Burn Survivors’ Near-Death Experiences: A Qualitative Examination

Abstract

Persons who come close to death but survive catastrophic accidents sometimes report very vivid experiences during times when their survival was in doubt, when they were believed to be dead, and during resuscitation efforts. This qualitative study builds upon existing research on near-death experiences (NDEs) by focusing on the oral accounts from a sample of individuals with large and life-threatening burns. The NDE accounts were obtained from burn survivors attending the Phoenix Society’s World Burn Congress and are similar to reports by notable researchers (Greyson, 2003; Moody, 1975; Ring, 1980) while reflecting the uniqueness of the individual survivor’s experiences. Six major themes are reported. Counselors and health professionals need to be aware of and educated about NDEs as these experiences can have profound effects upon the individual. Patients who have had NDEs may need to discuss them but fear professionals will reject their stories as being crazy.

Keywords

near-death experiences NDE qualitative burn survivors content analysis

Human beings, perhaps unlike other mammals, have the capacity to contemplate their own demise, and knowledge of this inevitability is “a universal psychological quandary for humans” (Lehto & Stein, 2009, p. 24). While the ability of the medical profession to preserve life after severe traumatic injury has rapidly developed in recent decades, there is much still to learn about what cognitions occur during a rapid dying process.

Physician Raymond Moody (1975) is credited with popularizing the phrase “near-death experience” (NDE) with his book Life After Life that contained approximately 150 anecdotal accounts. His widely cited description of the prototypical NDE follows:

A man is dying and, as he reaches the point of greatest physical distress, he hears himself pronounced dead by his doctor … After this, he suddenly finds himself outside his own physical body, but still in the same immediate physical environment, and sees his own body from a distance, as though he is a spectator. He watches the resuscitation attempt from this vantage point … He is overwhelmed by intense feelings of joy, love, and peace. (pp. 21–22)

Since Moody’s book, many others have followed. Psychologist Kenneth Ring (1980) and cardiologist Michael B. Sabom (1982) replicated Moody’s work based on their own independently collected accounts of NDEs. Sabom’s cases include six patients reporting specific events they should not have known occurring during their resuscitation such as the exact number of defibrillation attempts and descriptions of specific procedures and comments made by the medical staff.

The NDEs of cardiac patients (Greyson, 2003; Klemenc-Ketis, 2013; Parnia, Waller, Yeates, & Fenwick, 2001; Schwaninger, Eisenber, Schechtman, & Weiss, 2002; Van Lommel, Van Wees, Myers, & Elfferich, 2001) have been examined as well as those with medical problems such as being on hemodialysis (Lai et al., 2007). The vast majority of NDEs arise from illness, accidents, and surgery but also have been reported in childbirth and suicide attempts (Zingrone & Alvarado, 2009). However, despite the passage of four decades and many articles in peer-reviewed and medical journals, no research has focused on the NDEs of survivors of large burns—a population that experiences incredible trauma. Multiple surgeries are common and can be required for skin grafts, reduction of scar tissue, and reconstruction of hands, facial features, and so on. Loss of physical capabilities as well as relationships often result in depression and post-traumatic stress disorder (Cukor, Wyka, Leahy, Yurt, & Difede, 2015; Patterson, Ptacek, Cromes, Fauerbach, & Engrav, 2000). Zingrone & Alvarado (2009) have noted that NDE research is “still underdeveloped” (p. 39).

Why should clinicians and health professionals gain an understanding of NDEs? Individuals reporting profound near-death experiences (NDErs) must grapple with how to understand their experiences, their possible meaning, and how to integrate them. Those with NDEs may feel guilty about wanting to return to a place of peace and unconditional love—not their physical bodies where they would have continued pain, physical challenges, or disabilities (Mandalise, 2013). Unable to convey the depth or power of their experience, unwilling to have it ridiculed as a drug-induced hallucination, and to avoid being considered crazy, NDErs may feel it necessary to keep the NDE to themselves—and for good reason. One study found that one in five NDE disclosures received negative, unpleasant, and harmful reactions from professionals (Holden, Kinsey, & Moore, 2014). The authors concluded: “The fact that more recent NDErs in this study reported just as negative disclosure experiences as NDErs whose experiences occurred decades ago indicates that current research-based information about NDEs is not reaching health professionals” (Holden, Kinsey, & Moore, 2014, p. 285).

It may be hard for professionals without knowledge of NDEs to be nonjudgmental when hearing detailed descriptions of individuals looking down on their own bodies during medical emergencies. NDEs can be quite profound but also very distressing as in the case of those having “hellish” experiences (Greyson & Bush, 1992).

This article examines the NDEs related by a sample of burn survivors and makes comparisons with those found in established literature.

Method

Participants

Each year the Phoenix Society for Burn Survivors hosts a conference, the World Burn Congress, for burn survivors, their families, professionals who work in the field, and firefighters. The conference provides an opportunity for the burn-injured to meet other survivors. They hear inspirational stories about healing and recovery, and can acquire helpful peer support and knowledge about going forward in life when there have been disfiguring scars, loss of limbs, and devastation associated with loss of jobs, homes, and family members or friends.

