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The term near-death experience (NDE) was coined in 1975 in the book Life After Life by Raymond Moody, MD. Since then, many researchers have studied the circumstances, contents, and aftereffects of NDEs. The following material summarizes many of their findings. A near-death experience (NDE) is a distinct subjective experience that people sometimes report after a near-death episode. In a near-death episode, a person is either clinically dead, near death, or in a situation where death is likely or expected. These circumstances include serious illness or injury, such as from a car accident, military combat, childbirth, or suicide attempt. People in profound grief, in deep meditation, or just going about their normal lives have also described experiences that seem just like NDEs, even though these people were not near death. Many near-death experiencers (NDErs) have said the term near-death is not correct; they are sure that they were in death, not just near-death. Near-death experiencers (NDErs) have reported two types of experiences. Most NDErs have reported pleasurable NDEs. These experiences involve mostly feelings of love, joy, peace, and/or bliss. A small number of NDErs have reported distressing NDEs. These experiences involve mostly feelings of terror, horror, anger, isolation, and/or guilt. Both types of NDErs usually report that the experience was hyper-real even more real than earthly life.
A sensation of floating out of one's body. Often followed by an out-of-body experience where all that goes on around the "vacated" body is both seen and heard accurately. Passing through a dark tunnel. Or black hole or encountering some kind of darkness. This is often accompanied by a feeling or sensation of movement or acceleration. "Wind" may be heard or felt. Ascending toward a light at the end of the darkness. A light of incredible brilliance, with the possibility of seeing people, animals, plants, lush outdoors, and even cities within the light. Greeted by friendly voices, people or beings who may be strangers, loved ones, or religious figures. Conversation can ensue, information or a message may be given. Seeing a panoramic review of the life just lived, from birth to death or in reverse order, sometimes becoming a reliving of the life rather than a dispassionate
viewing. The person's life can be reviewed in its entirety or in segments. This is usually accompanied by a feeling or need to assess loss or gains during the life to determine what was learned or not learned. Other beings can take part in this judgment like process or offer advice.
A reluctance to return to the earthplane, but invariably realizing either their job on earth is not finished or a mission must yet be accomplished before they can return to stay. Warped sense of time and space. Discovering time and space do not exist, losing the need to recognize measurements of life either as valid or necessary. Disappointment at being revived. Often feeling a need to shrink or somehow squeeze to fit back in to the physical body. There can be unpleasantness, even anger or tears at the realization they are now back in there bodies and no longer on "The Other Side."
Hearing the news. Reporting hearing people talking even though presumed dead. Feelings of peace and quiet. Many people describe extremely pleasant feelings and sensations during the early stages of their experiences. "Pain was gone", "All my troubles were gone". The Noise. Various auditory sensations. "Bells tingling", music, majestic music, loud ringing, buzzing noise, whirling noise, clicking, roaring, banging, etc. The Dark Tunnel. Some reports of black, utterly void, narrow passageway, dark valley, time tunnel, down a path. Out of the Body. Often finding oneself viewing his own physical body from a point outside it, being unfamiliar with their body, Floating, passing through walls, floors, etc. Meeting Others. Awareness of other spiritual beings nearby. Relatives, friends, feelings they had come to protect or guide. Guardian spirits. The Being of Light. Encounter of very bright light. Unearthly brilliance. Identification of being of light varies from individual to individual. Many biblical parallels. The Review. Extraordinarily rapid. Vivid and real incredible detail, three dimensional and in color, like slides clicking. The Border or Limit. Fence, large body of water, line, warnings that if one crosses the border the they cannot return.
