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1. Introduction to Hypnosis and NDEs
Research published in the Journal of Near-Death Studies shows that hypnosis has been explored in several ways in relation to near-death experiences (NDEs). These studies do not claim that hypnosis produces death-related “real” NDEs in a medical sense, but they do show that hypnotic states can sometimes reproduce – or help access – experiences that closely resemble them. The study described in this article explored whether hypnosis could deliberately evoke experiences similar to NDEs. Researchers used a guided hypnotic script with participants and found that: (a) People reported classic NDE features such as: out-of-body experiences, movement through darkness or tunnels, and encounters with light or presences; (b) The overall structure and emotional tone of these experiences resembled naturally occurring NDEs; (c) The study suggests that NDE-like phenomena can arise in non-life-threatening altered states of consciousness, including hypnosis.
However, the authors of this study emphasized that these were “NDE-like” experiences – not identical to spontaneous NDEs that occur during actual medical crises.
Researchers have also treated hypnosis as a research tool rather than a cause of NDEs. Findings across studies suggest: (a) Hypnosis can help participants recreate vivid subjective experiences; (b) It may allow researchers to study emotional intensity, perceptual features (light, separation from body), and narrative structure of NDEs; (c) Hypnotic states can feel “more real than imagination,” which makes them useful for studying consciousness and memory. This has made hypnosis valuable for comparing brain and psychological processes between imagined, hypnotic, and real NDE reports.
Related research examines reports of “death experiences” during hypnotic regression where participants under hypnosis sometimes describe leaving the body, entering light-filled environments, and feeling peace or transcendence. Some of these experiences score similarly to NDEs on standardized measures like the Greyson NDE Scale. However, these findings are controversial. Researchers caution that memory under hypnosis can be highly suggestible. They also caution that such experiences may be constructed or influenced by expectations.
There are key similarities and differences between hypnosis-induced NDE-like experiences and medical-crisis induced NDEs. Concerning the similarities, both hypnosis-induced experiences and NDEs can include out-of-body perception, intense emotions (peace, awe), encounters with light or beings of light, and a sense of meaning or transformation. Concerning the differences, NDEs typically occur during life-threatening events while hypnotic experiences occur in safe, controlled environments. NDEs often lead to lasting life changes, which may be less consistent in hypnotic cases. Hypnosis involves suggestion, which can shape the experience. As one analysis summarized, hypnosis and NDEs are distinct phenomena but may share underlying psychological or neurological processes.
The Journal of Near-Death Studies presents hypnosis as: (a) A window into altered states of consciousness; (b) A tool for simulating aspects of NDEs; and (c) A way to explore whether NDE features come from brain processes, psychological mechanisms, or potentially deeper aspects of consciousness. At the same time, the research stops short of claiming that hypnosis can reproduce a “true” NDE. Instead, it shows that the human mind can generate experiences remarkably similar to NDEs without physical danger.
The research published in the Journal of Near-Death Studies demonstrates that hypnosis can recreate many features of NDEs. They help researchers analyze the structure and meaning of these experiences. They also highlight the role of altered states of consciousness in producing NDE-like phenomena. But it also reinforces an important distinction: hypnosis can imitate the form of NDEs, yet it does not fully replicate the conditions – or possibly the depth – of genuine NDEs.
2. About This Article
ABOUT THE AUTHORS: Ana Sofia Machado Ferreira, MA (Psychology), is a clinical psychologist and researcher at the Laboratory of Mind-Matter Interaction with Therapeutic Intention (LIMMIT) at the University of Lisbon in Lisbon, Portugal. This article is based on work leading to her PhD thesis, Induced near-death-experiences in healthy volunteers: Phenomenology and aftereffects, which she will submit to the University of Northampton in Northampton, England, UK. Mário Simões, PhD (Psychiatry), emeritus professor on the Faculty of Medicine at the University of Lisbon, is Director of LIMMIT. Ana Paula Farinha, PhD (Molecular Biology), is an independent researcher and a resident consultant at LIMMIT. The authors wish to thank Enrico Facco, MD, and Bruce Greyson, MD, for their encouragement and suggestions in the preparation of this article. We also would like to acknowledge the essential roles that BIAL Foundation, as well as Chris Roe, PhD, and Callum Cooper, PhD, both at the University of Northampton, played in the further development of the project described in this article. Correspondence regarding this article should be sent to Ms. Machado Ferreira at email: sofiamachadoferreira@yahoo.com.
ABOUT THE JOURNAL: The Journal of Near-Death Studies from the International Association for Near-Death Studies (IANDS.org) is the only peer-reviewed scholarly journal devoted exclusively to the field of the study of near-death experiences (NDEs). To access the latest issues from the previous three years and receive new issues of the quarterly journal, you must subscribe to the journal simply by joining and becoming a member of IANDS. The Journal of Near-Death Studies also encourages submission of articles. Basic information about the journal is available.
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The following is a reprint by permission of the article “Hypnotically Induced NDE-Like Experiences: An Exploratory Study of Phenomenological Similarities to NDEs” by Ana Sofia Machado Ferreira, MA; Ana Paula Farinha, PhD; and Mário Simões, PhD published in the Journal of Near-Death Studies, 40(1), Spring 2022, Human Sciences Press, Inc.