Data for this study were collected at the World Burn Congresses held in Anaheim, California, in October 2014 and in Indianapolis, Indiana, in October 2015. Both years, a brief description was placed in the conference program schedule (Special Session: Recovery from a Burn Injury: Life Satisfaction, Posttraumatic Growth, Near-Death Experiences) and two separate days and times were scheduled each year. Upon arrival at the session, interested persons received a one-page description and a questionnaire. The description explained that the 75-minute sessions involved both data collection and the sharing of personal accounts. Burn survivors were asked to voluntarily and anonymously complete the prepared questionnaire. Approximately 15 minutes was allowed for this task and the quantitative portion of the study with 92 burn survivors has been published separately (Royse & Badger, 2017). That study, using the Near-Death Experience Scale (NDES) described later in this study, found no significant differences in life satisfaction or post-traumatic growth between burn survivors who met the criterion for an NDE and those burn survivors who did not. However, participants who indicated their religion was a source of support or comfort reported a higher level of life satisfaction and post-traumatic growth.

After the quantitative data were collected, the first author transitioned the group to the qualitative portion of the study by talking briefly about the literature on NDEs. The floor was then opened and participants shared their own NDEs. The format was similar to a focus group in that respondents freely volunteered their accounts and the moderator (first author) often probed for further clarification. All sessions were digitally recorded. It is estimated that approximately 200 individuals attended the four sessions, and these were a mixture of burn survivors, family members, and professionals. The current study, however, draws upon the first-hand accounts of burn survivors only.

Data on the demographics of the attendees of the four sessions are available from the quantitative study of burn survivors—some sharing NDEs and others who did not. These burn survivors were divided almost equally by gender with a mean age of 46.5. Their total body surface area (TBSA) burned was 46% (SD = 23.3) and ranged from 1% to 95%. The extent of their burns was similar to those reported in other studies of burn survivors (Badger & Royse, 2010, 2012). Burn injuries occurred 14 years ago (SD = 14.5) on average.

The study received an exemption certificate from the University of Kentucky’s Institutional Review Board.

Data Analysis

A qualitative content analysis process was used to analyze the data (Elo & Kyngas, 2007; Graneheim & Lundman, 2004; Hsieh & Shannon, 2005). First, the digitally recorded conference sessions containing individual accounts were transcribed and numbered. The 16 items from physician Greyson’s (1983) NDES, developed to screen populations and identify NDEs with a standardized measure, served as a template to differentiate presumed NDE accounts from those not meeting minimum criteria. The NDES (Greyson, 2001) contains questions about cognitive processes (Did scenes from your past come back to you?), affective processes (Did you have a feeling of peace or pleasantness?), transcendental processes (Did you see deceased spirits or religious figures?), and paranormal processes (Did you feel separated from your physical body?).

As “no experience containing all features has been reported” and “no single feature is common to all NDEs” (Kelly, Greyson, & Kelly, 2009, p. 372), the investigators read each account looking for the 16 features described by Greyson (1983) in his widely used scale. As the number of NDE features per case is highly variable (Zingrone & Alvarado, 2009), compelling accounts (e.g., apparent life-changing effect upon the participant) were also considered evidence of an NDE.

The authors immersed themselves in the data and read the transcripts independently numerous times to identify major features in the burn survivors’ accounts (Graneheim & Lundman, 2004). The authors read each individual account seeking NDE features as described by Moody (1975) or Greyson (1983) and then discussed all accounts before agreeing upon those that seemed to conform and those that did not.

Rigor

Trustworthiness is an important consideration in evaluating qualitative data (Lincoln & Guba, 1985). In this study, credibility and dependability of the data were established several different ways.

To begin, many of the burn survivors could be identified by scarring on their faces, hands, arms, necks, and so on. Some had tracheotomy scars. These individuals all arranged to travel to the conference site and most paid several hundred dollars in registration fees in order to attend.

Second, their oral NDE accounts appeared well accepted by the audience of burn survivors, family members, and health professionals hearing them. Details about hospitalizations and length of time in medically induced comas “rang true.” Further, some of those sharing their stories as burn survivors had previously volunteered as peer supporters of burn survivors and were recognized as persons with integrity. At least two of them had their recovery stories previously published in the Phoenix Society’s Burn Support News.

Third, without being asked, four participants reported their experiences in both 2014 and 2015, and these accounts were comparable. For instance, both years a respondent reported the paramedics telling her to take three deep breaths after they strapped her into the gurney and she (#17, 2015) then responded to them with, “Now what?” both years. One of these four respondents, while surviving a small plane crash, was determined not to have had an NDE.

Fourth, member checking of this manuscript was conducted with two burn survivors and the spouse of one of them; they did not find any inaccuracies.

