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Near-Death in the Borderlands of Consciousness

Kevin R. Nelson

The Oxford Handbook of Psychedelic, Religious, Spiritual, and Mystical Experiences June 20, 2024 DOI: 10.1093/oxfordhb/9780192844064.013.28 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Key findings Near-death experiences are caused by REM intrusion triggered by cerebral ischemia, producing a hybrid state of waking and REM consciousness that explains their core features.

Abstract

Abstract Near-death experiences have gained wide attention, forging an indelible image of spiritual experience in many people today. This chapter examines the neuroscience underpinnings of near-death, including principles that have often been neglected or distorted, often skewing the common impression of near-death. During near-death from fainting or cardiac arrest, the boundary between consciousness and unconsciousness blurs in moments of insufficient cerebral blood flow (ischemia). Brain ischemia can also disrupt the physiological balance between conscious states, leading the brainstem arousal system controlling conscious states to blend waking and rapid eye movement (REM) consciousness into a hybrid state (REM intrusion). The concept of REM intrusion contributing to near-death addresses otherwise vexing issues. First, REM intrusion explains how diverse conditions evoke near-death, including non-threatening conditions. Secondly, it provides an understanding of how cerebral ischemia most often triggers near-death. Lastly, REM intrusion offers a cohesive physiologic system underlying key features of near-death: light, motionless appearance of death, out-of-body sensations, euphoria, and rich narrative landscape. Independent evidence converges from many points supporting this notion, including multiple observations that individuals experiencing near-death are physiologically susceptible to REM intrusion. Furthermore, review of current evidence indicates that near-death shares features with the classically described mystical experience, but the two experiences remain distinct varieties of spiritual expression driven by different neurophysiologic processes.