Sensing the presence of gods and spirits across cultures and faiths.

Hearing the voice of God, feeling the presence of the dead, being possessed by a demonic spirit-such events are among the most remarkable human sensory experiences. They change lives and in turn shape history. Why do some people report experiencing such events while others do not? We argue that experiences of spiritual presence are facilitated by cultural models that represent the mind as "porous," or permeable to the world, and by an immersive orientation toward inner life that allows a person to become "absorbed" in experiences. In four studies with over 2,000 participants from many religious traditions in the United States, Ghana, Thailand, China, and Vanuatu, porosity and absorption played distinct roles in determining which people, in which cultural settings, were most likely to report vivid sensory experiences of what they took to be gods and spirits.

Culture and the plasticity of perception.

Culture shapes our basic sensory experience of the world. This is particularly striking in the study of religion and psychosis, where we and others have shown that cultural context determines both the structure and content of hallucination-like events. The cultural shaping of hallucinations may provide a rich case-study for linking cultural learning with emerging prediction-based models of perception.

Absorption and spiritual experience: A review of evidence and potential mechanisms.

Some people seem to have a 'talent' for spiritual experience: they readily sense the presence of supernatural beings, receive special messages from God, and report intense feelings of self-transcendence, awe and wonder. Here we review converging strands of evidence to argue that the trait of 'absorption' captures a general proclivity for having spiritual experiences. Participants scoring highly on the Tellegen Absorption Scale report vivid experiences of hearing God's voice during prayer, intense mystical experiences in response to psychedelics or placebo brain-stimulation, and strong feelings of presence and transcendence when confronted with natural beauty, virtual reality, or music. Several mechanisms may help to explain the relationship between absorption and spiritual experience. We suggest that absorption captures an experiential mindset that intensifies inner and outer sensory experience in ways that reflect both prior expectation and novel sensory engagement. It seems to enable that which must be imagined to feel more real.

Neurofeedback with fMRI: A critical systematic review.

Neurofeedback relying on functional magnetic resonance imaging (fMRI-nf) heralds new prospects for self-regulating brain and behavior. Here we provide the first comprehensive review of the fMRI-nf literature and the first systematic database of fMRI-nf findings. We synthesize information from 99 fMRI-nf experiments-the bulk of currently available data. The vast majority of fMRI-nf findings suggest that self-regulation of specific brain signatures seems viable; however, replication of concomitant behavioral outcomes remains sparse. To disentangle placebo influences and establish the specific effects of neurofeedback, we highlight the need for double-blind placebo-controlled studies alongside rigorous and standardized statistical analyses. Before fMRI-nf can join the clinical armamentarium, research must first confirm the sustainability, transferability, and feasibility of fMRI-nf in patients as well as in healthy individuals. Whereas modulating specific brain activity promises to mold cognition, emotion, thought, and action, reducing complex mental health issues to circumscribed brain regions may represent a tenuous goal. We can certainly change brain activity with fMRI-nf. However, it remains unclear whether such changes translate into meaningful behavioral improvements in the clinical domain.

Source Localization of Brain States Associated with Canonical Neuroimaging Postures.

Cognitive neuroscientists rarely consider the influence that body position exerts on brain activity; yet, postural variation holds important implications for the acquisition and interpretation of neuroimaging data. Whereas participants in most behavioral and EEG experiments sit upright, many prominent brain imaging techniques (e.g., fMRI) require participants to lie supine. Here we demonstrate that physical comportment profoundly alters baseline brain activity as measured by magnetoencephalography (MEG)-an imaging modality that permits multipostural acquisition. We collected resting-state MEG data from 12 healthy participants in three postures (lying supine, reclining at 45°, and sitting upright). Source-modeling analysis revealed a broadly distributed influence of posture on resting brain function. Sitting upright versus lying supine was associated with greater high-frequency (i.e., beta and gamma) activity in widespread parieto-occipital cortex. Moreover, sitting upright and reclining postures correlated with dampened activity in prefrontal regions across a range of bandwidths (i.e., from alpha to low gamma). The observed effects were large, with a mean Cohen's d of 0.95 ( SD = 0.23). In addition to neural activity, physiological parameters such as muscle tension and eye blinks may have contributed to these posture-dependent changes in brain signal. Regardless of the underlying mechanisms, however, the present results have important implications for the acquisition and interpretation of multimodal imaging data (e.g., studies combining fMRI or PET with EEG or MEG). More broadly, our findings indicate that generalizing results-from supine neuroimaging measurements to erect positions typical of ecological human behavior-would call for considering the influence that posture wields on brain dynamics.

