individual. Positive religious experiences can improve cardiovascular health, reduce depression and anxiety, and increase the expected lifespan. Conversely, negative religious experiences have been shown to increase depression and anxiety, as well as cause long term mental trauma. This paper will examine the psychological effects of multiple religious activities (prayer, regular attendance of a religious service, meditation, consuming ceremonial drugs such as ayahuasca or psilocybin), and non-religious circumstances that have been correlated to feelings of spirituality (presence of cortical lesions, epilepsy, recreational/secular hallucinogenic drug use).

Examining the effects of religious belief through a neurological perspective does not come without its shortcomings. As spiritual experiences are inherently subjective, it is difficult to assess their presence through objective means such as brain imaging techniques such as MRI, PET, and SPECT. Additionally, the equipment used for these techniques can often be quite cumbersome to deal with for the subject. It is often difficult to observe the neurological state of a spiritual experience without simultaneously disturbing it. As such, many of the studies reviewed in this paper rely on a combination of brain imaging and personal interviews to cover the gaps in the objective methods with details of the subject's subjective experiences.

Prefrontal Cortex and Religion (McNamara 2006)
Research by McNamara (2006) has indicated that intense religious experiences, such as feelings of transcendence, have been significantly correlated to increases in dopaminergenic functioning in the prefrontal cortex. The prefrontal cortex is the region of the brain which encompasses the most anterior section of the frontal lobe. This region of the brain is believed to be involved in processing language, working memory, the expression of an individual's personality, the sense of self, and even the will to live (McNamara 2006). Neurological disorders such as schizophrenia, obsessive-compulsive disorder, bi-polar disorder, and dimentia have been linked to the prefrontal cortex.

Importantly, this region of the brain also has significant correlations with a number of religious traits. Individuals with schizophrenia and obsessive compulsive disorder have been significantly associated with high religiosity. Anti-psychotic medication that is taken to suppress these conditions have also been shown to decrease religious behaviors and delusions. Additionally, individuals which have overactive dopamine receptors in the prefrontal cortex have been indicated to display increased measures of "self-transcendence" on the Temperament and Character Inventory (TCI) personality test (McNamara 2006).

Cortical Lesions Modulate Human Self-Transcendence (Urgesi et al. 2010)
The Temperament and Character Inventory is a widely used psychological personality test which includes a personality dimension that measures spiritual thoughts and feelings onto a dimension called self-transcendence. Self-transcendence is defined as the diminished functioning of neurological systems which provide the individual with a representation of themselves as an entity which is separate from their environment (Urgesi et al. 2010). As such, self-transcendence is often experienced as a dissolution of self-object boundaries and feelings of oneness with the universe. The tendency to experience these feelings has been indicated to have a genetic component, as shown by twin studies that estimate between 0.37 and 0.41 heritability for the trait (Urgesi et al. 2010). The Temperament and Character Inventory measures the susceptibility to self-transcendence through the following five characteristics:


 * 1) Self-forgetful vs. self-conscious experience
 * 2) Transpersonal identification vs. self-isolation
 * 3) Spiritual acceptance vs. rational materialism
 * 4) Enlightened vs. objective
 * 5) Idealistic vs. practical

A study performed by Urgesi et al. (2010) compared the effects that brain surgery in the frontal and temporoparietal regions have on self-transcendence. They compared a sample of 88 individuals with brain glioma (cancer) before and after surgery which involves the removal of neural matter. Half of these patients (44) had surgery performed on the frontal lobe, while the other half had surgery performed on the temporoparietal region. Each individual was tested through the Temperament and Character Inventory personality test before and after surgery. Individuals which had surgery on the temporoparietal region had significant increases in the self-transcendence personality dimension; these increases were significantly higher than those who had surgery on the frontal lobe. As such, Urgesi et al. (2010) concluded that the tendency to experience self-transcendent feelings is significantly associated to reduction in temporoparietal neural matter. They suggest that dysfunctional parietal activity may explain self-transcendent experiences in individuals who have not undergone surgery.

Neuropsychological Spirituality (Johnstone and Glass 2008)
These results are supported by a separate study performed by Johnstone and Glass in 2008. They examined a sample of 26 adults who had experienced traumatic brain injury in one of three lobes: frontal, temporal, and right parietal. By measuring spirituality through the Core Index of Spirituality psychological assessment, they found that individuals with right parietal lobe damage scored significantly higher on this index than individuals without right parietal lobe damage. As such, they suggest that high-spirituality, including strong emotional experiences relating to god figures, prophet figures, and demonic figures, may be associated with disfunction in the right parietal lobe (Johnstone and Glass 2008).

