• Comprehensive Analysis of Cerebral Activity Religious and Spiritual Practices
This project would extend the existing data to include a broad array of religious and spiritual practices utilizing functional neuroimaging with both PET and SPECT to measure cerebral activity patterns in the brain. The overall purpose would be to compare various types of practices and traditions to determine the similarities and differences from a neurophysiological perspective. We have already studied Tibetan Buddhist meditation, Centering Prayer, Transcendental Meditation, Yoga Meditation, and Speaking in Tongues. We intent to recruit additional subjects both within the traditions and across traditions to determine the different physiological states associated with spiritual practices and experiences.

Status: Ongoing; previously funded through John Templeton Foundation, currently in additional pilot phase.



• Longitudinal Study of Serotonin and Dopamine Effects of Spiritual Transformation
  
  
The 30 day Ignatian spiritual exercises is a commonly used program in the Jesuit community (as well as by others) that is intended specifically to bring about spiritual transformation. A comprehensive analysis of the neurophysiological and physiological mechanisms underlying the long term effects of spiritually transforming practices has never been performed. This analysis is necessary for all future studies of such practices in order to better assess their effects on the brain and body and to help focus future studies on physiological measures that appear to be most affected. This study will utilize positron emission tomography (PET) and single photon emission computed tomography (SPECT) with three different radiopharmaceutical agents in order to measure cerebral glucose metabolism, dopamine transporter activity, and serotonin transporter activity. The latter two systems can be studied utilizing radioactive tracers that are unique to the University of Pennsylvania and provide an important window into the neurophysiological mechanism underlying meditation. Imaging will take place within one week prior to healthy volunteer subjects entering into the 30 day Ignatian retreat. They will then be imaged immediately following the retreat in order to compare scans. Overall, this study will be the most comprehensive study to date of the long term neurophysiological and subjective effects of spiritually transforming practices.

Status: Proposal ready for submission to private foundation.



• Longitudinal Effects of Iyengar Yoga on Cerebral Blood Flow (in conjunction with Dr. Ray Townsend)
This project is performed in conjunction with an NIH funded trial of the effects of Iyengar Yoga on high blood pressure. Subjects will also be scanned during baseline and meditation states before and after a 12 week training program. The purpose is to determine the effects of practice on novice meditators. The results will demonstrate whether a meditation-based training program actually results in long term effects of the brain's basic functioning. Furthermore, we will assess how the brain changes during meditation practice in individuals who have never practiced and then again after a training program. In this way, we will help determine how the brain changes in response to a spiritual practice.

Status: Ongoing; Primary study funded through NIH R21.



• Effects of Meditation Program on Patients with Depression (in conjunction with Dr. Jay Amsterdam)
There has been an ongoing NIH funded study utilizing imaging techniques to evaluate the effects of various types of therapy on depression. These imaging studies have focused on the relationship between dopamine and serotonin in depression and treatment. We are currently preparing a proposal based upon these studies in which a well established meditation-based program will be compared to standard psychotherapy. By determining the effects of meditation on depression as well as on the dopaminergic and serotonergic systems in the brain, we hope to establish a more specific link between spiritual practices and mental health.

Status: Proposal in development for submission to NIH.



• Evolutionary and neurocognitive correlates of human character strengths (in conjunction with Dr. Patrick McNamara, Boston VA Medical Center)
The purpose of this project is to test the hypothesis that selected religious practices and religiousness foster both the character traits that facilitate short and long-term cooperative interchanges and the neurobehavioral systems that mediate development of character strengths. In doing so we seek to provide part of the answer to the question posed by the Templeton Advanced Research Program RFP: "How do religious rituals and practices enhance human flourishing and well-being?" Productive cooperative interchanges are impossible unless participants in those exchanges are reasonably trustworthy, reliable, honest, and generous. Thus, character matters. Religion, we suggest, helps build character via its effects on the neurocognitive systems that support development of character strengths. Our overall goal is to rigorously test this idea/hypothesis by deriving testable predictions from it and then testing those predictions with a multi-level interdisciplinary approach. Our use of a multi-level interdisciplinary approach will include evolutionary, behavioral and functional neuroimaging analyses to test the hypothesis that religiosity enhances human well-being via its direct support of character strengths as well as its effects on neurobehavioral systems that support development and maintenance of character strengths. These character strengths, once again, are held to be crucial for facilitation of cooperative interchanges.

