September 2013 Article of the Month
Khanna, S. and Greyson, B. "Near-death experiences and spiritual well-being." Journal of Religion and Health 53, no. 6 (December 2014): 1605-1615
SUMMARY and COMMENT: Stories of Near Death Experiences (NDEs) are relatively common for chaplains, but what research may be paired with that anecdotal experience? Our article this month is co-authored by one of the leading medical scholars of NDEs, Bruce Greyson, and Surbhi Khanna, a Psychiatry Resident at the University of Virginia Health System. They note that studies indicate perhaps 17% of critically ill patients have the experiences, but "many patients are reluctant to acknowledge them due to lack of acceptance and social support" [p. 1606]. Chaplains, as among the few with whom patients may venture discussion of NDEs, should find the insights from research useful in contextualizing the phenomenon.
Khanna and Greyson summarize "profound and transforming" effects of NDEs:
They may lead to value and life changes similar to those reported following spiritual awakening, including enduring self-transformation and self-transcendence, and are not associated with prior religious affiliation or religiosity, nor are they typical of those resulting from traumatic experience…. A recent review of research into the characteristic changes following NDEs found the most commonly reported to be loss of fear of death; strengthened belief in life after death; feeling specially favored by God; a new sense of purpose or mission; heightened self-esteem; increased compassion and love for others; lessened concern for material gain, recognition, or status; greater desire to serve others; increased ability to express feelings; greater appreciation of, and zest for, life; increased focus on the present; deeper religious faith or heightened spirituality; search for knowledge; and greater appreciation for nature…. [p. 1606]Moreover, "one of the most significant changes following an NDE is spiritual growth, often involving a more loving attitude, knowledge of God, and inner peace" [p. 1606]. However, "the specific construct of spiritual well-being has not yet been investigated in persons reporting NDEs" [p. 1607; italics added], and so the present study seeks to explore that particular relationship.
"Participants were 224 individuals who had previously contacted the authors to share their accounts of their experiences when they had come close to death" [p. 1607]. They were assessed by a mailed battery that included two well established measures: the Spiritual Well-Being Scale (Paloutzian and Ellison) and the Near Death Experience Scale (Greyson). The NDE Scale was used in two ways: first, to assess whether the individual did indeed have an NDE, thereby dividing participants into an NDE group (203 = 91%) and a comparison group of "non-experiencers" (21 = 9%); and second, to assess the depth of the experience of those in the NDE group as "subtle," "deep," or "profound," [--see pp. 1608-1609].
Among the findings:
In general, the data from this study suggest that NDEs are associated with an increased sense of spiritual well-being, and that the "deeper" the NDE, the more profound this effect becomes. [pp. 1611-1612] …[T]he depth of NDE was associated with higher scores on the SWBS and on both the religious and existential well-being subscales. [p. 1613] …As individuals go deeper into their NDEs, they report a stronger level of connection with their inner being or ‘‘spiritual self,’’ as well as with the world around them. These connections impact NDErs’ entire outlook toward life and often impel them on a journey to find the same harmonious, peaceful, and serene feeling. These changes may explain NDErs’ higher scores on the SWBS compared to respondents who had come close to death without NDEs. [p. 1613]Also:
SWBS scores among our sample of NDErs tended to be comparable to those of religious samples in other studies. [p. 1612] …The comparably high scores among NDErs suggest either that prior religiosity facilitates NDEs or that NDEs are transformative experiences that alter experiencers on a spiritual level. [p. 1613]The authors consider their data in light of other studies and conclude:
The data from this study support previous research suggesting that NDEs may be considered a form of, or vehicle for, spiritual awakening. We suggest that a causal link between NDEs and spiritual well-being may cautiously be proposed as the best fit for the cumulative data so far. However, the retrospective design of almost all the supportive research obliges us to regard that causal interpretation as a hypothesis still to be tested by prospective study. [p. 1613]Khanna and Greyson are models of scientific caution about making generalizations from a single study's findings. They are quick to point out that "our confidence in and interpretation of these findings must be tempered by certain weaknesses inherent in a retrospective study of this type" [p. 1612], including the fact that their sample was self-selected. Their challenge for future studies to be prospective may be one that research chaplains could be in a position to explore.
One final note about the article: our authors give particular attention to a recently-proposed theory (by Sam Parnia and Josh Young in their 2013 book, Erasing Death: The Science That Is Rewriting the Boundaries between Life and Death): namely that "the biology of cardiac arrest is sufficiently different from that of other close brushes with death to justify considering experiences under those two circumstances separately" [p. 1608]. The present study "did not find any difference in SWBS scores" between individuals based upon such a categorization, though Khanna and Greyson are again cautious in drawing conclusions from this finding.
Suggestions for the Use of the Article for Student Discussion:
The analysis in the results section of this month's article may be difficult for non-researchers to follow, but the Introduction and Discussion sections should be accessible to all students. The Introduction, especially, could open a general discussion of Near Death Experiences and a comparison of the broad outline of the research with chaplains' awareness of the phenomenon. Consulting the NDE Scale itself may give a good sense of the defining characteristics of NDEs [--see Related Items of Interest, II, below]. What have students ever heard from patients along these lines? What do they make of the authors' comment of the reluctance of people to tell of NDEs? Have students heard patients preface disclosures with phrases like, "This probably sounds crazy..."? Do patients seem aware that NDEs are not uncommon? Also, have patients indicated NDEs have been anxiety-relieving or anxiety-causing? Have they been perceived as transformative? What theological dynamics have come up for patients?
Related Items of Interest:
I. We previously looked at studies of Near Death Experiences, including works by Greyson, in our May 2006 Article-of-the-Month. See that for page for earlier references on the subject.
II. This month's study employed the Near Death Experiences Scale. That 16-item measure is online through the International Association for Near Death Studies at http://iands.org/research/important-research-articles/698-greyson-nde-scale.html. Note: the scoring information about the scale states only that a score of 7 or greater identifies a Near Death Experience, and there is no mention of the depth-indicators used in the present study for assessing "subtle," "deep," or "profound" NDEs.
III. In addition to providing information about the Near Death Experiences Scale, the International Association for Near Death Studies site offers a great deal of information about NDEs. See http://iands.org.
IV. Bruce Greyson is Director of the Division of Perceptual Studies at the University of Virginia School of Medicine and Health System. The division's Perceptual Studies website includes a number of links to information of general interest on NDEs and other related topics.
V. Recent articles about Near Death Experiences include the following. Note the international origins of this scholarship.
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