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You are here: Home / Archives for Research findings

Research findings

By the numbers, #3: Hospital studies

September 30, 2011 By Nan Bush 7 Comments

In the first post of this series, I posed the question, how can it be that in the hospital-based studies, where participants are closer to death, the reports of distressing NDEs are at zero percent, and percentages of pleasant NDEs are typically 20% lower than in studies of the general population? Shouldn’t all those rates be higher, or are healthy people making up stories? These are the academic researchers who know how to do studies expertly; should we trust their data more?

In hospitals, we assume, a fair number of patients are close to death. It only makes sense, then, that hospitals would be where most NDEs occur. A great many accounts bear that out, as experiencers describe their surgery-associated NDE or what they have seen of the ER during an out-of-body episode. That has certainly been the assumption on which the hospital-based studies were designed: Go where the subjects will be. For an even richer sample, if you want a population that is unequivocally near death, study NDEs of people in cardiac arrest. Makes sense.

Unfortunately, sometimes “sense” doesn’t pan out.

Consider the following scatter chart. (Please do. In near-death studies, where quantifiable data is so hard to come by, any piece of numerical information is downright thrilling.) I can hear some of you wailing with excitement; but don’t worry, the chart simply gives a useful sense of what was where, and when.

The red dots indicate reports of distressing NDEs published in reputable journals; black squares indicate studies reporting 0% distressing NDEs; the left column shows the approximate percentage of dNDE accounts in each study; and the bottom row shows the year the study was published. An “H” (which is registering here as a blob) below a black square indicates a hospital study. My apologies for the blurry translation from .jpg to WordPress image.

Black = 0% dNDE (of 331 NDE)  Red = % dNDE (148 of 1024 NDE)  ?*= May be as high as

Studies: 1975, Moody; 1978, Rawlings; 1979, Garfield; 1980, Ring; 1981, Evergreen; 1982, Gallup, Sabom; 1983, Bush; 1985, Grey; 1987, Sutherland;  1992, Atwater;  1993, Rawlings; 1995, Serdahely; 2000, Rommer; 2001, Knoblauch, Parnia, vanLommel; 2003, Greyson; 2005, Schwaninger  Note: Total of dNDEs and the average percentage given here differ from those on the previous tables because not all those studies reported percentages.

* The Gallup study reported 1% hellish NDEs but as many as 28% in some way unpleasant.

This chart is what I mean about how sometimes questions absolutely jump off a chart. Why, with all those red dots indicating the existence of distressing NDEs (332 of them in those studies), did no hospital study report finding a single one? For that matter, why is it that the reported incidence of any NDE is lower in the hospital studies than in studies of the general population?

I believe that four principal issues can explain the disparity. First, why do hospital studies report so many fewer NDEs than general studies?

1) Research design and stringency of study criteria. The general studies (non-hospitalized participants, often self-selected) have largely been designed to answer questions like, “What is an NDE?” They provided the original first-person testimony establishing the existence of near-death experience, with some attention to demographic information. The general studies have been retrospective (including NDEs both recent and decades in the past), inclusive of all reported circumstances. What they may indicate is the prevalence of NDEs; that is, how many people are likely to have an NDE over the course of their lifetime no matter what the circumstances.

By contrast, the hospital studies have observed much stricter research protocols. They are prospective studies (catching any NDEs shortly after they occur). As described by Bruce Greyson (The Handbook of Near-Death Experiences), what these studies have reported is what the medical field terms the incidence of NDEs: that is, the number of NDEs reported by a specific group (the study participants) who were admitted to the study according to their recent experience of predefined medical conditions, so that it is possible to be relatively certain that the NDEs being reported occurred in the context of that condition. In other words, how many people in a strictly defined medical condition are likely to report having an NDE.

It’s like tea strainers: Prospective studies have a finer “mesh” than general studies. The finer the mesh (the tighter the study requirements), the fewer tea leaves in the cup (and the fewer the experiences in the study).

2. The nature of the population being studied. However ardently the participants in a general study believe they were close to death—and not all do—there is usually no objective information to say their perception is correct. Many of them were basically healthy, although perhaps injured or with a temporary illness.

