NDE and Hypnosis 2012

284 CONTEMPORARY HYPNOSIS AND INTEGRATIVE THERAPY
29(3): 284-297 (2012)
NEAR-DEATH EXPERIENCES AND HYPNOSIS:TWO DIFFERENT

PHENOMENA WITH SOMETHING IN COMMON
ENRICO FACCO, MD
Department of Neurosciences, University ofPadova, Italy: Italian Center of Clinical and Experi-
mental Hypnosis CIICS). Turin, Italy
ABSTRACT
Near-death experiences (NDEs) are an intriguing and somewhat awkward topic in the scientific
medicine.They can be defined as the memory of impressions occurring during life-threatening
conditions, including a number of special elements such as out-of-body experiences, pleasant
feelings, seeing a tunnel, a light, deceased relatives, or a life review. Their transcendent tonal-
ity leads one to consider them a priori as doubtful or non-existent, not relevant, or a matter
of psychiatric or organic disturbances at most. The available interpretations of NDEs, despite
being scientifically sound, so far remain only speculations or, at best, clues without any dem-
onstration, while others are not even plausible or neglect facts incompatible with the ruling
mechanistic and reductionistic view, showing the deep epistemological implications of their
explanation.
In the past few decades NDEs, hypnosis, relaxation, and meditation have been included
among the so-called altered states of consciousness (ASC), together with other physiologi-
cal and pathological conditions, such as dreaming, sensory deprivation, hypnagogic states,
epilepsy, effects of hallucinogens, and psychotic symptoms. However, the very term ASC, se-
mantically suggesting abnormality, looks to be questionable for physiological mind activities
like hypnosis and meditation.
NDEs and hypnosis appear as two entirely distinct phenomena, but some common pro-
cesses probably tinge them. Hypnosis has seldom been used to evoke previous NDEs in an at-
tempt to relive them; conversely, 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.
Fortunately, an increasing dissatisfaction has emerged in recent years with our merely or-
ganic medicine, which has been paralleled by a growing interest in consciousness, subjectivity,
and spirituality.There is an increasing need to reappraise our paradigm and the still mysterious
mind-brain-world relationship; the so-called ASC also call for a broader approach, to reap-
praise them in a perspective, including their still misunderstood physiology, merging mecha-
nisms, contents, and meanings in a whole without prejudices, not even scientific ones.
Keywords: hypnosis, consciousness, consciousness disorders, death, near-death, psychotherapy
Copyright © 2012 British Society of Clinical and Academic Hypnosis 29(3): 284-297 (2012)
Published by Crown House Publishing Ltd
NEAR-DEATH EXPERIENCES AND HYPNOSIS 285
Section: MODIFIED CONSCIOUSNESS
Near-death experiences (NDEs) are an intriguing and somewhat awkward topic in the scien-
tific medicine. NDEs can be defined as the memory of impressions during a non-ordinary state
of consciousness, including a number of elements such as out-of-body experiences (OBEs),
pleasant feelings, seeing a tunnel, a light, deceased relatives, or a life review; these memo-
ries are generated during life-threatening conditions, such as cardiac arrest, coma, and shock
(van Lommel et al., 2001; van Lommel, 2004; Facco, 2010). Despite all of us having heard
anecdotally about these phenomena, usually we are inclined to consider them as doubtful or
non-existent; anyway, not relevant, beyond clinical interest, or a matter of brain disorders or
hallucination at most. As a result, physicians do not usually ask patients who have survived a
life-threatening crisis about NDEs, nor do patients report them to physicians, or even to rela-
tives, for fear of being considered out of mind. Following the first report on NDEs by Moody in
the 1970s (Moody, 1977), an increasing interest in their phenomenology and pathophysiology
has developed, leading to the publication of a sizable number of papers (Rodin, 1980; Greyson,
1983b, 1993, 2003a, 2003b; Sabom, 1998; Parnia et aL, 2001; Parnia & Fenwick, 2002; van
Lommel et al., 2001; van Lommel, 2004, 2011; French, 2005; Facco, 2010; Agrillo, 2011, Facco
& Agrillo, 2012).
Their incidence, which is higher than commonly believed, as well as their phenomenology,
including an awkward transcendent and sometimes even parapsychological tone, make them
a relevant and intriguing phenomenon, which challenges the conventional reductionistic and
mechanistic view of consciousness and the brain-mind relationship. Therefore, NDEs might
help to open a new outlook on the definition of consciousness itself and its pathophysiology.
It is a tricky road, involving deep epistemological implications; in fact, errors leading to false
conclusions may spring from both an a priori acceptance or refusal of apparently strange and
not easily explicable facts.
NDEs also have a relevant impact in clinical practice, since both physicians and psycholo-
gists may come into contact with patients reporting NDEs, and their relatives, who may need
to understand the meaning of the experience in the process of recovering and coping with
their life, and who may benefit from psychotherapy. The ruling mechanistic and reduction-
istic thinking of primary care givers may lead them to consider NDEs as mere psychiatric
symptoms produced by brain disorders, misunderstanding the meaning and relevance of these
experiences; instead, it is essential to avoid any a priori judgement and listen to patients re-
spectfully with an open mind, in order to properly understand and help them in the process of
integrating their experience into their lives (Griffith, 2009).
When dealing with NDEs, one faces their apparent discrepancy with current opinions on
the nature of reality and consciousness, leading to an implicit inclination to neglect them or
consider them as a meaningless consequence of organic brain disorders. Instead, despite the
exact rate of incidence being unknown, it can be roughly estimated at between 10% and 40%
of critical patients and some 5% of the general population (Greyson, 1993 2003a; van Lom-
mel et aL, 2001), an incidence which has probably increased in the past few decades thanks to
the development of techniques of resuscitation and improved rates of survival and outcome.
Any prejudicial view, of whatever origin, introduces an unacceptable bias, which is likely to
be epistemological in nature: it is a crucial problem, since any a priori refusal of facts to protect
theories and beliefs inescapably turns scientific knowledge into a theology of paradigm and an
imposition of dogma. In most cases, NDEs take place at the boundaries between life and death,
between physics and metaphysics.They thus involve a wide and complex range of implications
286 FACCO
which do not pertain to science alone (in the more conventional and narrow meaning of the
term). In fact, science is by definition limited to the exploration of the physical world only, not
the other side of the divide. Our approach to the end of life necessarily calls for philosophy and
religion, the latter being a deep philosophical matter to be approached well beyond its narrow
doctrinal and dogmatic components.
On the other hand, this means reappraising the meaning of life and death as well as the
mind-brain-world relationship, still an unsolved problem, while some 90% of the physical
world consists of dark energy and matter which remains scientifically unknown (and probably
will remain unknown for a long time) (Wilczek, 2009). Thus, metaphysics is, as a matter of
fact, the tissue of the physical world and what we do know is much less than we believe we
know. The scientific explanations and philosophical implications of NDEs have been analysed
in detail elsewhere (Facco, 2010); here, the phenomenology of NDEs, their epistemological im-
plications, including the problems introduced by language and their relationship with hypnosis,
will be shortly outlined.
NDE: PHENOMENOLOGY AND SCIENTIFIC EXPLANATIONS

