Near Death Experiences (NDEs)

A dangerous operation and an amazing experience

Pam Reynolds was 35 when a large aneurysm required her to undergo extreme surgery in 1991. The operation was performed in the Barrow Neurological Institute in Phoenix Arizona.

Pam’s body was cooled down so her brain cells could survive longer without oxygen. Her heart stopped and her brain totally ceased functioning. The blood was drained from her brain to allow the surgery team to perform the delicate operation to clip off the aneurysm while she was effectively dead. Then her body was warmed, her heart re-started and her life returned.

The medical procedure all went as planned in a 7 hour operation. But when she recovered, Pam reported an amazing experience.

She had had an “out-of-body” experience where she travelled down a tunnel towards light, saw some long-dead relatives and felt a warm and loving godlike presence. The experience ended suddenly when her uncle led her back to her body.

None of this out of body experience can be verified, of course. But Pam reported some events in the operating theatre that could be verified from the medical records. Her eyes were bandaged shut and she had speakers emitting a loud noise in her ears (to allow the surgeons to stimulate her brain and monitor whether there was any activity). Nevertheless, she could describe the appearance of her shaved head, the shape of the saw used to open her skull, and some pieces of conversation.

Different conclusions

This is claimed to be clear evidence that Pam saw and heard events while she was brain dead and unable to see and hear through her normal senses. Her mind was operating independently of her brain. And if those aspects of her story are true, then perhaps the out of body journey actually occurred.

Sceptics argue that the verifiable events didn’t occur while she was brain dead. Rather she was merely unconscious, and experienced “anaesthesia awareness”, a rare occurrence when patients under anaesthetic can regain consciousness. But this argument is countered by the fact that she would have been unable to see or hear, even if conscious.

Questions and answers

This is one of the most quoted and documented of near death experiences, or NDEs.

NDEs like this raise important questions. Did these experiences actually happen? What scientific explanations are there? And do they tell us something about the human brain, and about life after death?

On this page I examine the claims of the true believers, the explanations of the sceptics, and the observations of open-minded investigators.

I think we can cautiously answer some of these questions.

What are NDEs?

A Near Death Experience is a “profound psychological event with mystical elements”. NDEs may occur when people are unconscious during or after a medical incident such as traumatic brain injury, a serious operation, cardiac arrest, drowning or hypothermia. Some of those who survive tell of an experience where they seem to leave their body and travel to a beautiful place, only to return again when they are revived.

It appears that more than a third of people resuscitated have some sort of sensory experience while unconscious. About a sixth have experiences that qualify as NDEs.

Thousands of NDE accounts have been recorded. Investigators have found that several factors are common to many or most of these experiences:

• An out of body experience, where the person feels they are floating above their body. They see themselves from above and observe what is happening around them (for example, medical staff trying to revive them), even though they are unconscious.
• Travelling through a tunnel towards a bright light, and arriving at a beautiful other-worldly realm.
• Meeting dead relatives or friends and also meeting spiritual beings, perhaps a supreme being.
• A strong sense of peace, love and acceptance, and feeling connected with creation.
• Often they review significant events their life from an external perspective, seeing how other people were affected by them (positively or negatively). They gain insights into past hurts, mistakes or successes.
• Reaching some clear end point or barrier (perhaps gates or a river), where they make, sometimes reluctantly, the choice to go back to their body and this life. Some are told they must return, often to complete some important task or destiny.
• There seems to be little difference between the experiences of people from various religious traditions, or none.

Most people find NDE experiences intense, overwhelming and real. So it is not surprising that those who have these experiences tend to come back to their normal life as changed people. They often modify their behaviour in positive ways and their priorities often become different. They tend to become more peaceful, accepting and loving; less materialistic and more altruistic.

The accounts of near death experiences, and the positive life lessons and insights people have gained through them, have become a multi-million dollar industry of books, films, videos and TV appearances. Unfortunately, it seems that this has attracted a few less than honest reports.

A small number of people experience negative NDEs that leave them fearful and unsettled.

Accounts of the experiences

Here are a few more reports, so you can get the flavour of the accounts. I describe these experiences as they were reported.

Maria

Maria had a severe heart attack in Seattle in 1977. While in the hospital coronary care unit she had a cardiac arrest, but was quickly resuscitated. During this time she had an out-of-body experience.

