Neha Pathak, MD, FACP, DipABLM: Welcome to the WebMD Health Discovered podcast. I'm Dr Neha Pathak, WebMD's Chief Physician Editor for Health and Lifestyle Medicine. Today, we're going to explore the science and research that shows how our spiritual lives can influence our emotional resilience, mental well-being, and even our physical health.

We're talking about the science of spirituality. I'm sure everyone listening has a unique concept of what spirituality means to them. So today we'll walk through the vast array of ways we can be part of a spiritual experience and learn what scientific studies tell us about spirituality as a natural, innate human component.

In our brain networks, whether or not we're part of a religious tradition, we'll explore the role of daily spiritual engagement, whether it's prayer, reflection, mindfulness, or something else that you do as part of your spiritual practice. And what role that practice has in fostering spiritual engagement, emotional strength, meaning making, and connection. 

We'll get into practical strategies for weaving spirituality into everyday life. From morning rituals and nature-based gratitude practices, to nurturing empathy and compassion in our relationships. And we'll talk about how to instill some of these values in the young people around us.

I'm really excited to also think about how we can approach suffering through a spiritual lens so that it may transform that adversity into opportunity for growth, healing, and deeper understanding. Whether you consider yourself deeply spiritual, spiritual curious, or a skeptic open to new perspectives, this episode offers science backed insights that will broaden your view of what it means to heal, grow, and to live more fully.

But first, let me introduce my guest, Dr Lisa Miller. Dr Miller is professor in the clinical psychology program at Columbia University Teachers College, where she founded the Spirituality Mind Body Institute. The first Ivy League graduate program in spirituality and psychology, and she's author of the book, The Awakened Brain. Welcome to the WebMD health discovered podcast. Dr Miller.

Lisa Miller, PhD: Dr Pathak, I am so delighted to be in deep, genuine conversation with you. 

Pathak: So before we jump into our conversation, I'd really love to talk about your own personal health discovery, your aha moment that brought you to studying spirituality and health. 

Miller: You know, Dr Pathak, I was a brand new intern on a psychiatric inpatient unit. When people are on an inpatient unit, there's a pain in their heart that is too heavy to bear and some of them even worry they might take their very life.

And so it is a safe place to be, it is the right place to be, but it's a place with a lot of pain. So at this particular time, it happened to be an inpatient unit with a lot of patients who were Jewish and we were approaching the Jewish high holidays, the most sacred time of the year. This is early fall, Rosh Hashanah, Yom Kippur.

One day in a community meeting, a gentleman who was very, you would say, he had bipolar, he tended to erupt when he was frustrated or anxious, raised his hand and said, “What will we be doing to honor the Jewish High Holidays?” And he asked this, it was the first time he'd ever spoken in the meeting.

And the resident and the unit chief, who were very good people, felt badly about it. They kind of looked down and said, “We're sorry, there's nothing planned.” And he said, “What? Nothing planned?” And he erupted and he walked out of the meeting. I looked over and I saw a woman who had really felt such shame and unworthiness, deep depression, profoundly slump over with sorrow and I thought, you know what, I can do something about this. 

I'm not a rabbi, but I, as a Jewish psychologist, have been to years of Yom Kippur and Rosh Hashanah services. So, I asked, could I just, you know, informally run a Yom Kippur service? They said, sure. So I showed up on Yom Kippur carrying my grandmother's prayer book and seated there that day, we were in the kitchen, little linoleum table with glaring fluorescent lights were the Jewish patients and right next to each patient, an aid.

There was a sense of specialness of sacredness. This linoleum kitchen had been sanctified. As it could be in any faith tradition by why we were called around the table, which was to come together in deep spiritual community in connection to our higher power, who in this. meeting we called God. So there we were and as we started to say the Yom Kippur prayers I quickly noticed that it was the gentleman with bipolar who had reached a very steady healing cadence holding us all through the prayers. So he instead of being the one who was at wit's end interrupting was really if you will our ambassador and we were connected in community to at the end of the ceremony, I looked over and the woman who'd been slumped was sitting up very tall. And I said, well, shall we go around and say how we experienced Yom Kippur, what it means to us?

