Insights from neuropsychiatry about the god module in our brain… DR. ENNAPADAM S. KRISHNAMOORTHY

Most dictionaries describe religion as “a way of life”. Religious beliefs, practices and experiences of individuals in our society, appear to have a strong cultural basis in their evolution and have been described as part of every ancient civilisation discovered and studied by modern man. On the face of it, therefore, it seems inconceivable that religious experiences may have biological basis in our brains.

Several questions remain unanswered in our quest to understand how religious experiences occur. Why are some people intense in their religious beliefs and practices and others considerably less enthusiastic? Or indeed, why do one's religious attitudes, beliefs and practices change during a life span, progressing sometimes: from atheism to agnosia to intense religiosity (or indeed in the converse direction)? Can socio-cultural factors alone have such influence on our lives, or are there more inherent biological determinants of these experiences and behaviours? Empirical observation suggests that a simple sociocultural explanation may be inadequate. There are for example considerable differences in religious attitudes and practices between siblings born of the same set of parents. The socio-cultural ethos in this situation is a virtual constant. Yet variations in the quality, frequency and intensity of religious experiences are observed and it's not uncommon to witness the entire spectrum, from intense religiosity to a strong atheistic tendency within the same family. While psychological experiences and social factors unique to each individual may have a significant role in determining these variations, they are often conjectures that arise from social and clinical observation.

Insights from neuropsychiatry

Neurology, psychiatry and their interface discipline neuropsychiatry provide many interesting models for the study of religiosity. Religious phenomena vary tremendously across brain and mind disorders. The religious ecstasy of the person in a bipolar mania is qualitatively different from the prophetic fervour of the person with paranoid schizophrenia. The depressed, anxious or avoidant individual is almost desperate in his pleas for religious salvation, rather different from the intense ritualism of the person with OCD or indeed the magical beliefs of the schizotypal individual. There are also variations in quality and intensity of religious experience across psychiatric disorders; for example, the acute hyper-religiosity of mania is rather different from the grumbling, slowly evolving, almost prophet-like religious fervour of the person with a schizophrenia-like illness. Are these variations in phenomenology, quality and intensity of religious experience governed by psychological and socio-cultural determinants alone? Or indeed do different brain mechanisms have a role to play in determining these variations?

Neurology too has its share of religiosity models. The Geschwind syndrome is a personality syndrome that has been described in people with poorly controlled temporal lobe epilepsy. While a well defined cluster of behavioural symptoms characterise this personality type (see “The Inside Man”, The Hindu Magazinedated November 29, 2009), intense hyper-religiosity with intensified preoccupations related to moral, philosophical, religious, or ethical themes are a core feature of this syndrome (see also box on Kumagusu Minakata). Bear and Fedio (1977) provided a biological explanation for this syndrome (the sensory-limbic hyperconnection” hypothesis). They proposed that ongoing electrical activity in the temporal lobe (in the person with temporal lobe epilepsy or TLE) resulted in all sensory experience (seeing, hearing, feeling, smelling, tasting etc.) being suffused with a strong emotional coloration. This resulted in relatively ordinary experiences being viewed with a certain emotional intensity by the person with TLE. Hyper-connection of critical brain structures for emotion, specifically the limbic system comprising the amygdala, hippocampus and other critical structures, was therefore thought to be the biological underpinning that determined hyper-religiosity and other personality features in TLE.

A god module in the brain?

Perhaps the most dramatic recent description of hyper-religiosity in epilepsy is that of V.S. Ramachandran in his book “Phantoms in the Brain”. In a chapter provocatively titled “God and the Limbic System”, Ramachandran draws on his clinical experience to give the reader an evocative description of a hyper-religious patient with temporal lobe epilepsy. He describes the dramatis persona complete with religious symbols and a prophetic fervour, accompanied by a firm belief (in that individual) that his life had special meaning and his existence a special purpose for the world we live in. While Ramachandran's subject had symptoms that were decidedly exaggerated (a caricature rather than the norm), hyper-religiosity in people with TLE evolves over time (a trait phenomenon), not just appearing suddenly (as in a state phenomenon). Ramachandran poses the interesting question "is religiosity a pre-determined biological trait"; paraphrased, this could read “is there a god module in the human brain?” Research using MRI volumetry and functional MRI (fMRI) techniques have demonstrated rather interestingly, links between structures in the limbic brain, especially the hippocampus and religiosity. Indeed, one paper that I co-authored (Wuerfel et al, 2004) demonstrated links between a small right hippocampus and hyper-religiosity in epilepsy.

Unanswered questions

While putative associations between religious experiences and the limbic system have been demonstrated, a number of questions remain unanswered.