As already mentioned, NDEs are well-organized experiences reported in a similar way world-
wide, across cultures and time (Belanti et al., 2008; Facco, 2010). Their main content can be
summarized as follows: (a) getting into a tunnel with or without seeing a light at its end; (b)
seeing a Being of Light; (c) OBEs; (d) holographic life review; (e) meeting dead relatives or
unknown persons (with possible communication through thought transfer); (f) bliss, uncondi-
tional love, peaceful and pleasant feelings; (g) return into the body (usually unpleasant).
NDEs are strong and deep experiences with a clear transcendent tone. Although they main-
ly occur in critical conditions with a loss of consciousness, they have also been described in
normal conditions and role transitions, such as two cases reported during divorce (Gabbard
& Twemlow, 1991; Facco & Agrillo, in press). During an NDE, subjects report the perception
of being in a non-ordinary dimension, of having trespassed the physical limits of their ego
and ordinary space and time flow with clear awareness (Greyson, 2005). The light they see
is defined as non-natural or supernatural, while the entities they meet are often not defined
(figures of the religion they belong to are present in a minority of cases only); a great bliss
and love is often felt, which can reach the mystic tone of full participation and fusion with the
whole world (Facco, 2010).
These experiences are usually transformational, leading to an overcoming of the fear of
death and to deep changes in their outlook on life and behaviour (Moody, 1977; Greyson,
1985,1998, 2003a; Parnia et al., 2001; van Lommel et al., 2001; Parnia & Fenwick, 2002). Al-
though these changes are generally positive (Greyson, 1983a, 1983b, 1993,2003a; Roberts &
Owen, 1988; Parnia et al., 2001; van Lommel et al., 2001), in some cases they may give rise to
negative after-effects in the process of coping with them, such as social and family problems
related to changes in the subject, including an increased risk of divorce (Greyson, 1998,2001).
Therefore, the process of transformation (including improved self-awareness, deeper insight,
increased empathy and spirituality, appreciation of life and ordinary things) may be preceded
by a difficult transition, during which the new values are properly assimilated. During this pe-
riod they may need to share their experience with others and/or a psychotherapeutic support,
which calls for a proper understanding that is free from any prejudice on the nature of NDEs.
Copyright ® 2012 British Society of Clinical and Academic Hypnosis 29(3): 284-297 (2012)
The main scientific explanations of NDE phenomenology are: (a) periphery-to-fovea retinal
ischemia as a cause for tunnel vision (Blackmore &Troscianko, 1988; Blackmore, 1996; Nelson
et al., 2007); (b) temporal lobe dysfunction, epileptic discharges, and REM sleep intrusions
(Cheyne et aL, 1999; Britton & Bootzin, 2004; Nelson et al., 2006; Facco, 2010); (c) glutamate-
dependent excitotoxic damage Qansen, 1989, 1990, 2000) and analogies between NDEs and
the effects of hallucinogens (for a review see Facco, 2010); (f) multisensory breakdown involv-
ing the right angular gyrus for OBEs (Blanke et al., 2004; Blanke & Arzy, 2005; De Ridder et al.,
2007; Lopez et al., 2008); (g) psychological hypotheses of afterlife expectation or memories
of being born (Blackmore &Troscianko, 1988; Appleby, 1989; French, 2001; Britton & Bootzin,
2004).
All of these interpretations, despite being scientifically sound, remain so far only specu-
lations or, at best, clues without any demonstration, while others are not even plausible or
neglect facts incompatible with the ruling mechanistic and reductionistic view (Facco & Agril-
lo, 2012). Moreover, any interpretation should take into account that the specific content and
meaning of an experience cannot be reduced to its hypothetical mechanisms only, although
this may be involved in their origin.The mind-brain relationship is not yet properly understood
and there is still a substantial lack of explanation on how neural circuit activities may generate
qualia and the subjective essence of mind (Chalmers, 1995, 1999; van Lommel, 2004; Facco,
2010). Rather, the reductionstic approach may help in refusing a priori awkward phenomena
such as NDEs and unduly relegate them to a meaningless activity, a mere consequence of brain
dysfunction.
The hypothesis of NDEs as a by-product of brain dysfunction and/or drug administration
is not tenable since the picture of delirium due to brain disorders or drugs (such as acute
anticholinergic syndrome) have been well described in anaesthesia and intensive care with a
clinical picture entirely different from NDEs (Facco & Rupolo, 2001;Xie & Fang, 2009; Frontera,
2011). Moreover, should NDEs be a mere epiphenomenon of brain dysfunction, a kaleidoscopic
array of different fragmented impressions might be expected rather than the lucid, coherent,
and well-organized transcultural experiences reported (which might be considered as arche-
typal, to use Jung's terminology). An amnesia yielded by the insult might be expected as well,
cancelling out all impressions (perhaps this might happen to people not reporting NDEs). In-
deed, the hypothesized mechanisms might have a trigger role for NDEs, but they cannot be
responsible for their specific content or psychological meaning and its transformational con-
sequence. Least of all can it explain other facts like witnessed OBEs.
The phenomenology of NDEs, including OBEs, might be regarded as intrapsychic psycho-
logical phenomena, like a sort of dream or hallucination, whatever their pathophysiology. On
the other hand, patients reporting OBEs are occasionally able to witness what happened dur-
ing the loss of consciousness (Sabom, 1998; van Lommel et al., 2001; van Lommel, 2004). The
documented evidence of being able to retain a sense of identity, perception, and conscious-
ness while clinically unconscious or in clinical death with a flat EEG (as in cardiac arrest) is
surprising, while perceiving oneself as out of one's body and able to witness facts is puzzling
and hardly explicable with our current concepts. These cases represent a difficult challenge
to the reductionistic and physicalist view, but they cannot be neglected. There are only two
possibilities: (a) the cases are fabricated (but this is not tenable) or (b) consciousness might
be more than a simple emergent property of brain circuits and have non-local properties. Ter-
tium non datur. Facing such a ticklish problem calls for a true sceptical stance; that is, neither
288 FACCO
accepting nor refusing anything a priori and avoiding to take scientific (undemonstrated) axi-
oms for absolute truth.
In conclusion, NDEs are outstanding clinical facts with well-documented evidence and epi-
demiology. A rigorous study of these and other consciousness features might disclose new and
unexpected trends leading to a deep reappraisal of the physiology of consciousness and even