3. Hypnotically Induced NDE-Like Experiences: An Exploratory Study of Phenomenological Similarities to NDEs
By Ana Sofia Machado Ferreira, MA; Ana Paula Farinha, PhD; and Mário Simões, PhD
ABSTRACT: NDEs are known to occur in individuals who go through the first stages of physical death but can also happen as a nontypical manifestation of several forms of non-ordinary states of consciousness. In this exploratory study, we assessed the possibility of inducing the phenomenological components of an NDE through hypnosis using a specific script in a group setting. Participants were 7 males (38.9%) and 11 females (61.1%) ranging in age from 15 to 59 years with a mean age of 35.9. NDE Scale (Greyson, 1983) scores among the 17 participants whose total scores met the criterion of 7 or higher were seemingly indistinguishable, in both content and intensity, from scores of spontaneous near-death experiencers. Older participants scored higher on the three non-cognitive subscales. The core phenomenological components were prevalently affective, pointing to the likelihood that expectations played a role in induced experiences, as may also be the case with spontaneous NDEs that were in some way anticipated. However, we were unable to conclude that, beyond phenomenology, a hypnotically induced experience was equivalent to a spontaneous episode. To affirm that a shift from ordinary consciousness, facilitated by hypnosis, is adequate to bring someone close to a theoretical mental threshold that might be called Near-Death Consciousness, in which a comparable event could be hypothetically achieved, at least four variables should be considered: the context, content, intensity of deviation from ordinary consciousness, and aftereffects of the experience.
KEYWORDS: hypnosis, near-death experience, near-death consciousness, near-death-like experience, non-ordinary states of consciousness
Since 1975 when psychiatrist Raymond Moody first identified a phenomenon he called near-death experiences (NDEs), researchers have studied it extensively (Holden et al., 2009). NDEs have been described in the scientific literature with regard to their phenomenology and common aftereffects, which include the ability to catalyze radical processes of inner transformation, sometimes equated with mystical experiences (Khanna & Greyson, 2013; 2015). A mostly positive and long-lasting display of transformative aftereffects seems to correspond to a consistent experiential pattern of transcendental elements that might be indicative of “a generalized awakening of higher human potential” (Ring, 1996, p. 187).
NDEs are known to occur to individuals who survive the first stages of physical death or the threat of imminent death. However, seemingly identical near-death-like experiences (NDLEs) also occur spontaneously outside the context of a close brush with death (Facco & Agrillo, 2012), and recent research (Charland-Verville et al., 2014) has shown the experiences occurring in the two circumstances – within vs. outside the context of a close brush with death – to be phenomenologically indistinguishable.
The earliest published use of hypnosis with regard to NDEs was a study (Holden & MacHovec, 1993) in which the researchers used hypnosis to enhance NDE recall in self-identified NDErs. They found their hypnotic procedure to be safe for experiencers; because their focus was safety, they did not assess the phenomenology of participants’ recalled experiences. Later, however, Palmieri et al. (2014) found that NDErs’ recall of their NDEs was significantly more detailed during hypnosis than during normal recall. More recently, Martial et al. (2019), while studying brain activity during hypnotic recall of NDEs, also found that the felt subjective experience was enhanced.
In addition to the occurrence of spontaneous NDEs and NDLEs, the latter experiences have been reported during the use of psychotropic substances, purposeful mystical practices, or tools such as hypnosis. In particular, hypnosis is well-established as a therapeutic tool to facilitate transpersonal experiences (Leskowitz, 2015). An acknowledged category of transpersonal hypnotherapy is out-of-body experiences (OBEs) and NDLEs produced hypnotically for the purpose of research (Zahi, 2009). Furthermore, Facco (2012) noted that “NDE-like experiences have been induced in hypnosis in the context of psychotherapy with the aim of approximating their transformational therapeutic aspects and facilitating both first- and second-order patient changes” (p. 284), including the resolution of existential concerns through the experience of how “dying” might feel. In one such application, Levitan (1985) has used a hypnotic technique known as death rehearsal to help reduce anxiety in patients facing imminent death. In another application, hypnotist Schenk (1999) has devised a technique he called “waking dreams” in which the patient is invited to experience a fictional “death” to evoke durable change (Schenk, 2006). Standard hypnotic procedures have also been used to induce OBEs (Tressoldi & Pederzoli, 2021; Tressoldi et al., 2014) and regression to death moments in alleged past lives (Lucas, 1993; Pederzoli et al., 2018).
In an exploratory study, Ohkado and Greyson (2018) compared spontaneous NDEs to death experiences during past-life regression therapy and concluded that “dying” in the two conditions is comparable with regard to both phenomenology and aftereffects. In a similar study, Pederzoli et al. (2018) came to the same conclusion. Finally, Facco et al. (2019), after using hypnosis to individually induce OBEs in a group of highly hypnotizable subjects, found an “intriguing link” between feeling out of one’s body and positive emotions, an aspect that might be associated with the transformational potential and possible therapeutical implications of such experiences.
The aforementioned studies indicate both the feasibility and the potential benefit of facilitating NDLEs in non-NDErs through hypnosis. To the best of our knowledge, no researchers have yet reported using hypnosis to induce an NDLE among non-NDErs in (a) a setting that is both non-therapeutic and involves group induction within a transpersonal context, and subsequently (b) assessing the phenomenology of the experience by comparing it to the phenomenology of actual NDEs. This was the purpose of the present study.
