The Neural of Religious Jeffrey
L. Saver,
John
Religious
experience
is brain-based,
like all human
experience. Clues to the neural substrates of religious-numinous experience may be gleaned from tern porolimbic epilepsy, near-death experiences, and hallucinogen ingestion. These brain disorders and conditions may produce depersonalization, derealization, ecstasy, a sense of timelessness and spaceless ness, and other experiences that foster religious-numinous interpretation. Religious delusions are an important subtype of delusional experience in schizophrenia, and mood-congruent religious delusions are a feature of mania and depression. The authors suggest a limbic marker hypothesis for religious-mystical experience. The tern porolimbic system tags certain encounters with external or internal stimuli as depersonalized, derealized, crucially important, harmonious, and/or joyous, prompting comprehension of these experiences within a religious framework. (The
Journal
Neurosciences
of Neuropsychiatry 1997;
9:498-510)
and
Clinical
R
Rabin,
M.D.
M.D.
eligious
experience
taken
as an
is brain-based.
unexceptional
ence is brain-based, mathematical deduction, creation, the
as well
neural
ther
as religious
confirmed
nor
argued apparatus
that
these
disconfirmed
by
experience.
demonstrating sustaining religious
belief because it provides has so constructed humans experience the divine.2 and neuropsychiatrist,
establishing
Indeed,
is hampered
animal
correlate
that
would
mentation. largely
Evidence derived from
with clinical
focal
have been individuals chiatric
brain of this
From UCLA-Reed Los Angeles, CA address. Copyright
brain
it has
the existence experience
by the
lesions,
absence
a higher power the capacity to
allow
From
© 1997
this
laboratory
will
scattered
Research correspondence
American
VOLUME
Psychiatric
expeaccepted experi-
import in patients
epileptic
We
and
of religious
of a widely
especially
Center,
Press,
9 #{149} NUMBER
the
experience
neuroanatomic observations
is anecdotal.
Neurologic 90095. Send
been
of a neural can reinforce
review
collected on religious experience and in different neurologic and
syndromes.
not
signifiis nei-
For the behavioral neurologist the challenge is to delineate
rience
much
does
spiritual percepts
distinctive neural substrates of religious their alteration in brain disorders. Investigation of the neural ground
with
Determining states
evidence that as to possess
be
experi-
reasoning, and artistic
of mind.
of
or demean their reality of religious
of religious
correlates
states
should
All human
scientific judgment,
of any
lessen external
This
claim.
including moral
substrates
automatically cance.1 The
and
498
Substrates Experience
disorders, data
that
in normal neuropsy-
literature,
710 Westwood to Dr. Saver at the
a pre-
Plaza, above
Inc.
3 #{149} SUMMER
1997
is
SAVER
liminary
unifying
experience
model
may
of the
CIRCUMSCRIPTION Most The
religious
fear,
are
and
analogues
and
ordinary
include
religious
religious
awe.
of ordinary
love,
fear,
tone, Their
but only in being directed neural substrate is likely
specifically
awe,
differing
religious
nature,
targets.
emotionality Similarly,
joy,
in
Focal
instead
ody and the right religious
to rest
have
been
substrates
differing topics
ordinary
substrate cognition
cus-
for relig-
multimodal observation,
is parallel,
affective
What
appear, of affect,
James
impair-
and
divine
others
have
NEUROPSYCHIATRY
suggested,
and
not
through
feeling, a feeling or divine presence.8’9 and
and
the
through of
a
of direct Studies of
neuropsychiatric
hypothesis substrate.
populations
suggest
a distinctive
surveys
in the
to 49% numinous
of
United
States,
individuals experiences,
60% when individuals
Britain,
report and
identified
experience
in British
ness
of the
and
eight
major
of God,
of being
types
The and
and
that
must
ders
provoke
that
of events that in some 2) an awareof receiving of being God, 5)
of someone
who
presence in nature, and 8) experiencing
all things twin
are
“One.”
Stud-
raised
apart
pairs
account for 50% of interiminterests and attitudes.’7
ubiquity of numinous experiences of religious dispositions argue
for a biologic neural mechanisms
substrate
secol-
numinous
awareness not called
presence
fraternal
had more
in de-
3) an awareness
that genetic factors variance in religious cross-cultural the heritability
of
1) a patterning him or her to happen,
in the
way
identical
20%
encompassing,
has died, 6) an awareness of a sacred 7) an awareness of an evil presence, in
Australia, personally rises to
of randomly Hardy and his
individuals,
presence
experiences across differ#{176}‘ In national
having this figure
in-depth interviews are conducted.8
leagues8’6
strongly specific
basis,
be gleaned
but fail involved.
from
the
qualitatively
sites
similar
to indicate the Clues to neural of brain
disor-
experiences.
ex-
EPILEPSY
AND
Humanity
has
RELIGIOUS
EXPERIENCE
or
to be medi-
concur,
IN
Surveys suggest that religious-numinous are common in both children and adults, ent historical eras, and across all cultures.
suggest dividual
no identifiable Accordingly,
we
RELIGIOUS EXPERIENCE NORMAL INDIVIDUALS
ies
sym-
awareness of God mark of specifically
and
this
in an extraordinary
areas. the neural
to religious
is likely
individuals
is
on first inspection, to reside not language, or cognition, but in
of the
healthy
in
neurocognitive prosodic, logical,
is, however, perception.
numinous-mystical of a sacred
an awareness
in part, by the neural systems for ordinary auditory, and olfactory perception. Wiland
OF
affective,
distinctive
experience. There organ of religious apprehension
occurs
help in answer to a prayer, 4) an looked after or guided by a presence
of religious affect and brain, employing proc-
It is the direct sensory that is a quintessential
ated, at least tactile, visual,
non-
processing.
would domains
religious separate
of
networks
association then, is that
of large-scale for linguistic,
be peculiarly
perception. the divine
neural
distributed,
might
divine
scending order of frequency, in a person’s life that convinces strange way they were meant
nonreligious attests. Pros-
problems
same
unique awareness
than lected
emotional processreasoning is
for the preponderance is the whole human that
JOURNAL
the
parallel
to religious
by the
bolic, with contributions networks subspecialized
liam
human
language
aphasia for experience
to produce
applied
mediated
frontal and parietal A first general
sensory
of
aphasia
and nonreligious scholastic/talmudic
reasoning
undoubtedly
perience in the
the
only in taking saas linguistic themes.
produce
parallels clinical
reported
of religious Similarly,
essing
upon
support nonby dorsolatrather than
other emotional contributions to discourse hemisphere apply to both religious and themes, and nondominant-hemisphere
lesions ments ing.5
emotional
perisylvian
lesions
ious discourse that discourse, as common
and
neural
its production, than nonsacred
left-hemisphere
the
of joy,
their
to a religious object. to contain nothing of a
dominant-hemisphere
cortices for cred rather
of
religious
emotions
not
but
The
perception
support neurolimbic
religious
These
have been extensively delineated.34 religious language depends upon
tomary
that
experience.
same limbic and subcortical networks that religious joy, love, fear, and awe, directed eral and orbital frontal cortices to religious nonreligious
of religious
operation of a distinctive sensory faculty, but the superimposition upon ordinary sensations
parallels
sentiments
religious
emotions
basis
OF THE TOPIC
experience
religious
love,
brain
be constructed.
RABIN
AND
long
recognized
a direct
link
between
epilepsy and the divine. The early Greeks viewed epilepsy as a “sacred disease,” a visitation from the gods, until the notion of divine genesis of seizures was dispelled
by Hippocrates.18
aissance periods, view that epileptic
In the
Medieval
wide currency seizures are
and
was given manifestations
early the
Renbiblical of de-
499
NEURAL
SUBSTRATES
monic and ity”
possession
OF
(Mark
RELIGIOUS
9:14-29).’
