I'll never forget the day the neuropsychiatrist Dr Peter Fenwick visited my undergraduate psychology class in the 1990s. Tall and dapper with a refined voice and neuroanatomical terms tripping from his lips, Fenwick conveyed old-school authority.
One of the subjects he lectured us about was so-called near-death experiences. Originally a sceptic, he said there was now compelling evidence that many people close to death were able to recall seeing themselves from above.
Even more astonishing, some described witnessing events in distant parts of the hospital – things they couldn’t have seen unless their consciousness had somehow separated from their physical bodies. Something about his erudite, understated delivery sent shivers down my spine.
Plenty more research has since explored near-death experiences (NDEs) – episodes of bodily disconnection, spiritual revelation, and intense emotions reported by those who come close to death and survive.
Turns out they could be incredibly common: one recent survey reported that 15 per cent of patients in intensive care had experienced a NDE.
NDEs are by no means a new phenomenon, however. The scholar Dr Gregory Shushan has collected accounts of NDEs through time and across cultures, finding numerous examples, from 7th-century BC China to 19th-century Ghana.
Hieronymus Bosch's 16th-century painting Ascent of the Blessed is widely considered a visual portrayal of a NDE.
The concept first really came to prominence in the 19th century when the Swiss geologist Prof Albert von St Gallen Heim collected stories from fellow climbers who nearly died.
The US psychologist Dr Raymond Moody then popularised NDEs with his 1975 book Life After Life, which Fenwick dismissed at the time as “psychobabble” before encounters with NDE-ers changed his mind.
In other words, there are plenty of documented NDE cases. And many continue to baffle scientists and raise perplexing questions about the nature of consciousness and life itself.
Should we believe them all? My reaction has always been scepticism tinged with wonder. It’s hard to listen to accounts of people who’ve had these experiences and not be moved.
For instance, Leanda Pringle from Connecticut had a NDE a little over 15 years ago, brought about by a double kidney infection. She experienced floating above her body and felt a sense of being everywhere and nowhere at the same time.
“I’ve no idea how long I was floating in that abyss before I began to feel a presence,” she recalls to me. “As it got closer I began to feel immense bliss. It was beyond anything I had ever felt before in my life. It’s very hard to put that feeling into words. It was as if I was intertwined with it, but at the same time it felt as if it was hugging me.”
Tommy McDowell, a retired army veteran from Texas, spent seven days on a ventilator after suffering multiple organ failure induced by sepsis. During that time, he had a NDE that involved feeling a powerful sense of goodness.
“It was a transformational presence of peace, comfort, serenity, love and home,” he says. “I was no longer confused. I was no longer alone.” He also saw a cloud of crystallised light that invited him towards it. As he entered, “I could feel embedded trauma, regret and loss washing away from my back and shoulders.”
Reflecting on what happened, Tommy says, “I experienced the presence of God. It was overwhelming and occurred in a way that I just don’t have language to fully describe.”
Similarly, Leanda tells me: “There’s no question in my mind that I went to ‘the other side’, and merged with and had a conversation with the Creator of all that is. I returned with a fraction of that unconditional love, which has never left me.”
The final flickers of life
By now, scientists have collected thousands of similar testimonies from people who have lived through a NDE. These accounts tend to include several recurring elements, including out-of-body experiences, seeing a bright light, entering a tunnel, undertaking a life review and feeling a deep sense of peace and relief.
Of course, for many neuroscientists, NDEs may reveal less about the divine and more about the brain's intricate workings.
In fact, some neuroscientists argue that many of these powerful subjective experiences can be attributed to intense neurobiological changes occurring as the brain approaches death – and they have the research to support this claim.
In 2024, researchers at the University of Michigan published groundbreaking findings from their analysis of brain recordings from four dying patients.
The patients were on life support and their brain activity was recorded by electroencephalogram (EEG), which tracks electrical activity in the brain via electrodes placed on the scalp.