First, what exactly is normal religiosity and what is hyper-religiosity? One suspects that this in itself is subject to transcultural influences. Western studies report about a third of people surveyed as being “religious” or “very religious”. We surveyed over 500 people using a suburban railway booking counter in Chennai and found almost 70 per cent of all individuals qualified as being “religious” or “very religious”. In the Indian social context, where religious expressions and beliefs are common place, the phenomenon of hyper-religiosity can be difficult to define. For example, in our Chennai survey, when we described hyper-religiosity as being two standard deviations from the median score in our questionnaire, we found only a small proportion of people qualified. Social norms of “normal religiosity” will therefore have a significant impact on what we perceive in each culture as hyper-religiosity.

Second, are religious experiences a trait or state phenomenon? It seems clear that religiosity can be both a state and trait phenomenon when observed across the spectrum of neuropsychiatric disorders. Contrary to popular perception, trait behaviours do not stop developing with the onset of adulthood and continue to evolve subtly over many years. It is conceivable that religiosity as a trait behaviour in people with neuropsychiatric disorders may exist from early on, but become very much more apparent during the course of the lifespan, periods of acute emotional distress being particularly prone for religious expression. On the other hand, hyper-religiosity may also be a pure state phenomenon, as observed in mania or acute psychotic episodes, with the person reverting to baseline levels of religious expression, post-episode. In a person without neuropsychiatric illness the religiosity trait may evolve over a lifespan, and depending on life experience may enhance or become muted. Our religiosity may also periodically achieve enhancement during times of adversity, sorrow and grief or indeed euphoria; times when we instinctively reach out to powers beyond.

Third, is religiosity a natural consequence of adversity rather than a pathological process? It seems entirely plausible, when viewed from a psychological perspective, that individuals meet adversity in their lives with an increase in religious interest and or experience. Indeed, society encourages and endorses such reactive religiosity and acute emotional breakdown states are often described as spiritual experience or transformation. The flight into hyper-religiosity in the context of a neuropsychiatric disorder may well be a helpful, socially endorsed coping mechanism; spiritual excess being better accepted in society than emotional distress. Why hyper-religiosity disappears in many disorders with the resolution of neuropsychiatric symptoms, and persists in others even after their resolution, does of course beg answers.

Fourth, is hyper-religiosity a pathological phenomenon? With the finding of a small right hippocampus being associated with hyper-religiosity and other descriptions of altered limbic physiology in this state, it seems conceivable that biological influences may in some way affect the development or maintenance of hyper-religiosity. Is hyper-religiosity as behaviour pathological? To decide this, one would typically have to refer to the individual's previous background (personal and socio-cultural) in the religiosity context. Religious behaviours especially those with sudden onset and not in keeping with the person's background may well be, from a behavioural perspective, pathological.

Finally, are the changes in limbic system structure and activity identified in brain imaging of hyper-religious individuals, a cause or consequence of this behavioural predilection? Changes in limbic system structure and function are thought to accompany the longitudinal course of many neuropsychiatric disorders: epilepsy, schizophrenia and depression to name a few conditions. Clarity about what precedes (structural change or behaviour) remains elusive and the changes observed in the brain may thus be both cause and consequence, the brain being a remarkably plastic organ.

Final analysis

So is there a god module in our brain? The evidence available seems to indicate that our emotional brain, the limbic system, the hippocampus in particular, perhaps more on the right side, plays a significant role in determining the nature and quality of one's religious experience and expression. It is very likely, the rich neuro-chemical networks that populate this region, including dopamine and serotonin, have considerable influence on our religiosity, notwithstanding the alteration of brain structure, right hippocampal atrophy. Religiosity may thus be viewed as a trait, which can undergo both physiological and pathological evolution during the course of a person's lifetime. The nature of the underlying biological framework in an individual is likely to determine the form, quantum and nature of religious experience and expression that psychosocial adversity and emotional illness provoke. The bio-psychosocial model of mental health and illness dictates that both the physiological and pathological manifestations of this trait marker are likely to be influenced strongly by the sociocultural ethos of the individual, as well as his psychological evolution during the course of a lifespan.

We must acknowledge here, the very significant role that religion and spirituality play, in helping human beings maintain optimal emotional well being or indeed achieve restoration of emotional health after a breakdown. One must also acknowledge our collective ignorance, as a society, about the biological, neuropsychiatric and psychological effects and virtues of theism, atheism and their many-splendored, much-debated, interface. Whether our religious predilections have a role in protecting and preserving or indeed enhancing our emotional state, remains thus, a matter of conjecture. The influence of this god module in our brain, "The Almighty Within", is however probably omnipresent, just as our ancients conceived the almighty himself to be. Strange then, indeed, are his ways!

The author is Director and T.S. Srinivasan Chair at The Institute of Neurological Sciences, VHS Hospital, Chennai. E-mail: esk@nsig.org

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Sunday MagazineJune 28, 2012