Religion in Epilepsy (Devinsky and Lai 2008)
The link between spirituality and disfunction of the temporal (Urgesi et al. 2010) and parietal (Johnstone and Glass 2008) lobes was supported in research on individuals with temporal lobe epilepsy (Devinsky and Lai 2008). In a study of 57 individuals with epilepsy, 51% of the sample had reported experiencing intense feelings of salvation in the past which lead them to become more religions (Landtblom 2006). The symptoms associated with this disorder often cause the individual to experience delusions involving religious figures and symbols, lose one's sense of self, and experience intense feelings of bliss or feelings of transcendence. Individuals often report feeling intense joy and unity with the universe before immediately seizures take place. Additionally, these seizures have been documented to illicit hallucinations of spiritual beings and auditory hallucinations of God's voice. It is important to note that individuals with forms of epilepsy which do not affect the temporal lobe experience these spiritual sensations significantly less frequently (Devinsky and Lai 2008).

Sensed Presence (Landtblom 2006)
A case study on a Swedish man who had been diagnosed with temporal epilepsy since he was 3 years old indicated a link between perceptions of a "sensed presence" and abnormal temporal activity (Landtblom 2006). "Sensed presence" is a term used to describe feelings that an entity or some form of abstract force is present with the individual. This experience often illicit feelings of comfort or joy. Landtblom (2006) analyzed his subject's brain through single-photon emission computed tomography (SPECT). Bilateral hypoperfusion was found in the left temporal lobe, as well as abnormally slow and sharp electrical waves in the left temporal lobe. Additionally, he found increased blood flow in the left frontoparietal region. The patient reported that he experiences a "sensed presence" approximately 2 to 3 times a month. He described the sensation as follows: ‘‘I have a feeling that someone stands behind me, someone with a distinct wish to support and comfort me. This person will follow me anywhere I would like to go.’’ However, the patient does not view these experiences through a religious perspective, and instead interprets them as simply an effect of his epilepsy. This indicates that these kinds of experiences may or may not be interpreted as spiritual forces depending on the individual.

Neural Correlates of Psalms (Azari et al. 2001)
Activities which have religious connotations may have strong psychological effects to the person partaking in them. A study was performed by Azari et al. in 2010 which examined the link between brain activity and reading psalms. Six religious adults (all from the same faith: the Free Evangelical Fundamentalist Community) and six non-religious adults (university students studying natural science) were asked to read a series of three texts. One was a religious text, Psalm 23. Another was a "happy" text, a well known nursery rhyme. The other was a "neutral text", phone card instructions from a telephone book.

During these readings, the brains of the subjects were monitored through positron-emission tomography (PET) imaging. During the recital of the religious text, it was only the religious subjects that experienced an activation of the frontal-parietal circuit and the dorsomedial frontal cortex, two regions involved in emotional cognition. The non-religious participants did not show signs of such activation. However, the happy text increased activity in the left amygdala in both religious and non-religious groups. Brain activity did not differ significantly from normal when reading the neutral text (Azari et al. 2001)

Meditation (Newberg and Iversen 2003)
In 2003, Newberg and Iversen compiled a review of existing data on the neurological effects of meditation. Meditation may be used religiously or secularly for stress relief, spiritual growth, improvement of concentration and cognitive abilities. Five forms of meditation were reviewed: Yoga, Tantric Yoga, Tibeten, Kundalini, and Yoga Nidra. Samples of up to 8 individuals per study were monitored through positron emission tomography (PET) scans, single photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI). Increases in activity of the prefrontal cortex, an area associated with working memory, personality, and sense of self, were observed during Tibeten and Kundalini meditation, while Tantric Yoga illicited minor decreases in prefrontal activity. Activity in the parietal lobe was observed to increase during Tantric Yoga and Kundalini meditation and decrease during Yoga. While this study does indicate that there are significant differences in neurological effect due to the form of spiritual activity performed, it is important to note that every single study in the review reported complaints from subjects about difficulty meditating properly while hooked up to brain imaging equipment. As such, studies that allow the subjects to perform their spiritual activities in a comfortable environment are crucial to understanding the effects of these activities as they would occur naturally.

Ayahuasca (Halpern et al. 2008)
Personal interviews with subjects are an alternative method of assessing psychological effects without disrupting the spiritual activity as it takes place. Halpern et al. (2008) performed extensive interviews on 34 out of 40 of the members of the Santo Daime Church, a church which uses the hallucinogenic tea ayahuasca as a sacrament. Ayahuasca is consumed as a tea by combining and boiling the vine of the Banisteriopsis caapi and the leaves of Psychotria viridis. These two plants contain monoamine oxidase inhibitors (MAOI) and dimethyltryptamine (DMT) respectively. A majority of the members of the church attend the services every week; the hallucinogenic effects last for approximately 1-2 hours.