Maria told of floating outside the hospital building and seeing a tennis shoe on a ledge on the third floor of the hospital. She couldn’t have seen it from any place she had been during the hospital visit, even if she had been conscious. She was able to describe the shoe’s position in detail, and her social worker later found the shoe and corroborated all the details Maria had given.

This seems to be a very clear case of the mind and senses being active quite apart from the body. However shortly afterwards, Maria couldn’t be found and so the account depends solely on the report of the social worker.

Reinee Pasarow

Reinee was a teenager in 1966 when she suffered an allergic food reaction in the street and became unconscious. An ambulance wasn’t immediately available, so two firemen tried to revive her. When an ambulance arrived, she was taken to hospital. She revived and then relapsed on the way and was initially pronouced dead on arrival. However her physician arrived, ordered some extra strong treatment and she revived.

Reinee reports an amazing story of what she experienced during this time. For much of the time, she was out of body but able to observe and hear all that was happening. Later she accurately recounted people’s actions and conversations. She felt she was telepathically aware of everyone’s thoughts and feelings.

For a while she was drawn away from what was happening to her body. She moved to a realm of light where she met her dead uncle. She had a review of her life with a “being of light”, felt absorbed into the light itself which was God or the universe.

She saw the unity of the whole world in space and time. She learned “how humanity is currently at a turning point and that it must deal with all the obstacles to unity before a new era of universal peace will come”.

Reinee, who had been interested in the Baha’i religion before this, became strongly committed to Baha’i after this experience.

This account illustrates the challenges of assessing NDE accounts. Her story contains elements that can be verified, yet there is limited objective documentation of these elements. The more “out there” parts of her account can be easily dismissed by sceptics, and may be explained by her interest in Baha’i, which has similar values. Yet she lived her life as an intelligent, educated and successful person, not as someone prone to mental illness or hallucinations.

Eben Alexander

In 2008 neurosurgeon Eben Alexander contracted bacterial meningitis. His doctors placed him in an induced coma to protect him from possible injuries caused by a seizure. He was in the coma for almost a week, and his chances of recovery were slim.

Eben later reported his experience of an NDE while unconscious. He said he rode on a butterfly, guided through a realm of beauty by a young woman who resembled a long-dead biological sister he’d never met. He saw family members and friends. He was taught deep spiritual lessons, including that God loves everyone unconditionally (a common theme in NDEs).

After six days, he made an unexpected recovery. Four years later he published his account, and what he learned, in his book Proof of Heaven. The book sold 2 million copies and was on several best-seller lists.

However the book met with a mixed reception. He became a TV and press celebrity, but significant doubt was expressed about many of his claims. Neuroscientists said some of his medical information was wrong, and he wasn’t in a brain-dead coma at all.

The book was debunked in Esquire magazine. It was claimed that Alexander had several incidents of professional misconduct, had been dismissed from several hospitals, and was facing a multi-million dollar law suit for malpractice.

Yet some of his critics also overstated and misrepresented the evidence. He maintained the truth of his story, and the matter remains controversial. So Eben Alexander illustrates how claims and sceptical counter claims about NDEs can be difficult to resolve.

Reports, books and fakes

The Near-Death Experience Research Foundation website has almost five thousand accounts of NDEs. Few of them provide as much detail as the above stories and few offer concrete evidence. But they are useful in providing a picture of what people have apparently experienced.

Many books and a few films have told of NDEs. Some books by doctors must be considered seriously but other stories provide no evidence and don’t inspire confidence. The child in the popular book The Boy Who Came Back From Heaven, later said the story was invented.

Different views

Believers: proofs of the experiences

For believers in the reality of the NDE experiences, the very many stories like these are proof enough. So many people have had similar experiences, surely the best explanation is that they are real?

Dr Jeffrey Long offers 9 “lines of evidence [that] point to the conclusion that near-death experiences are medically inexplicable and cannot be explained by known physical brain function”.