And she said, “ I'd always known we could ask for forgiveness on Yom Kippur, but sitting here with you, I realized we can be forgiven.” And she was bright and she was radiant. And so whatever had been the source of their pain. Suddenly, equal and opposite, the depressed woman awoke with self confidence.

The chaotic man was whole and even guiding. And I thought, you know, whatever is happening in this room, in sacred ceremony, needs to happen in the healing process. Psychotherapy has a huge spiritual hole, like a donut in the middle.

This was late nineties, and there must be another way that we can work more deeply to touch the spiritual core. So then for 20 years, my work has been about beholding through the lens of science. And I say this as a way of wedding religion and science witness to behold the awesome wonder of creation, the presence of source.

Whatever your word is in our lives and healing and renewal and some people say the universe, some people say Hashem, Allah, Jesus, some people say The Way, it doesn't matter what your word is, there's one source of life and what we now know through 25 years of science is there's one portal of human awareness with which we are all born to experience this source of life and when we connect it to the deep source of life, we are renewed. We are healed. Sure. We still need medication and psychotherapy, but we are healed in a deep way, body, mind, and soul and treatment without the spiritual core is disintegrating. We must reintegrate as we heal and renew.

Pathak: It's so beautiful and that is definitely the chapter and the point at which I was sort of reading in preparation of talking to you today. So it's just so interesting that you highlighted that chapter because I found it so powerful. And I also thought what was really interesting was your experience in the House of Medicine to try to share this experience.

With your patients that in some ways from the medicine science side, it seemed like you were shut down. You were sort of told this is not the space to introduce these types of concepts, though, we really think about the house of medicine as being a healing home, a home that we're trying to help heal people.

I had a very similar sort of experience, in my residency training. I had grown up in a spiritual tradition of yoga, meditation, deep breathing exercises, and this is over 20 years ago. So we were talking about a patient with cardiac disease, heart disease, and I asked, in addition to thinking about the medications that we would offer this person, is there a rule for yoga, this type of movement. 

And this is before we had, you know, a lot of the evidence, the type of evidence that you are, providing, which is this fMRI and evidence around changes in the brain that can happen with yoga. So it's sort of really, Lends a scientific factual basis. We're now prescribing some of these interventions, but at that time too, I was told, you know what?

that's not something that we are going to be talking about. We're going to focus on science here So I just found that your experience really mirrored and resonated with me.

Miller: Dr Pathak, how magnificent that you knew decades ago that yoga was a pathway of awakening and whole person renewal. We now have a meta analysis, a study of studies that shows that yoga indeed ameliorates anxiety and depression and a broad host of physical ailments and this may not surprise you once again that when yoga is shared in the deep traditional way.

Centuries of understanding of the deep running, understanding of the structure of reality, of who we really are on earth. When yoga is taught with its deep philosophy, it is three times more healing than when it's taught only as a series of physical movements as perhaps you might pick up in a gym. So if someone were to find their way into yoga, you know, maybe at first they do start in the gym, they might continue the path.

To engage the philosophy, to engage the whole way of being the nature of the cosmos. That is an awakening. That's how we're actually built to be as awakened beings. 

Pathak: Another image that really pops out to me from your book is the opening where you and your colleagues. Are getting ready to have your first meeting where you're looking at the data around what this awakened brain means. It's just such a powerful image.

And you're all sort of rushing to get to this room where you're going to convene and discuss the data. And there's one image that you are startled by that kind of gives you this very clear signal, this message about things that are happening in the brain, this awakened brain. You know, I think that we all potentially have a connection to a spiritual tradition, or we have friends and loved ones around us who do so we understand it may be, on a basis that is more spiritual. But can you talk to us a little bit about what you saw in the brain that was different? 

Miller: This gets right to your point, Neha, about people struggling in medicine to understand what spirituality possibly could have to do with depression or addiction or the diseases of despair. So, you know, for most of the 20th century, there were people who said, I am a rigorous scientist. I am in the field of medicine.