of its definition; this topic plays a key role in biology, psychology, science, philosophy and, in
general, in the whole of human life. Despite the fact that we seem to know almost nothing
as yet, a new, still narrow, path looks to be promising: that is, the approach according to rela-
tivistic and quantum physics. It provides an entirely new approach to consciousness, despite
being hardly understandable in the field of biomedicine, the paradigm of which is still clinging
to the physics of the 19th century. The quantum hypotheses of consciousness are as intriguing
as they are revolutionary, but they are far from being demonstrated as yet (Hameroff, 1997;
Hameroff et al., 2002; Nakagomi, 2003; Smith, 2006, 2009; Ventegodt et al., 2006; Persinger
& Koren, 2007). Should they be proved in the future, they would explain the possibility of the
non-locality of consciousness, turning NDEs, OBEs, and telepathy into natural and obvious
physical facts, instead of implausible phenomena with a paranormal flavour.
EPISTEMOLOGICAL ASPECTS
According to Antiseri and Gava (1983), the history of science is a wonderful story of theories
and beliefs disproved by new facts. On the other hand, beliefs (including scientific beliefs and
dogmas) are often stronger than facts and behave like powerful filters which prevent us from
understanding or even perceiving real facts when they look incompatible with them. As Scho-
penhauer said, 'Truth arises as a paradox and dies as obviousness'.
It is worth recalling the revolutionary strength of Copernicus and Galileo, up to the dis-
covery of the relativity of time and space by Einstein and the demolition of the paradigm of
classical physics by quantum physics. The most recent example of the supremacy of beliefs
over facts is the dispute between mechanistic physicists and relativistic/quantum physicists,
which led Max Plank to state: 'A new scientific truth does not triumph by convincing its op-
ponents and making them see the light, but rather because its opponents eventually die, and a
new generation grows up that is familiar with it' (Plank, 1949). It is the timeless human prob-
lem, well shaped by the allegory of Plato's Cave.
In general, any new theory has its detractors—they are ubiquitous figures in the history
of science. Of course, we should not believe just any new report, but we should be aware of
our cultural limits which may prevent us from recognizing true facts. At the beginning of the
third millennium, we should be aware that the exclusive use of the ruling mechanistic para-
digm is no longer enough and that the relationship between consciousness, language, and the
brain—and their relationship with the external and internal worlds—is still far from being fully
understood.
Our current paradigm is the result of Cartesianism, Positivism, and the Enlightenment,
which have focused mainly on external, objective, material reality, as well as emphasizing the
power of reason, intellect, and logic as the most relevant and powerful human faculties. This
stance has been of great value and has allowed for the outstanding development of science
and knowledge (mostly regarding the so-called objective physical world), but it has granted
only a partial exploration of reality. The source of bias in this approach rests in its dualistic
essence, which lets one analyse and know only at the cost of separating facts; thus leading to
the false belief that reality is the result of separate, frozen facts and mechanisms, where only
what we think to be significant is reaLThus, we have developed a utilitarian mind which is able
to work very effectively on separated facts to gain advantages but is not inclined to synthe-
sis—perceiving and fitting the complex relationship beyond the products of analysis. In many
instances this separation may turn into a dissociative activity, since it arbitrarily separates
what in nature is not, with an implicit risk of a sort of cultural schizophrenia.
Galilean science does not spring from a free epistemological reflection, but, on the contrary,
is the result of a compromise in Galileo's personal conflict with the Inquisition. This led to the
prevention of science from studying the mind and consciousness, since psyche has the same
etymological meaning as soul; thus, consciousness and psyche were disregarded for centuries
and relegated to philosophy and religion, and an artificial barrier was created between them
and empirical science. It is odd to see how medicine has mainly taken care of patients in terms
of Descartes"earthern machine', as if the role of mind would be irrelevant in both health and
disease.
Where consciousness is concerned, our current position unwittingly meets Cartesian radi-
cal dualism—the separation of body and mind—and gives rise to a contradictory stance. In
fact, we are inclined to perceive the mind as a strange guest hosted somewhere in the brain
but entirely separated from the body; at the same time, we learn to shape our mind as the
mere result of brain anatomy and neurochemistry, thus emphasizing only its organic aspect,
despite the absence of any clear proof for such an axiom. Fortunately, there is an increasing
dissatisfaction with this fragmented and contradictory view, and a movement to find a place
for subjective experience in the scientist's world picture (Zeman, 2001). On the other hand,
this is to recognize that Positivism has been invaluable in defining the boundaries of the field
of investigation, thus withdrawing the often prejudicial influences of philosophy, metaphysics,
and religion from empirical science; nevertheless, confined to the objective, material world,
science has implicitly underscored subjectivity.
We should be aware that we can only get in touch with the external world through our
mind and that so-called objectivity does not overcome the limit of shared subjectivity. Para-
doxically, metaphysics is no less realistic than physics, since it is the new reality we necessarily
meet when we die, whatever our religious, philosophical, or scientific position. Death looks like
a mysterious door (a sort of star gate) which we trespass from our current world towards the
unknown, whatever may it be (Nothingness, God, Hell-Heaven, reincarnation, none of them).
In conclusion, our conventional reductionistic and mechanistic approach seems not enough
when it comes to defining consciousness, life, death, and near-death (Facco, 2001, 2010;
Zeman, 2001; van Lommel, 2004, 2011); their definition is very hard, if at all possible, and
necessarily involves physics, psychology, philosophy, and religion, besides biology. Despite our
efforts to explain mental processes on an organic basis as the epiphenomena of brain circuits,
mind and subjectivity remain the essence of human life to such an extent that withdrawing
medical treatment is increasingly allowed in permanent vegetative states, while the very defi-
nition of brain death implies that life in itself is psyche.
290
CONSCIOUSNESS AND PSYCHE