1. Lucid, organized experiences while unconscious, comatose, or clinically dead.
   These shouldn’t happen according to conventional medical understanding.
2. Seeing ongoing events from a location apart from the physical body while unconscious (out-of-body experience).
   Studies by Dr. Michael Sabom and Dr. Penny Sartori found that patients resuscitated after an NDE are able to report facts about their resuscitation much more accurately that those who had no NDE.
3. Near-death experiences with vision in the blind and supernormal vision.
   These people had vivid visual experiences unexpected in those blind since birth.
4. Near-death experiences that occur while under general anaesthesia.
   It shouldn’t be possible to have a lucid organised memory under a general anaesthetic.
5. Near-death experiences and life reviews.
   “The consistent accuracy of life reviews, including the awareness of long-forgotten events and awareness of the thoughts and feelings of others from past interactions, further suggests the reality of NDEs.”
6. Encountering deceased loved ones in near-death experiences.
   In hallucinations and dreams, people are most likely to see living relatives, but in NDEs they are most likely to see dead relatives.
7. Near-death experiences of young children.
   Young children are less likely to have developed religious or cultural understandings about death and an afterlife, yet their experiences are similar to older people.
8. Cross-cultural study of near-death experiences.
   Again, the content is similar world wide, regardless of differences in culture and religion.
9. Near-death experience after effects.
   NDEs commonly lead to significant and positive life changes.

Dr Long says it is a “basic scientific principle that what is real is consistently observed”, and therefore argues for the authenticity of NDE experiences. However the question remains as to what is real – the external journey or the mind’s memory of an experience that may or may not have been real.

These “lines of evidence” relate to different aspects of NDEs, so some may be true and relevant while others may not. For example, the ability to report facts about physical surroundings (#2) doesn’t provide any “proof” of visiting a heaven-like realm.

Nevertheless, this list provides concrete “facts” which scientific hypotheses must try to explain.

The sceptics: scientific explanations

Few sceptics doubt that NDEs occur in patients’ brains. Some stories may be invented, but most are considered genuine reports of what people have experienced. But researchers point to the lack of hard evidence for the external reality of NDEs, their inherent implausibility and the incompatible descriptions of the world of the afterlife.

Rather, they say, NDEs have a neuroscientific explanation in the normal functioning of the brain in an extreme situation. (Table 1 of Near-Death Experiences: Neuroscience Perspectives on Near-Death Experiences lists nine features of NDEs with their hypothesised neuroscience causes.)

They argue (not always with evidence) that NDEs don’t occur when brain activity has ceased, but in the stages before or after that, when the patient is unconscious but the brain is active.

At least five different scientific hypotheses have been proposed to explain the different phenomena experienced in NDEs.

Oxygen depletion (hypoxia)

Oxygen depletion commonly occurs after cardiac arrest and can lead to confusion and hallucinations which may explain the visionary aspects of NDEs. Further, a reduced blood supply to the eyes can cause “tunnel vision” and, it is said, may contribute to the common NDE experience of travelling down a tunnel towards the light.

Neither of these hypotheses seem adequate in themselves. The eyes aren’t involved in NDEs (the patient is typically unconscious with eyes closed). And when the brain is starved of oxygen, hallucinations may occur initially, but within a short time different regions of the brain begin to shut down (see below) and hallucinations would cease.

Oxygen depletion seems unable to explain anything like the vivid and extended experiences of some NDEs, and this hypothesis seemed to be more popular ten years ago that it is now. However the gradual shutdown caused by oxygen starvation may cause other brain processes which may better explain NDEs.

Hyperactive dying brain

Oxygen depletion signals a crisis to the brain, which begins a set of survival responses, switching off successive regions of the brain.

Studies of rats whose hearts were stopped showed their brains’ first response, before starting to switch off functions, was intense action. Perhaps different parts of the brain were communicating with one another, effectively comparing notes on the stimuli they’re getting and seeking an emergency response.

If humans respond as rats do, this hyperactivity may trigger the following phenomena and so explain the source of NDEs.

A brain glitch

The temporoparietal junction (TPJ) is a region in the brain which gathers and processes information from the external environment, via the visual and auditory systems, as well as from within the body. It plays an important role in assembling all this information into an overall perception of the body.

It is known that damage to the TPJ, an epileptic seizure or electrical stimulation of the TPJ, can all cause an out-of-body experience. Presumably the brain’s perception of the body is distorted, and one result could be an out-of-body experience. Cases have been reported of children with Right Temporoparietal Epilepsy having out-of-body experiences.

It is therefore hypothesised that when a patient is in a coma, or the brain is shutting down, and an NDE occurs, the sensory information being processed by the TPJ is confusing. This leads to the out-of-body experience that is a common feature of NDEs.

Neurochemicals

Neurochemistry has a significant impact on how our brains operate.

• Dopamine is a neurotransmitter that can induce hallucinations and also give a feeling of pleasure and peace.
• During trauma the locus coeruleus region of the brain releases noradrenaline, which primes the brain for action. It increases visual awareness and improves the response to sensory inputs. Noradrenaline may contribute to positive emotions, hallucinations and other features of NDEs.
• Some psychedelic drugs such as ketamine and DMT (Dimethyltryptamine) act similarly to the brain chemical serotonin and have been found to produce effects similar to NDEs (primarily euphoria and hallucinations).

