"I'm Not Afraid To Die" - The Loss of The Fear of Death After A NDE

Mortality
Promoting the interdisciplinary study of death and dying
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“I’m not afraid to die”: the loss of the fear of death

after a near-death experience
Natasha A. Tassell-Matamua & Nicole Lindsay
To cite this article: Natasha A. Tassell-Matamua & Nicole Lindsay (2016) “I’m not afraid to
die”: the loss of the fear of death after a near-death experience, Mortality, 21:1, 71-87, DOI:
10.1080/13576275.2015.1043252
To link to this article: http://dx.doi.org/10.1080/13576275.2015.1043252
Published online: 05 Aug 2015.
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Download by: [Massey University Library] Date: 16 February 2016, At: 13:49
Mortality, 2016
Vol. 21, No. 1, 71–87, http://dx.doi.org/10.1080/13576275.2015.1043252
“I’m not afraid to die”: the loss of the fear of death

after a near-death experience
NATASHA A. TASSELL-MATAMUA & NICOLE LINDSAY
School of Psychology, Massey University, Palmerston North, New Zealand
Downloaded by [Massey University Library] at 13:49 16 February 2016
ABSTRACT According to terror management theory, fear of death is one of the most profound of
human anxieties. Yet, the near-death experience (NDE) and its associated pattern of after-effects
represent an intriguing exception to this theory. Studies indicate the loss of the fear of death is an
instantaneous and pervasive after-effect of NDEs. Some theorists propose this elimination of death
fear could be related to the sense of disembodiment felt during the NDE. In this article, we expand
on previous theories by suggesting the combination of four specific elements of the NDE directly
influence the loss of the fear of death, including: the sense of disembodiment, positive emotional con-
tent, meeting and greeting with deceased others and spiritual beings and exposure to a bright other-
worldly light. We conclude by making suggestions for future research endeavours in this area, and
their potential beneficial implications for health service delivery, particularly in end-of-life care.
KEYWORDS: near-death experience; death anxiety; death fear; death threat; mortality;
death; dying; disembodiment; spirituality
At some stage we all die. We may not know when or how, but we do know that
death is certain for everyone. Awareness of our own mortality can be
confronting for many people, provoking high levels of anxiety (Niemiec &
Schulenberg, 2011). According to terror management theory (TMT; Solomon,
Greenberg, & Pyszczynski, 1991), human behaviour is motivated towards
managing or eliminating this anxiety, which can result in a variety of culturally
specific social norms. In Western cultures, this can include an unspoken taboo
on talking and thinking about death (Braun, Gordon, & Uziely, 2010).
A reason for this death avoidance could be related to the conceptualisation of
death in many Western societies, which is typically based on an objective-
mechanistic model of dying. According to this model, when our physiological
structure ceases to function, we die, and that is the end. Nothing survives …
nothing lives on (Tassell-Matamua, 2014). In this sense, death is often defined
and understood by many, as an exclusively physical process, in which annihila-
tion of the self is the outcome (Carpentier & Van Brussel, 2012). This prevail-
ing clinical model has resulted in a pervasive belief within wider society that
Correspondence: E-mail: n.a.tassell-matamua@massey.ac.nz
© 2015 Taylor & Francis

72 N.A. Tassell-Matamua and N. Lindsay
death is an enemy, and within the medical profession that death is a failure
(Branch, Pels, & Hafler, 1998; Field & Cassel, 1997; Kelly & Nisker, 2010).
As a result, modern death has become progressively sanitised and removed
from the public domain (Kelly, 2012; Kelly & Nisker, 2010). Where once we
were surrounded by loved ones in our own home, research suggests in Western
societies, up to 50% of us now die in hospital, frequently alone (Edmonds &
Rogers, 2003). An increasingly secular society also means religious beliefs are
less relevant in our attempt to reconcile our own mortality, no longer offering
the same measure of comfort they once might have (Voas & Crockett, 2005).
Consequently, many consider death with trepidation and uncertainty, ill pre-
pared for the psychological experience of dying. As Kubler-Ross (1969) noted,
few of us approach death with the attitude of acceptance.
The near-death experience (NDE) and its associated pattern of after-effects

