Rx: 1 Dose Awe; As Needed

Dr. Krista Roybal
5 min readApr 27, 2021

For some, it’s catching the perfect wave…watching NASA land a rover on Mars…an evening at the ballet or holding a newborn baby.

It was a poem the other day for me. When I read The Cure For It All during my morning meditation last week, it struck such a chord of truth. Gratitude for the human experience washed over me and I felt connected to something bigger than myself. I felt the same way I imagine looking up at those magnificent redwood trees or gazing at a sky full of stars on a pitch black night. What an awe-inspiring feeling!

This feeling, until very recently, was the realm of theologians and philosophers only. But for the past several decades psychologists have been increasingly attracted to the study of this phenomenon…this “mysterious and complex stimulus provocation” which most of us know simply as “awe.”

The science of awe fascinates me. Not only because I’ve spent much of my life and career in proximity to awe-inducing situations (as a dancer, a doula, a physician…), but also because it has the potential to transform the way we connect — to ourselves, to one another, to the universe — and I believe that connection is the antidote to so much of what ails us.

In beginning to study awe, pioneering researchers first faced the unenviable task of defining it. How does one formally define that goosebump prickling, jaw dropping, thought-halting sensation that we’ve all experienced, but feels, by its very nature, indefinable?

Psychologists Dacher Keltner and Jonathan Haidt, in an oft-cited 2003 paper, suggest awe is defined by its two key hallmarks: Perceived Vastness (literal or metaphorical) and Need for Accomodation. In her white paper on The Science of Awe, Summer Wilson, Ph.D summarizes the latter hallmark as follows:

“An experience evokes a ‘need for accommodation’ when it violates our normal understanding of the world. When a stimulus exceeds our expectations in some way, it can provoke an attempt to change the mental structures that we use to understand the world. This need for cognitive realignment is an essential part of the awe experience as conceptualized by Keltner and Haidt.”

It is also, for me, an essential part of understanding the implications of awe. I feel like we can all sort of wrap our heads around the outcomes of perceived vastness. We can identify and put into words how it feels to look up at a giant redwood or stand at the base of a mountain, for example — small, certainly. Humbled, quite possibly. But it is the “need for accommodation” and the largely imperceptible psychological changes we experience, even momentarily, in service of said accommodation, that could elevate awe from “neat way to feel good” to a legitimate wellness tool.

Now putting aside for a moment that you know the topic of this newsletter, imagine coming across studies for a new methodology with the potential to:

I don’t think it’s a stretch to say that those of us working in mental health and addiction would be excited about those outcomes, which are, of course, outcomes of the awe experience. Moreover, there’s excitement to be found in the accessibility and scalability of something like awe. One of the most common ways individuals report experiencing awe is through nature. And even for those unable to get out into nature, a recent study was able to replicate awe’s mood boosting benefits for participants engaging with videos and narratives of natural wonders.

As I mentioned, the science of awe is still in its relative infancy, and there are many more questions to be answered in terms of efficacy of various awe elicitors, nature vs. nurture in predisposition to awe, and capacity to “teach” awe. I will be eagerly following along with future developments. But it couldn’t hurt, in the meantime, to encourage our patients and one another to invite more awe into life.

We are lucky, as caregivers and healers, to work in a field where awe-inspiring stories of resilience, transformation, and triumph are commonplace. For as much as I am moved by a beautiful piece of poetry, or the vastness of the ocean, I am equally moved by what happens within the walls of True Life Center.

Just last month at one of our True Life Ceremonies (a chance for patients “graduating” from our Intensive Outpatient Program to reflect and celebrate with their practitioners and loved ones), a dear patient invited her whole family to bear witness to her healing journey. It was like a vision of intergenerational trauma healing in front of my eyes. She described her health trajectory — from rigid OCD patterns, control-focused eating and projective anger, to deep self-compassion, forgiveness of her abusive mother, and love toward herself and her two adult daughters (both in recovery). Her daughters beamed with pride as their mother vulnerably shared her story of transforming pain to acceptance, resistance to surrender, and rigidity to lightness.

To me, the “identified patient” has the opportunity to be the leader in the family, braving the path to wellness and inviting others to connect more deeply and be seen in their truth. And in both these large, full-circle triumphs, and the small, in-session breakthroughs, it is an honor to bear witness to this type of healing.

Humankind’s ability to change, reflect, adapt, forgive and love is truly awesome.

The Cure For It All
by Julia Fehrenbacher

Go gently today, don’t hurry

or think about the next thing. Walk

with the quiet trees, can you believe

how brave they are — how kind? Model your life

after theirs. Blow kisses

at yourself in the mirror

especially when

you think you’ve messed up. Forgive

yourself for not meeting your unreasonable

expectations. You are human, not

God — don’t be so arrogant.

Praise fresh air

clean water, good dogs. Spin

something from joy. Open

a window, even if

it’s cold outside. Sit. Close

your eyes. Breathe. Allow

the river

of it all to pulse

through eyelashes

fingertips, bare toes. Breathe in

breathe out. Breathe until

you feel

your bigness, until the sun

rises in your veins. Breathe

until you stop needing

anything

to be different.

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Dr. Krista Roybal

Leading psychiatrist in integrative mental health care and addiction medicine. Medical Director and Founder of True Life Center in San Diego, Calif.