Islam: Spirituality and Mental Health

The World Health Organization defines health as "a state of complete physical, mental, and social well-being…" [1]. At present, this definition does not include spirituality, though attempts have been made for its inclusion [2]. Studies that show positive effects of mindfulness meditation [3] provide the possibility of it being used as a therapeutic intervention (see also article on page 5). When it comes to mental health, the spiritual philosophy in Islam is often overlooked or not thoroughly delved-into. Islam is mostly taken as a religious dogma comprising of political, religious and legal doctrines without considering its spiritual and moral dimensions [4].

Do We Need Spirituality?
Ibn-e-Hazm (994-1064 AD), a famous Muslim polymath, remarked "I searched for a common goal amongst humankind, to which all would agree to strive for excellence. I have not found anything other than the vanquishing of anxiety" [5].  The decline in mental health has been dramatic in the past few decades, with rates of depression increasing from 1988-2007 in the US [6]. Furthermore, the incidence of suicide has increased almost 40% in the middle-aged population [6]. The results of a cross-cultural study indicated that while wealthy countries may score higher on a happiness scale, they scored lower than poor ones on perceived meaning in life [7].

Islamic prayers as form of spiritual purification

One of the core features of spirituality lies in man’s ability to extract meaning from the world. According to Ibn-e-Hazm, the ephemeral nature of the world drives a person into an existential crisis and the only way to achieve happiness is to return towards God Almighty [4]. In Islamic tradition, spirituality may involve pondering over the ayaat (signs) of the Almighty and getting inspired from them to lead a life of servitude. Signs such as the presence of trees may remind one of the temporary nature of life. The intricate features and behavior of birds and animals may inspire one to marvel over the accuracy, beauty, and wisdom of the creator. However, not all may interpret these signs in a spiritual context.

Imaging Spiritual Prayer
A preliminary study in 2015 attempted to uncover the neurophysiological effects of salah (prayer) [11]. Muslims performing salah and dhikr (remembrance) showed less frontal lobe activity (crucial in executive functioning). The study also compared subjects performing prayer with and without spiritual concentration (khushu). Those performing prayer in a ritualistic manner without a lot of spiritual focus did not display any changes in brain activity, while those performing prayer with more spiritual fervor showed less activity in the frontal lobe and more in the basal ganglia (involved in the reward system) and anterior cingulate gyrus (involved in mood) [11].

"Sabr" and Its Role in Depression
Positive psychology includes studies that correlate self-regulation and gratitude with a lower incidence of mental illness. Dr. Timothy Strauman has suggested clinical depression to be a consequence of self-dysregulation [8]. In Islamic tradition, this practice of self-regulation is called sabr and Ibn al-Qayyim (1292-1350 AD) describes it as restraining and building character [4]. He also argued that the past cannot be changed with sadness, but by contentment, gratitude, patience, and a firm belief that everything that happens occurs due to the will of God [9].
In Islam, there are numerous supplications to ward off anxiety and depression. One factor that might explain the reduction in anxiety and depression experienced by depressed people performing supplications could be due to supplication working as a spiritual therapy. This practice may produce neurochemical alterations that may decrease the need for pharmacological intervention (which does not undermine the efficacy of the latter) [10].

Source

The interesting aspect about supplication or du’aa is that it can be used as a powerful form of psychotherapy. The crux of many supplications is not a request, but rather admitting one’s helplessness and asking for the Almighty’s mercy. Surrendering oneself may offer liberty from the world and its tribulations because the individual leaves the matter in the hands of someone far more powerful than him or her [4].
Many supplications call on to the Almighty by using names and qualities that evoke feelings of awe. According to Jonathan Haidt, the reality of awe involves a two-step cognitive process: vastness (anything experienced by the mind that is larger than one’s self) and accommodation (upon experiencing vastness, the mind adjusts to assimilate new information) [12]. So, experiencing awe by calling on the Almighty provides contentment in times of adversity. Islam envisages trials and tribulations as opportunities for submitting to the Almighty and building character.
In Islam, spirituality is intertwined in different everyday rituals and serves to elevate not only the physical, but also the psychological well-being of an individual [13].