The study of consciousness is a difficult multidisciplinary challenge; the term itself has such
wide meanings as to make it ambiguous. Consciousness includes a range of both conscious
and preconscious processes as well as implicit capacities, selectivity, variability of contents,
intentionality, and different aspects of self-consciousness (e.g. awkwardness in the company
of others, self-detection, self-recognition, awareness of awareness, self-knowledge). Its com-
plexity has also led to the formulation of several theories in the attempt to define its nature,
such as information processing, neurobiology, and social theories (Zeman, 2001).
Consciousness is only the tip of an iceberg, the definition of which is far from complete.
Our perception of consciousness is also biased by our prereflexive perception of the ego and
cultural traditions, springing from the Cartesian Cogito ergo sum. In fact, consciousness is not
the foundation of our existence but an evolutionary product; that is, the supernatant of a
deep and unknown psychic well working without the need of consciousness. It is worth noting
that the Zen tradition considers the Freudian unconscious as a part of the empirical mind (i.e.
oriented towards the external world) and belonging to the surface of psyche, while the whole
of the unconscious extends as far as the level of Buddha's nature—far beyond the conceptual
mind.The latter is a matter of enlightenment which can be reached with the no-mind doctrine
and meditation (Sukuki, 1958; Facco, 2010). It is worth noting how western culture discov-
ered only a part of the unconscious just a century ago, while eastern philosophy has known
about preconscious and unconscious mind processes for over two thousand years (e.g. the
Yoga Sutras of Patanjali).
Western culture, with its emphasis on intellect, logic, and dualism has developed a rather
egocentric, anthropocentric, and ethnocentric view of the world, where the usual third-person
perspective used in science is often no more than a shared anthropocentric and ethnocentric
first-person perspective—perhaps a view not so objective as is claimed. It also leans towards
a static, mechanistic description of reality, where phenomena are mainly described from the
outside, and are not sufficient to understand subjective reality.
Reality is not static; on the contrary it flows in an endless transformation. The psyche and
consciousness are also in a ceaseless flux of information and elaboration. Therefore, the con-
cept of state in classical physics and the term 5íaíe of consciousness are also errors of the
shared first-person perspective, only meaning that no significant change is perceived during
the period of observation.
THE DISTORTING LENS OF LANGUAGE