4. Method
Research Questions
With this experiment, we sought to answer the following research questions: Among non-NDEr participants in a group hypnotic induction of an NDLE, (a) What percentage of participants report the phenomenology of NDEs? (b) What is the relationship between participants’ demographics and their reported NDE phenomenology?
Measures
All participants completed two measures. One was a short sociodemographic questionnaire (SDQ) in which they reported gender, age, education, occupation, and religious or spiritual affiliation. The other was the Near-Death Experience Scale (NDE Scale; Greyson, 1983), extensively used in research and developed to address researchers’ needs to identify the presence and features of NDEs. The NDE Scale was developed based on responses of spontaneous NDErs. Interitem correlation resulted in 16 items grouped into cognitive, affective, paranormal, and transcendental four-item subscales (Greyson, 1983, 1985, 1990). Each item contains three response options: 0 (feature not present), 1 (feature moderately present), or 2 (feature strongly present). Total score ranges from 0 to 32, and each subscale score ranges from 0 to 8 (Greyson, 1990). The scale yields a unidimensional measure with interval-scaling properties, as each item in the scale differentiates NDEs qualitatively and quantitatively from other responses to the threat of death, as shown by a Rasch rating scale analysis (Lange et al., 2004). For research purposes, a score of 7 (1 standard deviation below the mean) or higher indicates the presence of an NDE. Regarding reliability, the entire scale yielded a Cronbach’s coefficient alpha of .88 for internal consistency as well as good split-half reliability and 6-month test-retest reliability. Regarding validity, NDE Scale scores correlated well with prior measures of NDEs (Greyson, 1983).
To address the first research question, we calculated percentages of NDE Scale total scores that met or exceeded the criterion of 7 or higher as well as subscale scores that met or exceeded the criterion of 5 or higher. Regarding our second research question, we conducted Pearson chi-square tests (p ≤ .05) to assess the relationship between SDQ data and the NDE total scale and subscale scores, on one hand, and Spearman´s rho correlation (p ≤ .05) analyses, on the other, to explore in more detail the association between age and NDE subscale scores. For all data analyses, we used IBM SPSS Statistics v. 25 software.
Participants
In the context of a conference organized by the European Transpersonal Association, the first and last authors offered a workshop entitled The Therapeutic Effects of Near-Death Experiences, for which 25 conference participants enrolled and attended. The full content of the workshop was previously approved by the organizing committee. Prior to the workshop, all participants were informed that, during the workshop, they would undergo a hypnosis experience designed to induce the typical phenomenological manifestations of an NDE. They were also informed about common risks associated with hypnosis, that full anonymity would be ensured, and that they were free to withdraw from participation at any time prior to or during the workshop. All participants were an adult or a minor with parental consent who reported no previous NDE and no current psychiatric diagnosis or medication.
Following the experiential component of the workshop, all participants completed and submitted the measures described below, of which seven forms containing more than one missing value were excluded. The remaining sample (N = 18) comprised 7 males (38.9%) and 11 females (61.1%) ranging in age from 15 to 59 years with a mean age of 35.9 (SD = 13.75). Regarding education level and occupation, 77.8% of the sample had university degrees, of which 38.9% were psychologists or therapists and 22.2% were teachers. Regarding religious/spiritual affiliation, 44.4% of the sample reported a religious affiliation, 22.2% a spiritual one, and 33.4% both.
Procedure
After hearing a presentation that included topics on phenomenology, explanatory models, and available scientific data on NDEs, the audience sat in chairs forming a large circle facing the experimenters. The induction protocol was applied (see Appendix), combining breathing and deep relaxation techniques, storytelling strategies, visual imagery, and background music, to facilitate an immersion into the fictional process of transitioning from life to near-death in a dreamlike scenario. The script included explicit and implicit suggestions concerning the main core elements of a typical NDE. After participants’ safe return to normal consciousness, they completed and returned the two assessment measures.
Results
Regarding the first research question, the total NDE Scale scores ranged from 2 to 23 (M = 13.89, SD = 6.33). Of the 18 respondents, 17 (94.4%) produced NDE Scale total scores of 7 or higher. Among those who scored above the cut-off point, 50% scored below 12, and 50% scored 12 or higher, with 44.4% scoring above 18. Regarding subscales, 10 of the 18 participants (55.6%) scored at least 5 on one subscale: five (27.7%) on the affective, three (16.6%) on the cognitive, and two (11.1%) on the transcendental subscale. The remaining eight participants’ (44.6%) scores did not reach the criterion of at least 5 on any subscale.
Regarding the second research question, we found no statistically significant relationship (p > .05) between total NDE Scale scores and participants’ gender, religious or spiritual affiliation, occupation, or age. However, we found a significant Spearman’s correlation between age and at least one component of the NDE subscales: Older age correlated with higher affective (rs = .478, p = .05), paranormal (rs = 0.585, p = .014), and transcendental (rs = 0.508, p = .037) subscale scores.
5. Discussion
Research Question Results
The aim of this exploratory study was to understand the aptitude of a group-administered hypnotically induced NDE to mimic the phenomenological components of a spontaneous episode and to understand the relationship between participants’ demographics and their results.