Morel2’ in 1860 recognized of epileptics, which they isolation, The first
and greater need reported conversion
related
to
was
patient experienced ing a fit. Spratlin3 52 of 1,325 patients century,
Esquirol2#{176} in
a heightened attributed
social tion.
a seizure
EXPERIENCE
for
noted
to
religious experience
by
Howden,
and
others
suggested
whose
that
figures to have investigations
epileptics
among
have been documented epilepsy (Table 1). of epilepsy-related
epilepsy-related
Ictal
Events
Ictal
events
religious
type
may
be the
explanation. unexpected-sudden
ticipated
and
often
extraordinary
ordinary
daily
flow
of consciousness.
culturally character
acquired naturally
Patients
religious
significance.
demonstrated that experiences portant, negative, and medical, particularly
have
likely
that like
to be interpreted
Studies are most
in a religious
imare frame-
work.25 Some explain
psychologists of religious experience
tribution viduals
not
the
same
theory. only
duced
Experiments interpret, but
physiologic
according laboratory
sympathetic
warding cognitive
arousals
across
the
to distressful, set at onset.26
religious intrinsically
individuals neutral
religious-numinous mediate
Human product
500
stimuli
attempted classical
demonstrate also inwardly in strikingly
are
variably
spectrum
of
according Attribution
different
character. some
ictal
religious
experience, however, of an interaction of
valence,
This
will
likely
experience, Among
auras
of auras
and
religious
states. ecstasy,
from
23%
of auras are psychic psychic or experiential
are
par-
interpretation
detailed review. with partial complex
ranges
Several derealiand
seizures,
to 83%,
the
and
up
in content.2729 The ictal manifestations
to
most of
temporal lobe epilepsy ory recall, and visual Hughlings Jackson
are fear, d#{233}j#{224} vu,jamais vu, memand auditory hallucinations. was among the first to identify
and
common
characterize
less
ictal
“intellectual
reality
is altered.31
The
auras”
intellectual
clude depersonalization, derealization, sciousness. Depersonalization
auras
and auras
in-
double produce
conan
and
are
from
re-
charges
often associated consciousness
or electrical
especially
erators
with (“mental
reality.33 of patients
a sense of detachdiplopia”) auras
the
producing
Available structures,
amygdala,
are
of unreality
The experience with temporal
often accompanied in Penfield’s series
dis-
intellectual
evidence, however, the hippocampus likely
about
the the
of unreality lobe epilepsy
by a sensation had a sense
and of
self
critical
gen-
or external
occurred in one
of fear.35 One of “not being
in 9% series, patient in this
world” each time the first temporal gyrus was stimulated, reflecting either direct lateral temporal cortical excitation or rapid spread of afterdischarge to mesolim-
mechanism
may
in-
bic structures. more recent
simply physiologic
the
feeling structures.
a
example, a dream-
of persisting remnants and of a new quasia different perception of
stimulations
of a feeling
experience as having
experiences.
environment-for surround is just
reality. Auras of depersonalization, derealization, dreamy state account for approximately one-quarter psychic auras.32 Well-documented localizations of spontaneous
and
In in-
individual’s predicts that
not
autoscopy,
and merit individuals
often events
is clearly nonspecific
states, to engender
auras are extremely rare. suggests that mesolimbic
ways carry.
labeled
to the theory
with epilepsy ictal physiologic
to at-
that indiexperience,
to the cognitive expectations they studies, identical, pharmacologically
experienced
deed
religion have by employing
Epileptic
emotional depersonalization,
create a simultaneous experience of one’s normal consciousness parasitical consciousness with
have
personal, seizures,
dreamy
ticularly
several specific auras, including
and also are ment. Double
explanatory systems of a religious tend to interpret any ictal experi-
as possessing
schemata.
of the reality of the external the feeling that the external
the
who
cognitive
alteration or loss of the sense of one’s own reality, often accompanied by a sense of detachment from others and the environment, and of acting like an automaton. Derealization auras generate an alteration or loss of the sense
of religious
into
zation,
external in
are paroxysmal, intrusions of unanexperience
set
(“dreamy states,” “cognitive auras”) in which the experience of the immediacy and liveliness of one’s own or
of ictal,
subject
Seizures
for
one-quarter common
religious
experiences
strates “psychic”
frequency
as having
and chronic interictal occurrence. and neurobiology of each differ
of any
or cosmological riveting, and
ence
the numlead-
have been marked by contradiction and conconfusion in part reflects failure to distinguish
subacute postictal, The phenomenology important aspects.
with
themselves are the most convincing evidence of the insufficiency of attribution theory, instead demonstrating the existence of distinct physiologic neural sub-
being transported to Heaven durin 1904 reported a religious aura in with epilepsy (4%). In the early 20th
Turner24
experience flict. This
arousal
consoladirectly
develop a distinctive interictal character, among features of which is religious fervor. A substantial ber of founders of major religions, prophets, and ing religious or suggested Modern
1838
“religiosdisability,
during
One series37
patient repeatedly
stimulation
VOLUME
in of
Gloor and experienced temporal
9 #{149} NUMBER
colleagues’ a faraway mesolimbic
3 #{149} SUMMER
1997
SAVER
AND
RABIN
E ‘
-‘
a
0
.1
I)
..
.0._t
a
0
>.
e
E .-0-
0; .
U’’0 U Li 81 0. a
a
,j
a5iI..
-
.
.
.
B
B
81
#{149}0a0
.
:0a
‘
a
‘‘
0a a
#{149}E
za
u
uEa
2
a
.0.
j.0’
Oa
‘B
0.
a..abc
aO.
u’
a -
asa
.
a0.0 aO
LI
a LI
a
a
.0 LLI
,
a
so a
.
0
0
LI.
1.1,
s
i;’ U
.0
U.0
-2 0
0.
I.’
a
2
n.
C -.
. a
a
.
a
ax
.
.
.:
0. . U’8
0
0
0
0.
0
W0.
Li
+
+
+
.2
8 #{149}
a 80
a.’
i..
i.
a
a
a
0.
0.
0.
0.
a.1 a
a.
a><
a
a
U
.
a
a #{149}
a
a
. a
a
2
0. 01
0
u
a U
. 0_
a
a
0.0
,.,
0a
a“
a a
a
U
.0as
LI.0.
U
u
a
E 0’ u
20 u
u
+
+
+
a
n.
.0
, 0.
B.
-
LU
81 +
+
+
+
+
0. 01 #{149}0
c’.
a a 0
V C 01
a a
0’
o
020
0
a
a
a
#{149}-a a a a
a
-
0
a F-0
=-.0
0
4
.-‘
aao
a a
C.
01
a
:‘
I-
.C 0
a’
a..
01
a-
5
a
IL,
.<
C
a
Ga
U
II.
a)
U.
LU
a
V .
..c,,,.a
81
E
a
aa
01
Oa
.0
0 :0
E.5
C
0
a
aU .0
0
aa a
a
.0
‘a. 0.Q. 22
C
01
so
,-a-
a
a
U
=
a
LU
<
r’) ‘C
-.
Li
0.
U00.
j U
aEij
‘?
:o0
a
a
0.
0
a
.E
OF
.0
NEUROPSYCHIATRY
:>
2
<
aU .
._
‘<
“
aS
0 C
a
.
a
c8L)0
a
>
0 .0 0
a
‘
“U
a.-
-
a
u
.
a
-
c
0
.
<
a0CU
0.tj
Un
8
v-’
a
>
o
,
#{163}
(I)
JOURNAL
5
2
a
,j
.Oa:0,...E
a
.
0
U
a’
E
o.
.0
U
n.m 0
.0
a00a
.0
2
..‘,8J
a
..
a
0
a
i0>
0.
a
Li
U
500
.5a0
0
0a .
.
aaa
0
a
..03
.0
a
0a
0‘
a.0
U
2_0m
C
‘C
.
aa
0a :00
.c0
Oa:0aa..
0
aU
abO0
a
b00U=
0
01
81 0.
:0
a 0
a 01
2a0
E0
a
0 8
aO >s
X
-
a
.0a8
a
500
tJ-
.‘.‘
081
. .
a a a
‘
a.
0
c
‘ .
a U.-
c
a
F-’-.’ .-
a
U-’
0
a
.-
u
<
501
NEURAL
SUBSTRATES
OF
RELIGIOUS
EXPERIENCE
.
__7
C
-.n
0
,0
a0)
U
V
aCa
U
01
o 0a
‘
a
n.o
E
aa
C
..
a
a
0gb
C
01
C .#{176}#{176}.‘
.
nUa)a-0
‘
.00
a
.2
C
a U
a
0
a
N
a.-
0
0
#{176}
.
a-
a 0
.
a
.
0)
a a N
a
a a
.
0
a,..
a x
aa0
0
-
+
+
.5.
0.X
a
a
aa... .
aa0 a-
a.0.’.’
0
0.
,..
a
a a0. x
.
E.’-.
U
U..
U
+
+
+
+ +
+
.
a-
a >.‘
.
a5n.
+
: ga
U
.&
0J
na. 0. xa
xa o n.
5
5#{176}Ea
S
a-
.9a-a
a
#{149}
a a.0
0.
n.ao)
U
.
a a
.E
a-
a
+
+ a
a
a
.0
a
0
0
a
0 a
>
a
m
0)
a
01
81aa
.
0.0’-
,-,a0 .‘..‘=a
QJ
01 a-
01 0 C.
>0 U001 010>
1810
a
= ‘ a81
N
om
a
C
.0
0
o
an
01a) 50
2a
P.00
‘-2.
E
OE.0
01
0
‘E
C
‘aaa
.
a-
01
0.
a0 0
>
aai V.0
a a-
a)0 #{149}.0
.0Ca
i2
a.0__ 0.
a
U
a
-a
a ba
0.0
a
Ca.
Ca
a-
a01
Ca-a
aa
0
o25a.
0 0.
01
U
a-aa
0.
0
aan
Ox
n a-
a’aa a-C
Ga- Ca
a> a)0
a)
-
.0”c 0
0UaC
cia
.5>
O5 a
._>.-C C500.
