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Precision Health Club

Interview – Michael Ferguson from Harvard Medical School

Rachel: So happy to have you here. Just for everyone in the audience, we have with us Dr. Ferguson, who is an instructor in neurology at Harvard Medical School and a lecturer at Harvard Divinity School. Prior to this, he was a course instructor in Human Development at Cornell. And Dr. Ferguson is preparing to launch the new laboratory for Neurospirituality in tandem with the Center for Brain Circuit Therapeutics in Boston. We are so excited to have you here, what a career! We’d love to hear more about what it is you’re working on and how you got to where you are. 

Mic: Sure. I mean, you hit some of the highlights, and the real here. I’m right now an instructor neurology at Harvard Medical School, I do work at this intersection of neuroscience, and spirituality studies that we’re coining as neurospirituality. And I’m very fortunate also to be a lecturer at Harvard Divinity School. And this semester, I’ve been teaching a course that I designed and implemented titled, Neurospirituality. How I got into this field, well, it’s because I grew up with a lot of spiritual experiences in my background. I was and I am very religious. I grew up in a home where spiritual experiences were just part of our family culture and part of our social culture, within our religious community. And so, it was actually kind of a learning process for me to realize that, okay, this isn’t necessarily common for people to be trafficking in the language of spirituality or spiritual experiences. And it’s set up a lot of scientific questions for me with regard to what’s going on at the level of the bodily systems or these types of experiences. And I went to a religious university, I went to Brigham Young University for my undergraduate education. And then, from there went on to graduate studies at the University of Utah, where I pursued Brain Imaging at the PhD level. And from there, as you mentioned, went on to do a postdoctoral fellowship at Cornell University in Cognitive Neuroscience. And I’m now doing more of a translational clinical approach to these types of questions through the lenses of Cognitive Neurology at Harvard Medical School. 

Rachel: Super interesting. So can you tell us a little bit more about kind of, what does it mean to be at the intersection of spirituality and neurology? What are the lessons that you’re teaching? What are the questions that you’re asking in your research? But yeah, dive a little bit more into what that means, what you’re learning, and how that might apply to kind of the rest of the world? 

Mic: You bet. So I really do wear two very different hats. One is a researcher, and the second is a teacher. When you’re doing scientific research, you have to really zoom in, so, so, so, so precisely on a very, very, very bite-sized question, with a very finely defined, logical set of inferences. Whereas as a teacher, I really am trying to get students animated about the bigger picture and about synthesis, not integration. And so the teaching side of things is really trying to look quite broadly at just things like the nature of knowledge. And so one of the things that we started out with a semester in the courses, looking at how much is wildly unknown in physical sciences, even at just a really, really big picture of cosmology, or of, you know, particle physics. There’s so much about hyper dimensionality of space and time, there’s so much about the basic nature, of energy and matter that we really don’t understand. And so, again, from that big, big, big picture trying to approach even our relationship with physical realities, from a stance in a posture of radical humility, I think is really important. On the research side of things, I most recently have published an article that’s looking at a psychological construct, termed Spiritual Acceptance. And spiritual acceptance is a stable trait tendency. It’s the tendency of an individual to integrate into their worldview, forces or aspects of reality that can’t be materially demonstrated or logically proven. And this trait of spiritual acceptance is part of a set of traits that constitute self-transcendence. I’m aware that I’m throwing out a little bit of jargon upfront, but, you know, bear with me to kind of get the jargon out on the table, and then we can break it down together. So, self-transcendence, from the point of view of a psychological instrument called the temperament and character inventory is constituted of these traits of self-forgetfulness. So in other words, the tendency to experience ego loss, to get absorbed into flow states. And then in addition to self-forgetfulness, there’s this trait of transpersonal identification. So this tendency that individuals may have to recognize self and other, whether that’s, you know, from kind of a yoga point of view, of the Namaste experience of you know, I salute the light in you that I also see in myself, or whether that’s naturalistic spirituality of perceiving oneself to be one with all of the ecosystem or all of the natural world. Or, from a more explicitly theological dimension of feeling oneself to have a unitive experience with God, with divinity. So that’s transpersonal identification. And then the third attribute in that set of self-transcendence features is spiritual acceptance. And so often, once individuals have had these experiences of self-forgetfulness, or kind of, you know, ego dissolution, followed by this sense of connectedness to Dynamics or to realities on themselves, then often, individuals will then create a more enriched worldview, where again, they accept as true aspects of reality that don’t necessarily fit into current material sciences, or pure logical explanations. So the work that I’ve been doing most recently, has been looking at brain circuit differences that may predispose an individual toward these traits of spiritual acceptance. You could you know, perhaps, in more common vernacular, translate these concepts into the differences of faith and doubt, or belief versus skepticism as a personality aspect, or as a, you know, an aspect of an individual’s disposition in nature. And then some of the work that I’m doing right now, is to also look at differences at the level of brain architecture that are related to mysticism, and then also to fundamentalism, or religious orthodoxy. 