Status: Letter of intent accepted (13 of over 100 letters); full proposal in development for submission to Templeton Advanced Research Program



• Measurement of Physiological Changes During Spiritual Practices
While brain imaging studies provide important information regarding the biological correlates of spiritual experiences, there are many other physiological processes that can be evaluated. In particular, this study will evaluate the effects of practices such as Iyengar Yoga and other spiritual practices on blood pressure, autonomic nervous system function, hormones, and immune function in both healthy and diseased populations. There is an ongoing study of the effects of Iyengar Yoga on high blood pressure and we hope to expand such studies to include other disease states and other physiological measures. Ultimately, we will try to integrate the physiological studies with brain imaging techniques to determine more precisely what is the actual link. Such changes will also be correlated with subjective experiences that people describe during spiritual practices.

Status: Existing Iyengar Yoga study funded by NIH; additional proposals in preparation.



• PET Study of Progressive Changes in Brain Function During Meditation Practice
Meditation is the most commonly used alternative therapeutic intervention with a wide variety of studies exploring its utility in the treatment of disorders ranging from hypertension and coronary artery disease to depression and attention deficit disorder. Our early research, in addition to current literature reports of imaging studies, suggests that meditation involves complex brain processes incorporating the integrated functioning of a number of brain regions. However, a comprehensive analysis of the neurphysiological and physiological mechanisms underlying the effects of meditation has not been performed. This analysis is necessary for all future studies of meditation in order to better assess its effects on the brain and body and to help focus future studies on physiological measures that appear to be most affected. This study, in response to the program announcement for studies on Basic and Preclinical Research on Complementary and Alternative Medicine, will utilize [15O]H2O PET imaging to measure cerebral blood flow (CBF) changes at multiple time points during a one hour meditation practice in order to quantify the acute effects of the practice on the brain and to correlate those effects with various physiological measures that will be recorded simultaneously.

Status: Proposal completed and previously submitted to NIH, now for resubmission.



• fMRI Study of Inaccurate Thought Processes in Spiritual and non-Spiritual Individuals
Several studies have suggested that religious individuals do not have the same critical thinking skills as those who do not believe in religion. These studies provide individuals with various logical problems to determine which group solves these problems more accurately. However, another set of studies suggested that both groups make errors in logic, but in the directions consistent with their pre-existing beliefs. Religious individuals will make errors in logical problems that have an anti-religious bias and non-religious individuals will make errors in logical problems that have a pro-religious bias. The question is whether these errors arise from similar or different brain functions. By utilizing functional MRI during logical problem solving tasks, we can determine which parts of the brain help both groups of individuals make accurate logical decisions and which areas are associated with mistakes in logic. This study might provide a richer understanding of the beliefs and thought processes associated with religious and non-religious individuals.

Status: In planning stage.



• Study of the Placebo Effect and Expectation on Pain Perception (in conjunction with Dr. John Farrar)
The use of placebo control groups in randomized clinical trials (RCT) has become the gold standard for testing therapeutic efficacy, especially for symptomatic conditions. Substantial concern has been expressed about the possible affect of differences in the placebo response rate on trial outcome, especially as it might relate to trial design factors. The response rate measured in a placebo control group, results primarily from two factors: 1) the natural disease progression that results in a regression to the mean; and 2) the symptomatic modulation exerted by the descending control system of the central nervous system (CNS). We propose to study the role of a subject's expectation of pain and relief in modifying their response to both the placebo and the active treatment. We propose to use the third molar extraction surgical model because it has been extensively and successfully used to demonstrate the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), and can be consistently designed to focus the study on the desired outcomes. Our study is designed to alter the subject's level of expectation of pain relief in a randomized double blind controlled setting, by using both an oral and an intravenous treatment known to be effective for dental pain. Subjects will also undergo SPECT scans at appropriate times to assess changes in brain function associated with the pain and then the pain relief they experience. This will help assess whether pain relief from active medication is similar or different from that achieved via the placebo effect.

Status: Preliminary data obtained; in preparation for resubmission to NIH.

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• Expand and Continue Web Based Survey of Spiritual Experiences
We currently have an on-line survey of religious and spiritual experiences. This web-based survey is designed to assess such experiences and determine their relationship to demographic data. More importantly, we hope to obtain substantial phenomenological data that can be used to determine similarities and differences between experiences and compare such experiences within and across traditions. There is an emphasis on the relationship between neuropsychology and spiritual experiences. This survey will provide the phenomenological data necessary to advance our existing models of spiritual experiences. Furthermore, this survey will provide an important database of individuals that could be studied in the future with neuroimaging and other physiological techniques.

