ORIGINAL ARTICLE Religion and Psychiatry in the Age of Neuroscience James Phillips, MD,* Fayez El-Gabalawi, MD,† Brian A. Fallon, MD,‡ Salman Majeed, MD,§ Joseph P.Merlino, MD, MPA,|| Jenifer A. Nields, MD,* David Saunders, MD, PhD,¶ and Michael A. Norko, MD, MAR# Abstract: Descartes. Copernican sun-centered astronomy ushered in the begin- In recent decades, an evolving conversation among religion, psychi- ning of conflict with religion because Earth had lost its special status atry, and neuroscience has been taking place, transforming how we conceptualize as the center of the universe. In the 19th century, Darwin's theory of religion and how that conceptualization affects its relation to psychiatry. In this evolution, followed by his book, The Descent of Man, delivered the article, we review several dimensions of the dialogue, beginning with its history most significant challenge to religion, countering the story of creation and the phenomenology of religious experience. We then turn to neuroscientific in Genesis and threatening human uniqueness in the order of nature. studies to see how they explain religious experience, and we follow that with two The 20th and 21st centuries have witnessed the advent of neuroscience, 02/28/2020 on BhDMf5ePHKbH4TTImqenVG+tKk+L7/T7CNkNYPmQeYzl/bf33a+3cZUxvdLcgBvl by http://journals.lww.com/jonmd from Downloaded related areas: the benefits of religious beliefs and practices, and the evolutionary including the ability to quantify, measure, and analyze mental processes Downloaded foundation of those benefits. A final section addresses neuroscientific and evolu- such as cognition and emotions in increasingly sophisticated and previ- tionary accounts of the transcendent, that is, what these fields make of the claim ously unforeseen ways. Predictably, these methods are now being used that religious experience connects to a transcendent reality. We conclude with a from to study religious experience, an area that has traditionally remained brief summary, along with the unresolved questions we have encountered. http://journals.lww.com/jonmd within the domain of religion and religious studies. At times, data from Key Words: Neuroscience, religion, psychiatry, phenomenology of religion, these experiments have prompted neuroscientists and others to chal- neuroscience of religion lenge traditional religious notions of various subjects, including mind, soul, will, and morality. (JNervMentDis2020;00: 00–00) by s we write, an evolving conversation among religion, psychiatry, BhDMf5ePHKbH4TTImqenVG+tKk+L7/T7CNkNYPmQeYzl/bf33a+3cZUxvdLcgBvl PHENOMENOLOGY OF RELIGIOUS EXPERIENCE and neuroscience is taking place. Nearly 20 years into the third A If we are going to study neuroscience, psychiatry, and religion, millennium CE, the age of neuroscience has dawned, transforming, we must begin with an understanding of what religion is. Given the among other things, how we conceptualize religion and how that con- great variety of religions and religious practices, along with the long ceptualization affects its relation to psychiatry. In the article that fol- cultural history of religion, this question does not allow for a simple an- lows, we unpack several key features of this dialogue—touching on swer. Try to compare, for instance, fundamentalist Christianity and subjects ranging from phenomenology to evolutionary biology, from Buddhism, or ancient Navaho rituals and contemporary Unitarianism. philosophy of mind to neuroanatomy. After offering a brief historical in- We can only mention some efforts to answer the question of what troduction, we proceed with a nuanced description of the phenomenol- religion is. ogy of religious experience. We then proceed to the neuroscientific We begin with two classics: William James' The Varieties of Reli- studies themselves to see how they explain religious experience, and gious Experience (James, 1987/1902) and Mircea Eliade's The Sacred we follow that with two related areas: the benefits of religious beliefs and the Profane (Eliade, 1959). James distinguishes religious experience and practices, and the evolutionary foundation of those benefits. Next, and religious institutions, a distinction that serves as a faithful starting we address neuroscientific and evolutionary accounts of the transcen- point in this discussion. In his groundbreaking Varieties, James declares dent, namely, what these fields make of the claim that religious expe- that he will leave institutional religion—beliefs, theology, hierarchies, on rience connects to a transcendent reality. Finally, we offer a brief church structures—aside and focus entirely on “personal religion.” He 02/28/2020 summary and conclude with remarks on the many unresolved questions defines