After the induction, we were able to verify empirically, through observation, that all participants responded to hypnotic suggestions with classical hypnotic physical signals, including physical relaxation, eyelids fluttering, twitching, changes in breathing pace, and catalepsy. Although pre-existent individual differences in hypnotizability and in depth and intensity of trance were not controlled for, they should be assumed, and despite their presumed existence, results pointed to a shift from everyday consciousness among all participants, leading them into a state of receptiveness regarding suggestions (Lynn et al., 2015).
NDE Scale (Greyson, 1983) results showed that all but one of the 18 participants scored above the cut-off point, indicating the presence of an NDE. Thus, the incidence of NDLE in this sample appeared indistinguishable from the incidence among Greyson’s (1983) validation study sample of NDErs. Therefore, as a result of our particular group-based hypnosis protocol, nearly all of our participants achieved the phenomenological content and intensity characterizing spontaneous NDEs that had occurred under the circumstances of a close brush with death.
Our participants also reported high levels of peace and joy in the affective subscale of the NDE Scale. This result matched results of previous studies in which predominantly non-cognitive experiences were reported both by spontaneous NDErs who had anticipated their life-threatening circumstances (Greyson, 1983; 1985) and by subjects who had been hypnotically regressed to the moment of their “death” in an alleged past life (Pederzoli et al., 2018). Conversely, when NDErs had not expected their life-threatening circumstances, their NDEs were predominantly cognitive, as in the case of military veterans whose NDEs had occurred during combat (Goza et al., 2014). Previous authors have discussed the hypothetically protective value of a predominantly cognitive NDE – with features such as time slowing down and thoughts speeding up during unanticipated life-threatening situations (Greyson, 2001; Ohkado & Greyson, 2018, p. 76). Thus, the presence or absence of expectation may increase or decrease noncognitive NDE features, respectively, confirming what Gabbard and Twemlow (1991) asserted more than 30 years ago: that the state of mind of the near-death subject is far more important than the state of the body in influencing the content of an NDE (p. 46).
Considering this apparent pattern, it seems reasonable to attribute the affective tendency we found to the fact that the participants were well informed, generally relaxed, and eager to let the experience unfold. In post-induction debriefings, no participant mentioned any reluctance to go into the virtual scenario nor any feelings of fear, anxiety, or overwhelm with disturbing emotions. Altogether, the relaxed setting, the previous preparation, and the tone of the script most likely predisposed the participants to abdicate possible inhibitory mechanisms that might have prevented a full immersion into the experience. Thus, among our non-NDEr participants, the factors of their having learned about NDEs and having been reassured about the very low probability of an adverse experience under hypnosis may have contributed, at least in part, to their subsequent reports of emotionally positive experiences.
One participant, who was grieving the loss of a close relative, reported that even though we had not yet made the hypnotic suggestion, they were already experiencing contact with their loved one. This experience could be due to the contents of the presentation, to a possible predisposition to make such a “contact,” or both. Other factors may have contributed to participants getting deeply involved in the novel experience we provided in the workshop. These include that participants were attending a conference on the topic of transpersonal phenomena and that almost 40% were psychologists or therapists interested in less conventional areas, which might indicate a preexisting interest in the topic, a motivation to become absorbed in the activity, and/or the presence of certain favorable personality traits such as openness to experience (Tellegen & Atkinson, 1974) that encompasses “both receptivity to many varieties of experience and a fluid and permeable structure of consciousness” (McRae, 1994, p. 251). In addition, any pre-existing hypnotic suggestibility may have been enhanced by expectancy and motivational factors.
The lack of correlation between sociodemographic characteristics and a reported NDLE supported the discriminative validity of the NDE Scale (Greyson, 1983) and replicated previous findings (Greyson, 1990; Greyson & Khanna, 2014; van Lommel et al., 2001). However, the relationship between higher scores on the three non-cognitive subscales and increased age that we found in participants over 40 years old might indicate that aging predisposes to a higher openness to the topic of death and dying and/or to a more relaxed and confident attitude towards non-ordinary experiences. Other possible factors include a longer involvement with the transpersonal community and experience with comparable practices and/or a greater likelihood of having lost a loved one. Personality variables would be worth exploring in future research with larger samples to learn if and how these variables might influence the experience.
6. Is a Hypnotically Induced NDLE a Real NDE?
The NDE Scale differentiates real events from ambiguous experiences (Greyson, 1990) and, for this reason, has been used in a variety of contexts (Timmerman et al., 2018; Van Gordon et al., 2018), including hypnotically induced past-life regressions, in which death experiences were facilitated (Ohkado & Greyson, 2018; Pederzoli et al., 2018). It is well known that an event resembling a spontaneous NDE can be elicited under various circumstances that facilitate deviations from normal, everyday consciousness, bringing forward episodes with comparable phenomenological elements. In fact, the type of circumstance does not seem determinant for the experience, along with the subsequent cascade of contents and aftereffects, to occur. Beyond NDEs occurring with individuals who go through the first stages of physical death, spontaneous episodes have been reported without any discernible causes (Facco & Agrillo, 2012); in the context of what have been called fear-death experiences in which life-threatening injury was anticipated but did not, in fact, occur (van Lommel et al., 2001); and during a variety of practices not involving proximity to physical death but facilitating non-ordinary states of consciousness (NOSCs), such as holotropic breathwork (Grof, 1992), ingestion of psychotropic substances (Bates & Stanley, 1985; Liester, 2013; Siegel & Hirschman, 1984; Timmerman et al., 2018), immersion in sensory isolation tanks (Gaona Cartolano, 2012), meditation (Van Gordon et al., 2018) and shamanic trance (Green, 1998; 2001). Therefore, the circumstance of the experience, by itself, does not seem to be a reliable diagnostic criterion to define the experience, as a considerable number of causes may be at the origin of the same effect.
