Medical Definitions of the Near-Death Experience (NDE)
In the English language, one of the popular of medical dictionaries used by doctors, nurses, and other medical professionals is Taber’s Cyclopedic Medical Dictionary. It defines a near-death experience as “The perception held by certain people that they have glimpsed an afterlife when coming close to death.”
The American Psychological Association (APA) offers a more detailed definition of an NDE. According to the APA Dictionary of Psychology, a near-death experience is:
“…an image, perception, event, interaction, or feeling (or a combination of any of these) reported by some people after a life-threatening episode. Typical features include a sense of separation from the body, often accompanied by the ability to look down on the situation; a peaceful and pleasant state of mind; and an entering into light, sometimes following an interaction with a spiritual being. Frightening NDEs have been reported as well. There is continuing controversy regarding the existence, cause, and nature of NDEs. Spiritual, biomedical, and contextual lines of explanation are still in play, and there is no solid evidence to support the proposition that NDEs prove survival after death.”
The University of Virginia, an eminent university in the United States, operates a Division of Perceptual Studies (DOPS) that for several decades has applied scientific rigor to investigating near-death experiences and related subjects. DOPS uses this definition:
“Near-death experiences (NDEs) are intensely vivid and often life-transforming experiences, many of which occur under extreme physiological conditions such as trauma, ceasing of brain activity, deep general anesthesia or cardiac arrest in which no awareness or sensory experiences should be possible according to the prevailing views in neuroscience.”
One of the most extensive definitions of an NDE is offered by the International Association for Near-Death Studies (IANDS). Based in the United States, IANDS was established in 1978 to study near-death experiences and provide information about NDEs. According to IANDS:
“An NDE is a distinct subjective experience that a minority of people 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. …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. Nevertheless, because they were not permanently, irreversibly dead, the term ‘near-death’ can be understood to mean ‘actually in the first moments of death though not permanently dead.’
“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. NDEs range from relatively simple, with few and/or less emotionally intense features, to relatively complex, with many and/or more emotionally intense features.”
Occurring in the mind, a near-death experience is one of the most profound events a person can have. Each NDE is also unique and does not always conform to how our popular culture portrays near-death experiences. The variety of experiences is vast. Furthermore, a person need not be clinically dead to have an NDE; merely the expectation that death is imminent may trigger an NDE. The possible occasions include during cardiac arrest, severe illness or injury, surgical complications, or during periods of clinical death. People who have had an NDE frequently describe the experience as entering an alternate reality that feels extraordinarily vivid, “more real than real,” many of them say. In some cases, they see vibrant colors that do not exist on Earth, or they may hear wondrous music more beautiful than they ever heard on Earth.
Almost as remarkable as an NDE itself is what happens after the experience. The overwhelming majority of people who have had an NDE lose their fear of death entirely. Many say they witnessed an afterlife, and their belief that it exists is unshakable regardless of rational arguments to the contrary. Many report feeling a greater sense of purpose and self-understanding, a stronger desire for learning and personal growth, and a deeper, more profound spirituality that does not necessarily mean that they adhere more to organized religion. Typically, their family and friends notice that they feel and express more compassion, more empathy, more concern for others—along with showing much less interest in material success or social status.
The statistics available on near-death experiences suggest that anyone can have an NDE. It can occur regardless of a person’s nationality, race, ethnicity, gender, education, social or economic class, age, or religion. A child can have an NDE. An atheist can have an NDE. Many have.
Most people, however, will not experience an NDE. Extreme conditions, usually life-threatening, are necessary for an NDE to occur—and even then, it may not occur. Only a minority of people have experienced an NDE, and within that minority an even smaller minority has experienced multiple NDEs, usually because those people have suffered multiple situations involving fatal accidents, deadly illnesses, or severe violence. There are estimates that between five and 20 percent of the human population has experienced an NDE, but those estimates involve numerous uncertainties and may exaggerate the extent. There is also a wide range between five percent and 20 percent.
Nevertheless, because the human population totals billions of people, those who have experienced an NDE probably totals many millions. There was a time when the mere idea of a near-death experience was treated by most people as absurd and perhaps a sign of mental illness. Scientists and physicians were especially dismissive. Sometimes even religious people who experienced an NDE were afraid to mention it, especially if the content of their NDE did not match the religious beliefs they were taught. Today, however, near-death experiences have became so prevalent and publicized that they are now topics of serious scientific study, as demonstrated by the medical definitions of NDEs. In major medical journals, there are at least hundreds of scientific articles published about the NDE phenomenon.