NDE Accounts

During the conference sessions, participants shared personal accounts they believed to be NDEs. The authors read the transcripts multiple times and discussed them looking for at least one feature captured by the NDES (Greyson, 1983). On average, participants identified 3.47 NDES elements with a range from 1 to 6. Given that the spoken accounts were more like brief summaries than full expositions, in three instances, the authors used their discretion and included stories characterized by one compelling feature such as a convincing out-of-body account or one that seemed to have had very powerful, if not life-changing effects. Excluded accounts were two individuals who were not burn survivors, six participants contributing third-party NDE accounts, and several whose accounts were ambiguous. There were 19 oral accounts meeting the criteria for an NDE in 2014 and 10 in 2015; of these, 26 NDE survivor accounts were unduplicated and drawn upon for this report.

Both the early study (Royse & Badger, 2017) and the current study drew upon burn survivors attending the same conference sessions. However, because they could respond or orally report their experiences anonymously, some participants may have completed the questionnaire but not described their NDE with those present. Similarly, some of those who shared their NDE orally may not have completed a questionnaire. The 92 burn survivors in the 2017 publication had a mean score of 7.8 on the NDES meeting the Greyson’s (1983) criterion score of 7 indicating the occurrence of an NDE. Further, 34% had scores between 10 and 29.

Results

The most prominent themes appearing in the burn survivors’ accounts are presented next with illustrative quotes. Later, these themes will be discussed relative to those identified by Greyson and other NDE researchers.

Feelings of Peace & Calmness

Almost two thirds of the burn survivors reported feeling peaceful and calm after their injury and sometimes while it was occurring.

But literally, from the moment that I was on fire, I didn’t see real pain, you know. I really felt a calmness, uhm, related to when you’re a child and your mother is holding you in her arms—is just the way I felt even though I was flailing and on fire for several minutes, uhm, I never felt any pain at all … It was this, this is it, it’s all over. You’re not going to survive this but there was a calmness and peacefulness that to this day I’ve never felt before (male, gasoline container blew up). #4, 2014

It’s a great peace that comes over you. I would call it the most neutral place in the world, and the peace that comes over you is overwhelming like it just takes over your whole body or your whole being really … that calmness I felt when I was burning in the car never left me the whole time I was in the hospital (Male, car accident). #8, 2014

There was just an immense peace like, like everything is okay (Female given 25% chance of surviving). #18, 2014

I felt myself wrapped with warmth and peace. Never felt any kind of panic or you know—never desperation or anything, just peace and warmth (Male, trapped in a burning car). #20, 2014

The vast majority of those with an NDE reported pleasant, peaceful affective experiences with a few exceptions that will be discussed later.

Out-of-Body Experience

Out-of-body experiences (OBEs) are not uncommon among those who reported NDEs. In this study, one-half of the respondents reported a perception of being out of their bodies or actually looking down and seeing their bodies. This account is from an adult burned in a propane explosion in her home.

They had put a yellow sheet trying to help me to warm up and that’s when my body started convulsing and all suddenly I could see these three firemen from up above working so hard on me trying to hold my body down while they were putting like belts on me to try to hold me down on the gurney. And I remember thinking how hard these guys were working to get me on that gurney and then the next moment I was back looking at them from here … my body just looking at them on the ground level (Adult female, propane explosion). #17, 2015

The next survivor shared an interesting account with an element that could possibly be confirmed.

My next memory is kind of coming out of my body and rising, looking down, seeing, just acknowledging what’s going on there. As I came out of my coma, I kind of got in an argument with my dad. “I had just gone on a nice walk you know” [She said]. Dad’s like, “There’s no way; you did not go on a walk. You did not go on any type of walk.” … I described the grounds of the hospital: there was a pond, the garden, the parking spot where people smoke their cigarettes … and my dad was just like, uhm, “You’ve never been to this hospital, there’s no way.”

After her accident, this burn survivor had been airlifted to a hospital 2 hours away that she had never been to. Her father informed her that she had died twice during surgery.

Some participants described fewer details: “I remember the incident and … I picture it very vividly from being above, watching me fall backwards into the flames.” (Adult male firefighter, #7, 2015)

I kind of remember it at that point … hovering over my body, and just kind of watching the paramedics arriving and working on me (Male, gasoline spill while burning leaves). #21, 2015.

One participant (#12, 2014) said that he looked up and saw his body but “it wasn’t a discernable figure but I knew, I knew it was me … Whatever was inside of me had left.” Two respondents reported viewing themselves from behind (#4, 2015; #6, 2015). Another reported an OBE occurring while “I was laying on the ground burning” and simultaneously being “in the fire truck with my husband” who was driving through smoke and flames to find her (#6, 2014). She later said, “I kept telling him, ‘I’m with you, I was with you, I went with you.’” When asked if she was trying to direct him to her, she responded, “Yeah. I was sitting in the seat, in the passenger seat.”

These accounts, while varied and individual, are not unlike other out-of-body accounts found in the near-death literature.

Seeing the Light

Two thirds of the oral accounts mentioned seeing or encountering a “light” during their NDE. Although Greyson’s (1983) scale asked, “Did you see, or feel surrounded by a brilliant light?” and allowed for the option of “unusually bright” or “light clearly of mystical or other-worldly origin,” this study accepted the term light as in the phrasing used by Participant #15, 2014 below.

