Near-death experience


A near-death experience is a profound personal experience associated with death or impending death, which researchers describe as having similar characteristics. When positive, which most, but not all reported experiences are, such experiences may encompass a variety of sensations including detachment from the body, feelings of levitation, total serenity, security, warmth, joy, the experience of absolute dissolution, review of major life events, the presence of a light, and seeing dead relatives. While there are common elements, people's experiences and their interpretations of these experiences generally reflect their cultural, philosophical, or religious beliefs.
NDEs usually occur during reversible clinical death. Explanations for NDEs vary from scientific to religious. Neuroscience research hypothesizes that an NDE is a subjective phenomenon resulting from "disturbed bodily multisensory integration" that occurs during life-threatening events. Some transcendental and religious beliefs about an afterlife include descriptions similar to NDEs.

Etymology

The equivalent French term expérience de mort imminente was proposed by French psychologist and epistemologist Victor Egger as a result of discussions in the 1890s among philosophers and psychologists concerning climbers' stories of the panoramic life review during falls.
In 1892, a series of subjective observations by workers falling from scaffolds, soldiers who suffered injuries, climbers who had fallen from heights and other individuals who had come close to death such as in near drownings and accidents was reported by Albert Heim. This was also the first time the phenomenon was described as a clinical syndrome.
In 1968, Celia Green published an analysis of 400 first-hand accounts of out-of-body experiences. This represented the first attempt to provide a taxonomy of such experiences, viewed simply as anomalous perceptual experiences or hallucinations.
In 1969, Swiss-American psychiatrist and pioneer in near-death studies Elisabeth Kübler-Ross published her well-known book On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families.
The term "near-death experience" was used by John C. Lilly in 1972. The term was popularized in 1975 by the work of psychiatrist Raymond Moody, who used it as an umbrella term for out-of-body experiences, the "panoramic life review", the Light, the tunnel, or the border.

Characteristics

Elements according to Moody (1975, close to death or death experiences)

A 1975 study conducted by psychiatrist Raymond Moody on around 150 patients who all claimed to have witnessed an NDE stated that such an experience has fifteen elements. Dr. Moody focused in depth on approximately 50 cases from the group. One of the unifying aspects of all these patients' experiences was that they had suffered from critical illness, experienced life-threatening conditions or died. Eleven of the fifteen elements pertain to the experience itself and include:
  1. Finding it challenging to express the experience in one's own words.
  2. Learning one is dead from spectators or doctors.
  3. One's pain is replaced by pleasant sensations or/and feelings of peace.
  4. Hearing a disturbing noise or pleasant unearthly music.
  5. Travelling through a dark tunnel.
  6. Finding oneself outside the body.
  7. Meeting other people.
  8. Meeting with a being of light.
  9. Panoramic review of one's life.
  10. Arriving at boundary, frontier or point of no return.
  11. Returning to one's body and earthly life.
Moody then described four more elements that relate to events occurring after the experience:
  1. Sharing the experience with other people.
  2. Impact on one's life.
  3. Changing one's view of death.
  4. Corroboration of the experience.
Moody also explained how not every NDE will have each and every one of these steps, and how it could be different for each experience.

Elements according to Ring (1980)

simplified Moody's observations and subdivided the NDE on a five-stage continuum. The subdivisions were:
  1. Peace
  2. Body separation
  3. Entering darkness
  4. Seeing the light
  5. Entering another realm of existence, through the light
The final stage is the person being resuscitated.

Common elements (2022 guidelines – close to death or death)

Since patient populations studied since Moody's original publication have drifted away from the original definition of NDEs thus from pathophysiological states resulting from critical illness, death, closeness to death, it has become challenging to compare peer reviewed publications where patients have diverse medical and non-medical conditions. Recent guidelines have addressed challenge by proposing to make a clear distinction between patient groups having experienced an authentic near-death experience, as in Moody's original publication, from other experiences.
To better identify patients' populations, the guidelines stress the importance of studying patients whose experiences follow the narrative arc of Moody's original transcendent experiences:
  1. A relation with death.
  2. A sensation of surpassing the physical or material world
  3. Ineffability
  4. Beneficial life changes tied to a deeper sense of meaning and purpose.
The guidelines also recommend to focus on experiences where:
  • the severity of illness leads to loss of consciousness,
  • there are no signs of the usual coma-associated phenomena like typical dreams, delirium, or delusional thinking, regardless of whether the person was in the ICU or a different environment.
The last two points are important:
  • to appropriately identify death-related experiences,
  • to exclude coma-related critical illness/life threatening,
  • to exclude diverse non-death related human experiences

