An encounter with death: a comparative thematic and content analysis of naturalistic DMT experiences and the near-death experience.

Abstract

Classical near-death experiences (NDEs) refer to states of disconnected consciousness characterised by a range of features occurring in the context of being close to death. Various psychedelic substances, such as N,N-dimethyltryptamine (DMT), consistently replicate NDE features and may be considered 'near-death-like experiences.' However, a systematic qualitative analysis comparing the specifics of content with the broader themes of both psychedelic and NDEs has yet to be conducted. We report the third thematic and content analysis of the DMT experience from a naturalistic field study, focusing on themes related to death and dying. Based on 36 semi-structured interviews, this analysis is then directly compared, qualitatively and in terms of content frequency, with a novel extension of a previous thematic analysis of 34 written NDE narratives. The 'canonical NDE themes' identified across the DMT experiences included Translocation, Bright Light(s), Sense of Dying, The Void, Disembodiment, Tunnel-like Structures, Light Being-esque Entities, Deceased Family, Life Review-like, and Hyper-empathic Experiences. A total of 95% of participants reported at least one of these. Twelve 'less typical NDE motifs' were also noted. Five classical NDE features were entirely absent from DMT, while DMT exhibited an even broader array of experience features that were absent from NDEs. DMT clearly shares a more basic phenomenological structure with NDEs but shows differences in the prevalence of certain features. Furthermore, DMT did not present any immediately recognisable linear sequencing of themes. Overall, DMT is distinctly unique in its qualitative content, characterised by its more prodigious and stereotypical nature, which includes kaleidoscopic, extraterrestrial, transcultural, fluctuating, and overwhelming elements. When examining the comparability between DMT and NDEs at a fundamentally more nuanced level of qualitative content (as opposed to broad themes or questionnaire items), the two experiences clearly diverge. However, a minority of NDEs, which are themselves unique, do share significant content with DMT. Taken together, DMT could be considered an 'NDE-mimetic.' The weaker comparability is likely due not only to differences in context but also to the complex neural processes occurring near death, in which endogenous DMT may only play a small role. In light of this level of parallelism with NDEs, some potential clinical applications of DMT are also discussed.