I remember I was walking in this lighted hallway. And I was just walking, walking, and it was stairs and it was nicely lit. (#15, 2014)

Another reported:

I was in this just bright light, like there is no ceiling, no floors and there was no, there is nothing … just floating there. (#18, 2014)

Light also took on spiritual or religious connotations. Participant #21, 2014 related: “ … the light at the end of the tunnel was the Glory of God and like the light of Christ.”

Both meanings for “light” were found in the sample of NDE accounts.

Another described the light as emanating from “meditating, praying beings,” who “emitted a light that was slightly bluish,” bathing him and helping him to float. (#3, 2014)

It is possible that some participants were coming into consciousness or were seeing the bright lights of the operating or hospital room. This is not always easy to discern. An adult male burned at age four while lighting newspapers stated, “I was in an all-white space, all-white space.” However, when he related more about his experience, there was this: “ … and when I looked at myself, I had no scars and I was just fine” (#22, 2014).

Instead of “light,” a small group of participants used the term dark, darkness, black, or blackness as a characteristic of their experience—a possible indication of loss of consciousness from trauma, medication, or anesthesia. For example, “everything went dark” (immediately after the explosion, #12, 2014) and “I remember the doctor saying, ‘Are you ready?’ and then everything went black” (#29, 2014). For most NDErs, being in “darkness” did not produce negative emotions.

A male critically injured with his friend in a car accident said that it was dark “And then all of a sudden, poof, there’s lights … I see this bright light and I see the Lord and he’s telling me, ‘Come on, man.’” (#11, 2014). Contrast that, however, with one male’s opening statement, “I’ll tell you about the opposite side of the light. I saw the Dark” which was associated with a hellish type of experience (see below).

Distressing Near-Death Experiences

A very small group reported extremely distressing experiences, not the prototypical positive NDE. The participant above who saw “the Dark” was “scared to death, just scared to death because I didn’t want to die. And thank God … when I woke up I just thought ‘you’d better start leading a better life so if it happens again maybe you’ll see the light”' (#14, 2015). When asked if he actually changed his life, the survivor replied, “You bet!”

Another participant initially had a negative experience and was “sucked into something or pulled into something that was really hell” with “cutting feelings” and “somebody else’s diabolical plan” (#3, 2014). However, the experience then changed for him and “suddenly I was in a very calm, still, sort of waiting place … I was waiting for someone pretty neat and powerful and others to show up.” He earlier described the “bluish light” which was “healing and regenerating” and “incredibly healing and incredibly loving.” When asked if he had a fear of dying, he responded, “It sort of greatly diminished.”

Encountering a Deceased Person, Spirit, or Spiritual Being

Approximately 40% of the NDE accounts reported encountering some kind of spiritual being or deceased person. These encounters were pleasant and comforting for the most part.

I was talking to a little girl … while I was in the coma … I woke up and remember telling him [her husband] that I spoke to our little girl that we lost. And at the time I did not know I was pregnant … I just remember telling him that I spoke to our little girl and I was thinking it was our future daughter and he had to inform me that you were pregnant. And I didn’t know that but I remember talking to her and carrying on a nice conversation with her. (#17, 2015)

Another survivor reported meeting his friend, the driver of the car, who had died in the same accident. The friend said, “Don’t worry about me, I’ll be fine” (#20, 2014).

Another burn survivor (#31, 2015) described encountering and having a pleasant discussion while in a medically induced coma with an African-American woman named Irene. His wife (also in the same conference session) then spoke and described meeting the same individual on multiple occasions in the hospital and talking, hugging, crying, and praying with her as the husband’s fragile prognosis either worsened or improved over several weeks. When the husband came out of the coma and began to make significant progress, the African-American woman could not be located. The wife went to the nursing station and began asking the staff if they knew where she could find Irene to tell her the good news but no one knew or remembered seeing an individual meeting her description.

Some survivors reported more of a religious presence. A female respondent (#29, 2014) burned over 70% of her body at age seven gave this account:

Jesus was standing at the end of the path, his hands upturned … he meets up with me and takes me by the hand … and we walked the rest of the path … he sat down on the park bench and there were people around the bench but I didn’t know who they were … then he lifted me up onto his lap and said, “I’m sorry that you’re suffering the way you’re going to suffer.” But he said, “You can stay with me or you can go home.” … I said, “I want my mother” and he told me then I would see my mother … I looked at him and said, “Are you Jesus?” … And he just smiled and nodded and then he told me it was time for me to go home. And he said, “You’re going to suffer as I did … but some day you’ll understand why this has to be.”

Seven of the near-death accounts mentioned encountering a religious or spiritual figure. Four participants identified this person as Jesus, Christ, Lord, or God. An Indian woman (#1, 2015) saw a “gentleman with a big flowy robe, white hair, and he [had a] very kind face, very gentle, very, I mean very peaceful.” A friend’s deceased dog that she had been very close to accompanied the spiritual/religious figure. There was also mention of “spiritual beings” (#3, 2014) and a light preceded “two female faces” that brought “enormous peace, joy, just such a settling in my heart” (#5, 2014). Of the deceased family members (n = 5) appearing in the NDEs, there were an aunt, uncle, grandmother, friend, and unborn child.