Rachel: What would you say would be the most kind of surprising thing that you’ve learned, related to the brain’s wiring? Or how the brain circuit differences kind of show up when thinking about these concepts? 

Mic: Yeah, so it seems that the most surprising difference up front is that this actually works. Because I think that, particularly in Western cultures, where we do have such a predominant bias towards secularism, and toward, like a radical skepticism, from a historical point of view toward things that have a spiritual dimension to them, the fact that there is a relationship at the level of the brain that we can visualize using scientific methods, I think on its face, that’s surprising. Beyond that, though, to me, one of the things that’s been surprising is that some of these aspects of spirituality that I’ve been investigating, are related to deep brain structures. So for example, this most recent study that we published, looking at this dimension of spiritual acceptance was related to a circuit defined by the periaqueductal gray, which is a brainstem area. And the brainstem is super ancient from an evolutionary perspective. And my bias going into this was to think that some of these spiritual attributes would be very abstract and that they’d be related to the cortex that they’d be related to the more recent developments in our neurobiological evolution. So the fact that we’ve been localizing some of these spiritual traits to such deep structures in the brain has been surprising to me. 

Rachel: So, in terms of these kinds of circuits and where we’re finding the connections within the brain, are there noticeable differences from a genetic standpoint? Is it cultural, is it family upbringing? Is there any scientific research around why certain people may be more skeptical than others or why people might be more inclined to have more faith or believe more deeply? 

Mic: Yeah, that’s a great question. There are a lot of different aspects to this particular topic. So, allow me to kind of complexify the answer here. At the level of genetics, we are in fact, looking at genetic variations, there’s been some previous work that’s been done looking at it’s called the V mat two receptor. And it’s part of the serotonin system. And it’s been dubbed the God gene, so to speak, because of differences in expression of this receptor with tendencies to be spiritual or to have some kind of a religious inclination. And very provocatively, differences in expression in this V mat two receptor are lining up in the same brainstem region, which is encouraging to me that we now have multiple different ways of looking at the brain. One, using functional imaging methods. And then the other one using EDEK imaging methods, and that they’re both pointing to the same regions of the brain helps to increase the confidence that this might be a real, biological platform for spiritual aspects of behavior. I will be very quick to point out that, even though we’re getting significant statistical results localizing these attributes of spiritual behavior to these brain circuits, it accounts for a relatively small percent of the variance in behavior. In other words, by no means are we being biologically deterministic in this type of work. By no means are we saying that, Oh, well, if you have this particular gene, then you have this particular behavior. Or if you have this particular circuit function, then you’re destined or determined to have this particular type of behavior. It’s not that at all. Biological systems are so probabilistic or so stochastic, that we really have to be very careful in the way that we interpret the relationship between biology and behavior. It’s way too much of an overstatement to treat these types of relationships with brain circuits, or with genetic biology as the absolute determining factors for differences in behavior, even if they are significantly contributing to an individual’s disposition toward a particular type of behavior. 

Rachel: It sounds like genetics play a role, brain circuits play a role into how people might be predisposed to behave. But the cultural and the kind of family upbringing layer, so the environment layer, is really the more important part here. Is that correct? 

