The convergent neuroscience of Christian prayer and attachment relationships in the context of mental health: a systematic review

Egbert Haverkamp^1,2*Erik Olsman¹Branislava Curcic-Blake²Hanneke Schaap-Jonker³Andre Aleman⁴Johannes C.F. Ket³Victor Vila Ramirez²

• ¹Protestant Theological University, Utrecht, Netherlands
• ²University Medical Center Groningen, Groningen, Netherlands, Netherlands
• ³VU Amsterdam, Amsterdam, Netherlands, Netherlands
• ⁴Maastricht University, Maastricht, Netherlands

In recent years it has become increasingly accepted within psychotherapy to incorporate various forms of spirituality and religiosity to address the rising prevalence of mental health issues. This is well-founded, for a growing number of findings report benefits of spiritual practices over the course of depression, anxiety and stress. However, science-based guidelines on how to embed spiritual practices in therapeutic interventions have not been developed, as the mechanisms by which human cognition, spirituality and mental health positively or negatively interact remain largely unknown. Considering one of the most widely practiced religious behaviors worldwide, prayer, it was posited that the experience of interacting with God is psychologically comparable to human attachment bonds that are strongly associated with mental health. The aim of this systematic review is to provide an overview of the neural correlates implicated in Christian prayer and attachment relationships, and to discuss their hypothesized convergence. A systematic search was conducted in eight databases, resulting in 44 included records that assessed the neural correlates of prayer or the activated attachment system in adults. Preliminary evidence was found for convergence between prayer and areas affiliated with the mentalizing module of attachment, comprising the Default Mode Network (DMN) and areas sustaining Theory of Mind (ToM), both related to social cognition. No strong differences between prayer and attachment were observed in regions designated as the approach and emotion (self-) regulation modules of attachment, whereas findings diverged for the aversion module of attachment, particularly in the insula. Together, these findings highlight shared cognitive and affective dimensions to attachment and prayer. Nonetheless, future research is warranted to identify whether neural patterns observed for different attachment styles coincide with distinct neural patterns of (Christian) prayer, so that both positive and negative effects of prayer can be better understood and integrated into psychotherapy.