Life Review/Sense of Purpose

About a quarter of the NDEs contained some type of life review. The majority of those reporting a life review used some form of the verb “flash.”

I didn’t expect to be in that situation [fully engulfed in fire] and I guess when they say your life flashes before your eyes, I totally experienced that. In my sense of time, it slowed, everything slowed down, and I remember that all of my memories since childhood, you know, laughing and Christmas, every single memory kind of like fast forwarded into—it’s like someone pressed, literally, Fast Forward on this device and then in my brain, I just got caught in thought and all these images shuttered through all the way to the present. (Male firefighter, #4, 2015)

I saw everything at one time, everything in your entire life, just in a flash. Everything, everything … I sort of lived it. (Adult male, auto accident #8, 2014)

And I initially just laid out on the floor; I already know I’m going to die and, and it just was like every—in an instant I saw my entire life; I saw everything in an instant. (Male firefighter, #9, 2014)

All of a sudden, I started seeing like he said. It was just all a flash of my life. I said, “I’d seen myself as a child and all the injuries that I ever got, everything I ever accomplished. (Male, car accident (#11, 2014)

The life reviews generally occurred in the early part of the burn survivors’ NDE accounts.

Not Your Time

Half of the burn survivors with NDEs clearly received an impression that, although their situation was grave, they would not die. Seven in the sample were told that it “was not their time.” An example of not being provided a choice is the account of the woman who encountered her deceased uncle and a grandmother who said:

“No” and shook her head and turned and walked away. And I got very upset. “Why can’t I go? Like why? Why can’t I go with you?” and I started screaming. As I screamed “No” like this and that’s when I felt my jolt and jolted up in the bed screaming “No!” and ripped all the air tubes out of my throat. And the nurse, all I heard was a scream, “Oh my God, she’s alive!”

Later, this female survivor added, “I was definitely left with that feeling it wasn’t my time but [also] I’m not good enough—like I had to correct something or fix something” (#1, 2014).

The Indian participant who met the friend’s deceased dog and a gentleman in the “flowy robe” said that he “kept saying, ‘you need to turn around and go back’” but the participant wanted “pretty much [to] go through.” At some point, the robed gentleman and the dog “walked me all the way back” (#1, 2015).

Another burn survivor related this:

In the corner is my aunt and she had passed away about a year beforehand and she and I used to play bingo together when we would hang out. So, I sat down and I played this really quick; we played a really quick little game of bingo together and I don’t remember who won but and then she told me “Okay. Well, this is our last game. You need to go back.” And I woke up three weeks later in the ICU. (Female, initially burned as a child but this NDE stemming from almost dying 2 years later with meningitis, #24, 2014)

Six of the participants felt that they made a choice. One participant described some hard negotiating with God where he argued, “I don’t want to go, it’s like my bucket list is not finished yet. I have things to do, I have a family to raise … and I said, ‘Lord, it’s not my time, I have to do something.” (#11, 2014). Another was “climbing a golden staircase to get to the top and then the ventilator alarm would go off and ‘that would stop me.’” The burn survivor “decided, you know, come back, get off.” (#20, 2015)

Participant #29, 2014 (previously discussed as having a conversation with Jesus as a child) was given a choice, “you can stay with me or you can go home.” She decided to go back—she wanted her mother.

Discussion

Of the 16 cognitive themes in Greyson’s (1983) NDES, six themes were prominent in the burn survivors’ oral NDE accounts with one quarter to two thirds of the participants describing the themes. On average, three themes conforming to Greyson’s NDES were reported per burn survivor. However, other individual features were not counted (e.g., beautiful music and smells). The features described here are those most often endorsed by study participants.

Two-thirds of the NDErs in this study reported the theme of light. This compares with 61% in Greyson (1983) when scale items are summed for the descriptor choices of “light clearly of mystical or other-worldly origin” (43%, score of 2) plus a more ambiguous category (18%, score of 1) “Unusually bright light.” Respondents never reported the light to be so harsh as to be frightening. Ring’s (1980) respondents described light in terms of being “very restful, comforting and, apparently of ineffable beauty” (p. 56).

Surprisingly, many of the burn survivors mentioned sensations of being calm or at “peace” during or immediately after their trauma. Sixty-two percent addressed this theme compared with 77% in Greyson’s (1983) research participants who believed they had a valid NDE based on their reading of the phenomenological literature and had become members of the International Association for Near-Death Studies. It is not known how many, if any, burn survivors were involved in that sample of 74 individual NDEs.

