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A near-death experience (NDE) is a striking state of consciousness undergone
by persons who are either at the point of death, for whatever reason,
but recover.
Death-bed vision (or experience) is an older term for aspects now included
under the term NDE, in particular, the dying person feels exalted, sees
visions of dead relatives who they had not known were dead (1A,14A).
Clinical observations by Elisabeth Kubler-Ross and the 1975 book by Moody
stimulated recent research (11), but reports go back centuries (13, 26,
27, 29). Recent changes in society have also helped; improved medical
technology means that relatively more people are experiencing NDEs; discussion
about death is no longer taboo; simple religious views of the afterlife
are being questioned; and people find it easier to take charge of their
life rather than rely on the authority viewpoint (10A). NDEs arguably
provide the best current evidence, though inconclusive, for survival of
death (11A, 27A). On the other hand, theories based entirely on brain
chemistry and psychology also have strong support (2A).
Characteristics
The features below are typical of NDEs (4, 5, 11, 19, 23). However, the
perfect composite NDE is rarely reported. Analysis of individual reports
is more fruitful (1).
The person is convinced he or she has died, for example, a doctor is
heard pronouncing the death.
A loud ringing or buzzing is heard, and the person moves rapidly through
a long dark tunnel.
The physical body is seen from a distance (an out-of-body experience
or OBE).
The spirits of dead relatives and friends and a loving warm "being of
light" are seen.
Rapid panoramic play-back of one's life.
Feelings of joy, love and peace are overwhelming.
The person approaches a barrier, decides to return, suddenly finds the
self back inside the physical body, and wakes up.
Subjective impressions include distortion of space and time (slowing
of time, a sense of detachment) as well as faster thoughts. The experience
is difficult to describe. Precognitive and prophetic visions sometimes
occur.
The NDE usually produces personal growth and healing, increased spiritual
awareness or rebirth (5, 6, 11, 11A, 23, 27D).
Subsequent to their NDE, subjects often report an increased incidence
of a wide range of psychic phenomena (27B, 27D).
Paradoxically, suicide victims who report an NDE, despite their romanticisation
of death, are less likely to attempt suicide again compared to non-NDE
suicide victims (7).
A few NDEs are atypical. In a few reports, the NDE is distressing; the
person senses an existential void or an evil force, or suffers a hell-like
experience (5, 8A, 18). A drug-induced NDE pushed the man into a semi-permanent
mystical-like state of "shining darkness" (28). A Jungian therapist,
meditating upon archetypes, reported many features of the NDE without
being near death (4). A man jailed for murder, when reliving the murder
from the victim's point of view, was thrust into a "universe of bubbles"
(an NDE by proxy) (27C).
About 15% of the US population have been close to death; about 35% of
these reported an NDE (4A). Other surveys support a figure about 30%,
from both unselected (7) and selected samples (19, 23).
Children report much the same experiences as do adults, and these reports
are unlike visions of seriously ill children (10B, 11B). Children are
not subject to cultural conditioning; thus, conditioning is not a major
factor in many NDEs.
NDEs have been reported from many cultures and centuries, but detailed
comparisons are few. Zaleski (29) found that both medieval Christian and
modern NDEs involve exit from the body, a guide, a journey, obstacles,
a judgement, and re-entry to the body; the NDEs displays increased humanity
and spirituality. These features are culture-free, and thus definitive.
However, medieval Christian NDEs also contain fiery rivers, torments of
purgatory, and doom, reflecting a punitive God. Modern NDEs are coloured
by terms such as energy, magnetism and vibrations, reflecting our scientific
society. These latter features are culturally conditioned.
One or several types?
Ring considers the NDE to be a unitary experience (19,21). He has tested
an index that measures the "depth" of this unitary experience (7,19).
However, other studies question a unitary model.
Sabom (23) analyzed 71 cases, and split them into two types; autoscopic
(visualizing one's body from a height) (30% of cases); and transcendental
(apparent passage of consciousness into a "higher" realm) (54%). The other
14% had elements of both.
Noyes statistically found three components of the NDE; hyperalertness
(heightened arousal); depersonalisation (dissociation of consciousness);
and a deeper rarer mystical consciousness (7, 14).
NDEs arguably provide the best current evidence, though inconclusive,
for survival of death.
Greyson (8) analysed 89 NDE reports. The statistical procedure (cluster
analysis) split the NDE into three components.
Cognitive: time distortion, thought acceleration, life review and sudden
insight.
Emotional: feeling of joy, peace and cosmic unity.
Transcendental: encounter with mystical beings or spirits in an apparent
unearthly realm.
A fourth expected paranormal component - enhanced vision or hearing,
precognition, out-of-body experiences - did not separate into a fourth
cluster, but was spread over the other three clusters.
In this sample, sudden near-death events, as in accidents and cardiac
arrests, were more closely associated with the cognitive component than
were anticipated near-death events, as in suicide attempts and complications
of surgery. This suggests that the psychological state of subjects before
the NDE affects the content of the experience (8).
Drug-based models
Hallucinations resulting from anaesthetics differ from NDEs in being
generally more vague, and inconsistent from account to account (11). Hallucinations
from medical drugs are more variable and idiosyncratic in both content
and structure (23). Persons taking hallucinatory drugs are, in fact, less
likely to have an NDE than those on no drugs (19). Persons who have encountered
both drug hallucinations and an NDE can distinguish the two (23, 28).
Moreover, persons who have had no anaesthetics or drugs also report NDEs.