By contrast, in the five hospital studies here, the study participants are known to have been clinically dead and resuscitated, many of them with multiple serious health conditions. Contrary to what TV shows routinely indicate, cardiopulmonary resuscitation, or CPR, is hardly a cure-all. One recent study in the United Kingdom reported that even with optimum conditions, following CPR the immediate survival rate was 38.6%, with 24.7% surviving 24 hours later, 15.9% alive to be discharged, and 11.3% surviving at 12 months. American Heart Association figures show that of witnessed in-hospital cardiac arrests, 48% survived immediate CPR, with 22% surviving long enough to be discharged.

In short, these are desperately ill folks, many of whom die well before survey interviewers can get to them. Of those who survive to participate, well under one in five is still alive a year later, around the time the study is concluding its follow-up interviews. They have not lived long enough for a researcher to report their experiences. And this brings us to the third reason and fourth reasons I believe there are so few distressing near-death experiences in the hospital studies:

3. As has been reported consistently, it takes a long time for people who have had a distressing NDE to be ready to talk about it. But given the statistics above, by the time people with an NDE coincident with cardiac arrest might be ready to reveal their distressing experience, most of them have died.

4. Going with this disclosure issue is one more, which is the matter of trust. The most satisfactory information appears to come under four circumstances: a) when NDErs are interviewed well after the experience, b) in an informal setting, c) with no time constraints, and d) by a person they trust. Cherie Sutherland was clear in Transformed by the Light that trust is essential for the revelation of intensely personal confidences. That empathy enabled the charismatic physician Barbara Rommer to report that even in her early interviews she was already finding “accounts that were very frightening.” The hospital studies, on the other hand, a) initiated questioning shortly after the cardiac arrest, b) were in a formal clinical setting, c) in circumstances that could not afford leisurely questioning, d) by people with whom most patients had no genuine personal relationship. It is worth remembering Carol Zaleski’s quoting the comment of a hospitalized NDEr: “I’ll be damned if I share my feelings about death and dying with anyone who makes 2-minute U-turns at the foot of my bed.”

To repeat: Even the best-designed study cannot draw out an NDE, particularly a distressing one, if the person is not ready or able to talk.

Please note: These are my opinions. Clinicians or NDErs who have an alternative to any part of my explanation are invited to post their views.

And a P.S.: The dots and squares on that chart show all the reputable journal-published studies of near-death experiences over the 30 years 1975-2005. You may wonder “Why so few?” There is a short answer: No funding. We’ve come a long way, baby, but it’s an even longer way to mainstream acceptance.

Tagged With: distressing NDE, distressing near-death experience, hospital studies, medical study NDE, NDE cardiac arrest, near death research, negative NDE, Research findings

By the numbers, #2

September 24, 2011 By Nan Bush 5 Comments

Maybe you have to be a numbers geek to be interested in the previous post, but I find the numbers fascinating. Not the numbers themselves, but what they suggest (and some seem to shout). That post was simply tables showing the incidence of distressing NDEs in studies published in responsible journals between 1975 and 2005. Questions nearly jump off the pages. For instance:

1. The early attention. Where were the distressing experiences in the early reports of near-death experience? Were the major researchers hiding something? Did the distressing NDEs only start later?

2. Hospital studies. How can it be that in the hospital-based studies, where participants are closer to death, the reports are of zero dNDEs and percentages of pleasant NDEs are typically 20% lower than in studies of the general population? Shouldn’t all those rates be higher, or are healthy people making up stories? These are the academic researchers who know how to do studies expertly; should we trust their data more?

3. Why that 1% rumor? With a thorough literature review showing that on average almost one in five reported NDEs has been distressing, why is it that for over two decades almost everyone has said that only 1% of NDEs are “negative”?

I’ll start with the first question now and deal with the second and third in the next two posts.

Where were distressing experiences in the early studies of near-death experience?

They were there but invisible. The reasons for the silence are relatively simple and understandable.

Researchers. Nowadays, we are pretty much used to NDEs. Although the great majority of them are still wonderful and life-shaping, and they bring comfort to millions of people who hear about them, today’s pleasure and reassurance seem pale compared to the stunning sense of hope and mystery when people were first hearing about them. Audiences and researchers alike were simply transfixed. Researchers are certainly not immune to the same hopes and anxieties as the rest of humanity, and what these researchers wanted to know about specifically were the glorious NDEs, the peaceful ones, the ones that sounded like heaven.

One answer, then, about why dNDEs were invisible comes from this: what questions did the researchers ask? Their eyes were so intently fixed on happily transformative experiences, it didn’t occur to them to ask about anything unpleasant; and if it did occur to them to wonder, it seemed they didn’t really want to know enough to add those inquiries. This can be considered humanly understandable or, less kindly, as researcher bias.