Coming Back. Some do not want to come back or have difficulty. Squeezing back into the body. Telling Others. Feelings of lack of sympathy and understanding when telling others. Difficulty talking with relatives, ministers, peers. Effects on Lives: Reticent to tell others. Broadened and deepened by experience. More reflective and more concerned with ultimate philosophical issues. New Views on Death No longer afraid of death, feelings of a lot of changing to do before leaving here, mission, disavow suicide.
completely known and completely loved by this being. They sometime say they experienced a life review: All at the same time, they re-viewed, reexperienced, and experienced being on the receiving end of, all their actions throughout life. Some pleasurable NDErs say they went beyond the light, seeing cities of light and knowledge. The final phase of the pleasurable NDE is a return to the physical body. About half of pleasurable NDErs say they chose whether or not to return. When they chose to return, it was because of a love connection with one or more living people. The other half say they didnt choose to return: They either were told or made to return, or they were just suddenly back in their bodies.
illness. None of these aspects of a person has made it possible to predict who will or wont have an NDE, or whose NDE will be pleasurable or distressing. Research also has shown that no personality traits predict whether someone in a neardeath episode will have a near-death experience or which type theyll have. One exception involves a characteristic called absorptionthe ability to focus attention on something without being distracted. However, it isnt known whether higher levels of absorption contributed to the greater occurrence of NDEs or whether NDEs contribute to higher levels of absorption.
Also of interest are NDEs that involved alleged veridical perception. This refers to accurate perception of specific, unique events that the NDErs physical body could not have seen or heard, and that the NDEr could not have figured out through reasoning and logic. These cases include NDE vision in persons blind from birth. They also include NDE vision and hearing in a woman undergoing brain surgery whose eyes were taped shut and whose ears were plugged with a small speaker emitting a clicking sound. Meanwhile, her body was chilled down, her heart stopped and did not beat for nearly an hour, and the blood was drained from her brain so surgeons could repair a blood vessel. By all measures, her brain was completely inactive. Nevertheless, she correctly described instruments used by the doctors and conversations held between the doctors and nurses conducting the operation. So NDEs are subjective experiences, but they also may be objective real in terms of physical, earthly reality. Researchers around the world would like to find the funding to conduct more systematic study of veridical perception in NDEs. Most NDErs say their NDEs have changed them. Some changes happened right away, others more gradually over time. Many people who have had NDEs need time to integrate the experience. Some people need months; others need years. People who have had distressing NDEs may feel especially challenged to make sense of their distressing experiences. Research shows that the great majority of people who have had NDEs, whether pleasurable or distressing, sooner or later come to see them as beneficial. Often they think their NDEs were the most profound and helpful experiences of their lives.
8. A feeling of being returned to the body, often accompanied by a reluctance to return. 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 (Lange, Greyson & Houran, 2004). The most intense NDEs involve an awareness of things occurring in a different place or time. Among the clinical circumstances that are thought to lead to an NDE we find such factors as: cardiac arrest, shock in postpartum loss of blood or in perioperative complications, septic or anaphylactic shock, electrocution, coma, intracerebral haemorrhage or cerebral infarction, attempted suicide, near-drowning or asphyxia, apnoea, serious depression (van Lommel et al., 2001).