Every near-death experience is unique because every NDE is deeply personal, tailored to the person’s spiritual needs at that time. This does not mean that the NDE fits whatever the person might expect from a sudden visit to the afterlife. Typically, the NDE and its message are very surprising to the person. Books about near-death experiences could fill entire libraries, but this book will mention only a few aspects that many NDEs have in common. A typical near-death experience can be divided into stages, although not every NDE includes every stage. Since every NDE is tailored to the person who experiences it, not every NDE needs to include every stage. The following are some of those stages:
The Out-of-Body Experience (OBE)
If this occurs, it usually occurs at the beginning of an NDE. In an OBE, the consciousness of the person seems to leave the person’s physical body but the consciousness remains aware. It even becomes more aware. Typically, the consciousness of the person sees the person’s body from above, as if the detached consciousness were floating. Some experiencers say that they needed a little time to realize that the body they saw below is their own. They recall feeling indifferent towards that body, instead of feeling any fear of being outside of it. In some cases they watched medical personnel urgently working on their body. If the body was feeling any pain (such as after a severe accident), the person’s detached consciousness suddenly felt no pain at all.
Despite being detached, the consciousness of the person could still see, hear, think, and feel emotions. Some experiencers have said, “When I was out of my body, I was still me.” Furthermore, they report that their senses improved dramatically, such as seeing things with microscopic clarity, even at great distances. There are accounts of people who were born blind but, during an OBE, they could suddenly see—and later reported what their consciousness saw, such as medical personnel working on their body, and likewise the specific medical procedures and medical equipment being used, even surgeries. Having been born blind, those experiencers never saw any of those things in their lives before having an OBE.
One human activity that experiencers are not capable of during doing an OBE is talking, or at least not being heard. Many report that during the experience they tried to tell the people surrounding their body that the experiencer is perfectly fine, not in any pain, is observing the scene below, and even enjoying watching so many people urgently attending to the broken body. But during the OBE, no humans could hear the experiencer.
So, sometimes, the OBE experiencer will choose to float around, unseen but observing and hearing everyone else. For example, if the body is taken to a hospital, the experiencer may visit other rooms in the hospital and observe what occurs there.
The phenomenon of veridical perception is different from an out-of-body experience. During an OBE, a person may see and hear information which the person’s body should not know because of where the body is located and its medical condition. Sometimes, after the body is resuscitated (and the consciousness of the person is back in the body), the information that the person reports is either not accurate or not specific enough to be verified. However, if the information is accurate and is verified, which is a seemingly impossible feat, that is called a veridical perception. And veridical perceptions do occur. Some skeptics argue that verification is only anecdotal or perhaps exaggerated, but veridical perceptions are corroborated and often highly detailed. In a now famous incident, an unconscious patient had an OBE and later, when awake, the patient reported details of a conversation conducted by a physician in an entirely different room of the hospital. That physician, Dr. Bruce Greyson, was so surprised and so intrigued that he later devoted himself to investigating the NDE phenomenon and eventually became a co-founder of the International Association for Near-Death Studies, or IANDS.
In another reported case of veridical perception, a woman being prepared for brain surgery was fully anesthetized. Additionally, her eyes were taped shut, and her ears were plugged with small speakers emitting noise. Nevertheless, after the operation, she correctly described the medical instruments used by the physicians on her body and also described conversations between hospital personnel during the operation.
A Void, a Tunnel, and a Brilliant Light
Not all NDEs include these three aspects, but many NDEs do. Someone having an NDE might suddenly be floating in an endless black void, an experience that the person may interpret as either profoundly peaceful or terribly distressing (each person is different), but there might not be any tunnel or light. More typically, the experiencer may enter a void that looks like outer space but soon becomes a tunnel, perhaps swirling with different colors. The experiencer shoots through the tunnel at amazing speed and soon sees a brilliant light ahead. As the experiencer gets closer, the light becomes so bright that looking at it would hurt human eyes; nevertheless, the experiencer does look at it, feels no pain while doing so, and soon discovers that the brilliant light is actually alive, intelligent, and radiating pure unconditional love. In many NDEs involving such a light, the experiencer soon merges with the light. Then another stage begins.
The Life Review
This occurs in less than 30 percent of the NDEs documented by researchers, but the life review is a remarkable aspect of the NDE phenomenon. Before the review occurs, the experiencer may enter a realm that looks like a super-enhanced version of Earth. A common description is of a gorgeous natural landscape with grass, trees, clear water, maybe some animals, and sometimes one or more buildings, usually magnificent in their grandeur. The realm feels vividly real and includes feelings of profound peace, joy, and unconditional love. Most experiencers say that within that realm they felt that they had come home—and ever since their NDE, many continue to describe that realm as “Home.” Many say that they were greeted by deceased loved ones, including family members, friends, or beloved pets. Some say they met angels or famous religious leaders. (Jesus is mentioned often, though other sacred leaders from other religions are also mentioned.) Some experiencers say that they met God, the Creator.