Led by Dr Jimo Borjigin, the team made the remarkable observation that two of the patients exhibited a surge of brain activity shortly after their relatives had agreed to the removal of life support.
Previously, this kind of end-of-life surge in brain activity had only been witnessed in studies with rats, but here was the first evidence that it might occur in humans too.
The observed activity surge was in the gamma frequency range that’s normally associated with consciousness, and it was localised to the junction of the temporal and parietal lobes (near the rear of the brain), key neural regions thought to be involved in conscious processing.
There was also evidence of heightened connectivity with the prefrontal cortex, another key area involved in consciousness and decision-making. “This study strongly suggests that the dying human brain can be activated,” the researchers wrote.
Dr Charlotte Martial – a NDE researcher and neuropsychologist with the Coma Science Group at Liège University in Belgium – wasn’t involved in the paper, but describes it as “extremely intriguing” and sees it as the latest to link the study of the dying brain with other research on NDEs.
“This connection is crucial, as this observed surge of functional activity may account for the vivid and complex subjective experiences reported during near-death events,” she says.
She also encourages caution, though, because the patients in this recent study didn’t survive and therefore couldn’t describe what they’d been through. Perhaps they didn’t even have a NDE at all – we just don’t know.
Read more:
- To death and back: what near-death experiences could tell us about dying
- Are near-death experiences just hallucinations?
- Wild ideas in science: Death is reversible
A huge release of chemicals
Although they also can't describe their experiences (whether they survive or not) animals could offer key insights into NDEs. For instance, studies involving rats suggest there's a massive release of neurotransmitters – chemical messengers that allow nerve cells to communicate – in the dying brain.
For instance, Borjigin's team have previously studied rats in a state of asphyxia (a lack of oxygen in the brain – comparable to when a human has a heart attack) and found that this triggered a sudden release of brain chemicals, including adenosine, dopamine, norepinephrine, gamma-aminobutyric acid, glutamate and aspartate.
Serotonin also surged to 20 times its normal levels within just two minutes of asphyxiation.
Given the key roles these chemicals play in emotions and dream-like states, scientists suggest that this swell in neurotransmitters may contribute to the intense subjective experiences reported by people who undergo NDEs.
Further clues that this might be the case come from research using psychedelics – drug compounds that act in the brain and provoke experiences that are reminiscent of aspects of a NDE.
These substances include LSD (lysergic acid diethylamide), psilocybin (the hallucinogenic compound in ‘magic’ mushrooms) and DMT (dimethyltryptamine, the so-called ‘spirit molecule’ found in several plants located in the Amazon basin).
Many of these substances interact with the brain’s receptors for neurotransmitters, like serotonin, which can be released in the dying brain.
Martial was part of an international team that questioned volunteers about NDE-like experiences after taking DMT and after taking a placebo pill. The questionnaire included queries about sensations such as feeling as though they had left their body or had seen a bright light.
The volunteers’ responses were similar to those given by a comparison group who’d actually lived through a NDE.
“One can hypothesise that some endogenous molecules [those made within the human body] mimicking DMT or ketamine mechanisms could be released in life-threatening situations, such as when someone experiences a NDE,” says Martial.
Evidence of something... more
These are exciting developments, but many experts involved in NDEs aren’t persuaded by purely neurobiological explanations. Right up until his death in November 2024, Fenwick remained convinced that something more profound is going on.
To him, accounts of NDEs provide evidence that the human soul exists beyond the brain.
Similarly, the University of North Texas’s Professor Emerita Janice Holden – the current President of the International Association of Near-Death Studies – has serious doubts about the brain research, claiming spikes in serotonin and similar neurotransmitters offer too simplistic an explanation for these profound experiences.
“Small, brief, limited brain emissions, even if shown to occur reliably in association with NDEs – which as yet they have not – cannot account for the complex cognition involved in NDEs,” she says.
She also adds a surge of neurotransmitters can’t explain what the literature refers to as “verified perceptions” from NDEs, such as the ability for the dying person to witness events located elsewhere.