IC
.-.
.0.’.’
a>5a 5050a0aCa
V
a
00
‘
C
0.
a
C
o.
_
.
oE” GaO :0a50
0Jo
aU
.
C.a0G
‘C
aU
o
‘
C
-
‘
-
‘a-.0
a a
a a
LU
U
01
.2
0.50
U
cia 0.
a .0
0
a.-.,
X
0.01
a a
C
.C-’
0
oars a
F-
502
0.
1181 a
a...., .0
.C
‘B
oo
U
C
0 ,-
-.‘
LI.
VOLUME
9 #{149} NUMBER
3 #{149} SUMMER
1997
SAVER
Deep similarities intellectual auras reality tic
that
are
religious
are and
readily alterations
a common
feature
experience.
as hollow,
as a prelude iously
empty,
or
and
to finding
grounded
of intense,
Individuals
den religious awakening abruptly perceiving their selves
apparent between in the experience
unreal
nonepilep-
more
Similarly,
authentic,
a sense
sociate
their
intellectual
with
seems likely that repeated, intense, ences of the self or the external world tend to foster a belief in a supranatural
come affiliated the experience ences may be one’s
double,
ictal
taken genu-
that
percept
nomena occur tings of extreme neurologic
often
from
of one’s
above.
may
own
psychiatric
In the
Devinsky et al.,4#{176} 6% of consecutive lepsy reported autoscopy as an ictal ence. Among patients with identifiable had temporal lobe involvement. trend ing
in laterality the
of seizure
potential
evolve
for
a religious
this
focus type
evident.
of epileptic
character,
one
experiit from
in letters,
in other
series
experience
patient
with
of
to out-of-
to religious experience. and influential descripepileptic experiences
autobiographical
writings,
and
rare.
air
was
myself;
filled
me.
yes,
anything
I have
God
else.
OF
with
You
a big
really
exists, all,
NEUROPSYCHIATRY
noise,
touched
I
cried,
healthy
believe
I would
by
not
during felicity
me,
for
all
exchange
by
a supreme
and God. and people,
I thought
in his
He
it had
came
I don’t he
into
me
remember said,
can’t
seizure
this
a fulguration
exaltation
of of
emo-
The Idiot)
has
been
coexisting. of deep
applied
to two
The first pleasure,
vary. The second is primarily a of insight into the unity, harmony, of all reality, usually with pleasuraffect. Ecstatic seizures of either as an ictal
emotion
is reported
evidence seizures.
in humans
suggests Pleasurable
by
depth
a temporolimbic emotions
electrode
rarely,46’47 and has been hypersynchrony.48
well-studied
clinical
modern
cases
of feelings
and as the
a bearded
young
ecstatic
joy,
and
Continuous
man
total
EEG
demonstrated
bliss
resolved.
sun:
“My
mind,
my
feeling of delight.” discharges in the region
during
Postictal
ing
episodes
et al.5’
a religious
capturing
such
a seizure
discharge. woman visions
being
Naito
whose of God
was
in-
content).
seizures and the
pervaded
by
Interictal EEG demonstrated left anterior and middle
a
spike temporal
sleep.
Experiences
In an influential
versions
Cirignotta
emporolimbic
whole
ante-
temporal
were characterized environment,
(without
and Matsui52 described an older were characterized by joyous
Jesus
a right
anterior
seizures immediate
monitoring
a right
ineffable
resembling
Following
seizures
all
a bright light and sometimes
disclosed
described a patient whose by estrangement from the effable
of detachment,
tomography astrocytoma.
lobectomy,
seizures
substrate. All 7 of had temporal or a patient whose
fulfillment; visualizing source of knowledge;
Computed
of
associated The few
of ecstatic
appear to have had a temporolimbic Williams’s patients with ictal pleasure peritemporal foci.49 Morgan5#{176} described consisted
oribe
may
stimulation
the amygdala, albeit with hippocampal-septal
temporal
by
of epileptics.44’45
The available for ecstatic
rior
types
is primarily an the cognitive
may
Pleasure
0.5%
6 patients religious
engulfed
JOURNAL
than
Christ.
Illustrat-
fiction:4”3
The
if this
but
(Dostoyevsky,
often experience
visualizing
phe-
body transport experienced passage from a department store floor to a celestial realm (H#{233}caen,38 case 7). Ecstatic seizure experiences, ictal and peri-ictal, have been especially closely linked Dostoyevsky provided riveting tions of his own ecstatic-religious
feel
know
characterized
and
ecstatic
contentment, recognized
patients with epior postictal experiseizure foci, 88% No preponderant
was
are
less
seizures
body
especially in setand in a variety of
disorders.’39
term
induced
be-
Autoscopic
in healthy individuals, stress and anxiety,
and
bring,
were
subjectivity.
type
gin
with religious experience is autoscopy, of seeing oneself. Autoscopic experidivided into two categories: 1) seeing
perspective,
instants
epileptics
I don’t
or months,
may
content of which cognitive experience joy, and/or divinity able accompanying
visceral experias unreal would ground of reality
visualized in external space, and 2) out-of-body ence, a feeling of leaving one’s body and viewing another
life
we
attack.
hours,
that
of experience, emotional
experience,
phenomenon
a hallucinatory
seconds,
Such
which our
consciousness
The
suddenly
simultaoriented
religious
it
and a religious outlook. Another experiential
happiness before
joys
tional
self contesting for control of a recurrent leitmotif of religmany individuals do not asauras
for
the
relig-
of
doubling of consciousness-a of a higher, purer, religiously
self and a baser, irreligious one’s actions and spirit-is ious experience. Although
lasts
one.
often report unenlightened
seeing through a veil of appearances previously for real (derealization) to a deeper, supernatural, ine reality is a frequent aspect of mystical-numinous experience. Also, neous perception
second
the
sud-
the
the
RABIN
(depersonalization)
a truer,
self.
of
undergoing
conversion ordinary,
imagine
these
AND
paper,
Dewhurst
who experienced conversions in the occurred
during
of increased
the
and
Beard53
dramatic postictal first
seizure
described
and often lasting period. The conhours
activity,
of complex partial seizures of temporal recently, several groups have demonstrated
or days
follow-
usually
bouts
origin. that
More post-
503
SUBSTRATES
NEURAL
ictal
psychoses,
psychoses,
are
character.556
OF RELIGIOUS
in contrast
to acute
particularly
likely
Postictal
psychoses
EXPERIENCE
or chronic to
interictal
have
vance.
a religious
generally
emerge
after
an exacerbation teaching, they not clouded,
in seizure activity. Contrary to classical usually appear in patients with a clear, consciousness, after a lucid interval of
hours
since
or days
Grandiosity niments. psychosis,
the
last
psychoses.
a religious psychoses
Illusion
content, and 0%
of impending death postictal psychosis
zures groups
of
and
exclusively partial seiin all patients
the
three with
been
the interictal Waxman and
19th
they
suggested and
century,
religious
this
deepened
putative
affects,
terpersonal graphia. Quantitative by Bear religiosity
individuals reawakened that
of
hyperreligiosity
temporal patient
patients
temporal
lobe
responses and events
lobe
connections. exaggerated and
and was
hyper-
provided
described.62 to confirm findamong temporal
Differences in religiosity measures selection account for some of the An attractive unifying hypotheis not
to explain
a universal
abrupt,
(attribution
interictal
person-
temporal especially
sometimes
theory);
epilepsy
groups features. Gastaut that
and differed
Neutral affective
cosmological
or
focal epibetween
patients in
with
viscosity,
and colleagues’ interictal spiking
epileptics
leads
of patients continually encountering of heightened meaningfulness
origiand
to intensified
stimuli tone and beliefs
as products
seizure-induced sory-limbic
lobe those
bizarre
a response
of interictal
of sol-
seizure
to ictal
nu-
psychopathology;6
alterations integration.
are ensignifi-
are
natural and
Individuals
and
and
intensification
of sen-
objects rele-
EXPERIENCES in
severe,
experience
life-threatening
a variety
circumstances
of unusual
mental
phenom-
ena. Anecdotal autobiographical and literary descriptions of near-death experiences date back centuries. The first systematic study was performed by Heim69 in 1892, collecting
that religiosity trait epileptics from agaffective disorder
or extratemporal scores were similar
schizophrenia, but these hypergraphia, and other Bear,6#{176}enlarging upon nal hypothesis,6’ suggested
Religious
syndrome
in-
lobe epilepsy than in normal control subjects. In a subsequent
generalized Religiosity
sensory-limbic dowed with
a need
often
whose findings was that significantly higher in pa-
colleagues59 found temporal lobe disorder patients,
in temporal
hypermoralism,
irritability,
for this among were
patients, and lepsy patients.
kindling
been
have failed religiosity
active seizure disorders. Several mechanisms or in combination drive the development These may include a desire for religious
NEAR-DEATH
were
humorlessness,
aggressive
support
with
change plausible altera-
and
concerns
are
circumstantiality,
and Fedio,58 trait scores
Bear and distinguished character
have
however, interictal
religiosity
with more may singly religiosity.
arising
feature
with epilepsy. interest in this
cosmological
syndrome
viscosity,
tients with neuromuscular
behavior
group studies.
behavioral
several additional for seizure-induced
ality trait among individuals with epilepsy, but emerges in a subgroup,
ace;
features of a distinctive interictal personality of temporal lobe epilepsy. Additional feaof
in interictal
Several groups, ings of heightened
experiences
preoc-
to be a common of
philosophical
leading syndrome tures
early
suggested
character Geschwind57
when
intense
of interictal
minous experiences; lesional disruptions of the temporal lobe, giving rise to seizures and hyperreligiosity as independent outcomes; abnormal religious interests
in the
has
tions
sis is that of
Experiences
Esquirol
cupation
504
diplopia,
almost Complex
models created, and mechanisms
lobe epileptics.67 and in control conflict among
psychoses.