Additionally, many experiencers say that, in that realm, time itself either does not exist or it passes very differently than on Earth. And instead of spoken language, communication in that realm is usually described as occurring mind-to-mind, like telepathy.
Eventually, usually quite soon, the life review occurs. In a life review, the person sees or re-lives moments from the person’s lifetime. Experiencers usually report that they felt not only their own emotions but also the emotional impact of their actions upon others. (When the individual brought joy to other people, the individual feels all of that joy they felt. When the individual brought harm to other people, the individual feels all of that harm they felt.) The life review therefore reveals profound insights about the consequences of one’s choices and behaviors.
How the life review is conducted can be as unique as the lifetime itself. For some experiencers, the life review may proceed from birth to death; for other experiencers, from death to birth. The review might be a complete re-living of events, or it might focus on only specific moments. The review might be panoramic, surrounding the person as key moments from the life are re-lived. Or the person’s life might be presented from a third perspective, like watching a movie of your own life. (A very emotional, very vivid movie.) The life review might even be instantaneous, similar to the old popular saying of “Seeing your life flash before your eyes.”
Some accounts have described a high-technology room with many video screens showing different life experiences. Another account described an old-fashioned movie projector, showing a film. Yet another account described balls of energy in which each ball contained a memory that the individual would touch to re-live the memory.
One account described an auditorium full of loved ones and supporters who watched the person’s life review, cheering whenever the person performed a kindness. Another account said the life review was performed by a religious council composed of representatives from that person’s religion, similar to a legal trial. Some religious scriptures do describe such an event in the afterlife, although according to the particular experiencer, the representatives on the council were not cruel or abusive. Some accounts say the only ones present during the life review were the person and a Divine Being. The Divine Being did not judge the person while watching the review. Instead, the Divine Being radiated unconditional love and comfort, even if the person felt deeply ashamed of the lifetime.
Many experiencers emphasize that their life review was not about Divine punishment or condemnation. Instead, they considered it an opportunity to review one’s choices, feel the consequences, and recognize patterns of love, kindness, or harm.
A decision is made to stay or to return
During the NDE, many experiencers encounter some sort of boundary which, if the person were to cross it, the person’s lifetime on Earth would definitely end and a return to the person’s body would become impossible. Therefore, when that boundary is encountered, a decision must be made: Will the experiencer return to that present body and lifetime, or not?
In many cases, that decision is not made by the experiencer. Instead, the experiencer is told that the person’s lifetime includes a mission that must be completed and, therefore, the experiencer must return, although the specific mission is not always revealed. When told this, the experiencer typically becomes extremely disappointed and often insists on staying, preferring the incredibly joyous afterlife. Such refusals never seem to succeed, however, although the experiencer might then be told something reassuring that makes the return more acceptable. Soon thereafter the NDE ends, and the person is back in their body.
When an experiencer is allowed to choose whether to stay or to return, the choice to return is usually due to one of two situations. The first situation is that someone known to the experiencer, typically a child or a spouse, genuinely needs the experiencer—or else the loved one’s own life will be ruined and will never recover. The experiencer chooses to return to help that person. (Not every experiencer is allowed this choice.)
The second situation involves a lifetime that has been miserable and may have included physical or emotional abuse. You may wonder why anyone would willingly choose to return to such a life. The most common reason is that the soul was trying to grow spiritually and accelerating that growth by experiencing severe suffering. Some courageous souls are willing to do that. (If you have lived such a lifetime, you have a courageous soul.) Furthermore, that lifetime may achieve lessons that cannot be learned if that lifetime is ended prematurely, such as by suicide. The choice, therefore, is either to complete the lifetime begun by the soul (a lifetime which may actually improve after the NDE), or to end that lifetime but then face the prospect of living a future lifetime containing the same challenges and the same suffering because the soul still wants or needs those very difficult lessons. When those two options are presented and compared, the option of quitting the present lifetime becomes much less attractive.
Some scientific explanations of the NDE phenomonen, although not enough
A number of scientific theories emphasizing materialist interpretations have attempted to explain the NDE phenomenon. Critics of these theories call them insufficient, anecdotal, or even debunked. When all of the evidence is considered, the NDE phenomenon is remarkably difficult to explain using theories limited to materialist interpretations.