    Common elements in mislabeled NDEs (patients not facing impending death or death)

Due to a poor definition of what being "near-death" means, over the years researchers have drifted away from studying the same populations as Moody where patients suffered from critical illness, cardiac arrest or were in life critical-conditions. For example, in one series, 22% of the mislabeled NDEs have been claimed to occur during general anesthesia.
There is disagreement between the 2022 guidelines and another author about the existence of some common elements between:
  • Classical near-death experiences occurring in populations facing impending death or death
  • and mislabeled NDEs occurring in populations not facing impending death or death.

    Assertions of phenomenological diversity

The 2022 guidelines stress and that the themes of authentic death experiences have little in common with mislabeled NDEs, except perhaps for shallow similarities, like mentioning religious symbols or saying the experience felt peaceful.
The physiological context of patients near-death or experiencing death leads to a decline in mental clarity and consciousness and, in extreme cases, complete loss of detectable cerebral function. Paradoxically, however, genuine/authentic near death experiences—characterized by coherence, meaning, purpose, and lucid life review—arise during this state, not under normal conditions of preserved brain metabolism and function.
According to the 2022 guidelines, experiences termed “NDE-like” including those induced by ketamine or DMT, reliably display features unlike recalled experiences of death:
  • distorted body sensations,
  • inflated or self-centered perspectives, and
  • varied imagery such as elves, celebrities, geometric forms, aliens, or bright neon scenes.
Likewise, dreams and seizures exhibit unrelated, non-authentic NDE themes.

Claims of common elements

Another author instead claims that similar traits have been identified despite the differences among populations being studied and these include:
  • 50% awareness of being dead.
  • 56% a sense of peace, well-being, painlessness, bliss, euphoria and other positive emotions.
  • 24% an out-of-body experience. An OBE may be part of an NDE and involves a perception of one's body from an outside position, sometimes observing medical professionals performing resuscitation efforts.
  • 31% a "tunnel experience" or entering a darkness. A sense of moving up, or through, a passageway or staircase.
  • 32% being reunited with deceased loved ones or seeing religious figures.

    Interpretation of NDEs

A person's interpretation of an NDE experience often corresponds with one's cultural, philosophical, or religious beliefs. For example, in the US, where 46% of the population believes in guardian angels, the Light will often be identified as angels or deceased loved ones, while Hindus will often identify them as messengers of the god of death.
The cultural beliefs held by NDErs seem to dictate some of the phenomena experienced during the NDE, but more so affect the later interpretation thereof.

Negative NDEs or ICU delirium and delusions

In the years following Moody's descriptions of classical near-death experiences, reports of unpleasant experiences where people felt persecuted, distressed or frightened began to appear in the literature and in the media. These NDEs were categorized as negative or "hellish".
More recent research indicates that these distressing experiences generally do not share the same narrative structure or thematic elements as classical NDEs, nor do they exhibit the same long-term transformative impact, transcendent characteristics and ineffability. In essence, so-called negative NDEs appear to be fundamentally and phenomenologically distinct from classical NDEs. In fact, most of these accounts are better understood as mislabelings of ICU delirium and delusions—phenomena that are well documented in the literature, particularly in the context of toxic metabolic disturbances, withdrawal syndromes, and other conditions that can produce persecutory, frightening, or dream-like experiences in hospitalized and critically ill patients.
The original misclassification of these experiences lacked specific criteria or a scientific basis, and no formal definition or consensus has ever been established. Nevertheless, the use of these terms has contributed to the propagation of the idea of negative or "hellish" death-related experiences in the media and beyond.