Near-death research
A significant amount of the research on near-death experiences is co-ordinated through the field of Near-death studies. Among the pioneers of Near-death studies we find Dr. Raymond Moody, who has chronicled and studied many of these experiences in several books (Moody, 1975;1977;1999), and 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. Among the researchers associated with the field of Near-Death Studies we find such names as Bruce Greyson, Michael Sabom, Melvin Morse, PMH Atwater, Yvonne Kason and Peter Fenwick. Most of these researchers tend to emphasize the interpretative and phenomenological dimension of the experience. Other contributors to the research on Near-death experiences come from the disciplines of medicine, psychology and psychiatry. Neuro-biological factors in the experience has been investigated by researchers within the field of medical science and psychiatry (Britton & Bootzin, 2004; Jansen, 1995; Thomas, 2004). Among the researchers and commentators who tend to emphasize 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). Among the scientific and academic journals that have published, or are regularly publishing new research on the subject of NDE's we find: Journal of Near-Death Studies, Journal of Nervous And Mental Disease, British Journal of Psychology, American Journal of Disease of Children, Resuscitation, The Lancet, Death Studies, and Journal of Advanced Nursing 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 NDEresearch 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. This often implies the view that the NDE can not be explained by physiological or psychological causes only, and that consciousness, in some instances, might function independently of brain activity (Rivas, 2003). Some NDE-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). 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 agnostic/atheist inclinations before the experience. Many former atheists, such as the The Rev. Howard Storm (Rodrigues, 2004) [2] have adopted a more spiritual view of life after their NDEs. Howard Storm's NDE might also be characterized as a distressing near-death experience. The distressing aspects of some NDE's are discussed more closely by Greyson & Bush (1992). In some instances there might be ambiguity between medical and spiritual facts. There exist reports about, what appears to be, connections between deceased persons and persons who have had an NDE. These visualizations happen over a long period after the NDE. Ken Mullens (1992;1995), who was clinically dead for more than 20 minutes, reported spiritual encounters in his life after his NDE. As he reported, deceased persons he communicated with were often unknown to him, but were connected to people he met at a later point. While many such reports are criticized and discredited by the scientific field they remain a mystery. Since they have no apparent medical or physical explanation they might be said to belong the interpretative and phenomenological dimension of the NDE, as investigated by the field of Near-death studies. The mathematician John Wren-Lewis (1985), after his NDE, found himself in a more or less permanent state of equanimity, of contact with the void and with no separate existence from the whole. In support of an after-life interpretation one might point out that neurobiological models often fail 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. Regardless of the
origin of the phenomenon, the subjective experience of NDEs is well-documented by the field of Near-Death Studies.
As a naturalistic experience
Other commentators see near death experiences as a purely naturalistic phenomenon. According to this perspective the cause of the NDE might be understood as a result of neurobiological mechanisms, related to such factors as anomalous temporal-lobe functioning, epilepsy, compression of the optic nerve (as a cause of the tunnel sensation), chemical changes in the brain related to serotonin and endorphins, and general changes in brain functioning (Mauro, 1992; Britton and Bootzin, 2004). 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 (Pravda, 2004). Among the studies that support a naturalistic interpretation we find the research of Blanke et.al (2002), published in Nature Magazine [3], who found that electrical stimulation on the brain region known as the right angular gyrus repeatedly caused outof-body experiences to the patient[4]; though the patient did not report seeing her own face, for example. Researchers have largely 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. A well-known scientific hypothesis that attempts to explain NDEs was originally suggested by Dr. Karl Jansen (1995;1997) and deals with accounts of the side-effects of the drug Ketamine. 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. 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, Jansen's 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, who represents a sceptical position. Related to the findings of Jansen we find the work Strassman (2001) who induced near death experiences (in addition to some different naturally-occurring altered states of being) in a clinical setting by injecting subjects with DMT, a powerful psychedelic tryptamine. Because DMT is a chemical that is produced endogenously in the human pineal gland it might be relevant to the study of NDE's and other mystical, religious, and transpersonal experiences. Related to the findings of Jansen we also find the theory of Shawn Thomas (2004), director of Neurotransmitter.net, who has suggested that the neurotransmitter agmatine is the key substance involved in near-death experiences [5]. It is generally accepted that some people who reported NDEs were shown to have approached the clinical boundary between life and death. However, in support of a naturalistic interpretation of NDE's one might argue that 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.
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. Researchers have pointed out that the aftermath of the experience can be 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.
Clinical implications
Near-death experiences has many clinical implications for health professionals, for the dying patient and for family and friends.
recognize that most death-related events are not dramatic visions of an afterlife, but might be simple feelings and intuitions. Patients are often troubled if they dont have a dramatic vision of another life. It might also be suitable to encourage discussion among family and friends. Often death-related visions and their significance only become evident when several family members report having the same experience at the same time. A professional, being willing to validate the experience as normal and natural, can often give the family permission to trust their instincts and beliefs. Family members often perceive comatose patients as stuck in the tunnel. Others want to know why their child or spouse did not choose to return to them. These issues must be addressed in an individual manner (Morse, 1991; Morse & Perry, 1992).
childs accidental death can allow parents to feel there is some meaning to the death. This can convert a senseless tragedy to a senseful one, which is helpful in preventing pathological grief. Family and friends can find comfort in knowledge that those last moments of life may be serene and peaceful. Knowledge that it is now scientifically possible to entertain the survival hypothesis can give hope for eventually being reunited with the dying. This can be extraordinarily comforting to many. Death-related visions can give faith and confidence to survivors to trust their own spiritual intuitions and reaffirm their religious faith (Morse, 1991; Morse & Perry, 1992).