Neurofeedback, Self-Regulation, and Brain Imaging: Clinical Science and Fad in the Service of Mental Disorders.

Neurofeedback draws on multiple techniques that propel both healthy and patient populations to self-regulate neural activity. Since the 1970s, numerous accounts have promoted electroencephalography-neurofeedback as a viable treatment for a host of mental disorders. Today, while the number of health care providers referring patients to neurofeedback practitioners increases steadily, substantial methodological and conceptual caveats continue to pervade empirical reports. And yet, nascent imaging technologies (e.g., real-time functional magnetic resonance imaging) and increasingly rigorous protocols are paving the road towards more effective applications and a better scientific understanding of the underlying mechanisms. Here, we outline common neurofeedback methods, illuminate the tenuous state of the evidence, and sketch out future directions to further unravel the potential merits of this contentious therapeutic prospect.

Suggestion overrides automatic audiovisual integration.

Cognitive scientists routinely distinguish between controlled and automatic mental processes. Through learning, practice, and exposure, controlled processes can become automatic; however, whether automatic processes can become deautomatized - recuperated under the purview of control - remains unclear. Here we show that a suggestion derails a deeply ingrained process involving involuntary audiovisual integration. We compared the performance of highly versus less hypnotically suggestible individuals (HSIs versus LSIs) in a classic McGurk paradigm - a perceptual illusion task demonstrating the influence of visual facial movements on auditory speech percepts. Following a posthypnotic suggestion to prioritize auditory input, HSIs but not LSIs manifested fewer illusory auditory perceptions and correctly identified more auditory percepts. Our findings demonstrate that a suggestion deautomatized a ballistic audiovisual process in HSIs. In addition to guiding our knowledge regarding theories and mechanisms of automaticity, the present findings pave the road to a more scientific understanding of top-down effects and multisensory integration.

Learning to Discern the Voices of Gods, Spirits, Tulpas, and the Dead.

There are communities in which hearing voices frequently is common and expected, and in which participants are not expected to have a need for care. This paper compares the ideas and practices of these communities. We observe that these communities utilize cultural models to identify and to explain voice-like events-and that there are some common features to these models across communities. All communities teach participants to "discern," or identify accurately, the legitimate voice of the spirit or being who speaks. We also observe that there are roughly two methods taught to participants to enable them to experience spirits (or other invisible beings): trained attention to inner experience, and repeated speech to the invisible other. We also observe that all of these communities model a learning process in which the ability to hear spirit (or invisible others) becomes more skilled with practice, and in which what they hear becomes clearer over time. Practice-including the practice of discernment-is presumed to change experience. We also note that despite these shared cultural ideas and practices, there is considerable individual variation in experience-some of which may reflect psychotic process, and some perhaps not. We suggest that voice-like events in this context may be shaped by cognitive expectation and trained practice as well as an experiential pathway. We also suggest that researchers could explore these common features both as a way to help those struggling with psychosis, and to consider the possibility that expectations and practice may affect the voice-hearing experience.

Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings.

Background: Psychedelic drug experiences are shaped by current-moment contextual factors, commonly categorized as internal (set) and external (setting). Potential influences of past environments, however, have received little attention. Aims: To investigate how previous environmental stimuli shaped the experiences of patients receiving ketamine for treatment-resistant depression (TRD), and develop the concept of "imprinting" to account for such time-lagged effects across diverse hallucinogenic drugs. Methods: Recordings of treatment sessions and phenomenological interviews from 26 participants of a clinical trial investigating serial intravenous ketamine infusions for TRD, conducted from January 2021 to August 2022, were retrospectively reviewed. A broad literature search was undertaken to identify potentially underrecognized examples of imprinting with both serotonergic and atypical psychedelics, as well as analogous cognitive processes and neural mechanisms. Results: In naturalistic single-subject experiments of a 28-year-old female and a 34-year-old male, subjective ketamine experiences were significantly altered by varying exposures to particular forms of digital media in the days preceding treatments. Higher levels of media exposure reduced the mystical/emotional qualities of subsequent psychedelic ketamine experiences, overpowering standard intention-setting practices and altering therapeutic outcomes. Qualitative data from 24 additional patients yielded eight further spontaneous reports of past environmental exposures manifesting as visual hallucinations during ketamine experiences. We identified similar examples of imprinting with diverse psychoactive drugs in past publications, including in the first-ever report of ketamine in human subjects, as well as analogous processes known to underly dreaming. Conclusions/interpretation: Past environmental exposures can significantly influence the phenomenology and therapeutic outcomes of psychedelic experiences, yet are underrecognized and understudied. To facilitate future research, we propose expanding the contextual model of psychedelic drug actions to incorporate imprinting, a novel concept that may aid clinicians, patients, and researchers to better understand psychedelic drug effects. Clinical trial registration: ClinicalTrials.gov, identifier NCT04701866.