We use a language to communicate with each other, but we must be aware that we are mas-
ter and slave of our language and culture at the same time: the adopted paradigm allows for
understanding a part of reality, but it prevents us from checking and even perceiving facts
incompatible with it. Medicine, being focused on diseases and mainly adopting a statistical
concept of normality, leans towards defining as dysfunction whatever looks to be different
from the most ordinary conditions. Even the disease and its diagnosis are in some way a con-
ventional fact, a noun attached to a wider and often only partly known process (Berganza et
al., 2005), the definition of which depends on biological components, psychosocial and cultural
frameworks. Such an approach has a strong risk of misconstruing the nature of awkward ex-
pressions of mind, with the possibility of taking a non-disorder for disorder (Wakefield, 2010).
In the past few decades, NDEs, hypnosis, relaxation, and meditation have been included
in the so-called altered states of consciousness (ASC), together with other physiological and
pathological conditions, such as dreaming, sexual activity, starvation, respiratory manoeuvres,
sensory deprivation, rhythm-induced trance, dancing, hypnagogic states, epilepsy, the effects
of hallucinogens, psychotic symptoms, stupor, coma, and vegetative state (Nichols, 2004; Vaitl
et al., 2005; Boveroux et al., 2008). Despite the ASC classification distinguishing physiological
from pathological forms, the term altered states of consciousness looks to be questionable for
physiological and intentional mind activities which do not necessarily imply the features of
ASC. In fact, the term altered semantically implies the idea of dysfunction, assigning them a
bad and unwarranted label of abnormality; on the other hand, the term state is inappropriate,
since consciousness is a ceaseless processing unit.The term non-ordinary activity of conscious-
ness looks to be semantically more appropriate. The very concept of ASC also implies that
only what is ordinarily observed can be considered as normal. The same is true for the folk
link between genius and madness, since both are beyond the limits of normal; however, the
genius and enlightened man lie on the other side of the Gaussian distribution of normality in
comparison to the mad.
Names, besides being verbal signs, provide substance to the designated phenomena: they
belong to the grammatical category of substantives, the etymology of which means indicating
or giving substance. The power of names has been well known since the beginning of human
kind, since in the Bible it is told: 'So out of the ground the Lord God formed every beast of the
field and every bird of the air, and brought them to the man to see what he would call them;
and whatever the man called every living creature, that was its name' (Genesis 2:20). And then:
'Come, let us build ourselves a city, and a tower [Ba'bel] with its top in the heavens, and let
us make a name for ourselves, lest we be scattered abroad upon the face of the whole earth'
(Genesis 11:4).
The power of names and their meanings has strongly conditioned the history of hypnosis,
where terms with a pathological or paranormal flavour, such as magnetism, trance, or experi-
mental hysteria (assigned by Charcot) have helped in dismissing it. The same is true for the
term ASC when applied to physiological and valuable mind processes like hypnosis and medita-
tion. Where NDEs are concerned, the term ASC helps to perceive them a priori as pathological,
skipping their cognitive and transformational potential. Likewise, the terms hallucinogens and
psychotomimetics, used to indicate a class of psychotropic drugs, spring from psychiatric dis-
orders, providing them with strongly negative connotations. On the contrary, shamanic culture
considers them as master plants able to provide relevant teachings; other more apposite terms
for these substances are psychedelics, empathogens, entheogens. and entactogens. The term
psychedelic, introduced by Humphrey Osmond (Osmond, 1957) in the 1950s, emphasizes
their capacity to reveal hidden aspects of the psyche, while empathogens and entactogens
indicate their power to generate mystic experiences (increased feelings of participation and
fusion with the whole world). Entheogens, introduced by Ruck et al. (1979), etymologically
means having God inside and also denotes the power of fostering mystical experiences with an
aspect of religious and divine inspiration (Jaffe, 1990; Nichols, 2004; Facco, 2010).
These examples show how names may give substance and lead us to judge a phenomenon
according to its name; this is exactly what the Latin saying nomen omen (name is destiny)
means. On the other hand, it is worth noting that hallucinogens have accompanied human
kind since prehistory and have been always linked to spirituality, from the use of KUKECJÜV
292
(kykeon—the psychotropic drink of the Eleusynian Mysteries) to contemporary native reli-