It is believed that when the brain is under stress, some of these neurochemicals may be released and cause many of the different aspects of NDEs, mainly bliss and hallucinations. However it seems that these remain hypotheses not fully tested yet.

REM intrusion

Rapid Eye Movement (REM) sleep is the deep state of sleep where we dream. Normally it takes about 90 minutes to begin REM sleep, but some people begin much sooner after they fall asleep. Some people with a sleep disorder may experience REM intrusion where they dream and have visual hallucinations while they are awake (generally just before they fall asleep or just after they wake).

In a crisis, the brain can switch between waking and REM consciousness to bring about survival behaviours. Studies have shown that there are many similarities between REM dreams and NDEs, and that REM switching contributes to NDEs. Further, those who have experienced an NDE are more likely to experience REM intrusion, and vice versa.

Some neuroscientists believe REM intrusion is an important part of the neurological explanation of NDEs.

Assessment

These explanations, developed by expert neuroscientists who have investigated NDEs, are clearly plausible. But some fellow neuroscientists critique these explanations because:

• These hypotheses explain what might happen, but generally not what has been shown to happen duing NDEs.
• The fact there are so many hypotheses suggest that none is conclusive.
• Each of these hypotheses explains some elements of NDEs, so to explain NDEs fully requires several of the explanations to work together.

Many neuroscientists are confident that further research will reveal the remaining parts of the NDE puzzle. However in some reports, this confidence is based on the materialistic assumption that all phenomena can and must be explained by physical causes, with no non-physical processes allowed. Some critics (e.g. Enrico Facco and Christian Agrillo) argue this is wilful closed-mindedness.

We may cautiously conclude that science hasn’t explained the NDE recall of real events, but there may be neuroscientific explanations for the other-worldly events.

The open-minded investigators: difficult facts to explain

Not all neuroscientists and psychologists believe that the above explanations are adequate. While not endorsing the true believers’ enthusiasm for NDEs, neuroscientists like Sam Parnia, Mario Beauregard and Pim van Lommel believe that these physical explanations are not sufficient.

• Lack of oxygen tends to lead to a confused state, whereas during NDEs people’s reactions are clear and logical.
• The various neurological parallels lead to experiences that are unreal and illusory whereas NDEs seem “ultra real”.
• Hallucinogenic drugs often produce frightening and weird visions that are easily seen as illusory, whereas NDEs are almost always positive and perceived to be real.

Perhaps the most compelling reason to question the “reductionist” sceptical explanations of NDEs comes from the University of Southampton AWARE study led by Dr Sam Parnia. 140 people who had experienced cardiac arrest were interviewed, with the following outcomes:

• None of the patients exhibited any outwards signs of consciousness while they were unconscious, but about 40% had some perception of awareness during this time.
• Those who had some awareness or memory of their unconscious time reported a range of experiences. Some saw plants, animals, the sun, light and family members. Quite a few reported “fearful and persecutory experiences”. However most of these experiences didn’t meet the criteria for an NDE and they didn’t describe any external verifiable events.
• Nine of the patients experienced an NDE, with some of the common NDE elements such as out-of-body travelling through a tunnel toward a very strong light, a beautiful scene and beautiful people.
• Just two of these patients also recalled events in the operating theatre. One was unable to be further interviewed due to ill-health, but the remaining patient was able to accurately describe people, sounds, and activities from his resuscitation, from an out-of body perspective looking down from above. His account suggested he had been aware of external events for about 3 minutes after cardiac arrest, whereas physical brain activity normally ceases within 20-30 seconds of the heart stopping.

Dr Parnia says: “The fact that people seem to have full consciousness, with lucid well-structured thought processes and memory formation from a time when their brains are highly dysfunctional or even nonfunctional is perplexing and paradoxical.” He concludes that this is good evidence that this man’s mind was still functioning when his brain wasn’t.

“I believe it is possible for consciousness to be an as of yet undiscovered scientific entity that may not necessarily be produced by synaptic activity in the brain.”

It is notable that this study draws no conclusions about the reality of the NDE “visionary” experiences, which are unverifiable.

Answering the big questions

From all this information, I think we are in a position to answer some of the questions we began with.

Are NDEs fake?