Status: Active project (see: www.neurotheology.net)



• Develop and Test Spiritual Survey of Children and Adolescents
We have recently published several chapters regarding religious and spiritual development throughout the life cycle. This has emphasized changes in brain function from infancy to old age and has correlated such changes with spiritual development. A number of studies have suggested that religious and spiritual beliefs and experiences are different in children and adolescents compared to adults. Further, there may be an inverse relationship between some religious beliefs and various "high risk" activities. We intend to adapt the web based survey for adults to children and adolescents to determine the similarities and differences in these populations as well as assess changes during different stages of development.

Status: In planning.



• Expand Analysis of Suicide Bombers
We have been working with an individual who has had the unique opportunity to interview Palestinian suicide bombers. Her work has suggested an important influence of ritual behaviors in these suicide bombers and this has led her to our work in brain function associated with ritual activity. We hope to be able to expand this collaboration since this research could have important implications regarding global conflict, particularly as it relates to religious beliefs.

Status: Ongoing discussion regarding collaboration.



• Expand and Continue Patient and Physician Survey Regarding Importance of Spirituality in the Doctor/Patient Relationship
This was a project initially conceived of by the Department of Pastoral Care and published in the Archives of Internal Medicine. The project asked patients in a pulmonary care setting about how their religious beliefs might affect their health care decision making and whether they would want physicians to address such issues. The results showed a substantial interest in having physicians address such issues even though physicians rarely do. However, the study also raised some important questions that could be developed in future projects.

Status: Original data published.

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• Develop Textbook for Undergraduate and Graduate Studies of Neurotheology
There has been substantial interest in the topic of the brain and religion throughout a number of universities. Many classes now utilize existing books to provide information for students, but there has never been a well designed and comprehensive review of the topic in a textbook format. Using the expertise of the faculty involved in this Center, we are in the process of writing the manuscript that will include a discussion of the topics, information on additional resources, and possible activities and coursework that could be used in both the graduate and undergraduate setting.

Status: Currently written in draft form for finalizing; University of Pennsylvania Press is the publisher.



• Develop and Test Curriculum on Spirituality for Medical Students, Medical Residents, and Psychiatry Residents
Given the importance of religion and spirituality in the health care setting, it is important to provide evidence based information for medical students and residents, that will enable them to better manage this issue with patients. To that end, we intend to develop a curriculum in conjunction with the departments of psychiatry and pastoral care that will emphasize important issues, potential problems, and how to obtain additional resources for dealing with religious and spiritual issues in the health care setting.

Status: In development.



• Develop and Test Curriculum on Psychology and Health for Clergy and Chaplains
Given the influence that clergy and chaplains can have on individuals from the religious and spiritual perspective, it is imperative that there is appropriate training for clergy regarding mental and physical health care issues. To that end, we intend to develop a curriculum in conjunction with the departments of psychiatry and pastoral care that will emphasize important issues, potential problems, and how to obtain additional resources for dealing with health care issues in the religious or pastoral care setting. This can help encourage clergy to emphasize beneficial health habits and to recognize potential health problems with their congregation and individuals.

Status: In development.



• Develop and Test a "Systematic Spiritual History" for Patients in the Health Care Setting
Since research has suggested that religion and spirituality can influence health and, more importantly, impact health care decisions, it is necessary for health care providers to have available well conceived, brief method for taking a spiritual history. It will be important to ask the necessary questions in a respectful manner in order to assess this dimension of the patient. The results obtained from such a history can then be used to aid in administering appropriate pastoral care, assess whether there are any negative influences of religion, and determine what issues might arise when dealing with health care decisions. The development of such a spiritual history requires a systematic, reliable, and well tested approach.

Status: In development.

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• Relationship Between Brain Function on Philosophical Ideas
How are philosophical concepts conceived in the mind? Why are certain topics of principle importance to philosophers? Why do people philosophize in the first place? Philosophy usually considers various fundamental concepts such as those related to being, causality, logic, and phenomenology. Philosophy less often examines its own tenets and the mental mechanisms involved in the production of philosophical concepts. One of the major developments of contemporary philosophical thought has been the field of hermeneutics. Hermeneutics considers the environmental, linguistic, and cultural factors that influence a given philosopher in order to determine how particular ideas may have been shaped. However, no one has ever examined philosophical thought specifically from the hermeneutical perspective of the neuropsychological substrate that underlies such thinking. This neurohermeneutic refers specifically to the functions of the brain and how they are related to various thought processes that have been at the cornerstone of philosophical thought and its development throughout history. This new hermeneutic is based upon a synthesis of information from multiple fields including anthropology, neurophysiology, theology, and philosophy. Many of the major milestones in the history of philosophical thought from pre-Socratic thinkers to the present day can be considered from the perspective of the functioning of the human mind and its multimodal interaction with the social, cultural, intellectual, and physical environment. This revolutionary approach to philosophical thought will provide readers something to think about for the millennium to come.