Tri-process model of interpersonal mindfulness: theoretical framework and study protocol.

According to the Center for Disease Control and Prevention, over 14% of the US population practice mindfulness meditation. The effects of mindfulness training on physical and mental health have been consistently documented, but its effects on interpersonal relationships are not yet fully understood or investigated. Interpersonal relationships play a crucial role in the wellbeing of individuals and society, and therefore, warrants further study. The aim of this paper is to present a tri-process theoretical model of interpersonal mindfulness and a study protocol to validate the proposed model. Specifically, according to the proposed model, mindfulness meditation training increases the self-awareness, self-regulation, and prosociality of those receiving the training, which ameliorates the quality of interpersonal interactions and the socioemotional support provided to other individuals. Finally, better socioemotional support increases the support receiver's ability to regulate their emotions. Using a multiphasic longitudinal design involving 640 participants randomized into 480 dyads, the proposed protocol aims to validate the tri-process model and to investigate its mechanisms of actions. The proposed study has important theoretical and social implications and will allow devising new and more effective interpersonal mindfulness programs with applications in multiple fields.

Effects of virtual reality guided meditation in older adults: the protocol of a pilot randomized controlled trial.

Background: Virtual reality (VR) based meditation has been shown to help increase relaxation and decrease anxiety and depression in younger adults. However, this has not been studied in Randomized Controlled Trials (RCT) in the older adult population. The aim of this RCT is to assess the feasibility and acceptability of a VR-guided meditation intervention for community-dwelling older adults and its effect on stress and mental health. Methods: We will recruit 30 participants aged ≥ 60 years, whose perceived stress score (PSS) is > 14 (moderate stress), and randomize them 1:1 to the intervention or control waitlist group. The intervention will involve exposure to eight 15-min VR-guided meditation sessions distributed twice weekly for 4-weeks. Two modalities will be offered: in-home and at the hospital. Data analysis: Baseline and post-intervention assessments will evaluate perceived stress, anxiety, depression, sleep quality, quality of life, and mindfulness skills. Analyses will employ mixed methods repeated ANOVA tests. Qualitative analyses through semi-structured interviews and participant observation will be used to assess participants' experiences. Study outcomes include: (A) feasibility and acceptability compared to a waitlist control (B) stress, using the Perceived Stress Scale (PSS); (C) anxiety, and depression, using the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9); (D) insomnia, quality of life and mindfulness skills, using the Athens Insomnia Scale (AIS), Quality of Life Questionnaire (EQ-5D-5L) and Five Facets Mindfulness Questionnaire Short Forms (FFMQ-SF), respectively. We will also measure immersive tendencies, sickness and sense of presence using the Simulator Sickness Questionnaire (SSQ) and the Presence Questionnaire (PQ). Discussion: Virtual reality-guided meditation could be an acceptable, feasible, safe, and cost-effective novel alternative health intervention for improving older adults' mental health.Clinical trial registration: NCT05315609 at https://clinicaltrials.gov.

Can expectation enhance response to suggestion? De-automatization illuminates a conundrum.

Disparate theoretical viewpoints construe hypnotic suggestibility either as a stable trait, largely determined by underlying cognitive aptitude, or as a flexible skill amenable to attitudinal factors including beliefs and expectations. Circumscribed findings support both views. The present study attempted to consolidate these orthogonal perspectives through the lens of expectancy modification. We surreptitiously controlled light and sound stimuli to convince participants that they were responding strongly to hypnotic suggestions for visual and auditory hallucinations. Extending our previous findings, we indexed hypnotic suggestibility by de-automatizing an involuntary audiovisual phenomenon-the McGurk effect. Here we show that, regardless of expectancy modification, the experimental procedure led to heightened expectations concerning future hypnotic response. We found little effect of expectation, however, on actual response to suggestion. Our findings intimate that, at least in the present experimental context, expectation hardly correlates with--and is unlikely to be a primary determinant of--high hypnotic suggestibility.