[1] http://bit.ly/2f3Sbe1
[2] Chuengsatiansup, Envir Impact Assessment Rev, 2003
[3] Chiesa and  Serretti,  Psycho Med, 2010
[4] http://bit.ly/2f4epfR
[5] Ibn Ḥazm. Akhlāq wa as-Sīr, p. 76.
[6] Smith, The power of meaning, p. 22.
[7] Oishi and Diener, Psycho Sci, 2013
[8] Strauman, Self and Identity, 2002
[9] Ibn al-Qayyim, Zād al-M’aād, vol 2. p. 325.
[10] Porto et al., J Neuropsychiatry & Clinical Neurosci, 2009
[11] Newberg et al., J Physiology, 2015
[12] Haidt and Keltner, Cognition & Emotion, 2003
[13] http://bit.ly/2hjgViR


By Zara Khan, MSc Student MedNeuro

This article originally appeared September 2017 in CNS Volume 10, Issue 3, Spirituality in Science

Looking for God in the Brain: Neural Correlates of Religiosity

What makes humans religious? There must be something about our brain that makes religion a common denominator of humanity. Is there some area in our brain dedicated to the perception of the divine? Or maybe it is all just in our minds. Studying the neural correlates of religious behavior is no easy task, but some scientists have dared to address these questions.

To Believe Or Not Believe, Is That the Question?

How can we study the neural underpinnings of religion, this complex cultural phenomenon that affects many aspects of human behavior? Well, we can start by asking people if they believe in it. It is assumed that having faith is a prerequisite to comprehend and find relevance in religious activity. Whether or not faith and belief are the same thing is an ongoing debate in theology. Nevertheless, it is obvious that religious people believe that the specific word view provided by their religion is true. Therefore, an important area of research has focused on the neural correlates of what is happening in the brain when you judge a statement as true or false.
Interestingly, in a study in which subjects were asked to rate different kinds of statements as true, false or undecided, agreement generally activated the same brain area: the ventromedial prefrontal cortex (vmPFC) [1]. The vmPFC is strongly connected to the limbic system and incorporates emotional and reward associations to factual knowledge and reasoning tasks. This means that the act of agreeing with a statement, be it “2+2=4 “or “Jesus is the son of God”, activates the same area of the brain linked with positive emotions. In contrast, rejecting a statement as false differentially activated areas associated with feelings of disgust, such as the anterior insula, an area involved in the perception of pain and unpleasant odors.

A spiritual side to the brain?

In another study [2], the same group compared the brain activity of Christians and non-believers when agreeing or disagreeing with religious and non-religious statements. The answers (either true or false) to non-religious statements activated temporal areas of the brain associated with memory retrieval like the hippocampus, while the answers to religious statements activated similar areas of the brain found for disagreement in the previous study (likely from non-believers). In addition, the posterior medial cortex was activated, an area that is associated with the evaluation of self. That means that the participants were affirming their identity when agreeing or disagreeing with religious statements.

courtesy of Hector Salaza

Also interesting was the response to blasphemous statements like “the Biblical God is a myth”. The ventral striatum, a critical component of the reward system, was highly activated when believers rejected the blasphemy as false as well as when non-believers accepted the blasphemy as true. These findings make sense as we all know how Christians enjoy rejecting blasphemies while non-believers seem to take special pleasure in affirming them.

Talking To God – As a Friend
A key belief across religions is in the capacity to communicate with their God(s) through prayer. It was shown that praying, both through "official" religious texts and personal prayer, activates the reward system, specifically the dorsal striatum, which is associated with the expectation of future rewards and habit maintenance [3]. Interestingly, personal prayer activates areas of social cognition. In a study that compared personal prayer versus the Lord’s Prayer (an important part of Christian religious ceremonies) or making wishes to Santa Claus in committed Christians (who believed in God but not in Santa), it was found that personal praying differentially activates the temporoparietal junction, temporopolar region and the anterior mPFC. These three regions have been described as the “theory of mind” (ToM) areas, which are active when thinking about other people’s emotions and intentions [4]. This indicates that personal prayers imitate everyday social communication with real persons and provides God with intent and reciprocity (all the participants affirmed that God answered their prayer in some way). Indeed, it was found in another study that the activation of the ToM areas occurred before the activation of other non-ToM areas when accepting religious statements [5].
So far, no "God brain area" has been found. However, these findings tell us that religious people are no different than non-religious in the process of believing or disbelieving, which always comes with an emotional tone. In addition, it seems that religious thoughts are strongly linked to identity and social cognition. Interestingly, this supports theories from evolutionary psychology that religiousness might have emerged as a by-product of increasingly sophisticated ToM areas [6]. In other words: if there really is a God or other holy figure(s), it might just as well be that we believe in them "by (evolutionary) chance".

[1] Harris et al, Ann Neurol, 2008
[2] Harris et al, Plos One, 2009
[3] Schjoedt et al, Neurosci Lett, 2008
[4] Schjoedt et al, Soc Cogn Affect Neurosci, 2009
[5] Kapogiannis et al, Brain Connect, 2014
[6] Boyer, Trends Cogn Sci, 2003

by Silvina Romero Suárez,  PhD Student AG Infante

This article originally appeared September 2017 in CNS Volume 10, Issue 3, Spirituality in Science