Also, phenomenology, by itself, does not seem a reliable criterion to establish the “realness” of the experience. In the context of this study, the outcome was purposefully induced, as the protocol contained several suggestions designed to facilitate the process of going through the core structure of a spontaneous episode. Because suggestion was part of our protocol, our results indicating phenomenological equivalence between our participants’ experiences and spontaneous NDEs should be interpreted with caution – even though during informal post-workshop conversations with our participants, we learned that, beyond the script content, their inner experiences incorporated idiosyncratic features that we had not suggested, as in the case of a participant who, during her experience, met a deceased relative who offered the participant personal advice. As Facco (2012) affirmed, “experiences similar to those of NDEs can be easily generated during hypnosis” (p. 292), meaning that, as in spontaneous NDEs, relevant elements of a transpersonal nature spontaneously arose, intertwining themselves with explicit suggestions and personal features, including history, culture, and belief systems, thus providing tailormade experiences as a result of a subjectively unique combination of variables. Regarding hypnosis, as Spiegel (2005) concluded, “multilevel explanations are an absolute necessity in understanding human mind/brain/body phenomena because we are both neurally-based and social creatures who experience the world in mental phenomenal terms” (p. 32).
This synergy of internal (set) and external (setting) aspects adds difficulty to the process of discerning the “realness” of an hypnotically induced NDE episode, as it is already challenging to clearly separate between elements within the realm of NOSCs or, as they have been called, “modified” or “altered states of consciousness” (ASCs). A state of consciousness, according to Kokoszka 2007), is a way of experiencing, a state of mind delineated by both its content and its form. When any “alteration” or “modification” occurs, it becomes a state in which an “extraordinary” content is experienced or in which the manner of experiencing is “unusual,” or both. It is precisely because of their extraordinary nature that, even among skilled subjects in the NOSC experiential ground, differentiating between what belongs exclusively to the hypnotic script and what belongs to the NDLE, might constitute a challenging endeavor. Indeed, non-ordinary experiences are reputed to be “ineffable” (Yaden et al., 2015).
However, discussion about correctly discerning between, on the one hand, phenomenological aspects attributable to the script’s suggestions and, on the other hand, other aspects attributable to the episode the script was meant to induce is somehow incontrovertible, because the tool facilitating the event – hypnosis – also limits the conclusions that can be legitimately drawn. Being able to differentiate between what came from the script and the NDLEs, in order to help discern the “realness” of the result, is not a straightforward process. In fact, there are no rigorous methodological tools designed to compartmentalize NOSCs, but one of them is Vaitl et al.’s (2005) four-dimension reference system. Using their model, we observed that the relaxed activation, narrow awareness, absent self-awareness and decreased sensory dynamics are features that apply both to hypnosis – a psychological method for inducing an NOSC – and spontaneous NDEs. In our study, the experiences were psychologically induced, causing a seemingly overlap of categories and bringing about further challenges in distinguishing experiences.
What we can conclude is as follows. The fact that there may be several aspects present, consisting of possible manifestations of more than one state of consciousness, also prevents phenomenology from functioning as a diagnostic element even when a certain type of content is, in principle, a distinct trait of an NDE. Therefore, a word of caution should also be used concerning the ability of the NDE Scale (Greyson, 1983) to discriminate between anomalous experiences, especially those lying outside the category of non-life threatening or consciousness compromising episodes (Tassell-Matamua & Holden, 2020). Similar scores between NDEs and NDLEs might look the same but might not, in fact, reflect the same phenomena. Thus, even considering the encouraging results of hypnosis as an induction tool, the degree of similarity between spontaneous and induced events remains unclear.
Considering the results so far, there is no substantiated evidence to support an unequivocal equivalence between spontaneous NDEs and hypnotically induced NDLEs. Because specific suggestions were part of the equation, the results clearly manifested a phenomenological outcome, but a reasonable degree of similitude to a non-induced NDE cannot yet be established.
7. Near-Death Consciousness as a Diagnostic Criterion and Considerations for Future Studies
Considering what we know so far, many documented – but also nondocumented and even non-documentable – factors might be at the origin of a specific state of consciousness, eliciting a mysterious event that has been coined an NDE. However, even if a variety of situations might carry the aptitude to prompt an episode, it might also be true that not all NDEs are created equal, even when sharing a core phenomenology. Hence, the question that needs to be answered is whether a hypnosis protocol can induce NDLEs comparable to NDEs in not only phenomenology – the qualitative element – but also aftereffects – the quantitative element.