Because of the nature of their severe injuries, burn survivors receive large doses of opiate painkillers during their weeks of hospitalization and emergency medical personnel may have administered opiates immediately upon first encountering these individuals with severe injuries. These drugs may be responsible for some of the euphoria reported by our burn survivors. However, burn survivors reported feelings of peace, calmness, and acceptance, in some instances, as the trauma was occurring (e.g., #8, 2014; #12, 2014). In most of the NDE accounts, it is difficult to know exactly when features of the NDE occurred—especially when the burn survivor went through multiple surgeries, was in an induced coma for many weeks, and when their vital signs initially were unstable. One should note, though, that several of those in this study were emphatic that they were able to identify the difference between drug-induced hallucinations (spiders and centipedes all over the wall) and their NDE. Unlike dreams or hallucinations, the NDEs were more vivid, more real—even 14 or more years later. One burn survivor, unable to talk initially because of damage to her throat and lungs, wrote down details of her experience as soon as she was able and said, “ … it is so attached in my mind as if it happened yesterday” but remembered nothing else during a month-long hospitalization (#1, 2015). Another stated that the NDE was “very real … because it’s burnt, you know, I have [it] burnt really right into my mind” (#20, 2014).

Half of the 24 NDErs (50%) reported an OBE. This compares well with the 53% in Greyson (1983) and the more recently reported 48% “from a recent analysis of several hundred cases” (Greyson, 2010, p. 41). Ring (1980) found 37% in his study. Most seem to conform to what Ring called “observer like detachment, often associated with a feeling that ‘all this is perfectly natural’” (p. 49).

Close to half (42%) of the NDErs in this study met a deceased family member, friend, or spiritual being. Greyson (1983) used two items to capture this theme. The first asked about a “mystical being or presence” (47%) and the second asked about “deceased or religious spirits” (26%). However, these two items are not mutually exclusive. More recently, Greyson (2010) reported a similar 42% of experiencers “meeting one or more recognizable deceased acquaintances during the NDE” (p. 42). In Ring’s (1980) conceptualization of stages, meeting deceased persons or spirits occurred most often in the deeper stages (e.g., fourth or fifth stage). In our small sample of NDErs, five (21%) described meeting deceased family members or friend.

Consistent with Ring’s (1980) observations, the role of deceased family members appears to be informing the individual “it isn’t your time” (p. 68). However, experiencers in this study received this message from mystical or religious spirits as well. The burn survivor who met the “light of Christ” received the distinct impression that he had to return because “there was work for me to do” (#21, 2014). In addition, one NDEr reported negotiating with Jesus (#11, 2014).

Several burn survivors responded along this line, “But I just had this ‘not yet’ that was in my head” (#21, 2015). Half of the NDErs in this study described a decision or receiving advice that it was not their time. This compares with 26% of those in Greyson (1983) endorsing an item that asked about coming to a border or point of no return where a conscious decision was made or one was “sent back.” In Ring (1980), one third of the experiencers “either chose, bargained, or willed themselves to return. Five stated that they felt they were sent back” (p. 68).

Of the six themes that emerged from the burn survivors, the one endorsed least by the burn survivors (27%) was the Life Review. However, Greyson (1983) reported 22% of his participants indicated “My past flashed before me, out of my control” or “I remembered many past events.” More recently, Greyson (2010) has written, “An analysis of several hundred NDE cases showed that in 24% of them there was a report of some degree of revival of memories during the NDE” (p. 40). Ring (1980) also observed that about one quarter of his experiencer sample reported this phenomenon.

Conclusion

Four of the six themes found in this sample of burn survivors who self-identified as having an NDE corresponded closely to data reported in one or more of the three comparisons. These four themes were: Peace, OBEs, Persons, Spirits, or Spiritual Beings Encountered, and Life Review. More of our informants were observers of Light and more felt that they were instructed to return to their previous life/physical body than Greyson (1983, 2010) or Ring (1980) reported. Possibly these differences can be explained by differences in data collection and variation in the composition of the samples with conceivably more of the burn survivors associated with accidents as opposed to life-threatening illness or suicide attempts. (Ring’s 1980 experiencer sample was composed of 60% illness survivors, 17% suicide survivors, and only 23% accident survivors.)

Without debating hypothetical explanations for the common features associated with NDEs which have been discussed in other articles and books (e.g., Greyson, Kelley, & Kelley, 2009; Sartori, 2014, Van Lommel, 2012), it is clear that the individuals who shared these accounts were often profoundly affected by their experiences. Informants were eager to share their experiences—possibly to check for validation by the other burn survivors. Several stated that these NDEs were kept private and not shared with very many people. Within these group sessions, there was an air of authenticity and credibility as fire fighters, homemakers, and average individuals unaccustomed to speaking in public struggled to find the right words to describe their observations and emotions. The audience sat patiently even though they could not always hear all parts of the raspy and strained accounts from burn survivors whose throats or vocal cords had been damaged.

In terms of limitations, only 237 minutes of digitally recorded conversations were captured. By necessity, the accounts were brief and only minimal probing was possible. Participants were sometimes hard to understand and may have omitted details unintentionally that would have been of interest. Possibly, some of the excluded NDE reports could have been included had more time been available for probing.