Status: Manuscript in preparation



• Relationship Between Brain Function and Theological Concepts
Everyday religious experiences and the everyday aspects of religion are crucial to any discussion of religion, especially from the perspective of how the brain works. Since the brain is the part of us that processes all of our thoughts, feelings, and behaviors, all aspects of religion need to be included in such an analysis. This is an important distinction between our perspective on this research and several other scholars who have been pursuing similar lines of research. In particular, several researchers have focused exclusively on the mystical-type experiences and the brain processes with which they are associated. This research is extremely important because these experiences have formed a crucial aspect of religions in general with many of the great founders of religions people who have had such experiences. In our view, any model of religion, especially one from the brain science perspective, must be able to account for these experiences that lie on the extreme end of the religious spectrum. However, while it is necessary to be able to describe such experiences from the neurological perspective, it is not sufficient if one is going to try to develop what we have called a "metatheology" or a "megatheology". A metatheology is an approach that helps describe how all specific theological principles may have arisen. A megatheology is one in which the concepts are so universal that a person from any particular perspective can understand these concepts and integrate them into their own specific belief system. It has been our hope that a very careful elaboration of our approach, one that has been described as a neurotheological approach, might be able to accomplish both. It is also crucial that whatever perspective touted to have such a universality, help in the understanding of all aspects of religion. This would include mystical experiences, but would also include all of the other things that make religions what they are - the community and family, morality, love, altruism, devotion, forgiveness, awe, a sense of belonging, and a sense of being a part of something greater than the self.

Status: Ongoing publications in preparation and in press.



• Relationship Between Brain Function and Religious Beliefs
We are biologically driven to find meaning and wholeness throughout our lives. In fact, our brains have the capacity to create and maintain a system of beliefs which can take us far beyond our survival-oriented needs. These belief systems not only shape our morals and ethics, but they can be harnessed to heal our bodies and minds, enhance our intimate relationships, and deepen our spiritual connections with others. However, they can also be used to manipulate and control, for we are also born with a biological propensity to impose our belief systems on others. Where do our beliefs come from, and why do we hold on to some of them even if there is evidence to the contrary? It is not because we are uneducated; rather, our brains are designed to interpret and seek out such possibilities in the world. Simply put, we are born to believe in nearly anything, and our brains will readily accept what we are told by others whom we tend to trust. Later in life, our brains will strive towards retaining the beliefs we previously formed as a way of maintaining emotional security. This investigation will explore how brain-scan technology can be used to differentiate constructive and destructive beliefs, thus guiding us towards more compassionate and humane behaviors.

Status: Manuscript completed; The Free Press (Simon & Schuster) is the publisher to be released in 2006.



• Epistemological Issues in Neuroscience and Religion
One of the most ancient problems of philosophy is the epistemological question, "How do we know that the external world corresponds, at least partially, to our mental representation of it?" The question of what is "really real" has been considered, with various answers, since the time of the presocratic Greek philosophers in the West. Preoccupation with this question is even older in Oriental religio-philosophical traditions. The three most common criteria given for judging what is real are:


• The subjective vivid sense of reality
• Duration through time
• Agreement intersubjectively as to what is real.
However, we have argued that all three of these criteria determining what is real can be reduced to #1 above -- the vivid sense of reality. If we are forced to conclude that reality is ultimately reducible to the vivid sense of reality, then what are we to make of states that appear to the experiencing subject as more real than baseline reality, even when they are recalled from within baseline reality. If we take baseline reality as our point of reference, it seems that there are some states the reality of which appears to be inferior to baseline reality and some states the reality of which appears to be superior to that of baseline reality when these states are recalled in baseline reality. Mystical states of consciousness are often described as "more real" than baseline reality. Thus, by combining information from neuroscience with phenomenological information of various mystical experiences, we hope to develop a neuroepistemology that seeks to integrate our knowledge and understanding of reality.

Status: Ongoing publications in preparation and in press.

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