Halpern et al. (2008) interviewed the members of the church on lifetime drug use, a structured assessment of DSM-IV disorders, specific assessments of anxiety, depression, attention-deficity hyperactivity disorder, and childhood conduct disorder. They also performed physical exams to assess the neurological health of each individual.

Members reported a wide range of positive and negative effects of the ayahuasca ceremonies. The most commonly reported positive effects were increased physical health and mental clarity, improved relationships, and an increased sense of purpose. The most commonly reported negative effects included nausea, exhaustion, the bad taste of ayahuasca, and simply feeling that the ceremonies go on too long. A majority of members stated that the positive effects outweighed the negatives. However, Halpern et al. (2008) stress that these results were specifically gathered in a religious context, and should not necessarily be extrapolated to include recreational hallucinogen users.

DMT (Cakic et al. 2010)
That being said, recreational users of DMT (a principle component of ayahuasca) have reported that taking the drug has induced significant spiritual experiences. Cakic et al. (2010) performed a survey on 121 Australian citizens who had taken DMT at least once. A majority of these individuals were non-religious (73.6%), and many cited non-religious interest in the drug such as curiosity (41.7%) or psychotherapeutic benefits (31.1%). Nonetheless, most individuals (54.1%) reported experiencing spiritual feelings when taking DMT, with 75.5% reporting meaningful insight, and 29.6% reporting euphoria. Negative psychological effects included psychospiritual distress (23.5%) and anxiety or stress (10.9). These results provide evidence that even non-religious people can experience meaningful spiritual experiences through non-religious activities by altering their mental state through chemical changes.

Psylocybin (Griffiths et al. 2006)
Psilocybin, a hallucinogenic compound found within Psilocybe mushrooms, has long been known to elicit spiritual experiences. These mushrooms have been used for centuries by certain cultures in religious ceremony. Griffiths et al. (2006) performed a double-blind study on the effects of Psilocybin on 36 healthy adults who had not taken hallucinogens before. Psilocybin was administered in a comfortable environment with a research personnel in the room for support. All members of the study reported at least occasional participation in religious affairs (church, prayer, meditation, etc.).

Participants would be administered either psilocybin or methylphenidate (a hallucinogen with similar effects) during two separate trials, with a two month gap in between each session in order to assess the long term effects. Neither the participant nor the researcher would be aware of which drug was administered during the study. Psychospiritual changes were assessed through the mysticism scale, a 32 question survey which analyzes spiritual experiences. The mysticism scale measures three main components: feelings of deep positivity or sacredness, experiencing transcendence, and feelings of unity. Over 95% of the participants who were administered psilocybin reported feelings of deep positivity or sacredness and experiencing transcendence, while 60% of the participants reported feelings of unity. 67% of the participants noted that it was the most spiritually significant experience of their life (Griffiths et al. 2006).

Authentic Religious Experiences (Helminiak 1984)
A question that may arise when measuring spiritual experiences such as these is whether or not these experiences are truly authentic. Can an epileptic attack be considered a spiritual experience? Can recreationally smoking DMT bring genuine spiritual insight? David Helminiak, a priest and professor at University of West Georgia has tackled this issue (1984). His perspective is that, "An experience is authentic if it furthers the authentic growth of the subject, regardless of what triggered it." This would include physical illness, psychological disorders, or any abrupt chemical changes in the mind. Essentially, if the individual genuinely believes the spiritual experience is real, it is a genuine spiritual experience.

One historical example of this perspective can be seen in the visions of from 14th century German nun Margareta Ebner. Late in her life, she fell ill to an unidentified sickness that gravely worsened her health and would cause her to uncontrollably laugh or cry for hours on end. She claimed to have visions of the baby Jesus recounting how his own circumcision was performed, and to hear God instructing her to nurse the wooden statue of baby Jesus whom she would let rest in a crib. While these examples may seem strange, spiritual experiences are inherently out of the ordinary events. The foundation of intense spiritual experiences lie in moments such as these, where the individual truly believes deep down that the moment is divine, significant, or spiritually meaningful in some way. As such, regardless of if the most spiritually significant moment of one's life was consecration at the alter, an epileptic attack, or recreationally taking hallucinogenic mushrooms, these experiences should be regarded as genuine.