Clearly they are not, in the main. Whatever we make of them, most people are reporting what their brains experienced.

Can the mind exist without the brain?

It appears that consciousness can continue for at least a few minutes after the physical brain shuts down. There is plausible evidence that awareness and thoughts can be produced by processes that cannot be currently measured by neuroscience. Perhaps this evidence will be discounted or explained in the future, but Dr Parnia’s AWARE study and the evidence of Pam Reynolds and others cannot be explained in physical science terms at present.

It may be that there is a physical explanation that currently eludes current neuroscience and its measurements. It may be that there are non-physical but quite natural causes that are not currently known because our science is explicitly physics-based. And it may be that the explanation is supernatural.

But the scientific evidence challenges our physicalist science.

Are out-of-body experiences real?

There is no direct evidence to answer this question. Even if we accept that consciousness may exist for a time after physical brain processes cease, and so a person may hear and/or see activities around them via some non-physical means, there is no evidence that the self can or does actually leave the body.

Many NDEs include an out-of-body experience where the self rises above the body and observes the action from near the ceiling. The AWARE study sought to test this by installing images on shelves in rooms where resuscitation was likely to occur, and in positions only visible from the ceiling. It was hoped that patients experiencing NDEs might report seeing these images (or not) and so verify (or not) this aspect of NDEs.

Unfortunately many resuscitations, including the two patients who reported awareness of external events, occurred in other locations. So this aspect was not tested in this study, nor am I aware of it being tested in other controlled studies. So we are left with only unverified reports.

So it may well be that the conscious mind hears external events and visualises floating, without any out-of-body movement. But the possibility of out-of-body travel cannot be excluded, though it cannot be explained in any scientific terms.

Are NDEs “visions” based on real events outside the mind?

There is no direct evidence to answer this question either. While there is evidence that people whose brains are inactive may nevertheless see and hear real world events accurately, there is no reason why the rest of their experiences must be real too. Plausible neurological explanations have been offered for some of those experiences at least.

In my analysis of mystical experiences, I suggested that we are prima facie or initially justified in accepting things are the way they appear if (1) it does appear that they are that way, and (2) there is no reason to think that something has gone wrong. I suggested some criteria to test these two requirements:

1. our senses perceive things that way;
2. there is no alternative causality that suggests our senses have perceived wrongly;
3. there is no good reason to think our senses have perceived wrongly;
4. our perceptions are regular and consistent; and
5. we have confirmation of our perceptions from others.

It seems to me that few of these criteria can be claimed for the NDE accounts of travel to another realm, meeting God or relatives, etc. NDEs are not experienced by the physical senses and there are at present possible alternative causalities.

So at present, each person is free to interpret the other-worldly events according to their spiritual and religious beliefs or scepticism. Nevertheless, we can all agree that these experiences were generally beneficial for the recipients.

My personal conclusion

I believe there is a God and human life has a spiritual component as well as the physical. I believe the mind is more than the brain, otherwise we would be unable to escape the chain of physical cause and effect, and all our “choices” would be totally determined. I believe these things for reasons other than NDEs (e.g. see Why believe in God?).

I am therefore free to accept whatever conclusion is suggested by the evidence.

My tentative conclusions are:

1. Most people who report NDEs really had these experiences in their minds.
2. The reports of awareness while the brain is “dead” are sometimes true and accurate. Therefore the mind must be more than the physical brain, and it appears that the mind can exist at least for a short time (maybe more) after the brain is “dead”. This evidence supports the christian view that humans are more than physical.
3. I don’t believe that out-of-body travel actually occurs in most or all NDEs. I think these visions are in the mind and the causes may well be those suggested by the neuroscientists. Nevertheless, they may reveal truths and realities of one kind or another.
   (I am reminded of a scene in Harry Potter and the Deathly Hallows where Harry dies and meets his late headmaster in an ethereal white place. He asks: “Is this real? Or has this been happening inside my head?” Albus Dumbledore replies: “Of course it is happening inside your head, Harry, but why one earth should that mean that it is not real?”)
4. I believe many or most NDEs are probably just products of the individual person’s mind, experiences, hopes and fears. But I wouldn’t rule out the possibility that there may be more to them than that. And I believe God could certainly use NDEs to reveal truth, even though I doubt that is happening in most cases.
5. I think christian belief in an afterlife doesn’t depend on NDEs or the hope that our “soul” lives on. The christian hope is that God will resurrect us into a new earth, just as he resurrected Jesus.