Further, it was still so early in the NDE research game, interviewers weren’t quite certain how far it was all right to probe. As many of the experiencers being  interviewed were in fragile health, no responsible investigator wanted to go in like a SWAT team, asking challenging questions that might be harmful. What if  tough questions precipitated another experience and this time the person actually died?

Experiencers themselves. In the years we’re talking about, roughly 1975 to 1982, NDEs were still considered “iffy” in terms of mental health. For psychotherapists and physicians, one big question was whether these were psychotic events. Experiencers often contacted the IANDS office anonymously, afraid of being too self-revealing. No matter what the method of communication, an experiencer’s most common opening statement was, “I hope you won’t think I’m crazy, but…”

The days of wide-open websites were far in the future; reporting an NDE was considered so intensely private that in setting up the first NDE account archive, IANDS promised three different levels of security to safeguard contributor confidentiality. And all these cautions were about the pleasurable experiences! If blissful experiences were considered so hush-hush, imagine the secrecy and anxiety, not to mention the shame, around a frightening experience!

Even today, put yourself in the experiencer’s place: Knowing what people speculate and wonder about dNDEs, would you want to go public with a terrifying near-death account? The reluctance of experiencers to describe their dNDEs is why, when psychiatrist Bruce Greyson and I began pulling together experience accounts for the first study of distressing NDEs, it took ten years to collect the 50 narratives that made up our study sample. Even the best -designed study will not bring out experience accounts until people are ready to talk about them.

The audience and media. In that first decade, the Big Four of researchers were Raymond Moody, Kenneth Ring, Michael Sabom, and George Gallup. Their books dominated the scene. Maurice Rawlings did well in conservative Christian circles with his books about hell, but they did not hit the mainstream as the others did. And the media, riding high on stories of blissful NDEs, were in no hurry to stop the torrent. The few other mentions of difficult NDEs were in journal articles, not books, and never claimed much in the way of public attention.

Overall, the result is what we have seen: mystery and invisibility surrounding distressing near-death experiences.

Next time: The hospital studies.

Tagged With: NDE, near death experience, negative NDE, Research findings

dNDEs by the numbers

September 21, 2011 By Nan Bush 2 Comments

Preparing for the IANDS conference at Houston’s M.D. Anderson Cancer Center in 2006, I did a detailed review of the research literature 1975-2005 to see what various studies had said about distressing NDEs. The findings were distributed as handouts but were not included in the published report in The Near-Death Handbook. Some readers here may be interested. In the next post, I’ll comment on them.

Distressing Western NDEs, 1975-2005: Research Summary

Note:  Please keep in mind that figures for “n NDE” and “n dNDE” are the numbers of experiences reported, not necessarily the actual number of experiences. Under-reporting, especially of distressing NDEs, has been recognized as  common. (Hoffman, Greyson-Bush, Bache, Bush, Clark Sharp)

 General  Studies, no dNDEs

Study       Population /type n NDE n dNDE % Findings; author’s words Comment
R. Moody19751978 AnecdotalSelf-selected from
general pop
50 0 0 In the mass of material I have collected no one has ever described … a state like the archetypal hell. Reflections 10 Theclassic on NDE, established the pattern & the fieldMentions ‘no archetypal hell’ but does not exclude other types of dNDE
K. Ring1980 QuantitativeSelf-selected general 46 0 0  … sometimes …feeling scared or confused near … beginning of their experience, none felt that they …either were on their way to hell or …had “fallen into” it.  …affective tone and the visionary aspects of the near-death experience … predominantly and highly positive.  192-93  [Frightening features] appear to have been, in the main, hallucinatory visions 195 First quantified study of NDE, introduced Weighted Core Experience Index (WCEI)Beyond descriptive data, speculative as to mechanics and purpose of NDE (holographic universe)
Sutherland Self-selected general 50 0 0 No mention Modified WCEI, interp ‘grounded theory’
Medical, prospective
Study       Population/type n NDE n dNDE % Findings Comment
Sabom In-patient 78 0 0 “In my sample …I did not encounter a “hellish” NDE . . . Since [then], I have encountered a few distressing NDEs…” ** **Sabom JNDS 14(3) 208
vanLommel Cardiac arrest 62 0 0 “No patients reported distressing or frightening NDE”
Parnia et al2001 Cardiac arrest 7 0 0 No mention Greyson scale
Greyson
2003
Cardiac in-pts 27 0 0 No mention FNDE questions not asked
Schwaninger 2005 Cardiac arrest 11 0 0 “None of the NDErs reported resignation, curiosity, anxiety, fear, anger, dread, despair, or anguish” WCEI & Greyson
               8 n=331 0 0%