Interictal
cance.
mental
occurred group.
temporal origin predominated and accounted for 80% of
postictal
study, scores gressive
1.2 days).
versus only 3% of chronic interictal
of familiarity,
feeling in the
topic
(average
and elevated mood are common accompaIn a study of 91 patients with epilepsy-related Kanemoto et al. found that 23% of postictal
psychoses had acute interictal
Since
seizure
Animal
have been neurobiological
Alps,
the and
accounts
of over
subsequent
30 survivors
investigators
tients variety
surviving of other
death
experiences
serene lasting
and joyful and may produce changes in beliefs and values.
features
cardiac arrest, conditions.7072 are
surveyed
or hellish,73
experience
reports
and a near-
most
profound The most
in the pa-
near drowning, Although some
distressing
of near-death
of falls
have
are
and longcommon
are
a sensa-
tion of peace; a lack of emotion and a feeling of detachment; a sense of being out of the body viewing the self; a sensation of traveling in a darkness or void at the end of which is an encounter with light; a life review;74 altered passage of time, usually slowed; and a sense of harmony or unity. Thus, depersonalization, derealization, tures. The tural.
autoscopy, brain
and basis
Sociocultural
fluence the content underlying driving One speculation
time
distortion
of near-death factors
are experiences
and
expectations
frequent
fea-
is conjecclearly
in-
of near-death experiences,75 but an biologic mechanism appears likely. supported by scattered available evi-
VOLUME
9 #{149} NUMBER
3 #{149} SUMMER
1997
SAVER
dence is endorphin-induced The limbic system is richly
limbic endowed
tors.78
beta-endorphin
In an
tion
into
animal the
increases
in
model,
cerebrospinal limbic
system with
fluid
neuronal
activity.76’77 opiate recep-
activity
marked
at the
same
strates
time
that the animals become outwardly immobile.798#{176} A sudden increase in beta-endorphin in brain tissue, cerebrospinal fluid, and serum occurs in dogs conscious at the moment of cardiac arrest, but not in anesthetized animals77 A second
intriguing
hypothesis
periences blockade
to by
molecules poxic-ischemic
that
ketamine,
phencyclidine,
have been near-death
reported experience
dampen settings.8’
and
other
induce in normal
ex-
NMDA
blockers
precise
anatomic
sub-
of hallucinogen-induced
and after of induced
temporal lobectomy showed reduced richness perceptual experience after temporal lobe
resection.89 strongly
The influences
experience
elucidated, role. Patients
ex-
have not been an important
but the temporal given LSD before
cognitive expectation set of the quality and interpretation
induced
sensory
DELUSIONAL
deprivation,
other
the
user of the
by hallucinogens.
suggested
that
DISORDERS
depersonaliza-
delusions psychotic
cepted delusions and
have
The
features
5-HT, recepcortex, and
perience lobe plays
Religious
several aspects of the individuals, including
hallucination,
mood. authors
near-death
structures.82’
for various
RABIN
(NMDA) receptor neuroprotective
glutamate excitotoxicity in hyExogenously administered
to
depersonalization, and elated Several
relates
N-methyl-D-aspartate putative endogenous
activity, particularly at 5-HT2, 5-HT,A, and tors, widely distributed in basal ganglia, temporolimbic
administraproduces
AND
are
a feature
illnesses.
of schizophrenia
Distinguishing
religious-mystical poses both
beliefs a practical
ac-
from bizarre psychotic challenge to clinicians
an epistemologic-theoretical
dations of psychiatric Mystical states and
and
culturally
challenge nosology.9094 psychotic
states
to the are
both
founcharac-
tion phenomena may be hard-wired, predetermined responses of the nervous system to extreme stress, and that they may have adaptive benefit.”#{176}’7#{176} For prey trapped by a predator, passive immobilization, feigning
terized by apparent delusions, hallucinations, strange behavior, and social withdrawal. Ultimately, no diagnostic system can irrefutably characterize certain beliefs
death,
as delusional,
may
promote
survival.
More
generally,
the
clar-
ity of perception and insight associated with dissociation might allow individuals to identify and carry out previously unrecognized strategies to escape desperate, life-threatening
circumstances.
as having
no correspondence
reality. Several features, ate culturally idiosyncratic ally validated mystical religious hallucinations
gin are more likely to be auditory, deviance, to involve personal HALLUCINOGENS
affectual
distress
social The
classic
hallucinogenic
agents
include
diethylamide (LSD), psilocybin, and typical experiences after hallucinogen visual
illusions
and
experiences mystical been
closely experience.
employed Church,
strated Protestant
to prompt church
of some
vividly
parallel religious Mescaline-containing and
religious
reveries
psilocybin
has
in the been
ingestion of subjects
kind,
91%
saw
sessions, experienced religious
coland These
numinous peyote
mystical religious experiences services.86 In one series
served hallucinogen and peyote, 96% agery
often
Protoinclude
and autoscopy; euphoria; intelligence or presence.83
to foster
American
acid
mescaline.82 ingestion
hallucinations,
ored; depersonalization awareness of a larger
lysergic
and has Native
demonduring of 206 ob-
chiefly of LSD religious imbuildings,
and
recognized
in 90% of schizophrenic ence, of persecution, are
schizophrenia; 10%, 8%, and delusions are
phrenia
JOURNAL
OF
NEUROPSYCHIATRY
agonist
most
content
is shaped
effects
vary
65%
serotonergic
the
among
the
of the
typical
and
members course
of illness of referof being
and
not
only
historical and mid-l9th
delusions belief in the
an
beliefs
across
of the 13 State Exin schizo-
culture.98
contemporary
in
in 12%, religious of unse-
are one Present
delusions
individual’s
to be of the
Delusions aberrant
of religious by
individuals in
by
they are present respectively 4% of unselected patients. But common, being present in 3.2%
amination.97 The specific
their
with
invalid stage
to progressive
blocking,
patients.95 of self-depreciation,
lected patients.96 Religious categories of delusional
also across preoccupations
properties
and
on illness and to produce
to lead
thought
patient’s own subculture. Delusions occur at some
58% encountered religious figures.87 Although the hallucinogenic drugs share dopaminergic and noradrenergic properties, current views affiliate psychedelic
to involve as bizarre
controlled
to focus grandiosity,
or indifference,
isolation,
to objective
however, do tend to differentipsychotic states from culturstates (Table 2). In general, and delusions of psychotic ori-
These
cultures,
but
time. In Britain, the frequency delusions of a religious character with
schizophrenia
century
to 23%
declined in
the
of
from mid-2Oth
505
NEURAL
SUBSTRATES
TABLE
2.
Features
OF
tending
RELIGIOUS
EXPERIENCE
to distinguish
mystical
and
psychotic
Feature
Mystical
Hallucinations
Often
Vocabulary
Religiously imbued word harmonious connotations: peace, spirit
Personal
Individual higher
of state
Transient,
Withdrawal
Psychotic
visual;
Ecstatic,
Duration
typically
speech
Cultural
output
compatibility
Note:
Based,
century, Theories
in part,
on refere
nces
divided ception
have process
The
as self-negating power
about
initial
and information beliefs. Defects identified
firmatory
evidence.
of
“delusional
precedes
the
patient
character genesis
important strange,
return
to share
several formation
generation
perceptual
restless,
figure,
distinct can be perrea-
of beliefs, refute have
such been
Bayesian inor discon-
emphasized
the
affectual
change
cognitive
delusions.’#{176}5
and
suspicious
and
is about to happen. unreal. Attention
that feels The and
mission
charging
of stimuli)’07
delusions. Mood nations disorders.