I only take to be true that which can be shown by science. What is this spirituality and religion stuff? What does it have to do with our work here? And then there were others who said, I am a deeply spiritual and perhaps spiritual and religious person. I don't care if science has picked this up or not.

I know this in my heart to be true. Finally, we can wed the two. What we'd seen was that people, you know, this is around 2012 or so.

Depression is biological. Depression is a medical illness, always and only. Spirituality, that has, you know, that's not medical, that's not scientific. So, we took the lens of science, and perhaps what science takes to be its most persuasive lens onto the human condition, which is an MRI study that takes effectively a picture of our brain, and we saw through the lens of the MRI that there are indeed neural correlates for spirituality.

And in fact, every single one of us, whether or not we are religious, and if we are religious, whether we're Hindu or Muslim or Catholic or Jewish, whatever our faith may be, every one of us has the same neural correlates of spiritual awareness. There is one spiritual brain and every beautiful human being on earth has the same spiritual brain.

Now, of course we can strengthen it and there's human variability like there's with music or math or anything else, but we are all spiritual beings. So sitting there in the lab that day, in the scene that you so beautifully identified, we saw for the first time the neural correlates of sustained spiritual life in people who are walking their life, made the choice to day in and day out, whether it was prayer, whether it was sacred text, whether it was right action and good works, whatever their spiritual walk might be, day in and day out for eight years, effectively had strengthened like thick branches on a tree, a cortex that was thick and strong across the regions of the awakened brain. What did this say? This said that, wow, you know, we are all born with an innate capacity for spiritual awareness. When we choose to engage, our spiritual awareness day in and day out, we actually strengthen like a muscle, our natural spiritual brain. 

The second thing we found that day, that I think was perhaps most shocking to the medical community, this article went into JAMA Psychiatry, people were really amazed by who we are as human beings, was that those regions that are thick and strong when we practice our spiritual life. When we build our spiritual brain are not thick but thin in people with recurrent major depression, which means we all have a choice to strengthen our spiritual awareness.

And when we do, we have a way out of despair. We still have hard times. No one gets off Scott free. We still have painful moments in there. Actually are times where through despair, we strengthen. Depression can be a knock at the door for an awakening and a strengthening, but when we build a spiritual response to suffering: why did my child do exactly as I asked him not to do?

Why did my spouse turn on me? Why am I facing bankruptcy? When we look at tough moments, really painful moments, and instead of saying, oh, why is me and what could I have done differently? Say, okay, what is life showing me now? What is God asking of me now? How might I love more deeply? Where is there guidance in the universe?

How might in my prayer life or meditation or yoga, I discover awaken a new way forward. That's a spiritual response to suffering. And it literally builds the pathways in our brain so that we are more resilient and more able to come through tough times with a spiritual eye. Next time we're more resilient.

Pathak: I do feel like this is a good place to ask this question in terms of defining spirituality, which you kind of have for us versus religion. So, I think that for a lot of people, there may be some tension there in participating in one formal, type of spiritual process.

Can you help us understand if these changes, these healthy changes in our brain exist, regardless of the type of spirituality that we're practicing, however, we label it?

Miller: About two-thirds of people will say I am spiritual, and I am religious. So in my path, in my heart, my connection to the universe, my direct transcendent relationship is held in the practices, the prayers, the meditations of my tradition. About one-third of people will say I am spiritual, I feel a deep connection with all life in nature in family, in music or art, that I am not religious. Whether or not we are religious, we are all spiritual beings, which means we are born. And we know this through the lens of science with an innate capacity to be in a deep transcendent relationship, to be connected to the deeper nature of life source, whatever your word may be.

And to feel that loving presence towards fellow human beings and living beings. Both are forms of relational spirituality. 

Pathak: Do you see these same benefits if you are practicing in a way that is in communion with others, because for a lot of people sometimes spirituality can be being on your own alone, away from others. So what are some of the differential -- or are there differential impacts on our brain depending on how we practice the spirituality?

Miller: Such a beautiful point because Neha, when we practice alone, there's profound spiritual engagement. And when we practice with others there's profound spiritual engagement. But I will say that science has shown that at least some practice with others can be deeply awakening. And here's a beautiful study.