Overgaard and Overgaard (2010) argued that conclusions about levels of consciousness depend in a very direct way on conclusions about content, but we would add that the argument goes both ways, and that the type of content also depends on the level of consciousness. Assuming consciousness encompasses quantitative and qualitative aspects (Plum et al., 1998), beyond the type of trigger (quality) and its ability to produce a shift in consciousness, the degree of such a deviation (quantity) might be equally relevant to produce a certain type of content and aftereffects, which could hypothetically facilitate an NDLE. All considered, it seems crucial to move beyond the method of induction and phenomenology, as sole diagnostic criteria, to establish the “realness” of induced NDEs. Indeed, when observing other experiences described in the literature that involved consciousness-altering tools, what seems to precede NDEs unvaryingly is an adequate shift from an ordinary to a non-ordinary type of consciousness.
In our study, the theoretical point of departure was the assumption that, in response to specific suggestions, participants could achieve an approximation to a hypothetical NOSC we labeled Near-Death Consciousness in which they would experience a certain phenomenological result, conceptually defined as an NDE. Metaphorically, and imagining that different states of consciousness are rooms inside a house allowing for different dimensions of perceptual experience, hypnosis would facilitate entering a so-called NDE room (or rooms) through one of many possible doors. Each entrance would correspond to a specific trigger, whether life-threatening, non-life-threatening, spontaneous, or planned. Beyond this door, and after a critical shift from everyday consciousness was achieved, a typical experience would become accessible. However, based on our data, we were unable to conclude unequivocally that our participants went beyond the optimum threshold and experienced an induced NDE – not only because the experience might be caused by different triggers, but also because the phenomenological results, by themselves, are insufficient to determine if a critical threshold of activity needed for a certain dynamic to happen did, in fact, happen.
To determine if this specific type of hypnotically induced event carried the aptitude, beyond phenomenology alone, to facilitate an experience analogous to a spontaneous NDE, other variables should be considered, with the goal of attaining a clearer perspective on how suitable a tool such as hypnosis is to approach the threshold we called Near-Death Consciousness. Thus, a hypothetical assessment model for using hypnosis as a tool to induce NDLEs should include at least four variables. Regarding the quality of the experience, two elements were already considered in this study:
(a) the context, or trigger, used to facilitate the NDLE, that is, the group hypnotic induction and the script of choice, and
(b) the content, indicated by the phenomenological elements, assessed with the NDE Scale (Greyson, 1983);
Regarding the quantity of the experience, two new elements should be measured in future studies:
(c) the shift from an ordinary state of consciousness, indicated by the intensity and depth of the subjective deviation, retrospectively assessed with adequate psychometric tools, and
(d) the aftereffects, projecting into the future the magnitude of the experience’s impact, as to provoke irreversible structural biopsychospiritual changes and outstanding attitudinal adjustments, as it happens in spontaneous NDEs, assessed in follow-up with appropriate instruments.
In addition to such elements, there might be very different degrees of success in inducing an NDLE with hypnosis as a trigger, depending on other conditions. The combination of different scripts with more or less detailed suggestions and the measurement of individual variations in hypnotizability should provide a more precise idea about the degree of influence to expect from the suggestions and the intensity of the experience in each subject. By manipulating such variables and discriminating between subjective and objective factors, it would be possible to know more about the adequacy of hypnosis to facilitate an NDLE. In a project in its final stages (Machado Ferreira, under review), with the financial support of a BIAL Foundation Grant, such limitations were partially addressed by exploring additional variables.
8. Conclusions
As far as phenomenology is concerned, it was possible to conclude that a structured hypnosis protocol caused an observable response reaction seemingly indistinguishable, in content and intensity, to an actual NDE, according to what the NDE Scale (Greyson, 1983) measures. As predicted, a specific hypnosis protocol can be used as a tool to mimic a spontaneous NDE, considering that 94.4% of our participants reported a phenomenologically indistinguishable experience compared to the original sample of NDErs from Greyson’s (1983) validation study. In addition, an induced event elicited positive responses regarding the affective quality of the event, supporting the probable role of expectations. Apart from a tendency of older participants to score higher in non-cognitive components, we found no correlation between sociodemographic variables and the occurrence of an NDLE. However, by using the NDE Scale as an a posteriori assessment tool built upon a pre-established pattern of experience, it was possible to conclude only that the participant’s narratives were phenomenologically similar to those of spontaneous NDErs. Therefore, hypnosis, as a method of induction could be considered an appropriate vehicle to bring forward an episode, with a phenomenological core structure resembling a spontaneous NDE. However, it remains unclear how much of the outcome was a mere expression of the content of the hypnosis script. Indeed, the phenomenological outcome of specific suggestions, by itself, did not provide enough data to conclude, beyond any doubt, that a hypnotically induced event replicated a spontaneous NDE. As such, methodological difficulties in differentiating between what belongs to the method and what belongs to the experience should be addressed in future studies. To be able to affirm that induced and spontaneous experiences are comparable and to conclude that hypnosis enables the participants to come close to a hypothetical state that can be called Near-Death Consciousness, other assessment strategies beyond the analysis of phenomenological variables should be used in the future, including the measurement of aftereffects.
9. References
Bates, B. C., & Stanley, A. (1985). The epidemiology and differential diagnosis of near-death experiences. American Journal of Orthopsychiatry, 55(4), 542–549.