Mic: Yeah. And it’s hard to say more important, but then it definitely is a contributing factor here as well as life experience. So one of the things that I’m interested in exploring is what I’m referring to as spiritual trauma. So if an individual goes through some kind of disruptive life event that has created some, I’m trying to think of another word, rather than saying trauma again. But I think that we have a sense of what psychological and emotional trauma are. Similarly, my hypothesis is that if individuals experience something that has a spiritual aspect to their traumatic events, that that can also shape the likelihood of the individual to rely on spirituality as a coping mechanism, to value spirituality, or to be naturally drawn toward spiritual seeking across their life. 

Rachel: Have you found any impact on kind of overall health, whether it be cognition, ability to focus, or kind of longevity health span related to spirituality? Is that something you look at? Is it something you’ve seen in research? 

Mic: Yeah. So, that is definitely a direction that we’re going right now. So much of this is very new. For decades, in fact, for most of the 20th century, spirituality has been intentionally left out of the paradigm of health, of clinical concerns, of clinical sciences. And so, we’re really in a lot of ways, trying to play catch up, so to speak, in terms of integrating the spiritual dimensions of human experience and human behavior, with the progress that’s been made using scientific methods applied to clinical studies or to medical science. So certainly, there are early indications that, for example, things like substance use disorder, alcohol use disorder. Some forms of depression have more of an existential aspect to them where an individual is really struggling to find some sense of stable value or meaning, or purpose in life are interrelated with spirituality. And those might be more intuitive. One of the things that is really exciting to me about looking at the brain circuit aspects of spirituality, is that we may encounter some non-intuitive connections with health. For example, in this most recent study that we published, one of the circuits that had an inverse association with our spirituality circuit was related to Parkinson’s disease. And so a speculative hypothesis emerging from this work is that perhaps, participation in different religious stimuli like religious or spiritual music, could activate circuits or neurochemical systems in the brain in a way that could be particularly therapeutic for patients that are experiencing Parkinson’s disease. 

Rachel: Fascinating. I would love for you to send through that research in this channel or in one of the other channels so that other folks would be able to read it. I’m sure, they would also find the research quite interesting. One thing I wanted to kind of go back to is you were talking about the brainstem, and where this kind of concept of spirituality really lives within the brain and how you think about if it’s more like within the brainstem, which is a more ancient or older part of the brain. But as the brains developed, there’s been increase in radical skepticism, as you mentioned. Do you have any theories or hypothesis as to why or how that developed? And is it a function of the brain? Or is it I guess, going back to this culture verse genetics question, is it more of something to do with culture? 

Mic: Yeah, no, that’s a good question, Rachel. And I think of it in terms of the dynamic range of behaviors that just as we’ve had over courses of evolutionary development, more elaboration in these deep brain structures, we’ve also had, particularly as Homo sapiens, much more elaboration in our cortex, and particularly association areas of our cortex. So in other words, areas of like our, you know, our most recently developed brain systems that integrate information channels with each other. And so on the one hand, that can allow us to have stronger attachments, deeper commitments to unconditional beliefs, and at the same time, can allow us in the other direction to have much more powerful critical thought or analytical thought or skeptical thought. And so I think about it really as this widening range of behaviors, and of internal states that we’re able to inhabit as a species as our brains have continued to develop. 

Rachel: Thank you for that. That makes a lot of sense, and is super interesting to think about. I would love to switch gears a little bit and talk a bit more about how you yourself stay healthy. How do you make sure that your brain is healthy, your body is healthy, as you think about mental and physical health and fitness? 

