Near-death experience

A near-death experience (NDE) is the perception reported by a person who nearly died or who was clinically dead and revived. They are somewhat common, especially since the development of cardiac resuscitation techniques, and are reported in approximately one-fifth of persons who revive from clinical death. The experience often includes an out-of-body experience.

The phenomenology of an NDE usually includes physiological, psychological and transcendental factors (Parnia, Waller, Yeates & Fenwick, 2001) such as subjective impressions of being outside the physical body (an out-of-body experience), visions of deceased relatives and religious figures, transcendence of ego and spatiotemporal boundaries and other transcendental experiences (Lukoff, Lu & Turner, 1998; Greyson, 2003). Typically the experience follows a distinct progression, starting with the sensation of floating above one's body and seeing the surrounding area, followed by the sensation of passing through a tunnel, meeting deceased relatives, and concluding with encountering a being of light (Morse, Conner & Tyler, 1985).

A 'core' near-death experience reflects — as intensity increases according to the Rasch scale — peace, joy and harmony, followed by insight and mystical or religious experiences. The most intense NDEs involve an awareness of things occurring in a different place or time (Lange, Greyson & Houran, 2004).

Near-Death Research

Dr. Raymond Moody is recognized as the father of NDE research. He has chronicled and studied many of these experiences in several books (Moody, 1975;1977;1999). Another early pioneer is Dr. Kenneth Ring, co-founder and past President of the International Association for Near-Death Studies (IANDS).

Major contributions to the field include the construction of a Weighted Core Experience Index (Ring, 1980) in order to measure the depth of the Near-Death experience, and the construction of the Near-Death Experience Scale (Greyson, 1983) in order to differentiate between subjects that are more or less likely to have experienced a genuine NDE. These approaches include criteria for deciding what is to be considered a classical or authentic NDE. Well-known researchers in the field who support a moderate view, or sympathize with aspects of the after-life view are Kevin Williams, Bruce Greyson, Michael Sabom, Melvin Morse, PMH Atwater, Yvonne Kason, Sam Parnia, Peter Fenwick, Jody A. Long and Jeffrey P. Long. Much of this research is co-ordinated through the field of Near-Death Studies.

Among the researchers who support a naturalistic and neurological base for the experience we find the British psychologist Susan Blackmore (1993), and founding publisher of Skeptic magazine, Michael Shermer (1998). The possibility of altered temporal lobe functioning in the near-death experience is suggested by Britton & Bootzin (2004). In this study Near-Death experiencers were also found to have altered sleep patterns compared to subjects in the control group. Dr. Rick Strassman has attempted to induce NDE in a clinical setting by injecting subjects with DMT. This research is described in his book DMT - The Spirit Molecule (2001).

According to Martens (1994), the only satisfying method to address the NDE-issue would be an international multicentric data collection within the framework for standardized reporting of cardiac arrest events. The use of cardiac arrest-criteria as a basis for NDE-research has been a common approach among the European branch of the research field (Parnia, Waller, Yeates & Fenwick, 2001; van Lommel, van Wees, Meyers & Elfferich, 2001).

As an afterlife experience

Many commentators see near death experiences as an afterlife experience, and some accounts include elements that, according to some theorists, are most simply explained by an out-of-body consciousness. For example, in one account, a woman accurately described a surgical instrument she had not seen previously, as well as a conversation that occurred while she was understood to be clinically dead (Sabom, 1998). In another account, from a proactive Dutch NDE study [1], a nurse removed the dentures of an unconscious heart attack victim, and was asked by him after his recovery to return them (van Lommel et.al, 2001).

However, researchers have been unsuccessful in running proactive experiments to establish out-of-body consciousness. There have been numerous experiments in which a random message was placed in a hospital in a manner that it would be invisible to patients or staff yet visible to a floating being, but so far, according to Blackmore (1991), these experiments have only provided equivocal results and no clear signs of ESP.