Psychedelic medicine at a crossroads: Advancing an integrative approach to research and practice.

Psychedelics have been already used by human societies for more than 3000 years, mostly in religious and healing context. The renewed interest in the potential application of psychedelic compounds as novel therapeutics has led to promising preliminary evidence of clinical benefit in some psychiatric disorders. Despite these promising results, the potential for large-scale clinical application of these profoundly consciousness-altering substances, in isolation from the sociocultural contexts in which they were traditionally used, raises important concerns. These concerns stem from the recognition that the mechanisms of therapeutic action of psychedelics are not entirely dependent on neurobiology, but also on the psychological, social and spiritual processes for their efficacy. For these reasons, physicians or psychotherapists involved in psychedelic-assisted psychotherapy need training in ways to accompany patients through this experience to promote positive outcomes and address potential side effects. Psychedelic therapies may foster the emergence of a novel paradigm in psychiatry that integrates psychopharmacological, psychotherapeutic, and cultural interventions for patients with mental health issues.

Kundalini Yoga Intervention Increases Hippocampal Volume in Older Adults: A Pilot Randomized Controlled Trial.

Background: Among a rapidly aging population, there is increased need for neuroprotective interventions promoting healthy neurological aging. Mind-body interventions, such as Kundalini yoga, are actively being explored as accessible means to encourage healthy aging. However, little remains known about the neurobiological effects of Kundalini yoga. Aims: This pilot randomized-controlled trial (RCT) examined the potential neuroprotective effects of Kundalini yoga in older adults. Methods: We conducted an RCT with 11 healthy meditation-naïve older adults. Participants were randomized to a Kundalini yoga or psychoeducation intervention. Structural magnetic resonance imaging data were obtained at baseline and 12-week follow-up. The primary outcome measure was gray matter volume of the bilateral hippocampi and bilateral posterior cingulate cortex. Results: We found significant right hippocampal volume increases specific to the Kundalini yoga group (P = 0.034, ηp 2 = 0.408). Conclusions: These findings provide initial neurobiological support for the neuroprotective effects of Kundalini yoga.

From Generative Models to Generative Passages: A Computational Approach to (Neuro) Phenomenology.

This paper presents a version of neurophenomenology based on generative modelling techniques developed in computational neuroscience and biology. Our approach can be described as computational phenomenology because it applies methods originally developed in computational modelling to provide a formal model of the descriptions of lived experience in the phenomenological tradition of philosophy (e.g., the work of Edmund Husserl, Maurice Merleau-Ponty, etc.). The first section presents a brief review of the overall project to naturalize phenomenology. The second section presents and evaluates philosophical objections to that project and situates our version of computational phenomenology with respect to these projects. The third section reviews the generative modelling framework. The final section presents our approach in detail. We conclude by discussing how our approach differs from previous attempts to use generative modelling to help understand consciousness. In summary, we describe a version of computational phenomenology which uses generative modelling to construct a computational model of the inferential or interpretive processes that best explain this or that kind of lived experience.

Long-term Effects of a Brief Mindfulness Intervention Versus a Health Enhancement Program for Treating Depression and Anxiety in Patients Undergoing Hemodialysis: A Randomized Controlled Trial.

Background: Depression and anxiety affect approximately 50% of patients with kidney failure receiving hemodialysis and are associated with decreased quality of life and increased risk of hospitalization and mortality. A Brief Mindfulness Intervention (BMI) may be promising in treating depressive and anxiety symptoms in this population, but the long-term sustainability of the intervention's effects is unknown. Objective: We previously conducted a randomized controlled trial (RCT; n = 55) comparing an 8-week BMI with an active control (Health Enhancement Program [HEP]) for patients receiving dialysis, with depression and/or anxiety. Here, we examine the 6-month follow-up data to determine the long-term sustainability of BMI versus HEP in reducing (1) depressive symptoms, (2) anxiety symptoms, and (3) the efficacy of BMI versus HEP in reducing the likelihood of hospitalization. Design: In this study, we analyzed 6-month follow-up data from an 8-week assessor-blinded parallel RCT, which evaluated the efficacy of a BMI against an active control, HEP, in patients receiving hemodialysis with symptoms of depression and/or anxiety. Setting: The study took place at hemodialysis centers in 4 tertiary-care hospitals in Montreal, Canada. Participants: Participants included adults aged ≥18 years who were receiving in-center hemodialysis 3 times per week and had symptoms of depression and/or anxiety as indicated by a score ≥6 on the Patient Health Questionnaire-9 (PHQ-9) and/or the General Anxiety Disorder-7 (GAD-7). Methods: Participants were randomized to the treatment arm (BMI) or the active control arm (HEP) and completed assessments at baseline, 8 weeks, and 6-month follow-up. Depression was assessed using the PHQ-9, and anxiety was assessed by the GAD-7. Hospitalization rates were assessed using medical chart information. Results: We observed significant decrease in depression scores over 6 months in both BMI and HEP groups, with no significant difference between groups. Anxiety scores significantly decreased over 6 months, but only in the BMI group. Brief Mindfulness Intervention and Health Enhancement Program were comparable in terms of hospitalization rates. Limitations: The limitations of our study include the modest sample size and lack of a third arm such as a waitlist control. Conclusions: Our results suggest that the beneficial effects of BMI and HEP for improving mood disorder symptoms in patients receiving dialysis persist at 6-month follow-up. Both interventions showed sustained effects for depressive symptoms, but BMI may be more useful in this population given its efficacy in reducing anxiety symptoms as well. Trial registration: Prior to recruitment, the trial had been registered (ClinicalTrials.gov Identifier: NCT03406845).