hibit
congruence and
and
delusions abilities
with as 75% these
and
Bayesian
(perceptual (altered mood
in the is the
delusions As many
delusions,
Grandiose of 1) special
506
systems systems
genesis
distinctive a religious of patients are
have been (inventor,
deviance
and
omnipotence
or terrified for months delusions,
or years and reduced social
progressive
leave function
isolation
output bizarre
may contain associations, in known language; may occur
typically classified athlete,
rea-
distortion),’#{176}7 and affective
of schizophrenic feature content with into spiritual
to solve
to carry
sions in accusatory
in the
patient’s
are often reproachful
tation of chance anomalous 2) cognitive bias-acceptance of logical
CORTICAL The
our two
and
guilt-ridden voices
recent
produce hyporeligiosity sivity and decreased
the to
and
reasoning.
patients
with
loss that
literature disease
Alzheimer’s
in mood mania ex-
erate to advanced of 80 Al.zheimer’s ity changes were
of
and
experience
illustrate systems
DEMENTIAS
Alzheimer’s
a progressive illustrating
or or vi-
dementing
little studied, and extensive empiriRelevant preliminary observations
experience disorders:
by delu-
experiences of mood-congruent
probabilistic
experience
has been are lacking.
poral dementia. Patients with strate iors,
selected
positive or negative aminergic and serotolead to 1) misinterpre-
perceptual only
DEGENERATIVE
religious
from
of war,
4) special
to world).”#{176} Conversely,
Overwhelming in ascending systems
religious
delusions healer),
problem
historical
and
as divine in origin. and depressive delusions of perceptual and cognitive
influence. generated neurotransmitter
outcomes
of a famous 3) wealth,
depressed patients and may include
sions perceived Both manic vulnerability affective moods nergic
the
a message
of halluci-
grandiose.’#{176}8”#{176}9
(descendant of God),
(fated
God
for
(deductive
identity
incarnation
implicate
soning),’#{176}6 parietal and temporolimbic
accusatory
and
Beliefs are rejected by others culture or subculture
2) grandiose
disorders cal data
systems
often
of illness
Thought disorder: neologisms and but is predominantly thought blocking
in the
concentration may be impaired. This altered mood state drives the development of delusional thinking. Neuroanatomically, these psychologic mechanisms frontal
grandiosity
Obligatory:
language to speaker;
by others
experiences,’#{176}2
have
of overt event transformed,
Personal
May persist residual
experience output
increased. of delusions
operations: initial and probabilistic
mood”-an
is anxious,
that some world feels
themes
91, 143-145.
authors
appearance
auditory;
Frequent soul,
completely
populations,’#{176}#{176}”#{176}’ including
Some
Predominantly
for
resolves
as valid or subculture
recognized culture
defects in formal logical reasoning’#{176}3 and ference,’#{176}4 and bias in search for confirmatory
The
hours,
to corroborate or of these operations
of anomalous
State
Indifferent
usually
Beliefs are patient’s
perceptions,
in schizophrenic
occurrence
counselors
joyful
emphasized of belief
search in each
vessel
in tongues): incomprehensible
into several component of the surround, logical
soning
wise
choice, generally God, Christ,
Glossolalia (speaking is unknown and fluency retained
while those of a sexual of the neurobiological
in schizophrenia mechanisms.
role
elderly,
Facultative: eventual with others
Disordered
the
State
role
Affect
states
disease
are and typically
of religious interest the neurobiologic
can
be revealed
as well spontaneity Alzheimer’s patients, the diminished
VOLUME
of interest frontotemdemon-
and behavsubstrates of
by conditions
as hyperreligiosity. are common
that Pasin mod-
disease.’11 In one study most frequent personalinitiative with growing
9 #{149} NUMBER
3 #{149} SUMMER
1997
SAVER
apathy
in more
in more
than
than
60%
and
relinquishment
In our
50%.112
experience,
pursuit of lifelong interests commonly compromises religious concerns. The nisms tions,
are diminution leading to
cognitions
and
and
tion area connections, ability to construct pathologic usually
of
heimer’s
disease
type, ments
experiences a religious
without foster
area
loss
religious suspiciousness,
precludes
delusional themes. In contrast, a subset
of the
of with
hyperreligiosity. 17-linked frontal
affected Among
with
individuals patients
religiosity
appears
rather
than
M.D.,
personal
speculate religious First,
daily
more
more
frontotemporal
atrophy
communication, neurobehavioral and interests
experiences
receive
family 3 of 12
right
(Bruce
Miller,
1997).
processes in these
increased
We
heighten patients.
positive
valu-
ation as a result of predominance of left hemisphere (positive) over right hemisphere (negative) valence systems.”5 Second, orbitofrontal atrophy promotes impulsivity,
leading
proclaim tered
to
religious positive,
harmonious
A UNIFYING MARKERS The
core
willingness
to
for
frequently
to by
ion, are the ing touched
of religious
and
variety
noetic and the ultimate
mystical
of
unity,
spacelessness, and
joy.
and We
experience
an
experience
a feeling
suggest is the
experience,
the ineffable-the ground of reality
that limbic
of
of positive the
system.
primary
of religsense of havand the sense
features
of the expeare an ex-
timelessness affect, substrate
Temporolimbic
and of peace for
in limbic
arity”
arises
certain
a new religious
JOURNAL
OF
NEUROPSYCHIATRY
to
this
epilep-
stimuli
net-
positive
or
simple positive or negative can produce experiences that
limbic
divisions a sense
system
between of “famili-
as a quasi-emotional
Usually the limbic familiarity but it can appear discordantly,
3) harmonious-indicative between joyous.
psychic
with
of a con-
disparate elements, This limbic activity
seizure
auras,
account of the brain experience. Several
religious consequently
experience holistic
to the left an analytic
experiences is that
process-specific
the experience version that
experience. numinous ordinary limbic
In
into
rience, cannot tions,
a whole, of the
and/or
limbic
of the
can full
contents to those
Consequently, experience
of ordinary
expe-
appended to them Like strong emo-
be named
visceral
of of
tagged by the as detached,
numinous
contents
feelings in words.
markers
in their of ineffability.
as joyous.
nondo not callo-
an entirely of religious
cognitive as similar
of the
and the distinctive be captured fully these
into incom-
and they corpus
that they are importance,
contents
descriptions
event and transferred
is translated is inherently
provides ineffability
and seen
experience, except system as of profound
descriptions
of have
that was based a variety of that numinous
of dominant
hypothesis for the
The perceptual experience are
as united
it offers
the experience is reported as have several fundamental derest upon metaphorical rather accounts
limbic-marker explanation
of
basis of the ineffability theorists in the past
dominant hemisphere functions and that clearly apply to individuals with an intact sum and unitary conscious experience. The different
experi-
is a right hemisphere and nonverbal. When
hemisphere, and verbal
and 4) under-
near-death
advanced an explanation of ineffability on hemispheric specialization.’’3’ guises, the hypothesis was advanced
communicated in a report
external
neural with
ences, and the religious and mystical normal individuals. An attractive feature of this hypothesis
positive The
auras).’22 integrates
in the
nection or unity ecstatic-profoundly
resemble
(ecstatic system
addition discharges
self-referent,
tic discharges can produce each of these components in fragmentary or complete form: distancing from apparent reality (depersonalization, derealization), timelessness and spacelessness (autoscopy, time distortion), or affect limbic
events
are intermediate between customary affects and cognitions. For example,
than
of psychologists
of a distributed and
plete, and consequently ineffable. These theories fects, chiefly that they
EXPERIENCE
of the unutterability or incommunicability rience.’3’4”’2’ Frequent additional perience
and
encoun-
LIMBIC
RELIGIOUS
a wide
accept
phenomena.
HYPOTHESIS:
AND qualities
assented
greater explanations
Moreover, valence,
lies
behavior.”4 increased
January
is part stimuli
negative value.’21 This role of the limbic system is of great evolutionary value, marking the valence and the importance of a novel stimulus or experience for accurate memory encoding and automatic future retrieval.
and
with
and
marks
RABIN
producing d#{233}j#{224} vu or jamais vu experiences. We suggest that, similarly, limbic charges may mark experiences as 1) depersonalized or derealized, 2) crucially important
complex
frequently
drives that
marker of experience. jibes with explicit recall,
impairassociation
In the index dementias,
frontotemporal
that two experience
are not in Alz-
persecutory
showed hyperreligious asymmetric atrophy,
to occur
left
simple
elaboration
dementias exhibit for chromosome
intellectual In addition,
Memory cortical
of patients
of associa-
disease Delusions
content.”3 and
the
connec-
impaired cognitions.
typically
to and mecha-
cortical
in Alzheimer’s character.
are
work
charging
disrupted
producing religious
internal
decreased
extends likely
of temporolimbic-cortical decreased affective
stimuli,
of hobbies this
AND
intensity,
but
cannot
be
resulting
507
NEURAL
SUBSTRATES
The spects.
OF
limbic marker It predicts that
numinous peated
RELIGIOUS
EXPERIENCE
theory is testable in functional neuroimaging
experiences religious transports
limbic system activity. It predicts that loss of the ability to have numinous experiences will occur in individuals
behavioral
brain
with
orders
drome)
but
detailed experience We
not
pathology
other
focal
depth electrode to stimulations note
in conclusion
who have alterations
(Kluver-Bucy
lesions.