Charland-Verville, V., Jourdan, J-P., Thonnard, M., Ledoux, D., Donneau, A-F., Quertemont, E., & Laureys, S. (2014). Near-death experiences in non-life threatening events and coma of different etiologies. Frontiers in Human Neuroscience, 8, 203. https://doi.org/10.3389/fnhum.2014.00203
Facco, E. (2012). Near-death experiences and hypnosis: Two different phenomena with something in common. Contemporary Hypnosis and Integrative Therapy, 29(3), 284–297.
Facco, E., & Agrillo, C. (2012). Near-death-like experiences without life-threatening conditions or brain disorders: A hypothesis from a case report. Frontiers in Psychology, 3(490). https://doi.org/10.3389/fpsyg.2012.00490
Facco, E., Casiglia, E., Al Khafaji, B. E., Finatti, F., Duma, G. M., Mento, G., Pederzoli, L., & Tressoldi, P. (2019). The neurophenomenology of out-of-body experiences induced by hypnotic suggestions. International Journal of Clinical and Experimental Hypnosis, 67(1), 39–68.
Gabbard, G. O., & Twemlow, S. W. (1991). Do “near-death experiences” occur only near-death? – revisited. Journal of Near-Death Studies, 10, 41–47. https://doi.org/10.17514/JNDS-1991-10-1-p41-47.
Gaona Cartolano, J. M. (2012) ¿Son las experiencias cercanas a la muerte (ECM) la base empírica que demuestra la existencia del alma? [Are the near-death experiences (NDE) the empirical basis to prove the existence of the soul?] Journal of Transpersonal Research, 4(2), 72–108.
Goza, T. H., Holden, J. M., & Kinsey, L. (2014). Combat near-death experiences: An exploratory study. Military Medicine, 179(10), 1113–1118. https://doi.org/10.7205/MILMED-D-14-00051
Green, J. T. (1998). Near-death experiences, shamanism, and the scientific method. Journal of Near-Death Studies, 16, 205–222. https://doi.org/10.17514/jnds-1998-16-3-p205-222.
Green, J. T. (2001). The near-death experience as a shamanic initiation: A case study. Journal of Near-Death Studies, 19, 209–225. https://doi.org/10.17514/JNDS-2001-19-4-p209-225.
Greyson, B. (1983). The Near-Death Experience Scale: Construction, reliability, and validity. Journal of Nervous and Mental Disease, 171(6), 369–375.
Greyson, B. (1985). A typology of near-death experiences. American Journal of Psychiatry, 142(8), 967–969.
Greyson, B. (1990). Near-death encounters with and without near-death experiences: Comparative NDE Scale profiles. Journal of Near-Death Studies, 8, 151–161. https://doi.org/10.17514/JNDS-1990-8-3-p151-161.
Greyson, B. (2001). Posttraumatic stress symptoms following near-death experiences. American Journal of Orthopsychiatry, 71(3), 368–373.
Greyson, B., & Khanna, S. (2014). Spiritual transformation after near-death experiences. Spirituality in Clinical Practice, 1(1), 43–55.
Grof, S. (1992). The holotropic mind. Harper Collins E-Books.
Holden, J. M., Greyson, B., & James, D. (Eds). (2009). The handbook of near-death experiences: Thirty years of investigation. Praeger/ABC-CLIO.
Holden, J., & MacHovec, F. (1993). Risk management in hypnotic recall of near-death experiences. American Journal of Clinical Hypnosis, 36(1), 38–46.
Khanna, S., & Greyson, B. (2013). Near-death experiences and spiritual wellbeing. Journal of Religious Health, 53(6), 1605–1615.
Khanna, S., & Greyson, B. (2015). Near-death experiences and posttraumatic growth. Journal of Nervous and Mental Disease, 203(10), 749–755.
Kokoszka, A. (2007). States of consciousness: Models for psychology and psychotherapy. Springer.
Lange, R., Greyson, B., & Houran, J. (2004). A Rasch scaling validation of a “core” near-death experience. British Journal of Psychology, 95(2), 161–177.
Leskowitz, E. D. (Ed.). (1999). Transpersonal hypnosis. Gateway to body, mind and spirit. CRC Press.
Levitan, A. A. (1985). Hypnotic death rehearsal. American Journal of Clinical Hypnosis, 27(4), 211–215.
Liester, M. B. (2013). Near-death experiences and ayahuasca induced experiences – Two unique pathways to a phenomenologically similar state of consciousness. Journal of Transpersonal Psychology, 45(1), 24–48.
Lucas, W. B. (1993). Regression therapy: A handbook for professionals (Vol. I: Past-life therapy; Vol. II: Special instances of altered state work). Deep Forest
Press.
Lynn, S. J., Laurence, J. R., & Kirsch, I. (2015). Hypnosis, suggestion, and suggestibility: An integrative model. American Journal of Clinical Hypnosis, 57(3), 314–329.
Machado Ferreira, A. S. (under review). Induced near-death-experiences in healthy volunteers: Phenomenology and aftereffects [Doctoral thesis]. University of Northampton.