Mic: Yeah, that’s a great question. So I really try every morning when I first wake up, drink a tall glass of water. I know that sounds so simple. And then I’m particularly mindful intentional days. I will even like, speak to the water where I’ll be like, “Alright, let’s become love or like, let’s agency to choose whether what water in me are going to become is something that is more or less wise than when I start the day, that is more or less loving than when I start the day”. So I have kind of a personal morning ritual with my water. I do think that sleep is also really, really, really important. And we see this all kinds of studies across all kinds of methods, behavioral methods, neural methods, and I think that probably most of the listeners can relate even anecdotally that if your sleep gets disrupted, all kinds of things start to go down. Your emotional regulation takes a hit your cognitive acuity or ability to focus takes a hit. So water, sleep. I really do also personally try the, you know, if I’m reaching for something during the day to instead of reaching for a diet coke reach for kombucha. Like I personally try to think about, okay, what are the positive things that I’m adding? And then, I find it easier that if I’m more conscious of adding positive things into my diet, that I don’t have to spend so much executive control on avoiding the negative things or the less ideal things. Also I will say that I try to walk a lot, I don’t have a car, everywhere that I go, I’m either walking or taking public transportation. You can do that, you know, when you live in an urban core where things are accessible by foot or by public transportation. But I definitely need to incorporate more physical activity. I do end up sitting in a chair a huge portion of my time and looking at a screen. I don’t love that about my current lifestyle habits. You know, you’ve all probably heard it said that sitting is the new smoking. And I do think that that’s true. And so I recently took up taekwondo as a way to try to get something that is, like skillfully embodied to try to connect with movement more than I happen. 

Rachel: I think that movement is something that a lot of people struggle with, but it definitely sounds like you’re being really intentional around creating healthy habits around making more positive choices. And the concept of how do I get more good things into my body versus how do I avoid the bad is something I’ve heard and seen work really well as we think about how to kind of not only optimize short term health, but think about longevity and health span also. And yeah, we’ve gotten a couple of, or a number of comments from our listeners as well. So I’d love to start to bring those in. Starting with, we had a comment where someone in the community said, “According to my experiences and research, the idea of God seems inherent to the human mind, where the concept of self-consciousness seems very similar to the concept of the soul. And they would love to get your opinion on that. 

Mic: Yeah, no, it’s interesting. We do tend to see the children have these ideations of God. And it’s I mean, it’s really, really, really hard to know the degree to which that is culturally determined versus something that’s innate biologically. And then with regard to the questions of soul and self, there certainly is a lot of overlap, philosophically, the way that the terms soul had been used in the way that the term self has been used. I’ll say that when I’m personally thinking about philosophical approaches to that word soul, that I do draw pretty heavily from the Aristotelian tradition. And again, go a little bit into some technical philosophical terms here. Within the Aristotelian concepts of soul, there is this notion of hylomorphism. Hylo meaning matter, it’s a Greek word for matter. Morphe, being the Greek word for form, and the soul being a form of the matter. In other words there are ways that we can engage with historical, philosophical traditions of soul without having to depart from our incarnate realities or depart from our bodies as it were. And I think that there is something that’s really important about approaching our thought with regard to the human being or the human soul with a degree of reverence. Again, whether that gets expressed in a theological system or a spiritual but not theological or spiritual, but not religious system, as a combination of cultural factors of life experience, factors of developmental context, contextual factors as well as again, it really seems that there is a biological basis feeding into these differences in the way that people put together a cohesive worldview. But all of that, you know, diversity on the table, I do think that an important through line is for us to consider really deeply how it is that we infuse a sense of sacredness in our approach to one another as human beings to our planet that we inhabit. And I do get very concerned about what happens if we lose that sense of sacredness about one another and about our environment. 

Rachel: Another question, this from Lily, how do you integrate divinity and medicine? Are they separate entities or are they thought to be in tandem? 

Mic: Yeah, so right now, it’s really from a patient-centered perspective. There’s some great work that’s being done by a clinical psychologist named David Rosemaryn who has looked at, I mean at this point, he’s looked at thousands and thousands of patients data and the responses to questions about spirituality or, you know, beliefs in divinity. And it turns out that even here in eastern Massachusetts, which you know, it’s not exactly the Bible Belt, that patients put a lot more thought into things that have a spiritual or a divine dimension to them, than they would forthcomingly share with their physician. And so in terms of right now, how it is in putting divinity and medicine, conceptually in conversation with each other. Right now, it’s largely through the patient experience and how the patient understands their own condition and their own coping. 

Rachel: Okay, that makes sense. And then I have a couple questions from IJ. First, could you elaborate on the inverse relationship between a fundamentalist verse mystic brain lesion mapping. 