General Studies: with dNDEs

   Name       Pop n NDE n fNDE % Findings Comment
Garfield1979 Cancer patients 47 22 <50 4 types: classic radiant; demonic or nightmarish images; dreamlike images –“blissful,” “terrifying,” or alternating; Void, tunnel, or both (contrast between freedom/ constraint). Almost as many of the dying patients interviewed reported negative visions (demons and so forth) as reported blissful experiences, while some reported both Additional survey of 36 cardiac patients over 3 interviews showed consistency of recall (contrary to Rawlings)
Evergreen1981 Self-selectclinical death or believed self died &  back 55 11 20 One (<2%) hellish; fiery pit, devil.  18% “negative”: “…extreme fear, panic, anger…visions of demonic creatures that threaten or taunt”; most transform to positive NDE, but some positive  become negative First academic study following Ring LADInterview, WCEI
Gallup1982 Random sample, national poll Not given 1-
<28
1% sense of  hell or torment; but “picture is more complex than that.  [M]any…had either a neutral or negative experience.”Void; nothingness; uncaring God; being tricked or duped; featureless, forbidding figures; confusion, fear of death Popular broad (& erroneous) reference to the 1% as total of  distressing NDEs; instead, it is a single mention of elements of biblical hell (“gnashing teeth, searing flames”).“Many” others in the sample neutral or  distressing but not hellish by Gallup definition.
Evans Bush1983 Most self-selected,
2 mothers
17 2 12 1 child in darkness, threatened by mysterious presence1 child met “the devil” but rebuffed him First report of NDE/dNDE in children, based on retrospective accounts, 2 mothers of then-4-year-olds
Grey1985 NDErs 41 5 12 “extreme fear or panic…anguish…lost…
desolation…traditional fire/ devil
First attempt to document dNDEs. Gave explicit definitions, descriptions
Serdahely1995 Non-random NDErs 12 4 33 “Frightening, scary, unpleasant” but no hellish images Two other (secondhand) reports include hellish imagery
Knoblauch et al   2001 Random German national poll 82 c 36 43 Structure differs from classic NDE ; accounts are scenic more than narrative, less emotional; later,
improved outlook but not major moral life changesdNDE: More E Ger (60%/) than W Ger (29%)
Culturally anomalous
               7 254 c 80 c 17%

Distressing NDEs Only

Study       Population/type n NDE n dNDE % Findings Comment
Rawlings1978,1993 AnecdotalMost cardiac in-patients “Several hundred”*33*15 *12*32 3948 Interview immediately post-resuscitation or NDE will be repressed, forgotten or recalled as pleasantLiteralist Christian: Accounts taken as evidence of biblical hell, urgent need for salvation * Sabom calculations (JNDS 14(3))Vivid accounts but shaky data: factual errors; accounts inconsistent in retelling; conclusions not replicated by othersIntent is to rescue non-believers  more than to provide research data.
Greyson-Bush1993 Self-selected 50 50 100 No single “dNDE” but three types: classic elements perceived as terrifying; Void; images of traditional hell First analytical study of exclusively dNDE accounts; reports patterns but does not speculate as to causes
Atwater1994 AnecdotalGenl. NDErs 700
277
105 14 Void, limbo, hellish, indifference; seem to have deeply suppressed/repressed guilts, fears, angers/ expect punishment or discomfort at death Strongly attuned to experiencer perspectives. Insightful and wide-ranging, though undocumented, exploration of dNDEs, marked by metaphysical pronouncements of cause, effect, and mechanics of phenomena.
Rommer2000 NDErs 300 53 >18 “feelings of terror, despair, guilt, and/or other overwhelming aloneness”“Every [distressing near-death] experience I have studied has been transforming” Perhaps the best collection of dNDE reports, but projects own beliefs onto experiencers; draws conclusions without substantiation: “He had no life review because it wasn’t necessary.”
               4 1,375 252

Totals

n NDE

n dNDE % dNDE
All categories 1,910 332 17

 

Tagged With: incidence, NDE research data, NDE statistics, near death experience percentages, near death research, prevalence, Research findings

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