Awe as a Pathway to Mental and Physical Health

This article is a narrative synthesis and theoretical review rather than an empirical report of new data. Monroy and colleagues draw on a broad set of literatures—experimental inductions of awe, daily-diary and naturalistic studies, computational analyses of emotional responses to audiovisual stimuli, cross-cultural work, neurophysiology, and clinical research on psychedelics—to characterise awe and its downstream effects. The extracted text does not report a formal systematic search strategy, inclusion/exclusion criteria, dates of search, or meta-analytic pooling methods; thus it appears to be a conceptual and integrative review rather than a systematic review with pre-specified methods. The authors integrate findings at multiple levels of analysis. Evidence types cited include behavioural experiments (e.g., resource-allocation tasks, helping measures), observational and diary studies linking naturally occurring awe to daily outcomes, neurophysiological measures (vagal tone, inflammatory biomarkers, brain-network activation), qualitative and ethnographic accounts from festivals and rituals, and clinical studies of psychedelics that report subjective mystical or awe-like experiences and clinical outcomes. Where available, the review refers to meta-analyses in particular domains (for example, on spirituality and health, and on music interventions), but the extraction does not present a quantitative synthesis protocol. Monroy and colleagues organise the evidence to test a multi-pathway model in which awe-producing elicitors lead to specific mediators that are known to associate with mental and physical health outcomes.

The review presents several empirical characterisations of awe and summaries of findings across domains. First, awe is advanced as a distinct positive emotion elicited by stimuli experienced as vast and requiring accommodation of existing mental models. Cross-cultural and computational work indicates that awe is separable from related emotions such as fear, joy, and beauty. In naturalistic and laboratory samples roughly 75% of reported awe episodes are predominantly positive while about 25% are imbued with threat; cultural variation affects this balance, with some cultures (for example, Japan) showing more threat-based awe. Awe has recognisable expressive features—raised inner eyebrows, widened eyes, an open mouth—and distinct vocalisations. Physiologically, studies report a profile associated with health: increased vagal tone, reduced sympathetic activation, characteristic ‘‘goose-tingles’’ (rather than shuddering linked with fear), elevated oxytocin in response to morally uplifting awe, and lower levels of the inflammatory biomarker interleukin-6 in relation to self-reported awe. Neuroimaging work associates awe with reduced activation of the default-mode network (DMN), a brain network involved in self-referential processing. From these empirical findings the authors identify five mediator pathways. Evidence for the first pathway—neurophysiological shifts—links awe-related vagal tone, reduced sympathetic arousal, oxytocin changes, and lower inflammation with improved mental and physical health indices (optimism, reduced anxiety and depression, cardiovascular and immune benefits). Second, multiple methods (lab, diary, in vivo) show that awe diminishes self-focus or produces a ‘‘small self’’; for example, visitors at Yosemite drew themselves smaller after an awe experience, and diary studies find lower self-centredness on days with awe. Third, experimental and dispositional studies report increased prosociality following awe inductions: participants allocate resources more equitably after an awe video, volunteers exposed to awe are more willing to give time, and field studies (e.g., looking up at towering eucalyptus) found greater helpfulness and reduced entitlement. Fourth, awe is tied to social integration: laboratory and naturalistic studies report increased feelings of common humanity and connectedness to social and natural worlds, and qualitative work from festivals and pilgrimages reports strengthened communal belonging. Fifth, awe provokes meaning-making: because vast stimuli demand accommodation, awe can prompt searches for and experiences of meaning, which in turn associate with lower distress and better mental and physical well-being. The authors report effect sizes for awe’s effects on these five pathways in the range of 0.20 to 0.48. The review then applies this framework to five domains. In nature, studies link contact with natural environments to reduced stress, lower inflammation, improved parasympathetic activity, and immune benefits, with specific work showing awe mediates reductions in rumination and PTSD symptoms among adolescents and combat veterans during outdoor activities. Spiritual and religious engagement is associated with lower depression and reduced all-cause mortality; the authors note that awe is a core component of mystical experience and likely contributes via social integration, meaning, and reduced stress. Collective movement—music, dance, and ceremony—elicits awe and is associated with physiological and psychological benefits: music therapy improves heart and respiratory outcomes in premature infants, and meta-analyses show music reduces stress and pain in adults; synchronous dance increases interconnectedness and pain tolerance (a proxy for endogenous opioid release), and dance-movement therapy reduces anxiety and depressive symptoms. Finally, for psychedelics the review summarises that 50% to 70% of participants report one of the most significant spiritual experiences of their lives—often awe—and that psychedelics produce DMN deactivation and reduced amygdala reactivity, increases in connectedness and altruism, and clinical reductions in depression, anxiety, and addictive behaviours. Across domains, the authors emphasise that threat-based awe may diverge from these benefits and could be harmful.

Monroy and colleagues interpret the assembled evidence to support their central claim that awe is a distinct positive emotion that operates through five interlocking processes to promote mental and physical health, provided threat appraisals are not dominant. They propose a parsimonious model in which brief awe experiences shift neurophysiology, reduce self-focus, foster prosociality, strengthen social integration, and prompt meaning-making, all of which are established predictors of better mental and physical outcomes. The authors position this model as a way to unify disparate findings linking nature, spirituality, music, collective ritual, and psychedelics to health benefits. The review is careful to highlight several key caveats and directions. One major qualification is the distinction between positive awe and threat-based awe; the latter shows different neural signatures, weaker prosocial effects, and minimal to negative effects on well-being in some studies. Cultural moderators, individual differences (for example, neuroticism), and contextual factors (such as hierarchical salience) may amplify threat appraisals and therefore alter outcomes. The authors also acknowledge that much of the evidence is preliminary and descriptive: while relationships between awe and each mediator have been empirically identified, the complete causal pathways from specific awe elicitors through mediators to health outcomes remain only partially tested. For future research the review calls for more process-focused and hypothesis-driven studies to unpack the mechanisms depicted in their model. Suggested priorities include experimental tests that isolate physiological mediators (inflammation, vagal tone, DMN activity), rigorous differentiation of positive versus threat-based awe, cross-cultural work to examine moderation, and longitudinal or intervention designs to assess sustained health effects. The authors view these empirical steps as necessary to move from a promising conceptual framework to rigorous evidence about how sublime experiences can ‘‘repair’’ the mind and body.