Regardless of the origin of the phenomenon, the subjective experience of NDEs is well-documented by the field of Near-Death Studies, and follows certain patterns:

It is generally accepted that some people who reported NDEs were shown to have approached the clinical boundary between life and death. However, it is not shown that the experiences themselves took place in any time other than just before the clinical death, or in the process of being revived. In altered states of consciousness such as this and during dream states or under the influence of drugs, the subjective perception of time is often dilated.
Those who report NDEs typically respond by a major change of life perspective and direction, generally away from self-orientation toward outward orientation, or what they call "a more loving life". Greyson (2003) notes that Near-death experiences are associated with enhanced purpose in life, appreciation of life and with reduced fear of death, but also with adverse effects, such as posttraumatic stress symptoms. Many former atheists have adopted a more spiritual view of life after NDEs, for example Howard Storm (Rodrigues, 2004) [2] and George Rodonaia. Howard Storms NDE might be characterized as a distressing near-death experience. The distressing aspects of some NDE's are discussed more closely by Greyson & Bush (1992).
Many people who experience an NDE tend to see it as a verification of the existence of an afterlife (Kelly, 2001). Core NDE experiencers, in particular, tend to be convinced of the reality of the experience as an intimation of the afterlife. This includes those with skeptical/atheist inclinations before the experience. Few experiencers tend to view the NDE as a brain hallucination. The tendency to explain the experience in terms of a materialistic model is usually offered by non-experiencers [3].

As a naturalistic experience

Other commentators see near death experiences as a purely naturalistic phenomenon. For example; a Swiss study (Blanke. et.al, 2002), published in Nature Magazine [4], found that electrical stimulation on the brain region known as the right angular gyrus repeatedly caused out-of-body experiences to the patient[5]. According to this perspective the etiology of the NDE is understood as a result of neurobiological mechanisms, related to such factors as epilepsy and brain stimulation. The similarities amongst the experiences of the many documented cases of NDE may be understood to signify that the pathology of the brain during the dying and reviving process is more or less the same in all humans, as suggested by Russian specialist Dr. Vladimir Negovsky (Unkn. publ. year) in Clinical Death As Seen by Reanimator. However, this model fails to explain NDEs that result from close brushes to death where the brain does not actually suffer trauma, such as a near-miss automobile accident.

A well-known scientific hypothesis that attempts to explain NDEs was originally suggested by accounts of the side-effects of the drug Ketamine by Dr. Karl Jansen (1995;1997). Ketamine was used as an anesthetic on U.S. soldiers during the Vietnam War; but its use was abandoned and never spread to civilian use because the soldiers complained about sensations of floating above their body and seeing bright lights. Further experiments by numerous researchers verified that intravenous injections of ketamine could reproduce all of the commonly cited features of an NDE; including a sense that the experience is "real" and that one is actually dead, separation from the body, visions of loved ones, and transcendent mystical experiences.

Ketamine acts in part by blocking the NMDA receptor for the neurotransmitter glutamate. Glutamate is released in abundance when brain cells die, and if it weren't blocked, the glutamate overload would cause other brain cells to die as well. In the presence of excess glutamate, the brain releases its own NMDA receptor blocker to defend itself; and it is these blockers Dr. Jansen (amongst others) hypothesize as the cause of many NDEs. Shawn Thomas, director of Neurotransmitter.net, has suggested that agmatine is the key substance involved in near-death experiences [6].

Critics of Jansen's hypothesis point out that although some aspects of the experience may be similar, not all NDEs exactly fit the ketamine experience; and that while it might be possible to chemically simulate the experience, this does not refute the possibility that spontaneous NDEs have a spiritual component. As Dr. Jansen himself notes:

Claims that NDE's must have a single explanation (e.g. Ring, 1980), or that a scientific theory must explain all of the experiences ever given the name of NDE (e.g. Gabbard and Twemlow, 1989) are difficult to justify (Jansen, 1995).