gions and shamanic culture. The solely negative view of modern western culture is likely to
depend on its materialistic stance, while master plants in themselves are neither good or evil,
but only the use men make of them. Thus addiction is much more a cultural by-product than
an unavoidable effect of the substance; this has been clearly shown by opiates, the substances
with the highest potential for addiction, and, at the same time, invaluable therapeutic agents
with no major risk for addiction when properly used.
Other terms, like hallucination, have been widely used to define both NDEs and aspects of
hypnotic phenomenology. This term traditionally provides an instinctive and powerful nega-
tive suggestion of mental disease, skipping the fact that both illusions and hallucinations,
like hypnagogic and hypnopompic ones, may also be a physiological phenomenon, spontane-
ously occurring in everyday life. It is worth reappraising the concept of eidetic imagination, a
physiological phenomenon allowing us to perceive things that are non-existent in the external
reality, in order to regain an awareness of the good, physiological powers of the mind and the
limits between its normal and pathological expressions. Creativity is also a unique human vir-
tue enabling us to make real what previously did not exist. A proper reappraisal of physiologic
non-ordinary activities of consciousness would be welcome to avoid the verbal shortcuts lead-
ing us to implicitly misunderstand the nature of observed phenomena.
In conclusion, the problem of language, and the proper definition of mind activities, has
deep cultural implications, since the inclination to render a pathological image of non-ordinary
psychic phenomena seems to be a product of the 20th century, dominated by a materialistic
and mechanistic view of the world. It is now time to reappraise the foundation of this naive re-
alism and move towards a post-materialist psychology (Greyson, 2010). This will enable us to
rediscover the world of subjectivity in medicine, as well as some apparently awkward aspects
of mind physiology and spirituality, which are much more real and relevant faculties than was
believed in the previous century.
A LINK BETWEEN NDES AND HYPNOSIS