Confused family members tend to regard this sudden switch in behavior as oddly threatening, as if their loved one had become aloof, unresponsive, even uncaring and unloving. Some mistake this "unconditional" way of expressing joy and affection (heart-centered rather than person-centered) as flirtatious disloyalty. Divorce can result. One of the reasons life seems so different afterward is because the experiencer now has a basis of comparison unknown before. Familiar codes of conduct can lose relevance or disappear altogether as new interests take priority. Such a shift in reference points can lead to a childlike naivete. With the fading of previous norms and standards, basic caution and discernment can also fade. It is not unusual to hear of near-death experiencers being cheated, lied to, or involved in unpleasant mishaps and accidents. Once they are able to begin integrating what happened to them, discernment usually returns. Most experiencers develop a sense of timelessness. They tend to "flow" with the natural shift of light and dark, and display a more heightened awareness of the present moment and the importance of being "in the now." Making future preparations can seem irrelevant to them. This behavior is often labeled "spaciness" by others, who do their best to ignore the change in perception, although seldom do they ignore the shift in speech. That's because many experiencers refer to their episode as if it were a type of "divider" separating their "former" life from the present one. There's no denying that experiencers become quite intuitive afterward. Psychic displays can be commonplace, such as: out-of-body episodes, manifestation of "beings" met in near-death state, "remembering" the future, finishing another's sentence, "hearing" plants and animals "speak." This behavior is not only worrisome to relatives and friends, it can become frightening to them. A person's religious beliefs do not alter or prevent this amplification of faculties and stimuli. Yet, experiencers willing to learn how to control and refine these abilities, consider them beneficial. Life paradoxes begin to take on a sense of purpose and meaning, as forgiveness tends to replace former needs to criticize and condemn. Hard driving achievers and materialists can transform into easy-going philosophers; but, by the same token, those more relaxed or uncommitted before can become energetic "movers and shakers," determined to make a difference in the world. Personality reversals seem to depend more on what's "needed" to round out the individual's inner growth than on any uniform outcome. Although initially bewildered, families can be so impressed by what they witness that they, too, change-making the experience a "shared event." The average near-death experiencer comes to regard him or herself as "an immortal soul currently resident within a material form so lessons can be learned while sojourning in the earthplane." They now know they are not their body; many go on to embrace the theory of reincarnation. Eventually, the present life, the present body, becomes important and special again. What was once foreign becomes familiar, what was once familiar becomes foreign. Although the world is the same, the experiencer isn't. Hence, they tend to experiment with novel ways to communicate, even using abstract and grandiose
terms to express themselves. With patience and effort on everyone's part, communication can improve and life can resume some degree of routine. But, the experiencer seems ever to respond to a "tune" no one else can hear (this can continue lifelong).
Aftereffects cannot be faked. Nor can you hide your response to the way they affect you (whether you realize what you are doing or not). You may be able to delay their onset or lessen the impact they have, but you cannot pretend away the complex and life-altering potential they bring. Irrespective of any drama brought on by near-death states, what happens afterward is where true value and real meaning are established. It is possible to have near-death-like experiences without the threat of impending physical death. Children, for instance, can have death dreams that are unusually powerful. Adults can emerge unscathed from mishap, or find themselves slipping into a different meditative state, only to discover later on "they have changed." If a genuine case, the individual will exhibit the same pattern of aftereffects as a neardeath experiencer. Adjusting to the aftereffects takes time. The first three years tend to be the most confusing, almost as if the individual isn't "fully back.