The most common of these theories is that NDEs are hallucinations. The theory is that when the brain is under extreme duress, as when the body is dying, the brain struggles to interpret reality and avoid severe pain, so it invents a hallucination. However, NDEs do not neatly match the standard definitions of hallucinations, including of illusions induced by psychedelic drugs or other chemicals. NDEs are often remembered with exceptional clarity, often as vividly as the day they occurred, even decades later. Although a hallucination may feel real during the event, it is usually remembered as disorienting, fragmentary, or confusing, and the memory may fade or blur over time. Furthermore, hallucinations rarely cause a moral transformation of a person’s behavior that lasts throughout the person’s lifetime. NDEs almost always do.
If an NDE includes an out-of-body experience, it may include one or more veridical perceptions. Veridical perceptions are confirmed facts which the experiencer should not know because otherwise they do not qualify as veridical perceptions. Typical hallucinations do not include veridical perceptions.
Another materialist theory is that NDEs are caused by a lack of oxygen to the brain, a condition called oxygen deprivation or hypoxia. A similar phenomenon is called G-force-induced loss of consciousness, also known as G-LOC, pronounced JEE-lock. G-LOC sometimes occurs in military pilots who fly high-performance jet aircraft. The letter G stands for gravity. A G-force of one (called 1G) is equal to normal gravity. A G-force of two (or 2Gs) is equal to twice the force of normal gravity, causing your body to feel literally twice as heavy. The extraordinary speeds of some military aircraft can produce a G-force of nine or greater. Imagine if your body suddenly felt nine times heavier and the G-force was also affecting your body’s blood circulation, preventing oxygen from reaching your brain. That can cause a G-LOC episode. During it, the pilot may experience tunnel vision, see bright lights, lose consciousness, imagine scenes of beautiful places, feel sensations of euphoria or floating or disassociation, and perhaps even experience a short OBE. And if, later, the pilot remembers the G-LOC episode, the pilot might consider it remarkable.
The pilot’s brain was starving for oxygen and the pilot’s body felt like it was being crushed by multiple G-forces. Perhaps the brain felt like it was dying. However, there are also significant differences between G-LOC episodes and near-death experiences. For example, oxygen deprivation may not be the cause of an NDE. Some NDEs have occurred in hospitals when the patient’s oxygen levels were being actively monitored—and those oxygen levels remained adequate. In other words, there was no oxygen deprivation during the NDE. G-LOC episodes can cause convulsive, jerking behavior in the pilot’s arms and legs, temporary paralysis, and afterwards the pilot may feel disoriented. G-LOC episodes do not last long, and its visions are very brief. G-LOC episodes do not include a life review and they do not include meeting decreased relatives, although the second idea was once a popular rumor.
Pilots tend to remember a G-LOC episode as if it were a dream, if they remember it at all. An NDE typically transforms a person’s moral behavior for the rest of the person’s life. A G-LOC episode typically does not. This difference between them is especially noteworthy because among military pilots of high-performance aircraft, at least 10 percent of them do experience a G-LOC episode at least once during their careers, usually early in their training. If G-LOC episodes were truly equivalent to near-death experiences, then a substantial minority of military pilots ought to be behaving like NDE experiencers. Also noteworthy is that G-LOC episodes can be created deliberately, but authentic NDEs are much more difficult to create. Researchers prefer to simulate NDEs through deep hypnosis, meditation, and training in lucid dreaming. Even then, the exact conditions for an NDE can be very difficult to replicate.
Another theory about NDEs involves hormonal surges. This theory suggests that when chemicals such as endorphins, serotonin, or dopamine are suddenly produced by the body, as during extreme stress, then a vivid hallucination may result. Critics of this theory do admit that hormones might be involved in NDEs as a contributing factor, but they insist that there is not enough compelling evidence to support this theory. It does not account for veridical perceptions, for example, and no conclusive evidence that such chemicals can produce the highly structured experiences that characterize NDEs.
A phenomenon called dissociation occurs when a person becomes mentally disconnected from the person’s usual sense of self, emotions, memories, or surroundings. A mild and harmless form of dissociation is daydreaming. Dissociation can also occur during religious or spiritual practices, such as during prayer or meditation. Dissociation allows the brain to cope with stress. Dissociation can also result from using alcohol or narcotics, and it can occur during times of extreme trauma or duress. At its most extreme, dissociation can cause serious mental health problems, known as dissociative disorders.
There is a theory that an NDE is a type of dissociation, perhaps mixed with a hallucination. Again, however, this theory does not adequately explain all NDEs. NDEs are described as being more vivid and emotionally profound than the person has ever experienced before, and are typically recalled with remarkable clarity even decades later. Dissociation, by contrast, is often associated with foggy memory, emotional numbness, or feeling disoriented. Dissociative episodes do not usually cause lasting personal transformations, such as shifts in the person’s moral values or a reduced fear of death. NDEs typically do.