Contexte: La dépression et l'anxiété touchent environ 50% des patients atteints d'insuffisance rénale sous hémodialyse et sont associées à une diminution de la qualité de vie et à un risque accru d'hospitalisation et de mortalité. Une brève intervention basée sur la pleine conscience pourrait s'avérer prometteuse pour le traitement des symptômes liés à l'anxiété et à la dépression dans cette population. On ignore toutefois la viabilité à long terme des effets d'une telle intervention. Objectifs: Nous avons précédemment mené un essai contrôlé randomisé (n = 55) comparant une brève intervention de pleine conscience (IPC) de huit semaines à un témoin actif (Programme d'amélioration de la santé [PAmS]) chez les patients sous dialyse présentant des symptômes de dépression et/ou d'anxiété. Nous examinons ici les données après six mois de suivi pour déterminer la viabilité à long terme de l'IPC par rapport au PAmS sur la réduction (1) des symptômes dépressifs, (2) des symptômes d'anxiété, et (3) l'efficacité de l'IPC par rapport au PAmS à réduire la probabilité d'hospitalisation. Type d'étude: Un essai contrôlé randomisé, d'une durée de huit semaines, mené en parallèle et en aveugle pour l'évaluateur, lequel évaluait l'efficacité d'une IPC par rapport au témoin actif (PAmS) chez les patients sous hémodialyse présentant des symptômes de dépression et/ou d'anxiété. Cadre: L'étude a eu lieu dans les centres d'hémodialyse de quatre hôpitaux de soins tertiaires de Montréal (Canada). Participants: Des adultes qui recevaient des traitements d'hémodialyse en centre 3x/semaine et qui présentaient des symptômes de dépression et/ou d'anxiété tels que définis par un score ≥6 au questionnaire sur la santé des patients (PHQ-9) et/ou sur le trouble général d'anxiété-7 (GAD-7). Méthodologie: Les participants ont été répartis aléatoirement dans le groupe de traitement (IPC) ou le groupe témoin actif (PAmS) et ont répondu aux questionnaires au début de l'étude, après huit semaines et après six mois de suivi. La dépression a été évaluée à l'aide du PHQ-9 et l'anxiété par le GAD-7. Les taux d'hospitalisation ont été évalués à l'aide des dossiers médicaux. Résultats: Nous avons observé une diminution significative des scores de dépression sur six mois dans les groupes IPC et PAmS, sans différence significative entre les groupes. Seul le groupe IPC a montré une diminution significative des scores d'anxiété sur six mois. Les taux d'hospitalisation étaient comparables dans les deux groupes. Limites: Taille modeste de l'échantillon et absence d'un troisième bras tel un groupe témoin constitué de patients sur une liste d'attente. Conclusion: Nos résultats suggèrent que les effets bénéfiques de l'IPC et du PAmS sur les symptômes des troubles de l'humeur des patients sous dialyse persistent après six mois de suivi. Les deux interventions ont montré des effets durables sur les symptômes dépressifs, mais l'IPC pourrait s'avérer plus pertinente dans cette population puisqu'elle a également montré une efficacité à réduire les symptômes d'anxiété. Enregistrement de l'essai: L'essai avait été enregistré avant le recrutement (ClinicalTrials.gov Identificateur : NCT03406845).