Mic: You bet. So some of the work that I’m doing right now is looking at brain lesions because a brain lesion is a source of causal information. One of the basic maxims of science is that correlation does not equal causation. And so for some of these FMRI studies, where people will go into a scanner, and we’re looking at correlations in their brain, with a particular task or with a particular trait, that’s valuable information but it’s not causal information. So one of the reasons why I’m looking at ways that brain lesions or in other words that damage to focal areas of the brain influence behavior is because we can make a causal inference with that. So some of the work that I’m doing right now is to look at brain lesions that nudge a person in a more mystical direction, or that nudge a person in a more fundamentalist direction. And what we’re able to then infer from that, is a set of brain circuits that have a causal role in driving mystical behaviors, or brain circuits have a causal role in driving more fundamentalist, or orthodox related behaviors, concerns about, you know, doctrine, as opposed to these experiences of spiritual expansiveness or of unitive consciousness. And what I’m finding right now, my preliminary data, is that the brain circuits that appear to be driving mystical experiences and traits versus brain circuits that appear to be driving fundamentalist or orthodox oriented behaviors are inverted to one another. And now, it doesn’t necessarily mean that an individual person is either a mystic, or a fundamentalist. Rather, it means that in each of our brains, there are these brain circuits that are in some way, in competition with each other. So that if I am in a, you know, an internal state that might have a more mystical dimension to it, then it seems from our current data, likely that the brain circuits that are involved in a fundamentalist or orthodox orientations are going to be less active and vice versa, if I’m in an internal state where I’m really concerned about Orthodoxy or doctrine, that I may be in an internal condition where my brain circuits would be driving some kind of a mystical or unitive conscious experience might be decreased. Again, it’s not to say that a person is either mystically inclined, or they’re fundamentalistic in nature, but that it appears that there is some kind of a seesaw up and down push pull relationship in the individual brain between these circuits. 

Rachel: Another question from IJ, is hylomorphism a better way to solve the problems in the philosophy of mind caused by dualism and reductionism? 

Mic: Yeah. So coming up these questions about spirituality or these questions about philosophy of soul from that type of a hylomorphic perspective, it certainly makes it much more compatible with our material science methods. It’s not to say that Aha like this is definitely the best or final paradigm for understanding the human being. From a bridge building perspective of trying to bring different disciplines into a productive working relationship with each other, that type of a hylomorphic philosophical approach is one that definitely creates compatibilities between neuroscientific methods. And then philosophical traditions that have been integrated into a lot of different religions, particularly monotheistic religions. Especially if you go into like the Islamic scholastics, or the Jewish or Christian scholastics, they were drawing really heavily from these Aristotelian Hylomorphic perspectives. I will also say that and I’m self-conscious of the fact that we’re, you know, we’re getting a little bit technical, which is okay here, that if you’re going with a hylomorphic perspective, it doesn’t eliminate the possibility of more spooky dynamics or something like pan-psychist effects. In other words, you could still have a universe where there is intelligence that just saturates the fabric of reality, or, you know, a universe where consciousness is a first principle of existence, and at the same time, have a hylomorphic understanding of the human being. 

Rachel: When do you say that these kind of concepts and things that we’re just discussing are still the case if someone is spiritual, versus being, like what someone might categorize as religious or kind of being spiritual without believing in God? Do all of these things hold true, or does it have to be kind of the religion based spirituality? 

Mic: Yeah. So for a lot of these traits, they were designed to try to understand universal principles. So for example, with this trait of spiritual acceptance, it’s related, the likelihood of people being religious, but it’s definitely not restricted to it. So you can definitely be an individual who is not religious at all. But who has this tendency to perceive reality as having aspects or forces or dynamics that we don’t capture with our current material sciences. With the fundamentalist side of things, I think also, that we’ll likely see that the types of behaviors or the types of underlying psychological drives that incline a person toward religious fundamentalism are going to be very similar, if not even identical, to the types of underlying drives and psychological motivations that would drive a person to be a political fundamentalist. In other words, you could have people who are very rigid and dogmatic about a political ideology or a secular ideology or an atheistic ideology. And my guess, my speculation is that those types of ideological or dogmatic approaches to life be shared, whether that’s a religious dogmatism, an atheist dogmatism, a political dogmatism, a secular dogmatism, etc. 