In tests of NDE experiencers, there is one psychological condition that a majority of experiencers do exhibit, a condition called absorption. Absorption is a person’s tendency to become deeply immersed (“absorbed”) in mental imagery or specific experiences. Examples of absorption include feeling physical sensations while listening to an especially emotional song, or having a vivid daydream, or not noticing the passage of time while reading a book. Absorption does not mean that NDE experiencers are inventing the NDE or dreaming it. Instead, absorption may affect how a person enters into, experiences, and remembers extraordinary states of consciousness. People who are more prone to absorption might be more likely to enter altered states, process them vividly, and recall them in rich detail. Absorption as a condition does not explain the NDE itself, however.
Absorption should not be confused with self-absorption, which is a clinical term describing someone who is excessively preoccupied with the person’s own thoughts, feelings, or interests. Self-absorption is sometimes combined with narcissism or selfishness. Self-absorption is not directly connected to near-death experiences. In fact, many experiencers return from their NDEs showing less self-absorption than they showed before the event.
Hell is what you imagine
An honest description of the NDE phenomenon must include experiences that cause great distress. It is called a distressing NDE, or dNDE, and the cause of the distress varies widely. Perhaps one in five NDEs is distressing, though the true number may be higher because people hesitate to report them. Some involve realms that resemble Hell, but those are rare. There is no evidence that dNDEs are Divine punishment. Saints have reported hellish NDEs, and criminals have experienced blissful NDEs. Being religious does not protect you from having a dNDE, and being an atheist does not make you more likely to have one.
There are three types of a dNDE: inverted, void, and hellish. An inverted type is very similar to a pleasant NDE, often including tunnels and a brilliant light, but the experiencer feels distress. For example, an NDE may include flying through outer space at incredible speeds—which some experiencers enjoy, but others panic. A key factor seems to be how the experiencer relates to the ego. If the ego is treated as the person’s entire identity, the experiencer may fear losing control and resist the experience, which increases distress. However, when the experiencer surrenders to the experience, relaxes and allows it to happen, then typically the experience converts into a pleasant NDE. Most dNDEs on record follow this pattern.
In a void type of dNDE, the person enters a realm of absolute darkness. Some experiencers describe the void as peaceful and calming, but others feel terrified, afraid of being alone in infinite blackness, perhaps forever. Some report a message that all existence is an illusion. So, despite being aware and having past memories, the person may fear that nothing exists except the possibility of being trapped in the void. Although this type of dNDE is a genuine spiritual experience, its cause might be somewhat medical: not receiving enough medical anesthesia during a surgical procedure or during childbirth. Void dNDEs typically do not convert into pleasant experiences. Some experiencers feel dread, including fear of death. Others treat the void as a hallucination. Still others treat the entire experience as a warning: if existence is an illusion, then your ego is nothing permanent.
The hellish type of dNDE accounts for less than one percent of all reported dNDEs. That percentage is so small that even if the actual number is several times higher, this type of dNDE is quite rare. It may include terrifying imagery such as demonic entities, harsh landscapes, fire, unbearable heat or cold, waiting sounds, physical torment. In Christian and Muslim traditions, Hell is imagined as a realm of eternal punishment. If such a place exists, no soul would ever get out. Yet, experiencers of hellish dNDEs do return into their bodies and are revived, typically in a hospital. This suggests either they imagined a realm that was not Hell or eternity has a different meaning. Hindu and Buddhist traditions have an idea similar to Hell called Naraka, but it is a temporary realm where a person’s sins or “bad karma” are removed. A realm with a similar purpose—cleansing the soul—is described in some versions of Judaism and Daoism, similar to the idea of Purgatory in Roman Catholic Christianity. If such a realm exists and some dNDEs reflects it, then the idea of being eternal might be due to a perception that, in the afterlife, time itself does not exist. Many experiencers of pleasant NDEs report this same perception. In other words, Hell feels eternal but may not be. Hellish dNDEs suggest the way out is to ask for Divine help. When experiencers do this, they are often rescued or the experience ends and they are revived.
Afterward, some people adopt a more religious or spiritual lifestyle, though not always. Because hellish dNDEs vary widely, the imagery may reflect deep feelings of guilt, shame, or inner conflict—fears that the ego intensifies.
Most people who have had a distressing NDE ultimately remember it as beneficial. Some dismiss it as a hallucination, but most say it prompted spiritual growth. The dNDE forced them to confront illusions, re-evaluate their lives, and grow in ways they might not have otherwise.