It predicts
studies at limbic
will map and not
that
rein
neuroscience of the neural achieve of all
limbic
individuals would reveal
religio-the religious animal. Behavioral must encompass a fully realized account
substrates of religious experience if it is to systematic understanding of the brain basis man behavior. The task before neuropsychiatrists
bilateral
in
several reduring
although
synthat
more
The authors
psychology
thank
of religion has a long gations of the neural
and honorable history,’32 investisubstrates of religious experience
M.D.,for supported
are
Humanity
Fellowship
from
22. Howden
JC:
in
their
infancy.
has
been
called
is to fully
promote,
intensify,
ence-unique clues nature of humanity.
numinous other sites.
the
neurologists that
homo
to the
Jeffrey
understand or alter
neural
Cummings,
religious
a huand dis-
experi-
basis
of the
M.D.,
and
spiritual
David
Bear,
thoughtful comments and suggestions. This work was in part by a Frederick Sheldon Memorial Traveling Harvard
U. L.S.).
University
References 1. James
W:
Religion
Experience. 2. Mackay
DM:
religion
ated
(oral
Neurologic
edition,
biologists’
Research
edited
by
Heilman
6. Feuerbach
L: Lectures
on
R. New reality
New
the
York,
and of God.
K: Religious
J:
Types
Press,
1951,
translated
Co,
pp
and
IL,
Experience.
Chicago,
London,
Philosophy. JY: Mysticism.
New New
York, York,
Spiritual
Kojetin
Nature BA,
of Man.
of Chi-
Bouchard
influences on religious of twins reared apart and
18. Hippocrates: Society,
The
Genuine
1846,
pp
TJ,
brain
Masson,
1860
environ-
attitudes, and Psychol Sci 1990;
values: 1:138-142
London,
Syden-
Sci
WB
Saun-
for the
psychology
on attributions 1983; 22:326-339 physiological
of auras
Treatment
determi-
69:379-399
in partial
Neurology
seizures:
1992;
of Epilepsy:
E. Philadelphia,
to God.
Lea
42:801-806
Principles
and
Febiger,
Epileptic
forced
and 1993,
pp
MM,
lesions.
had
Neurol MF,
Perryman
symptoms D:
stimulation
Human
a
1959;
to a gross
R, et al: The
organic
of a crude state) in a disease
of the
phenomena FL,
116:397-414 occurring
of epileptic Clin
of temporal
lobe
et al: Clinical
temporal
and
lobes lobe
Neurosci
epilepsy.
responses
frontal
in temporal
seizures.
relationship
J Neuropsychiatry
attributes.
of the
with a warning aura (dreamy
lobe. Brain 1899; 22:534-549 Psychic phenomena in partial
11:100-109 B, Doss
P: Experiential
thinking
47:79-83
attacks intellectual
pointing
and psychological 8:287-292
Neurol
1996;
JP: Epileptic and with the
1991; Engebrit
KM:
Neurology
Brain
to electrical in patients
with
dysfunction.
Arch
Anatomy
of the
1:87-97
W, Jasper Brain.
H: Epilepsy
Boston,
Little,
37. Gloor P. Olivier in experiential
A, Quesney phenomena
1982; 23:129-144 38. H#{233}caen H, de
Ajunaguerra
corporelles
[Somatic
and Brown,
the
Functional
1954
LF, et al: The role of the of temporal lobe epilepsy.
J:
delusions
M#{233}connaissances and
et
hallucinationsl.
limbic Ann
system Neurol
hallucinations Paris,
Masson,
1952
843-858
maladies
in The
Cherrier
epilepsy. Brain 1993; 35. Weil AA: Ictal emotions
Press,
and
of Hippocrates.
19. Taxil J: Traict#{233}de l’#{233}pilepsie [Treatise 20. Esquirol JED: Des maladies mentales Balliere, 1838 21. Morel BA: Trait#{233}des
et al: Genetic
interests, together.
Works
Clarendon
value study.
1990; 113:1673-1694 34. Fish DR, Gloor P, Quesney
Macmillan, 1960 Oxford University
Oxford,
Ment
1907 theory
social, and Rev 1962;
localizing
auras,
frontal
who
33. Cloor 20.
30-47 and
Macmillan, attribution
retrospective
right temporo-sphenoidal 31. Devinsky 0, Luciano
auras 1996;
adolescence:
University
P: The
JH, Stewart of smell
Semin 32. Mendez
ages of 7 and 1994; 4:61-85
Philadelphia,
of event-character Study of Religion
by Wyllie
MF, left
patient
Glencoe,
Facts.
between the of Religion
edited
30. Jackson sensation
of Hardy’s of Religion
1975
in childhood
Epileptic
Practice,
from
1902
the
London,
JE: Cognitive, states. Psychol
and
28. So NK:
29. Mendez
Taplinger,
J
epileptics.
369-377
of Religious
of Meaning.
in
Its Treatment.
C: General
A, Gloor
36. Penfield
NC,
508
27. Palmini
1996
1979 17. WaIler
Paris,
(1851),
Studying
experiences
of Religious
A: The
ham
and
York,
of religious development Journal for the Psychology
16. Hardy
mental study
New Today:
Epilepsy.
B, Schmidt
26. Schachter S, Singer nants of emotional
of relig-
sentiments
and
of religion: the influence Journal for the Scientific
Oxford
component
religious
Epilepsy
a prospective
is the current status for the Psychology Creation
25. Spilka
associ-
York,
WP:
ders, 1904 24. Turner WA:
3rd
and Row, 1967 in The Varieties Green
the
Experience
14. Stace WT: Mysticism 15. Carmody DL, Carmody Press,
E. New
The
18:491-497
23. Spratling
specializaNeuropsy-
disorders
of Religion
Longmans,
and UCLA-
1990
a viewpoint International cago
Essence
biology of god”: What International Journal
Religious
12. Tamminen
13. Wach
Valenstein
York, Harper of the unseen,
Free Press, 1962 10. Hardy A: The Biology Mowbray,
CA,
Neuropsychology,
461-498 and the emotional 1995; 33:267-272
1994; 4:1-23 9. Gendlin E: Experiencing
D:
science
1981
in Clinical
KM,
pp
11. Hay
1872/1873;
Angeles,
1994; 7:1-19 E: Emotional
diseases,
Religious
1902
toward
Los
October
Neurology D, Valenstein
Press, 1993, Neuropsychology Psychology
Experience.
of
Co,
attitudes
archive).
Center,
University 5. Miller DA: ion. Pastoral
8. Hay D: “The hypothesis?
Varieties
and
RW, Buck R. Differential hemispheric and social emotions. Neuropsychiatry,
neurological
by Man nheim 7. James W: The
The
Green
interview
and Behavioral KM, Bowers with
in
Longmans,
International
ED, Homan of primary
chology, 4. Heilman
neurology,
York,
project
Reed 3. Ross tion
and
New
mentales
on epilepsyl. [On mental [Treatise
on
Tournon, illness]. mental
1602 Paris, illnessl.
39. DeningTR, 165:808-817 40. Devinsky
Berrios 0,
with seizures. 41. Voskuil PHA:
Feldmann Arch The
GE: Autoscopic E, Burrowes Neurol epilepsy
VOLUME
phenomena.
BrJ Psychiatry
K, et al: Autoscopic
1989; 46:1080-1088 of Fyodor Mikhailovitch
9 #{149} NUMBER
1994;
phenomena Dostoevsky
3 #{149} SUMMER
1997
SAVER
(1821-1881).
Epilepsia
42. Gastaut
H:
Epilepsia
New
1983;
1984;
on
Press,
1984,
the
epilepsy
pp
in Psychiatric Aspects of EpiDC, American Psychiatric
325-334
D: The
simple
structure
partial
of emotions
seizures:
Journal of Epilepsy 46. Stevens JR, Mark man. Arch Neurol 47.
Obrador human tion,
reflecting
in The
clinical
KJ. Berlin,
AJ: Toward
brain,
phenomenology
Springer,
a psychobiology
Psychobiology
ence.
Brain
1956;
H:
Surg
1990;
lobe
K, Beard Br
with
partial
Sudden
BK:
pp
areas of the Localizain the
by Davidson
report
and
with
with
J
religious
ecstatic
Ment
state
Dis
1990; 73. Greyson
conversions
in temporal
A, et al:
a multiple
J
Br
Psychiatry
Postictal
case
study.
psychosis
after
Epilepsia
1991;
J,
interictal
and
Kawai
I: Postictal
chronic
psychoses.
psychosis:
a comparison
Epilepsia
1996;
SG,
Geschwind
N:
epilepsy. K, Blumer
The
interictal
Gen
behavior
Psychiatry analysis
Arch Neurol 1977; D, et al: Interictal
lobe epileptics: relationship J Neurol Neurosurg Psychiatry
1975; 32:1580-1586 of interictal behavior 34:454-467 behaviour
H, Morn
C, Leserve
N: Etude
du comportement
des
tiques psychomoteurs interictal behavior
dans l’intervalle de leurs crises of psychomotor epileptics]. Annales
chologiques
113:1-27
62. Adamec
1955; RE:
Partial
kindling
of the
ventral
epilepsy.