If nine people are in a state of deep prayer and the 10th person walks in the door and sits down in the circle, they more quickly move into a state of deep transcendent connection. They more immediately awaken as measured by the rapidity with which their mirror neurons come up, which means we hold presence for each other.

Pathak: What are some ways that we can bottle this feeling and bottle these experiences so that we can carry these along with us through the course of the entire year. So how can we build that spiritual muscle? 

Miller: Every morning before you pick up your phone, before you turn to your computer, if possible step outside if not step to the window join with all life and there open your heart your soul to your morning practice. Now your morning practice can be 90 seconds, but your entire day will unfold differently when you welcome source, when you honor source, when you say, thank you.

I'll share my morning practice. I wake up, I go outside, and Neha, I go outside in the summer, spring, fall, and winter. And I start what for me is a morning prayer. And I say, thank you, God, for the gift of a new day, like a gift unwrapped. Right. I could have died in the night. My husband could have died in the night.

We're here. We're here. And then I thank God for every bit, for the sun, the air, the earth, the water, and all living beings of the earth, water, air, and beyond. And then I thank God for our nuclear family, for my children. I ask that they be safe, that they thrive in who God has intended them to be.

And then I asked that my husband and I stick together as the nucleus of the family and love and that I might be a vessel today to serve you God in love, that I be you as all life, that I see you, and that I act you and finally, please bless you, God. And that is the start of my day. I don't control my lot in life and my job today is not to advance Dr Miller. My job today is to live in dialogue, see how I'm being called and serve. And this is how all of us are built. We're built with an awakened brain to perceive that we are guided, that we are loved, held, that we're never alone. This is literally the circuits in the brain that run, allow us to perceive and receive the presence of source of spirit that is loving and holding, that is guiding, and never leaves us alone.

But we've got to open up and pay attention. That's a choice. 

Pathak: I cannot tell you how powerful that practice is, I mean, just listening to you and recognizing that that's a few minutes of your life, but you've started your day with an intention that is hopefully going to lead to positive thoughts, positive actions, positive behaviors for the course of your day. It's really interesting because I've been reading a lot about the microbiome and supporting our gut microbiome, and that's one of the key tips in making sure that our gut health is healthy is to wake up first thing, go outside before you eat breakfast, before you put something into your belly, and be out there in the world. 

And so, it's just a multi solving intervention when you think about what it means to get a good night's sleep for the following day, the best thing you can do is to wake up and go out and seek the sunlight when you wake up. 

So I just think that there's just so many profound solutions, and so many things that we're solving when it comes to a healthy lifestyle when you tie it to this spiritual sense. Which I think sometimes just in speaking to patients, and I'd love to hear your thoughts on it, patients, family members, others, when it's tied to such a deep connection, like your spirituality.

Do you find or does the research bear out that it helps with making positive changes, more easily if you're connecting it to your spiritual traditions or connecting it to spirituality in some way?

Miller: For all people, but particularly for women and for mothers and grandmothers, to know ourselves as sacred beings, to not know ourselves, you know, in a market economy as being bigger, littler, as fattish, skinny, as being inhibited, but to know ourselves as sacred beings, changes everything. And to know each other, to love our sisters as sacred beings changes everything.

Body, mind, and soul were one. So to your point, when we awaken, what really are we doing? You know, the 20th century notion of the brain was that the brain was somehow like a little factory churning out thoughts, like packages, or cars, or toaster ovens. The 21st century view of the brain increasingly is that the brain is more like an antenna.

It's a conduit to consciousness. a conduit to source. So when we are awakened, we are literally like a vessel receiving sacred presence. Of course, we bathe our body in healing presence and renewal. So, it's not just a belief, you know, a belief is somehow, I think this is the case. No, this is a way of being that opens the window and the sacred wind comes in and our body is literally, you know, Ayurvedic tradition knows this better than anybody.

We are healed and renewed and aligned, aligned with the deeper force in life. 

Pathak: So, you shared with us your morning practice. Do you have practices throughout the day that you do? How do you end your day?