Implications

What should health and other professionals make of near-death accounts? In order to do no harm, it is important to maintain an open, nonjudgmental attitude. Those experiencing NDEs have reported reluctance to disclose experiences to health-care providers (Fracasso, 2012; Holden, Kinsey, & Moore, 2014). Professionals who dismiss NDEs as fantasy or hallucinations not only reject survivors’ vivid and meaningful experiences that have become a significant part of their personal lives, but may create a path leading to depression or worse (Moody, 1980; Ring, 1984; Walker, 1989). Linda Jacquin (1999) was diagnosed with psychosis based on her NDE. In the current study, two of those sharing accounts and reporting OBEs were told by therapists that they had experienced psychosis. Indeed, beginning with Freud, there is a long tradition of professionals labeling spiritually transformative experiences as evidence of pathology (Greyson, 2014). However, his disciple, Carl Jung (1963), has described his own NDE.

The requirement to keep one’s judgment about patients’ spiritual and religious issues to oneself is central to the helping professions. However, not engaging persons who have faced life-threatening events and carefully listening to what they felt to be a spiritual or life-changing experience may not only be disrespectful and possibly harmful, it also contributes to professional ignorance about near-death cognitions and NDEs. Clinical psychologist McDonagh (2004) has shared information about NDEs with those grieving the loss of a loved one and with suicidal patients and reported beneficial results including a reduction or elimination of suicidal ideation. Similarly, Winkler (2003) reported success with a depressed 8-year old whose father had hanged himself.

NDErs commonly have a dramatic reduction in fear of dying even 8 years after the traumatic event and a definite increase in belief in survival after death (Kelly, Greyson, & Kelly, 2009). Could professionals’ preparedness to discuss NDEs be beneficial to the terminally ill and their friends and family members? There is some beginning, but not nearly enough, evidence of this (Enright, 2004; Foster & Holden, 2014). As we openly examine our own attitudes about NDEs and begin to become comfortable asking those who have lived through life-threatening events about their feelings and experiences, we will be able to explore more fully whether discussion of NDE accounts assists dying individuals in preparing for their transition.

The more we learn about NDEs, the better prepared we are to help those with grief, depression, and anger about dying as well as others who are grieving for loved ones who have already passed or may soon die. As W. Stephen Sabom (1980) observed, it is important not to view near-death survivors as “clinical lepers, but as human beings who have something very precious to teach the rest of us about life, and death” (p. 138).

Footnotes

Acknowledgments

The authors wish to acknowledge the assistance of the Phoenix Society for Burn Survivors and thank all of those survivors who participated in this research.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biographies

David Royse, MSW, PhD, is a professor in the College of Social Work at the University of Kentucky. He began working with the Phoenix Society for Burn Survivors approximately 10 years ago.

Karen Badger, MSW, PhD, is an associate professor in the College of Health Services at the University of Kentucky with a joint appointment in the College of Social Work. She has 25 years of direct service and management in a pediatric burn hospital and a major hospital trauma center. She has been actively involved in the Phoenix Society for Burn Survivors for many years.

References

Badger

Royse

(2010) Helping others heal: Burn survivors and peer support. Social Work in Health Care 49(1): 1–18.

Badger

Royse

(2012) Compassionate care: The burn survivor’s perspective. Journal of Burn Care & Research 33(6): 772–780.

Cukor

Wyka

Leahy

Yurt

Difede

(2015) The treatment of posttraumatic stress disorder and related psychosocial consequences of burn injury. A pilot study. Journal of Burn Care & Research 36(1): 184–192.

Elo

Kyngas

(2007) The qualitative content analysis process. The Journal of Advanced Nursing 62(1): 107–115.

Enright

(2004) Silent journey: The discovery of a near-death experience of a nonverbal adolescent. Journal of Near-Death Studies 22(3): 195–204.

Foster

R. D.

Holden

J. M.

(2014) Eternal connection: An exploratory study of the effects of learning about near-death experiences on adult grief. Journal of Loss and Trauma 19: 40–55.

Fracasso

(2012) Paving a new frontier: Near-death experiences and the unspoken aspect of what researchers have faced and continue to face. NeuroQuantology 10(2): 210–215.

Graneheim

U. H.

Lundman

(2004) Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24: 105–112.

Greyson

(1983) The Near-Death Experience Scale: Construction, reliability, and validity. Journal of Nervous and Mental Disease 171(6): 369–375.

10.

Greyson

(2001) Posttraumatic stress symptoms following near-death experiences. American Journal of Orthopsychiatry 71(3): 368–373.

11.

Greyson

(2003) Incidence and correlates of near-death experiences in a cardiac care unit. General Hospital Psychiatry 25(4): 269–276.

12.

Greyson

(2010) Implications of near-death experiences for a postmaterialist psychology. Psychology of Religion and Spirituality 2(1): 37–45.

13.

Greyson

(2014) Differentiating spiritual and psychotic experiences: Sometimes a cigar is just a cigar. Journal of Near-Death Studies 32(3): 123–136.

14.

Greyson

Bush

N. E.

(1992) Distressing near-death experiences. Psychiatry 55: 95–110.

15.