Indeed Dr. Jansen's own shifting perspective on the conclusions to be drawn from the ketamine-NDE analogy has been notable. He started out as an unequivocal debunker of the notion that NDE's are evidence of a spiritual (or at least transnormal) realm. But with time he has developed a more agnostic hypothesis: that ketamine may in fact be one particularly powerful trigger of authentic spiritual experiences - of which near-death may be another. In each case, according to Jansen's more recent pronouncements, all we can say is that the subject gets catapulted out of ordinary 'egoic' consciousness into an altered state - we cannot comfortably rule out the possibility that the 'worlds' disclosed in these 'trips' have ontological status. Latterly, therefore, Jansens position appears closer to thinkers like Daniel Pinchbeck (2002), who has written a book on hallucinogenic shamanism, and other names like Carl Jung, Ken Wilber and Stanislav Grof, than to thinkers like Susan Blackmore or Nicholas Humphrey (two particularly high-profile materialist skeptics).

Ultimately, the hallucination theory is one which is very convincing to materialists, and very unconvincing to the vast majority of NDE experiencers[7].

Spiritual and psychological after-effects

Accounts by NDE subjects sometimes include long-term after-effects such as a heightened sense of intuition; seeing apparently disconnected events being connected, as in the phenomenon of synchronicity; and internal feelings of bodily energy and/or altered states of consciousness similar to those associated with the yogic concept of kundalini (Greyson, 2000).

Greyson (1983) developed The Near-Death Experience Scale in order to measure the after-effects of a near-death experience. This research note that the aftermath of the experience is associated with both positive and healthy outcomes related to personality and appreciation for life, but also a spectrum of clinical problems in situations where the person has had difficulties with the experience (Orne, 1995). These difficulties are usually connected to the interpretation of the experience and the integration of it into everyday life. The near-death experience as a focus of clinical attention, and the inclusion of a new diagnostic category in the DSM-IV called "Religious or spiritual problem" (American Psychiatric Association, 1994 - Code V62.89), is discussed more closely by Greyson (1997) and Lukoff, Lu & Turner (1998).

Simpson (2001) notes that the number of people that have experienced an NDE might be higher than the number of cases that are actually reported. It is not unusual for near-death experiencers to feel profound insecurity related to how they are going to explain something that the surrounding culture perceives as a strange, paranormal incident.