NDEs and hypnosis appear as two entirely distinct phenomena, apart from being linked in the
classification of so-called ASC; indeed, they are clearly distinct, but some common processes
probably tinge both of them. Experiences similar to those of NDEs can be easily generated
during hypnosis, such as: (a) imagining seeing oneself from the outside, (b) changing time
perception, (c) recalling old and non-easily accessible memories, up to evoking reminiscences
of alleged previous lives, and (d) performing a life review. Of course, there is neither evidence
of any likelihood of previous life recollections (Ferracuti et al., 2002) nor do they imply the
possibility of reincarnation.
Hypnosis has seldom been used to evoke previous NDEs in an attempt to relive them. The
first case was reported in the 1940s (quoted in Holden & MacHovec, 1993) and concerned
a man who had previously had a very pleasant NDE during an anaphylactic shock yielded
by iodine contrast medium administration for a radiological investigation. The patient was
submitted to hypnosis with the direct suggestion of going back to the moment of the NDE.
When he recalled it, he underwent a sudden fall of arterial blood pressure with an increase
of heart rate up to 190 beats/min, which reversed after de-hypnotization. These data show
the psychosomatic power of hypnotic suggestions, which, in this case, replicated the whole
experience including physical changes; this also suggests the potential risks of directly evok-
ing critical situations. Holden and MacHovec (1993) addressed this problem and introduced
a hypnotic protocol able to prevent unwelcome somatic reactions related to critical physical
conditions during which NDEs are experienced.The way to safely evoke them during hypnosis
is essentially characterized by suggesting to the patient that he is to remain in his actual physi-
cal conditions while recalling the content of his experience only.
NDE-like experiences may also occur in normal conditions without any real or perceived
danger for life, in the absence of psychiatric disorders or psychotropic drug effects, but they
still maintain their transformational power (Facco & Agrillo, in press). On the other hand, rites
of passage in all cultures may include real risks and/or lead the subject to face the perception
of death and rebirth to a new phase of life with increased awareness. In the Bwiti religion (Con-
go) a complex ritual is still performed nowadays with the use of Iboga, a master plant, under
the influence of which subjects have an experience similar to NDEs (Strubelt & Maas, 2008).
The same can be achieved with hypnosis through its capability to induce experiences sim-
ilar to NDEs. In the context of psychotherapy. Schenk (1999) used hypnotically facilitated
waking dreams as an interactive projective technique to generate NDE-like experiences; the
aim was to approximate their transformational therapeutic aspects and facilitate both first-
and second-order patient changes. Patients were permissively suggested to imagine their life
going forward towards its end. Most subjects spontaneously underwent NDE-like experiences,
which were not dependent on any previous knowledge of NDEs or personal religious beliefs.
The main features of these experiences were a deep sense of well-being, love, and peace in
an atmosphere of forgiveness and absence of judgement. OBEs, life review, and the feeling of
the presence of a guide, represented as a relevant person for the subject, or a superior entity,
might also occur. These experiences, unlike true NDEs, did not end with the return into the
body but with the visualization of their out-of-body part disappearing in the light. The life
review also had distinct aspects, since during the simulated NDEs what mainly emerged were
previous critical episodes; that is, ones which called for being revised in order to allow for a
second-order change.
NDE-like experiences seem to have relevant therapeutic implications in achieving second-
order changes, leading to positive and durable solutions to patients' problems. This technique
looks curiously like the opposite of the usual retrospective psychoanalytic approach, since the
past is recollected from the most crucial moment in the future, the projection of one's death,
so is a sort of forward to the past or back to the future. \n this envisaged situation, the positive
ambience of forgiveness, peace, and love, devoid of any judgement, probably helps towards an
equable and effective revision of the patient's problems in a more contemplative view. Perhaps
the OBE also allows for keeping a proper distance from the conflicts and helps to revise them
in a more detached and meditative way by decreasing the patient's unease. On the other hand,
the transformative power of both true NDEs and NDE-like experiences is likely related to their
deep meaning and the radical change of perspective they produce in comparison to the limited
view of everyday life. This may help to increase the capability to think about life, death, self,
and the relationship between self and the external world from a wider and more philosophical
perspective, including the very meaning of life and the limited, relative value of social conven-
tions and relationships.
Finally, hypnotically simulated NDEs may help to unearth possible common psychological
and physiological aspects with real NDEs; they might lead to a better understanding of their
294 FACCO
nature and meaning. Instead, branding them as ASC (together with pathological conditions)
prejudicially leads one to distrust and beware of them as mere hallucinatory or psychotic
expressions unworthy of interest. There is a still misunderstood link between the phenom-
enology of NDEs, mystic experiences, vision of prophets and apostles, creativity, inspiration
in poetry, art, and music, neurological diseases (such as temporal lobe epilepsy), psychiat-
ric disorders, effects of hallucinogens, role transitions, hypnosis, and meditation (Facco, 2010;
Facco & Agrillo, 2012).They probably have in common, at least partially, neurocorrelates which
so far have been described in terms of dysfunction and pathology only, while their possible
physiology remain still unknown or even mysterious. It calls for a broader interpretation of
these phenomena, overcoming the limits of reductionistic interpretations, which are blind to
the meaning of experiences, and reappraising the so-called ASC in a physiological perspective
by merging their mechanisms, contents, and meanings in a whole without prejudices, not even
scientific ones. At the same time, we should be aware of knowing much less than we believe
in the field of the mind: consciousness might result in being more complex than we think
and, perhaps, might have still unknown properties which look incompatible with the current
mechanistic and materialistic approach, anchored to the physics of nineteenth century. It is a
hard challenge calling for strong efforts, reappraising our seientifie and epistemologieal ground
without aeeepting or refusing anything a priori.
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Correspondence to Enrico Facco, Department of Neurosciences, University of Padova, Via