Martial, C., Mensen, A., Charland-Verville, V., Vanhaudenhuyse, A., Rentmeister, D., Bahri, M. A., Cassol, H., Englebert, J., Gosseries, O., Laureys, S., & Faymonville, M. E. (2019). Neurophenomenology of near-death experience memory in hypnotic recall: A within-subject EEG study. Scientific Reports, 9, 1–11. https://doi.org/10.1038/s41598-019-50601-6
McCrae, R. R. (1994). Openness to experience: Expanding the boundaries of Factor V. European Journal of Personality, 8(4), 251–272.
Moody, R. A. (1975). Life after life. Mockingbird Books.
Ohkado, M., & Greyson, B. (2018). A comparison of hypnotically-induced death experiences and near-death experiences. Journal of International Society of Life Information Science, 36(2), 73–77.
Overgaard, M., & Overgaard, R. (2010). Neural correlates of contents and levels of consciousness. Frontiers in Psychology, 1, 164. https://doi.org/10.3389/fpsyg.2010.0016422
Palmieri, A., Calvo, V., Kleinbub, J. R., Meconi, F., Marangoni, M., Barilaro, P., Broggio, A., Sambin, M., & Sessa, P. (2014). The “reality” of near-death experience memories: Evidence from a psychodynamic and electrophysiological integrated study. Frontiers in Human Neuroscience, 8. https://doi.org/10.3389/fnhum.2014.00429
Pederzoli, L., De Stefano, E., & Tressoldi, P. (2018). Hypno-death-experiences: Death experiences during hypnotic life regressions. Death Studies, 45(4), 322–326. https://doi.org/10.1080/07481187.2019.1626949
Plum, F., Schiff, N., Ribary, U., & Llinás, R. (1998). Coordinated expression in chronically unconscious persons. Philosophical Transactions of the Royal Society London, Biological Sciences, 353,1929–1933.
Ring, K. (1996). Near-death experiences: Implications for human evolution and planetary transformation. In L. W. Bailey & J. Yates (Eds.), The near-death experience: A reader. Routledge.
Schenk, P. W. (1999). The benefits of working with a “dead” patient: Hypnotically facilitated pseudo near-death experiences. American Journal of Clinical Hypnosis, 42(1), 36–49.
Schenk, P. W. (2006). The hypnotic use of waking dreams: Exploring near-death experiences without the flatlines. Cromwell Press.
Siegel, R. K., & Hirschman, A. E. (1984). Hashish near-death experiences. Anabiosis: The Journal for Near-Death Studies, 4, 69–86. https://doi.org/10.17514/JNDS-1984-4-1-p69-86.
Spiegel, D. (2005) Multileveling the playing field: Altering our state of consciousness to understand hypnosis. Contemporary Hypnosis, 22(1), 31–33.
Tassell-Matamua, N. T., & Holden, J. M. (2020). Near-death experiences: The mystical feeling of “crossing over” and its impact on faith and spirituality. In K. E. Vail, III, & C. Routledge (Eds.), The science of religion, spirituality, and existentialism (pp. 51-64). Academic Press.
Tellegen, A., & Atkinson, G. (1974). Openness to absorbing and self-altering experiences (“absorption”), a trait related to hypnotic susceptibility. Journal of Abnormal Psychology, 83(3), 268–277.
Timmermann, C., Roseman, L., Williams, L., Erritzoe, D., Martial, C., Cassol, H., Laureys, S., Nutt, D., & Carhart-Harris, R. (2018). DMT models the near-death experience. Frontiers in Psychology, 1424, 1–12. https://doi.org/10.3389/fpsyg.2018.01424
Tressoldi, P., & Pederzoli, L. (2021, December 13). Out-of-body experience induced by hypnotic suggestion: Phenomenology and perceptual characteristics. https://doi.org/10.31231/osf.io/kqh3t
Tressoldi, P. E., Pederzoli, L., Caini, P., Ferrini, A., Melloni, S., Richeldi, D., Richeldi, F., & Trabucco, A. (2014). Out-of-body experience induced by hypnotic suggestion: Phenomenology and perceptual characteristics. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.2443719
Vaitl, D., Birbaumer, N., Gruzelier, J., Jamieson, G. A., Kotchoubey, B., Kübler, A., Lehmann, D., Miltner, W. H., Ott, U., Pütz, P., Sammer, G., Strauch, I., Strehl, U., Wackermann, J., & Weiss, T. (2005). Psychobiology of altered states of consciousness. Psychological Bulletin, 131(1), 98–127.
Van Gordon, W., Shonin, E., Dunn, T. J., Sheffield, D., Garcia-Campayo, J., & Griffiths, M. D. (2018). Meditation-induced near-death experiences: A 3-year longitudinal study. Mindfulness, 9(6), 1794–1806.
van Lommel, P., van Wees, R., Meyers, V., & Elferrich, I. (2001). Near-death experience in survivors of cardiac arrest: A prospective study in the Netherlands. Lancet, 358(15), 2039–2045.
Yaden, D. B., Eichstaedt, J. C., Schwartz, H. A., Kern, M. L., Le Nguyen, K. D., Wintering, N. A., Hood, R. W. Jr., & Newberg, A. B. (2015). The language of ineffability: Linguistic analysis of mystical experiences. Psychology of Religion and Spirituality, 8(3), 244–252.
Zahi, A. (2009). Spiritual-transpersonal hypnosis. Contemporary Hypnosis, 26(4), 263–268.