References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Washington, D.C.: American Psychiatric Association (Code V62.89, Religious or Spiritual Problem).
Blackmore, Susan (1991) Near-Death Experiences: In or out of the body? Skeptical Inquirer, 16, pp. 34-45
Blackmore, Susan (1993) Dying to live: Science and Near-Death Experiences. London: Harper Collins.
Blanke, Olaf et.al (2002) Stimulating illusory own-body perceptions. The part of the brain that can induce out-of-body experiences has been located. Nature, Vol. 419, 19 September, 2002
Britton WB, Bootzin RR. (2004) Near-death experiences and the temporal lobe. Psychol Sci. Apr;15(4):254-8. PubMed abstract PMID 15043643
Greyson, B. (1983) The Near-Death Experience Scale: Construction, reliability, and validity. Journal of Nervous and Mental Disease, 171, 369-375.
Greyson B. (1997) The near-death experience as a focus of clinical attention. Journal of Nervous and Mental Disease. May;185(5):327-34. PubMed abstract PMID 9171810
Greyson, B. (2000) Some neuropsychological correlates of the physio-kundalini syndrome. Journal of Transpersonal Psychology, 32, 123-134.
Greyson, Bruce (2003) Near-Death Experiences in a Psychiatric Outpatient Clinic Population. Psychiatric Services, December, Vol. 54 No. 12. The American Psychiatric Association
Greyson Bruce, Bush Nancy E. (1992) Distressing near-death experiences. Psychiatry, Feb;55(1):95-110.
Jansen, Karl L. R. (1995) Using ketamine to induce the near-death experience: mechanism of action and therapeutic potential. Yearbook for Ethnomedicine and the Study of Consciousness (Jahrbuch furr Ethnomedizin und Bewubtseinsforschung) Issue 4 pp55-81.
Jansen, Karl L. R. (1997) The Ketamine Model of the Near Death Experience: A central role for the NMDA Receptor. Journal of Near-Death Studies Vol. 16, No.1
Kelly EW. (2001) Near-death experiences with reports of meeting deceased people. Death Stud. Apr-May;25(3):229-49
Lange R, Greyson B, Houran J. (2004) A Rasch scaling validation of a 'core' near-death experience. British Journal of Psychology, Volume: 95 Part: 2 Page: 161-177
Lukoff, David, Lu, Francis G. & Turner, Robert P. (1998) From Spiritual Emergency to Spiritual Problem - The Transpersonal Roots of the New DSM-IV Category. Journal of Humanistic Psychology, 38(2), 21-50
Martens PR. (1994) Near-death-experiences in out-of-hospital cardiac arrest survivors. Meaningful phenomena or just fantasy of death? Resuscitation. Mar;27(2):171-5. PubMed abstract PMID 8029538
Morse M., Conner D. and Tyler D. (1985) Near-Death Experiences in a pediatric population. A preliminary report, American Journal of Disease of Children, n. 139 PubMed abstract PMID 4003364
Moody, R. (1975) Life After Life: The Investigation of a Phenomenon - Survival of Bodily Death. New York: Bantam
Moody, R. (1977) Reflections on Life After Life: More Important Discoveries In The Ongoing Investigation Of Survival Of Life After Bodily Death. New York: Bantam
Moody, R. (1999) The Last Laugh: A New Philosophy of Near-Death Experiences, Apparitions, and the Paranormal. Hampton Roads Publishing Company
Negovsky, Vladimir. (unknown. publ. year) Clinical Death As Seen by Reanimator. (Publishing details unknown)
Orne RM. (1995) The meaning of survival: the early aftermath of a near-death experience. Research in Nursing & Health. 1995 Jun;18(3):239-47. PubMed abstract PMID 7754094
Parnia S, Waller DG, Yeates R, Fenwick P (2001) A qualitative and quantitative study of the incidence, features and aetiology of near death experiences in cardiac arrest survivors. Resuscitation. Feb;48(2):149-56. PubMed abstract PMID 11426476
Pinchbeck, Daniel (2002) Breaking Open the Head: A Psychedelic Journey into the Heart of Contemporary Shamanism. Broadway Books, trade paperback, 322 pages
Ring K. (1980) Life at death. A scientific investigation of the near- death experience. New York: Coward McCann and Geoghenan
Rodrigues, Linda Andrade (2004) Ex-atheist describes near-death experience. Standard Times, Page C4, January 31, 2004
Shermer, Michael (1998) Why People Believe Weird Things: Pseudoscience, Superstition, and Other Confusions of Our Time. New York: W.H. Freeman & Company
Sabom, Michael (1998) Light & Death: One Doctor's Fascinating Account of Near-Death Experiences. Grand Rapids, Michigan: Zondervan Publishing House
Simpson SM. (2001) Near death experience: a concept analysis as applied to nursing. Journal of Advanced Nursing.Nov;36(4):520-6. PubMed abstract PMID 11703546
Strassman R. (2001)DMT - The Spirit Molecule. Rochester, VT: Park Street Press
van Lommel P, van Wees R, Meyers V, Elfferich I. (2001) Near-Death Experience in Survivors of Cardiac Arrest: A prospective Study in the Netherlands. Lancet, Dec 15;358(9298):2039-45.

Personal experiences

Embraced by the Light by Betty Eadie (1992). One of the most detailed near-death experiences on record.

Saved by the Light by Dannion Brinkley. Brinkley's experience documents one of the most complete near death experiences, in terms of core experience and additional phenomena from the NDE scale.

Fiction

In Passage, a 2001 novel by Connie Willis, the principal storyline centers around a researcher who has developed a technique for inducing an experience very much like a natural NDE. By studying the effects and comparing them with real NDEs, she hopes to find a biological basis for NDEs.

The novel Fearless (1993) by Rafael Yglesias is about an architect that survives a planecrash. His Near-Death experience starts a period of fearlessness and existential concerns which puts him in conflict with both his family and the surrounding culture. The book was later adapted to the screen by director Peter Weir, starring Jeff Bridges as the main character, Max Klein. See Fearless.

Flatliners (1990) is about a group of medical students who wanted to study the Near-Death experience. One of them each time would voluntarily die clinically and then his or her fellow students would use their practical knowledge to revive them, but their experiment begins to go awry.

External links

Academic

On-line sites and articles