Giustiniani, 2 - 1-35128 Padova, Italy
Email: Enrico Facco ([email protected])
Tel: +39 049 821 8024
Fax:+39 049 821 8229
© British Society of Clinical and Academic Hypnosis (2012)

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284 CONTEMPORARY HYPNOSIS AND INTEGRATIVE THERAPY

29(3): 284-297 (2012)

NEAR-DEATH EXPERIENCES AND HYPNOSIS:TWO DIFFERENT

Keywords: hypnosis, consciousness, consciousness disorders, death, near-death, psychotherapy

Section: MODIFIED CONSCIOUSNESS

NDE: PHENOMENOLOGY AND SCIENTIFIC EXPLANATIONS

Section: MODIFIED CONSCIOUSNESS

Section: MODIFIED CONSCIOUSNESS

CONSCIOUSNESS AND PSYCHE

THE DISTORTING LENS OF LANGUAGE

Section: MODIFIED CONSCIOUSNESS

(kykeon—the psychotropic drink of the Eleusynian Mysteries) to contemporary native reli-

A LINK BETWEEN NDES AND HYPNOSIS

Section: MODIFIED CONSCIOUSNESS

Section: MODIFIED CONSCIOUSNESS

Section: MODIFIED CONSCIOUSNESS

Correspondence to Enrico Facco, Department of Neurosciences, University of Padova, Via

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