Brain
J,
Res
Bandler
epilepsy-induced 111 65. Willmore U, religiosity.
1987; interictal
Heilman
1:390 77. Sotelo
J,
1980; 105:85-87 66. Sensky T, Wilson lobe
Perez
A, Petty
Fennell
of the
Adv E: Effect
American
R, et a!: The
epileptics:
NEUROPSYCHIATRY
religious
evidence
Neurol of chronic
Neurological interictal
belief
and
1991;
55:97-
seizures
on
Association
personality its
for
association
traits with
in the
Swiss
face
1987; Jour-
Alpine
Club
of life-threatening perspective.
of “near-death
patients
were
near-death
near
experi-
death.
approach
Lancet
of death
1995;
York,
F, et
opioid
CR,
of N,N-dimethyltryptamine 41:98-108 84. LaBarre W: The Peyote
drugs
and
the
University,
86. Doblin up and
Share
“Good
the fate 92. Bamhouse
1978; central utiliza-
Exp
near-death
Ther
experience,
by Bailey
EH,
LW,
J.
Yates
research
and
et al: Dose-response
in humans.
Arch
5th edition.
Norman,
Gen
relationship
Friday critique.!
J:
A, Lexow
tonin receptors are Neuropsychopharmacology
tology 90. Heise Beliefs,
the
Pharmacol
edited
consciousness.
87. Masters REL, Houston New York, Holt, Rinehart,
89. Serafetinides hemisphere
USA
study
Psychiatry OK,
University
between Doctoral
1994;
of
psychedelic
dissertation,
Har-
1963
R: Pahnke’s methodological
JN,
of opiate 245:447induces
Sci
drugs in psychiatric 183:127-138
of the
mystical
mo-
265-282
1995;
Cult,
Acad
J
and
Uhlenhuth
1989 analysis
1973;
Beta-endorphin
receptors.
pp
distribution Nature
Nati
Reader,
RJ: Hallucinogenic Nerv Ment Dis
and
at the
sites mediating the by changes in glucose
ketamine, 1996,
1981;
plasma,
in dogs
al:
Proc
Experience
Routledge,
I Nerv
17:223-225
seizures.
of mu
Press, WN: An
physi-
Lancet
in brain,
SH: Regional and human brain.
F, McCoy
262:415-423 K: Neuroscience, Near-Death
severe
(letter).
of beta-endorphin
Res
limbic
involvement
Psychiatry
during
P, et a!: Changes
contents
S, Bloom
experiences.
memories
75:5221-5225 80. Ableitner A, Schulz R: Neuroanatomical actions of beta-endorphin as mapped
88. Joyce
Dis
Psychiatric
39:19-27 a personal
I: Features
Involuntary
CB, Snyder in monkey
nonconvulsive
vard
temporal
Ment
Nerv Ment Dis 1995; 183:452-458 biology, and the near-death experience.
Neurol
MJ, Pert binding
Varieties Winston,
in the 1993;
D, Witzum of Ben Zoma. RT: How
E, Buchbinder Psychol patients’
follow23:1-28
Experience.
1966
uptake
limbic system 8:315-336
significance of in the production
BrJ Med to evaluate
a long-term Psychol 1991;
of Psychedelic
N, et al: Serotonin
altered
EA: The dominance
The and
Experiment”: Transpers
in man. Neuropsychologia 1965; DR: Delusions and the construction edited by Oltmanns TF, Maher
pp 259-272 91. Greenberg of
in
Nerv
of the
1976; experience:
or not
R, Guevara fluid
of death.
78. Kuhar receptor
Oklahoma 85. Pahnke
identifica-
et al: Neurobiological
disturbances.
KM,
Transactions
OF
NC,
J
RJ, Quails
400:360-364
R, Griffith
EW:
83. Strassman
tion of changes in limbic physiology which accompany changes in feline aggression and defense. Physiol Behav 1991; 49:443-453 63. Griffith N, Engel J, Bandler R: Ictal and enduring interictal disturbances in emotional behaviour in an animal model of temporal lobe
Yearbook
Distressing
or injury. A: Culture,
J
[Study of the Medico-Psy-
hippocampus:
NE:
82. Strassman treatment.
#{233}pilep-
Psychiatry of death
to whether
in
of sensory-limbic
falls.
168:259-263 EW, Stevenson
New
syn-
J
1980;
of
in hospitalised
to idiopathic psychiatric 1982; 45:481-488
60. Bear DM: Temporal lobe epilepsy: a syndrome hyperconnection. Cortex 1979; 15:357-384 61. Gastaut
syndrome
fatal
Dis 1993; 181:148-156 DB: Endorphins at the
1992; 81. Jansen
37:551-
Hyperreligiosity
R: Depersonalization
B, Bush
450 79. Henriksen
1988;
PJ:
relationship.
336:1175-1177
ment
1988;
117:497-507 psychoses.
F, Olivier
seizures:
ictal
Nerv
on
in relation
in The
temporal dromes.
JOURNAL
ence”
tion:
temporal lobe 59. Bear D, Levin
temporal
A: Remarks
Nerv Ment Dis 72. Owens JE, Cook
Ment 76. Can ec1980;
the
edited
545-549
27:327-337
cal illness 75. Kellehear
comparison.
Walker
RABIN
in Epileptology,
pp
175:181-184 68. Roberts JKA, Guberman A: Religion and epilepsy. nal of the University of Ottawa 1989; 14:282-286
1992; 55:95-110 74. Stevenson I, Cook
experi-
epilepsy Epilepsia
RA,
redefining
a description. E: The reality
in
Raven,
Novelly
R, Kietti
God
edited
epilepsy
1970;
temporal lobe epilepsy. Arch 58. Bear DM, Fedio P: Quantitative
64. Engel
DM, epilepsy:
danger: 71. Rodin
171-183
E: Temporal epilepsy).
Post-ictal
K, Kawasaki
acute
556 57. Waxman
1973,
hypergraphia.
Psychiatry
C, Andermann
32:225-231 56. Kanemoto
lobe
70. Noyes
stimulation
Emotion in Cerebral
a case
lobe
of AW:
J
SJ, Toone
complex
1984,
diagnosis.
33:413-416
behavior
epilepsy.
55. Savard
in Advances
York,
1892;
1980, pp379-464 reflected in epileptic
epilepsy:
N: Temporal
interictal
54. Logsdail 152:246-252
experiences,
R. New
cerebrospinal
21 :705-710 52. Naito H, Matsui 176: 123-124 53. Dewhurst
temporal
of transcendence:
51. Cirignotta F, Todesco CV, Lugaresi static seizures (so-called Dostoyevsky
and
mystical
interview
79:29-67
Dostoyevsky’s
Neurol
experi-
and
of Consciousness,
JM, Davidson RJ. New York, Plenum, 49. Williams D: The structure of emotions 50. Morgan
reported by Porter
69. Heim
Martin-RodriguezJG: therapeutic stimulation,
by Zulch
48. Mandell
in epileptic
E, et al: Structured
1991; 4:107-116 VH, Ervin F, et a!: Deep 1969; 21:157-169
S. DeIgadoJMR, brain and their edited
Dostoevsky.
67. Tucker epilepsy, D. Washington,
ences. Brain 1956; 79:29-67 45. Devinsky 0, Feldmann E, Bromfield for
of Fyodor
25:408-411
43. Ceschwind N: Dostoievsky’s lepsy, edited by Blumer 44. Williams
24:658-667
comments
AND
the
sites
and
sero-
of schizophrenics.
temporal lobes and of the LSD-25 symptoma-
of
95:53-63 of reality, in Delusional BA. New York, Wiley, 1988, IT: Mysticism
and
1992; 65:223-235 religious ideation,
psychosis: in Psy-
509
NEURAL
SUBSTRATES
chiatry LH.
and
Religion:
Washington,
93. Gaines ing,
Neale
SR, Weinberger
1986,
the
problem
and
by
by
Press,
Oltmanns
TF,
Robinson pp
1984
89-106
119.
of mean-
Maher
BA.
New
120.
and
delusional
Clin
thinking
in psy-
Psychol Rev 1983; in Schizophrenia,
DR. Cambridge,
MA,
Blackwell
Health Organization: Schizophrenia: An Study. New York, Wiley, 1979 JK, Cooper JE, Sartorius N: The Description
of Psychiatric
Symptoms:
CATECO
system.
Press, 1974 Westermeyer
An
Instruction
Cambridge, Some
Journal
of Mental
Garety
PA, Hemsley
3:227-253 edited
Science,
by
and
121.
1995,
International
Manual
England,
cross-cultural
RP:
structing 102.