Miller: Yes, throughout the day, it is my deep, spiritual quest to be in a sustained relationship with who I call God. And when we look through our MRI studies, we see that every one of us is built to be able to be in a sustained relationship with Source. To see that we are loved and held, the bonding network is engaged when we're awakened.

To see that we're guided, we shift from the I've got to have it dorsal to the wow, what is life showing me now, ventral, attention network. We awaken our attention and to feel and see that we are never alone. We move from being sort of walled off and what do I want? What did I say? And feeling alone to realizing, ah, we're part of this family of life.

That guy at the coffee store was so nice to me. You know what? He always is. We're actually part of a unit of reality. Loved, helped, guided, and never alone. How do we sustain that? Everyone has their own words and their own walk, but I can tell you that for me and my path, Neha, many times a day I ask to be in relationship to who I call God.

Many times a day I look to see what are opportunities to show up for other people to be loving and guiding and not leave them alone. 

Pathak: I'm a primary care doctor, so very interested in preventive medicine. Are there studies that show more resilience or protective benefits from things like anxiety, depression. So not necessarily just as a treatment, but from the prevention lens? 

Miller: Dr Pathak you hit the nail on the head, strong spirituality, I turn to my higher power for guidance. Nature is sacred to me versus, I don't really know what you're talking about. A standard deviation above as compared to below the mean in a strong personal spirituality is associated with an 80 percent decreased to relative risk of addiction in high school students.

And this is going through the window of risk for lifetime struggle. It is associated to the epidemic of our time. The auto accident has now been pushed out of first place for what kills our young people. The number one taker of lives of high school students is suicide, in a meta-analysis, a study of studies, when spiritual life is shared, shared in the Sangha, the Minyan, the fellowship, the squad, we are 82 percent less likely to take our life. We are four-fifths protected against suicide. There's nothing in the clinical or social sciences one third as protective. That is three, four times the size of anything else we have. 

Why? Why is it that when spiritual life is shared, our high school students, our college students are four-fifths less likely to take their life because this is who we really are. And it brings us into relationship in a way that's loving, and supportive and encouraging and guiding. It doesn't mean there's not hard times that we might be more forgiving. I teach at a university. I can look out over an auditorium of 300 students and 240 of them feel totally alone. But there's 300 students in the room. Why do they feel totally alone? It is a foreclosure.

It is a sealing off of this deep sense of connection. And how do we build that as moms? We build that by living it and breathing it and talking about it every single day. The most important thing we give our children is deep spiritual connection with other people. 

Pathak: My conversation with Dr Miller really emphasized for me the innate human capacity we all have for spirituality and how critical that spirituality can be in fostering our emotional and physical wellbeing.

Dr Miller's research demonstrates measurable neural correlates for spirituality and spiritual engagement and shows that consistent spiritual practices can actually strengthen our brain's capacity to cope, heal, and thrive, be resilient, and thrive regardless of the circumstances around us by framing difficult life experiences through a spiritual lens, which is often a time that many of us come to spiritual practices, we can sometimes move from despair and isolation toward deeper meaning, resilience, and connection with the people around us.

And I loved what Dr Miller had to say about not making spirituality or the practice of spirituality another thing we have to add to our list. She gave really great advice about how these spiritual threads can be woven through our everyday life from. What we do when we first wake up in the morning, our morning rituals, how we interact with nature throughout our day, being grateful for the nature that we are a part of, prayer, or even mindful reflection.

On this podcast, we often discuss the benefits of whole person care and lifestyle medicine. Our conversation today was really a powerful reminder for me that spirituality is a vital component of whole person care and ultimately embracing some form of spirituality is scientifically supported for holistic health. It shapes not just our own lives but strengthens our family and community connections. To find out more information about Dr Miller and her work, visit lisamillerphd.com or Instagram @DrLisaMiller and we'll have links in our show notes. 

Thank you so much for listening. Please take a moment to follow, rate, and review this podcast on your favorite listening platform. If you'd like to send me an email about topics you're interested in or questions for future guests, please send me a note at [email protected]. This is Dr Neha Pathak for the WebMD Health Discovered podcast.