Greyson

Kelley

E. W.

Kelly

E. F.

(2009) Explanatory models for near-death experiences. In: Holden

Greyson

James

(eds) The handbook of near-death experiences: Thirty years of investigation, Santa Barbara, CA: Praeger, pp. 213–234.

16.

Holden

J. M.

Kinsey

Moore

T. R.

(2014) Disclosing near-death experiences to professional healthcare providers and nonprofessionals. Spirituality in Clinical Practice 1(4): 278–287.

17.

Hsieh

H.-F.

Shannon

S. E.

(2005) Three approaches to qualitative content analysis. Qualitative Health Research 15(9): 1277–1288.

18.

Jacquin

(1999, August) I’m not crazy: I just died, Paper presented at the Annual Conference of the International Association for Near-Death Studies, Vancouver, BC, Canada.

19.

Jung

(1963) Memories, dreams, reflections, New York, NY: Pantheon Books.

20.

Kelly

E. W.

Greyson

Kelly

E. F.

(2009) Unusual experiences: Near Death and related phenomena. In: Kelly

E. W.

Greyson

Kelly

E. F.

(eds) The irreducible mind: Toward a psychology for the 21st century, Lanham, MD: Rowman & Littlefield, pp. 367–421.

21.

Klemenc-Ketis

(2013) Life changes in patients after out-of-hospital cardiac arrest: The effect of near-death experiences. International Journal of Behavioral Medicine 20(1): 7–12.

22.

Lai

Kao

Chiang

Chang

Lin

(2007) Impact of near death experiences on dialysis patients: A multicenter collaborative study. American Journal of Kidney Diseases 50(1): 124–132.

23.

Lehto

R. H.

Stein

K. F.

(2009) Death anxiety: An analysis of an evolving concept. Research and Theory for Nursing Practice: An International Journal 23(1): 23–41.

24.

Lincoln

Guba

(1985) Naturalistic inquiry, Beverly Hills, CA: Sage.

25.

Mandalise

(2013) The nursing profession and near-death experiences: A personal and professional update. Journal of Near-Death Studies 32: 59–79.

26.

McDonagh

J. M.

(2004) Introducing near-death research findings into psychotherapy. Journal of Near-Death Studies 22: 269–273.

27.

Moody, R. A. (1980). Commentary on “The reality of death experiences”: A personal perspective by Ernst Rodin. Journal of Nervous & Mental Disease, 168(5), 264–265.

28.

Moody

R. A.

Jr (1975) Life after life, Atlanta, GA: Mockingbird Books.

29.

Parnia

Waller

D. G.

Yeates

Fenwick

(2001) A qualitative and quantitative study of the incidence, features, and aetiology of near death experiences in cardiac arrest survivors. Resuscitation 48: 149–156.

30.

Patterson

D. R.

Ptacek

J. T.

Cromes

Fauerbach

J. A.

Engrav

(2000) The 2000 clinical research award. Describing and predicting distress and satisfaction with life for burn survivors. Journal of Burn Care and Rehabilitation 21(6): 490–498.

31.

Ring

(1980) Life at death: A scientific investigation of the near-death experience, New York, NY: Coward, McCann, & Geoghegan.

32.

Ring, K. (1984). Heading toward Omega: In search of the meaning of the near-death experience. New York, NY: William Morrow.

33.

Royse

Badger

(2017) Near-death experiences, posttraumatic growth, and life satisfaction among burn survivors. Social Work in Health Care 56(3): 155–168.

34.

Sabom

M. B.

(1982) Recollections of death: A medical investigation, New York, NY: HarperCollins.

35.

Sabom

W. S.

(1980) Near-death experience: A review from pastoral psychology. Journal of Religion & Health 19(2): 130–140.

36.

Sartori

(2014) The wisdom of near-death experiences: How understanding NDEs can help us live more fully, London, England: Watkins Publishing.

37.

Schwaninger, J., Eisenber, P. R., Schechtman, K. B., & Weiss, A. N. (2002). A prospective analysis of near-death experiences in cardiac arrest patients. Journal of Near-Death Studies, 20, 215–232.

38.

Van Lommel

(2012) Pathophysiological aspects of near-death experiences. In: Perera

Jagadheesan

Peake

(eds) Making sense of near-death experiences: A handbook for clinicians, London, England: Jessica Kingsley.

39.

Van Lommel

van Wees

R. V.

Myers

Elfferich

(2001) Near-death experience in survivors of cardiac arrest: A prospective study in the Netherlands. Lancet 358(9298): 2039–2045.

40.

Walker

B. A.

(1989) Health care professionals and the near-death experience. Death Studies 13(1): 63–71.

41.

Winkler

(2003) The Elias Project: Using the near-death experience potential in therapy. Journal of Near-Death Studies 22(2): 79–82.

42.

Zingrone

Alvarado

C. S.

(2009) Pleasurable western adult near-death experiences: Features, circumstances, and incidence. In: Holden

J. M.

Greyson

James

(eds) The handbook of near-death experiences: Thirty years of investigation, Santa Barbara, CA: Praeger.