Maher
for
the
123.
science, Aggleton
PSE
and
124.
DR:
in DeluYork,
years
ago
and
125.
today.
107:819-827
Delusions: New
126.
Investigations
Into
York,
University
Oxford
the
Press,
BA,
Von
syndromes
and
symptoms
edited
by
Bentall
RP.
M:
Delusions,
in Comprehensive
2nd edition, 1993, pp 263-293 E: The
edited
specific
laws
of
in
in Schizophrenia, of California Press,
104.
Hemsley
DR,
105.
sions: a Bayesian analysis. Br J Psychiatry 1986; Wiggins OP. Schwartz MA, Northoff C: Toward
PA:
of the
The
initial
Psychopathology,
edited
106.
ger-Verlag, 1990, Benson DF, Stuss
107.
perspective. Cuttingj:
The
formation
stages
1990;
108.
son with acute schizophrenia. Carlson GA, Goodwin FK: The sis of the manic episode. Arch
109.
World
Health
phrenia. 110.
Leff
Organization:
Geneva,
JP,
Fischer
of mania.
111.
Petry
S, Cummings
112.
dementia Chatterjee
A cross-national
1976; MA,
type. Smyth Neurol
Arch KA,
Neurol et al:
1992;
49:486-491
delusions:
review.
J
Br
1988;
phenomenology,
Psychiatry
1985;
changes anatomical
Davidson
116.
James
tion.
RI: Anterior
Brain W:
Cogn The
1992;
mans,
Green
and
Otto 1923
R: The
Idea
118.
Byrnes
IF:
cerebral
The
Mind. The
Co,
and
the
Experience.
New
Psychology
Holy.
of Religion.
York,
Oxford New
York,
University The
Press, Free
University brain,
edited
in The
of
Spectrum
J. New in
Press,
cerebral
the
of Ritual, York,
the
Colum-
Light
of
Brain
1988
hemisphericity mystical
1993,
Wulff
Press and
as
experiences,
pp
of America,
culture,
by AsbrookJB.
differential and
religious
Lanham,
pp
1993,
in Brain,
Culture,
MD,
45-75 and
University
the
Human
Press
of Amer-
77-108
DM:
Psychology
of Religion,
2nd
edition.
D:
Paul
0:
The
Falling
and
temporal
lobe
Sickness:
to the Beginning University Press,
Drucker
138.
Medicine Foote-Smith
139.
Johnson
140.
BrJ Psychiatry Foote-Smith
141.
37:211-218 Taylor DC,
T: Malaise
J:
Henry
Rev
New
York,
Wiley,
of Margery
Maudslay
of Arc. on
Marsh
SM:
Epilepsia
revealed.
Bernstein 485:84-103
Buckley 1981; Oxman states. Group Quest publ
P: Mystical
experience
and
LH,
1996;
paradigm
of
Psychiatry
et al: Vincent’s
schizophrenia.
of
psychosis.
Epilepsia
Dr Z: the
LLF,
Journal
32:810-815
Neurosurg
Neurol
the Johns
messianic
J
1991;
From
State
Jackson’s
vertigo.
Otolaryngol
1991;
Swedenborg.
1980; 43:758-767 Arenberg 1K, Countryman Acta
York
Swedenborg’s
Hughlings
epilepsy
Neurol
Baltimore,
New
1994; 165:690-691 E, Smith TJ: Emanuel
lobe
of Epilepsy
Neurology.
Kempe.
J
epilepsy.
Neurol 1994; 150:835-839 New York, Raven, 1991
A History
of Modern 1971
1972; 72:2911-2917 E, Bayne L: Joan
temporal 142.
St.
Psychiatry 1987; 50:659-664 P: La maladie de Saint Paul. MR: The Psychoses of Epilepsy.
137.
145. New
MD,
Temkin
Long-
1902
of the
Hall
Breakdown
1976
trance,
presence,
V: Body,
136.
of emo-
York,
Vectorial
the
Mifflin,
Wyndham
sensed
29:1241-1249
in
of ritual
IN,
MA:
134. 135.
143. nature
University
processing of social due to ventrome-
1991;
Houghton
neurobiology
for the
Neurosurg Vercelletto Trimble
144.
of Religious
Persinger
Landsborough
146:184-197
asymmetry
Neuropsychologia of Consciousness
Boston,
Bristol,
133.
cor-
20:125-151
Varieties
117.
132.
in
of a family
guidedited
Turner
in
45:1187-1190
Personality
the
Oxford
Damasio AR: Preserved access and in a patient with acquired sociopathy
dial frontal damage. Jaynes J: The Origin
Greeks Hopkins
of Schizo-
alterations
York,
abnor-
131.
analy-
epidemiological
Personality
Neuro-
1996
129:428-442 et al:
Clinical
Wilkins, 1996 to normal and
pp 217-228
Saver JL, knowledge
ica,
compari-
Study
and
A. New
An
1985
130.
a clinical
Lynch T, Sano M, Marder KS, et al: Clinical characteristics with chromosome 17-linked disinhibition-dementia-parkinsonismamyotrophy complex. Neurology 1994; 44:1878-1884
115.
510
Pilot
H, Benton
C
of Religion:
Prentice-Hall,
Williams and of the amygdala
edited
IL, Charles
Psychology NJ,
Religious
Psyche,
conversions. Percept Mot Skills 1993; 76:915-930 D’Aquili E: The myth-ritual complex, a biogenetic structural analysis, in Brain, Culture, and the Human Spirit, edited by Asbrook JB.
Sprin-
1987; 151:324-332 a longitudinal 1973; 28:221-228
The Cliffs,
Neuropsychology,
H, Eisenberg
1991,
Lanham,
and
York,
psychosis:
International
129.
phe-
on delusions:
16:403-411 of acute organic
AC: Hill
Arch
JL: Organic and
BA. New
BrJ Psychiatry stages of mania: Gen Psychiatry
Psychiatry JL,
disease.
Cummings relations,
114.
Br!
of the Alzheimer A, Strauss ME,
Alzheimer 113.
Levin
Spirit,
149:51-56 a Husserlian
RL:
Engelwood
128.
JS.
of delu-
pp 21-40 RW, Gorsuch
in
Human
et al. Springfield,
edited by D’Aquili EG, Laughlin CD, Mcmanus bia University Press, 1979, pp 117-151 Ashbrook JB: The Brain and Belief: Faith
1973
M, Bertelsen
study
pp
J,
Daane
Academic
mal emotional states. Trends Neurosci 1993; 16:328-333 Damasio AR, Tranel D, Damasio H: Somatic markers and ance of behavior, in Frontal Lobe Function and Dysfunction,
sources in
Kasanin 30-44
in Philosophy
influences
The
WHO,
by
maintenance
M, Maher
lobe
Schizophr Bull phenomenology
and
of
HN,
London,
experience,
in the
Lex BW:
H. New
schizophrenia,
edited 1944,
of schizophrenia,
by Spitzer
pp 21-34 DT: Frontal
P, Adams
logic
and Thought CA, University Garety
Handbook
by Sutker
Language Berkeley,
nomenology
Routledge,
religious
127.
in Recon-
London,
Malony
Belief.
Function
2nd edition. Baltimore, JP: The contribution
Research.
Spitzer
Damurus
of psychosis,
of
and
Approach.
Bicameral
Psychol-
phenomena
Its Nature WH,
of Religious
R: Neuropsychiatry,
Press,
Wiley,
Psychology
The
Thomas, 1973, Spika B, Hood Joseph
University
BA. New
a hundred
1961;
Reasoning.
The
Psychopathology, York, Plenum, 103.
WH:
122. Fol-
of delusions,
TF, Maher
Schizophrenia: Science
Schizophrenia, 23-60
pp
1990,
Clark
The
Empirical
Classification
Cambridge
aspects
by Oltmanns
of Delusional
Bentall
1987
by Clark
1994
101.
LB:
Press,
by
J:
sional Beliefs, edited 1988, pp 212-229 99. KIaf FS, HamiltonJC:
ogy
Brown
Experience:
15-27
96. World low-up 97. Wing
100.
edited
pp 230-258 JM: Delusions
a review of the literature. Descriptive psychopathology,
Hirsch
98.
psychosis,
Beliefs,
1988,
edited
Psychiatric
culture,
in Delusional
EXPERIENCE
Concerns,
American
A: Delusions:
chotics: 95. CuttingJ:
RELIGIOUS
Overlapping
DC,
York, Wiley, 94. Winters KC,
pp
OF
violent
Schizophr
Bull
7:516-521
J
TE, Rosenberg SD, Schnurr Nerv Ment Dis 1988; 176; for
the
or Psychic no 97). New
Advancement
of
PP. et al: The 401-408 Psychiatry:
language
of altered
Mysticism:
Spiritual
Disorder? (Mental Health Materials Center, York, Mental Health Materials Center, 1976
vol
Press,
VOLUME
9 #{149} NUMBER
3 #{149} SUMMER
1997
9,
