A near-death experience (NDE) 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.Mauro, James. "Bright lights, big mystery", Psychology Today, July 1992.
Etymology The equivalent French term expérience de mort imminente ("experience of imminent death") 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.Egger, Victor (1896). "Le moi des mourants", Revue Philosophique, XLI : 26–38. 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.Green, C., Out-of-the-body Experiences, London: Hamish Hamilton, 1968. 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.Schlieter, Jens (2018). What is it like to be Dead? Near-death Experiences, Christianity, and the Occult. New York: Oxford University Press, pp. 205-6. 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 (OBEs), 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. 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:
Finding it challenging to express the experience in one's own words. Learning one is dead from spectators or doctors. One's pain is replaced by pleasant sensations or/and feelings of peace. Hearing a disturbing noise or pleasant unearthly music. Travelling through a dark tunnel. Finding oneself outside the body. Meeting other people. Meeting with a being of light. Panoramic review of one's life. Arriving at boundary, frontier or point of no return. Returning to one's body and earthly life.
Moody then described four more elements that relate to events occurring after the experience: Sharing the experience with other people. Impact on one's life. Changing one's view of death. Corroboration of the experience.
Moody 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)
Kenneth Ring (1980) simplified Moody's observations and subdivided the NDE on a five-stage continuum (using Moody's 15 elements as inspiration). The subdivisions were:Ring, K. (1980). Life at death: A scientific investigation of the near-death experience. New York: Coward, McCann, & Geoghegan., p. 40 Peace Body separation Entering darkness Seeing the light 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—and 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 the 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 (medical and non-medical). 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: A relation with death. A sensation of surpassing the physical or material world. Ineffability. 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 (LOC); and 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; and to exclude diverse non-death related human experiences. +2022 guidelinesSeparation1Detaching from the physical body2Unexpected mental clarity3Initial disorientation4Realizing one's own death5Feeling freed and light as air6Visual perception: viewing the scene or body from above7Panoramic vision: felt capable of seeing in every direction8Emotional distance from earthly events9Core sense of "self" persists10Releasing the physical form11Connected via an energetic "thread"12Suspended or drifting in spaceHeading to a place13Being pulled toward a certain place14Passing through or seeing a tunnelLife playback: actions and motives are important15Life playback: every thought, action, and motive is important16The inexpressible: encounter with a radiant, loving, and ideal presence17Not measuring up: evaluating my real human value18Revisiting life events: reliving each experience19Empathy through others' eyes: understanding their perspective20Brief glimpse into both past and distant past21Ripple effect: understanding the chain reactions of my actions22The value of dignity: leading a life practicing ethics and morality23Everything has a cause: the principle of cause and effect24Regret and humility: recognizing I could have done better25Learning opportunity: the urge to grow as a person26A greater calling: wishing I had understood life's true purpose"Home" again27Coming back to a familiar place called "home"28Time functions differently29An environment filled with knowledge, goodness, gentleness, and truth30Receiving guidance or help31Meeting beings or experiencing themselves as light or images varying in intensity and magnitude32Communication through thought alone33Letting go of earthly attachments34Sudden acquisition of vast knowledge35Earthly life felt unreal: this was much more authentic36Existence of hierarchies that correspond to different levels of understanding37My hierarchical level depends on my wisdom and understandingComing back38Connection to a primary source or origin39Approaching an irreversible threshold40Strong desire to remain41Obligation to return42Sensory impressions during the return43Recognition of a personal life purposeEffects after living the event44Hard to put into words45Forgetting significant amounts of information46A positive event despite mistakes47Difficulties in interpreting the experience personally48A renewed quest for life's purpose and meaning49Diminished fear of dying50Reevaluating the role of struggles in life51Lasting beneficial impact
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 or not: Classical (or authentic) 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 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 (as defined by cardiopulmonary criteria) leads to a decline in mental clarity and consciousness and, in extreme cases, complete loss of detectable cerebral function. Paradoxically, 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 (OBE). 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 (or will be unidentified), 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