Can Medicine Integrate Spiritual and Religious Practice?

Traditional Western medicine hasn’t typically concerned itself with spiritual well-being. But that might be changing as a growing body of evidence shows spiritual and religious practice can have profound health effects, especially in regard to mental health. 

Higher levels of spirituality and religiousness are associated with lower levels of depression, suicide, and substance misuse in any number of studies. Sustained spiritual practice (going to church, praying, meditating, helping others) may also guard against posttraumatic stress disorder and boost psychological growth after a stressful situation, research shows. 

These practices can help you feel “loved and held” during times of despair, says Lisa Miller, PhD, founder of the Spirituality Mind Body Institute at Teachers College, Columbia University. 

People who find meaning and purpose through their spirituality often emerge from hard times feeling better prepared to handle the next horrible thing that might happen, she says.

And it’s not simply mental health. People who regularly attend religious services are less likely to end up in the hospital for any reason. And when they do, they’re hospitalized for less time, studies show. Even the sickest among us can benefit. Among people with cancer, no matter how severe, those with a spiritual practice report a better quality of life. 

In some cases, scientists can see changes in the brain. 

For example, certain regions of the brain linked to emotion, insight, and self-image light up when people have religious or spiritual experiences or think back on them, says Miller. 

And parts of the brain that shrink when people are chronically depressed can actually thicken when people who say spirituality is important to them engage in spiritual practices during and after recovery, she says. 

It may be these brain changes themselves buffer against certain mental health problems, Miller says, but the research is not yet clear. What is clear, says Miller, is that simple belief is not enough. It’s important to maintain a spiritual practice to reap the full benefits. (In this way it is similar to other behavioral interventions, such as cognitive behavioral therapy, for which consistent practice is key.)

One study looked at people who remained spiritual for 8 years. In that study, those who had a “spiritual awakening” through things like self-reflection, prayer, meditation, or service and maintained the practice were less likely to get depressed down the road, she says. 

Your spirituality doesn’t have to be overtly religious, says Miller. It can simply be a connection to “a higher power” or to “the transcendent.” Some people think of it simply as “something greater than yourself.” This can range from a traditional conception of God to connection with the universe, artworks, nature, or even other people, according to studies. 

“This natural spiritual awareness has a universal neural pathway,” Miller says. “So, it doesn’t matter if I’m spiritual but not religious or if I’m Christian, Catholic, Muslim, Jewish, Hindu. We all have the same spiritual brains, which is beautiful.” 

It could just mean, “I’m not a robot and I have deep emotions, and I care about humanity and the planet,” says Brandon Vaidyanathan, PhD, associate professor and chair of sociology at The Catholic University of America in Washington D.C.

Formal beliefs and practices aren’t required. You can practice gratitude and compassion, volunteer in your community, or spend time in nature. If you’re moved by music, poetry, or watching a sunset, then do more of that, he says. 

“Some of the language around spirituality can be very individualistic,” Vaidyanathan says. “But we are social creatures. We need other people. We need a place to belong.” 

That may be why religiousness seems to have a more robust effect on well-being compared to spirituality alone. At least that’s what Vaidyanathan and his colleagues found when they surveyed a group of scientists about their mental health during the COVID-19 pandemic.     

 “When you go to a temple or a mosque or a church and you’re together with people, there’s a sense of belonging, which is kind of the antidote to loneliness,” Vaidyanathan says. “And just sitting and meditating in a room by yourself isn’t going to give you that.” 

Joining a meditation group or other non-religious spiritual community might accomplish the same thing, though more research is needed to be sure, he says. 

It’s important to note that not everyone’s experience with religious or spiritual community is positive. Studies show you may have more anxiety, depression, or overall stress and distress if you feel guilty, abandoned, or punished by your God or your community.

“And if you’re in a religious community where there’s a lot of politics, a lot of tension, and a lot of infighting and backbiting,” Vaidyanathan says, “I guarantee you’ll find higher levels of stress and anxiety in those populations.” 

Some practitioners already fold individual religious or spiritual practice into cognitive behavioral therapy (CBT). Studies show this can be an effective way to manage a variety of mental health problems, particularly addiction, chronic depression, and trauma. 

But It’s not always easy to find this kind of treatment. 

“There’s definitely an unmet need, especially when it comes to things like depression and mental health,” says psychiatrist Anna Yusim, MD, a clinical assistant professor at Yale School of Medicine. Yusim is helping develop the forthcoming Center for Mental Health and Spirituality, which will be “a bridge between Yale Medical School and Yale Divinity School,” she says. 

Yusim integrates various religious and spiritual practices in her treatment protocols for patients.

If it’s part of their core beliefs, she’ll integrate prayer, sacred texts, or religious services into treatment. For those without a particular religious conviction, she uses other approaches such as meditation, yoga, and breath work, which have proven “very powerful and transformative” in her practice, Yusim says.

“Spiritual needs are a very core and integral part of one’s being,” Yusim says. “And that part has to be engaged in order for the person to feel whole and complete. It’s not the only thing that needs to be there, but it certainly is one of those things.”