religion accordingly: “Religion, therefore, as I now ask you these fields are bound to encounter. arbitrarily to take it, shall mean for us the feelings, acts, and experiences of individual men in their solitude, so far as they apprehend themselves SCIENCE AND RELIGION: A BRIEF to stand in relation to whatever they may consider the divine” (1987, HISTORICAL BACKGROUND p. 36). Although admirably trying to capture what is distinct in religious The rise of modern science in the 17th century is attributed pri- experience, James' sharp distinction has not gone unchallenged. Charles marily to the work of Copernicus, Kepler, Galileo, Newton, and Taylor (2002), for one, has pointed out that much religious experience— James' personal religion—takes place in a communal or institutional setting. Would James, for instance, want to say that monks, praying and chanting as a community, are not participating in real religious *Department of Psychiatry, Yale University School of Medicine, New Haven, experience? Although James' definition of personal religion has faced Connecticut; †Thomas Jefferson University Hospital, Belmont Behavioral Hospital, Philadelphia, Pennsylvania; ‡Department of Psychiatry, Columbia University, New many critiques, it continues to resonate with contemporary audiences, York, New York; §Penn State Hershey Medical Center, Hershey, Pennsylvania; who might reframe his term as personal spirituality. ||Downstate College of Medicine, Brooklyn, New York; ¶Yale Child Study Center; Alternatively, in The Sacred and the Profane (Eliade, 1959), one and #Yale School of Medicine, CT Department of Mental Health and Addic- of Eliade's many works on ancient religion, he describes a world di- tions Services, Law and Psychiatric Division, New Haven, Connecticut. Send reprint requests to James Phillips, MD, 88 Noble Avenue, Milford, CT 06460. vided into sacred and profane space. The sacred is the space where E‐mail: [email protected]. hierophanies, intense religious experiences, occur. He writes, “For reli- The authors are members of the Psychiatry and Religion Committee of the Group for gious man, space is not homogeneous; he experiences interruptions, the Advancement of Psychiatry, which has approved submission of this article as a breaks in it; some parts of space are qualitatively different from others. Group for the Advancement of Psychiatry product. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. Hierophanies show something that is no longer stone or tree, but the ISSN: 0022-3018/20/0000–0000 sacred”—that is something wholly other, ganz andere. As Eliade quotes DOI: 10.1097/NMD.0000000000001149 Exodus, “Draw not nigh hither,” says the Lord to Moses; “put off thy The Journal of Nervous and Mental Disease • Volume 00, Number 00, Month 2020 www.jonmd.com 1 Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. Phillips et al. The Journal of Nervous and Mental Disease • Volume 00, Number 00, Month 2020 shoes from off thy feet, for the place whereon thou standest is holy Neuroscientific Accounts of Religion and ground” (Exodus 3:5) (1959, p. 20). Eliade recognizes that the modern Religious Experience world has become desacralized, that we now live in a secular world, where a stone is generally never more than a stone. We invoke Eliade Research into the neuroscience of religion stretches back into the to capture a sense, not of religiosity, but of what the religious person early 20th century, when the tools for research were limited to mea- would consider real contact with the sacred or transcendent. We recog- surements of autonomic activity such as heart rate, blood pressure, nize, of course, that even in this secular age the sacred persists for body temperature, and electroencephalography. In recent decades, many—for instance, in the piece of bread called the Eucharist. more advanced neuroscientific techniques such as magnetic resonance The above quote contains another critical notion from Eliade's imaging, computed tomography, functional magnetic resonance imaging book. Along with the ideas of the sacred and hierophanies, there is (fMRI), single-photon emission computed tomography, and positron- the idea of the religious man (homo religiosus); man is the creature emission tomography (PET) scans have been used to measure the brain's uniquely able to experiences hierophanies. For primitive man, all value blood flow, dramatically increasing the ability of researchers to study is associated with sacred space. Ordinary, profane life is without value. brain functioning (Schjoedt, 2009). In addition, other techniques have In describing the sacred, Eliade invokes Rudolf Otto's notion of added sophisticated analyses of brain chemistry (Newberg, 2006). the “numinous,” described in The Idea of