Modern NDEs are coloured by terms such as energy, magnetism and vibrations,
reflecting our scientific society.
Temporal lobe model
NDEs are not simply hallucinations produced by a seizure of the brain's
temporal lobe (TLS). Electrical stimulation of the lobes produces hallucinations,
distorted perceptions, and feelings of detachment, fear, sadness and loneliness
(16). Past experiences - sights, sounds, thoughts - are recalled in great
detail; yet the patient is still conscious of the present. The recall
stops when the electric current ceases. The imagery content depends on
the fears and hopes of the patient (22). However the NDE differs from
the TLS as follows:
The TLS distorts the visual environment, but NDEs do not - though perhaps
viewed from an unusual angle near the ceiling.
The TLS replays a single audio and visual memory in real time. The NDE
has a rapid panoramic memory review of life's highlights.
The TLS has smell and taste sensations. NDEs do not.
NDEs generate calm, joy and warmth. The TLS causes sadness, fear and
loneliness.
Forced thinking occurs during the TLS but not during NDEs.
Some (NDEs) display features of the typical mystical experience.
Anoxia model
Dying is a gradual process; the heart produces electrical activity for
20 minutes after breathing ceases. The final mechanism of death is anoxia
(lack of oxygen), which kills brain cells. An early effect is increased
sense of wellbeing and power. Then follows loss of critical judgement,
delusions and unconsciousness (22). Because of their clarity of thought,
NDEs are unlike these delusions (26). NDEs also occur in the absence of
anoxia (20). The content of NDEs differs from that of toxic psychosis.
Some NDEs when in the out-of body state, watch attempts at resuscitation,
at times providing accurate detail, not expected during the semi-conscious
state of anoxia (23).
Blackmore (2A) combines anoxia with a memory model. Anoxia first produces
excess brain activity (thus excess mental activity) by disinhibition.
The tunnel effect with a bright light at the centre is produced by noise
in the visual cortex of the brain. An OBE occurs as the unstable sensory
model of reality is replaced by a memory model constructed in a bird's
eye view (thus, out of body). The life review, perception of other worlds,
and ineffable feelings, all occur as the normal model of the self falls
apart.
More physiological views
The chemical beta-endorphin injected into patients with intractable pain
from cancer produces complete relief for up to 70 hours (15). By contrast,
pain returns at once at the end of an NDE (23).
Siegel (24, 25) believes several factors combined cause NDEs. Bright
lights, colours and tunnel imagery are caused by firing of neurones in
the eye. The imagery content is controlled by personal beliefs. The voices
are similar to patients recovering from anaesthesia after an operation.
The beings are similar to the imaginary companions of sailors and children.
This model is reductionist; similarity need not imply cause and effect,
and the model does not explain why all effects occur at one time near
death (4).
Birth memory model
Sagan and Grof have suggested that the NDE is an archetypal birth experience
(6, 10, 23A). Perhaps arousal induced by threat of death invokes suppressed
memories of previous events of intense arousal, such as being born. This
early experience could explain the journey down a tunnel (birth canal), and the bright
light and a locale populated by beings (the hospital delivery room).
However, the nervous system of newborn babies is considered incapable of seeing and
storing the birth process in sufficient detail. This prejudice is driven
by the opinions of many neurologists and paediatricians, but birth
trauma studies suggest otherwise. Nevertheless, the birth process does
not contain all the same kinds of details as the NDE (2). Women having
difficult or Caesarean births do not have horrifying NDEs (4). Neither
paranormal nor positive transformative effects are explained (6).
Depersonalisation model
Depersonalisation is a defence against the threat of death. When faced
with death, a person becomes afraid, and the mind replaces the real world
with pleasing fantasies (13). Altered attention and time perception, lack
of emotion, feelings of unreality, detachment, loss of control and ineffability
are found in both NDEs and depersonalisation (13). However, the NDEr
had more heightened perception, speedier mental activity, and revival
of memories. Depersonalisation cannot handle paranormal elements and the
positive personality transformation (6,20). Noyes (12) argued that the
NDEs foresees imminent death; but this is not met by some of Sabom's cases
(27). Noyes dealt with persons psychologically near death, whereas NDEs
are physically near death - two different populations.
Mystical experience model
Pennachio (17) searched through NDE anecdotes and showed that some, at
least, display features of the typical mystical experience. The statistical
study of Noyes (7, 14) separated out "mystical consciousness" as one of
the three components of the NDE. The statistical study of Greyson (8)
also split the population of NDE reports into three groups. The cognitive
group contained "cosmic unity" as a part. On occasions, an NDE-like event
is known to trigger a lasting mystical experience (28).
Ring puts forward a "paranormal holographic model", similar to the mystical
experience model (19, 20), interpreted as a higher level of consciousness.
The feelings of peace, lack of pain, out-of-body experiences suggest disembodied
consciousness (19). The tunnel indicated a move towards a higher level
of consciousness. The light represented the energy level of this new state,
associated with a "being of light" (one -self or total self).
The "being of light", sometimes encountered and identified as Christ,
may radiate strong feelings of love, warmth and light. However, a strong
religious belief is not necessary, though religious beliefs do influence
the interpretation (19). The Christian sees Christ, and the Buddhist
sees Buddha.
Summary
The NDE is multi-faceted. The "deeper" experiences are similar to sudden-onset
mystical experiences. Overlaid on this experience, at a more superficial level, are
psychological aspects of the experience, such as depersonalisation and
the mind set or cultural conditioning of the subject.
References
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