Rachel: Okay. Yeah, I’m thinking about how all of this works together and there are a lot of terms. But I think based on the whole call, I think it’s all coming together. So thank you, everyone, for asking all the questions. I have one last one related to your thoughts on the latest research regarding ketamine. 

Mic: Yeah. So great question here. First thing that I’ll say is that ketamine is not a psychedelic in a strict sense, of psychedelics. Ketamine has definitely had some powerful impacts on treating depression. There’s work that’s going on to look at its impact on reducing risks of substance use disorders. And I think that this is a really powerful medicine that we’re at the very early stages of figuring out how to optimize. So for example, right now, you have someone who goes in for a ketamine treatment. And typically, it’ll be in a very sterile room that is not necessarily conducive to having a warm or a mystical or, you know, a spiritual type of experience. And so one of the directions that I would really like to see the work and the research around ketamine specifically and psychedelics more generally go into is how do we integrate the individual’s pre-existing systems of meaning into the experience? So, you know, if a person comes in with a particular spiritual paradigm, are there ways that we can incorporate music, or conversation or meaningful visual imagery into the physical environment so that the person’s experience when they’re under the influence of ketamine or of another psychedelic is being nudged by things that are very deeply meaningful to the individual. And I would suspect that if we do a little bit more work around scaffolding for a set and a setting that touches on a person’s deep sense of meaning, that we would see a boost in the positive effects for how some of these medicines are used. 

Rachel: Considering the research related to ketamine, is there any kind of understanding or research around if people have like specific brain injuries or have had like trauma in certain areas, whether or not it should or shouldn’t be used? Or any kind of specific populations related to brain health that it’s best for? 

Mic: Yeah, no, these are great questions. Right now, again unfortunately, we’re not at the stage of having precision-personalized approaches, we’re not at the stage of having really strong scientific level predictions, or who would benefit best from these types of medicines. And I do think, though, that we can get to the point where we’d be able to make a precise, and a personalized assessment for what type of a psychedelic intervention or a psychedelic adjacent intervention would be best match for an individual. I mean, when you’re looking at things like MDMA versus ketamine versus psilocybin, all of those are such wildly different compounds that are acting on very different underlying molecular systems and that are going to have a different psychoactive impact on the individual, that it will be really important if these types of medicines are going to become mainstream and more widely used and have a lot of rigorous science behind them. We’re going to have to eventually do very careful, controlled clinical trials to see what are the different predictive factors for impact and for positive therapeutic outcome? Whether that’s, you know, at the level of behavioral feature prediction, or whether that’s at the level of some kind of neuro prediction based on brain scans, or based on genetic biological assay that goes on. All of that, that’s kind of a long-winded way, Rachel, of saying that right now, the medical science is so early, that we don’t have strong tools to make predictions on how to precisely apply these medicines in a personalized fashion. 

Rachel: Instead, another way, there’s a lot of opportunity for improvement and innovation around really dialing in the best ways and the best treatments and interventions using these types of drugs and treatments, which is exciting to think about as we go into the future over the next decade or so to see the research really emerge and make headway and impact. 

Mic: Definitely. I mean the early results are incredible. The one that comes to mind was in May of 2021 in Nature Medicine, there was a study looking at PTSD, and looking at MDMA as a therapeutic intervention of PTSD. And I mean, just the effect sizes were really remarkable. And there were a lot of people who were severely suffering. We, you know, I mean, we don’t go into a long conversation with political overtones. I’ll sidestep that for now. But I mean, particularly when we think about veterans who are returning from combat zones with severe PTSD and who don’t have terrific treatments right now, it’s a ray of hope. I see these types of trials happening where there is so much promise for positive effects. 

Rachel: Yes, definitely. I think that’s a great place to end. Thank you so much for being on today sharing all of your knowledge and answering all of our questions. It’s been a pleasure. 

Mic: Thank you for having me, it’s nice to chat with you. 

Rachel: Yes. And thank you to everyone on the stage. We will make sure that you get access to this chat afterwards. And thank you again for joining us today.

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