“How could a brief gamma wave spike in the brain explain the accurate report of a leg amputation in the operating room next door?” she asks, referencing a case documented by French anaesthesiologist Dr Jean Jacques Charbonier.
(For their part, the neuroscientists say these perceptions have yet to be proven conclusively. “That said, the non-local consciousness hypothesis remains a possibility,” concedes Martial. “One we’re currently testing in one of our ongoing hospital studies.”)
For Holden and many others working in this area, a possibly more important strand of investigation concerns the psychological consequences for people who have lived through a NDE.
Studies show they’re usually left with incredibly intense and vivid memories of the experience, and many of them report feeling fundamentally changed by what they’ve been through, including having a profoundly altered attitude to death.
These various after-effects can be divided into several categories, according to Holden.
These are: psychological, which includes “changes in values, such as losing a fear of death, becoming less materialistic and more concerned about the welfare of others and planet Earth”; spiritual, “having greatly increased interest in spiritual topics.”
Physical, “changes in metabolism, appetite, need for sleep, and sensitivity to medication and environment conditions, such as light and sound”; and social, “married NDE-ers are more prone to divorce than the average person, as well as being more likely to change their friends, organisational affiliations and even occupation to better align with their newfound qualities”.
Given the profound psychological impact of having a NDE, some mental health experts argue that more should be done to provide support for critical care patients after they navigate the experience.
For instance, in 2021, Lilia Samoilo, a mental health and spiritual counsellor, and Dr Diane Corcoran, a past president of the International Association for Near-Death Studies, drew attention to what they called the “medical gap of care” for patients who go through a NDE, with their accounts either routinely ignored, disbelieved or, in some cases, prompting referral to psychiatric care.
“Whenever patients aren’t offered NDE education, their questions go unanswered and they remain in an emotional limbo,” the pair wrote. Their call is arguably all the more urgent given the rising awareness that a significant minority of NDEs can be emotionally distressing – including frightening features, such as hellish visions or experiences of non-existence.
Of course, it’s not possible to deliberately induce NDEs, but one intriguing way that researchers are trying to learn more about the psychological consequences of NDEs is by using virtual reality.
In one study, a team at the University of Barcelona recruited 16 participants to spend time on a virtual island. The experience culminated in the death of their virtual selves and a scenario that involved a virtual out-of-body experience and other elements typical of NDEs, including a life review and travelling through a tunnel towards a light.
Compared with a control group, these participants subsequently showed greater selflessness and more concern with global issues rather than materialistic matters. In another study, the same team found that a virtual out-of-body experience led to a reduced fear of death.
The team said their work was consistent with the idea that “death might be considered the most extreme example of a ‘transformative experience’”. As research on NDEs continues, they’ll continue to pose fascinating questions for scientists and philosophers alike.
In one of his final interviews before his own death in 2024, Peter Fenwick celebrated the fact that more people are now willing to come forward to talk about their “deep transcendent experiences” near death.
This increased openness about NDEs will assist the work of neuroscientists as they continue to uncover more details of what’s happening in the brain during these transformative moments. As they do so, the debate over whether there can ever be a purely biological explanation is likely to rumble on.
But what’s indisputable is the emotional power of NDEs for those who live through them.
“After that NDE experience, my life [will] never be the same,” says Leanda Pringle. “Although it has taken me a long time to fully integrate the experience, the abilities I now possess seem like something from a sci-fi movie. I truly believe I brought some of that realm back with me.”
About our experts
Dr Charlotte Martial is a near-death-experience researcher and neuropsychologist with the Coma Science Group at Liège University in Belgium. Her work has been published in many scientific journals, including Nature Reviews, Clinical Neurophysiology and International Journal of Clinical and Health Psychology.
Prof Emerita Janice Holden is the President of the International Association of Near-Death Studies and retired in 2019 as professor emerita of Counseling at the University of North Texas, USA. She is published in Journal of Consciousness Studies, Encyclopedia of Personality and Individual Differences and Journal of Near-Death Studies (to name a few journals).
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