present an intriguing exception to this norm. Despite the common assumption,
death anxiety is a fundamental part of the human condition; those who
undergo an NDE frequently appear to have transcended the fear of death.
They consistently display a markedly reduced or complete elimination of the
fear of death (Noyes, Fenwick, Holden, & Christian, 2009). It is especially
noteworthy that an experience like an NDE, which can occur during a time
span as fleeting as a cardiac arrest, can cause such a significant and pervasive
psychological shift in those who experience them (Tassell-Matamua, 2014).
Even the most advanced and empirically established psychological therapies
struggle to elicit the same effect (Lonetto & Templer, 1986).
Further examination of the NDE and its remarkable effect upon what is con-
sidered a universal and deep-rooted fear is warranted, and forms the purpose of
the present paper. We define and outline the main characteristics of NDEs,
before reviewing evidence indicating the loss of the fear of death is a common
outcome of these experiences. We then present a theoretical position suggesting
specific elements typically experienced during an NDE are implicated in the
loss of the fear of death. The article concludes with a discussion of further
research required to better elucidate the mechanisms behind this loss, as well
as suggesting the potential implications a greater understanding of the NDE
and its associated after-effects could have for health service delivery, particu-
larly at the end of life.
What is an NDE?
An NDE can be defined as a subjectively profound psychological experience,
which deviates from currently accepted norms of reality, due to the transcen-
dence of space, time and perceptual boundaries (Tassell-Matamua, 2014; van
Lommel, 2013). Cognitive, emotional and transcendental elements comprise
NDEs. Extraordinary conscious abilities, including an altered perception of
time, enhanced awareness, instantaneous memory revival and the perceived
separation of mind from body, are typical cognitive elements. Reported emo-
tional elements may include intense positive affect, such as joy, happiness,
I’m not afraid to die 73
peace and unconditional love. Seeing and being drawn to an unusually bright
light, encountering deceased others, communicating with a being of light and
cosmic unity, are among the transcendental elements (Greyson, 2000;
Schroter-Kunhardt, 1993; von Haesler & Beauregard, 2013).
NDEs have been reported across time and across cultures. Such experiences
are evident in the written and oral histories of the Sumerians and classical
Greeks (Schroter-Kunhardt, 1993), while more recent scholarly literature pro-
vides record of NDEs in modern cultures like Thailand (Murphy, 2001), Italy
(Giovetti, 1982), India (Pasricha, 1993), Germany (Knoblauch, Schmied, &
Schnettler, 2001), United Kingdom (Parnia et al., 2014), Australia (Sutherland,
1990) and New Zealand (Tassell-Matamua & Murray, 2014). Modern
resuscitation techniques have improved survival rates from near-fatal encoun-
ters, which likely accounts for the increased reports of NDEs by survivors in
recent times. Current empirical literature suggests NDEs occur in around
5–20% of cardiac arrest survivors, and 4–9% of the general population. Given
the stigma surrounding such phenomena, probably because they contravene
objective-mechanistic views of death and accepted norms of reality, there is a
possibility the experiences are under-reported, which means these figures could
be even higher (Zingrone & Alvarado, 2009).
NDEs are usually perceived positively by the experiencer, with relatively few
distressing experiences reported. However, unpleasant NDEs have been
described (Atwater, 2009; Bush, 2002), and they are also likely under-reported.
NDEs are of such a lucid and ineffable nature, major life changes and signifi-
cant psychological shifts are a typical consequence. Some of these can include
the termination of significant relationships, changes in employment, changes in
life priorities and goals and initial declines to subjective well-being (Christian &
Holden, 2012; Groth-Marnat & Summers, 1998; Musgrave, 1997; Stout,
Jacquin, & Atwater, 2006), which appear to be catalysed by alterations in
worldview and value systems.
The integration of the NDE into lived experience seems to be crucial in
facilitating after-effects, especially those deemed beneficial or positive (Noyes
et al., 2009). When integrated appropriately, overwhelmingly positive psycho-
logical outcomes tend to result, and can include: greater concern or compassion
for other people; enhanced appreciation and subjective quality of life; positive
attitude towards self; enhanced sense of self-identity; reduced consumerism and
materiality; reduced negative affect and cognitions; and a greater ‘thirst’ for
knowledge (Atwater, 2008; Greyson, 2003a; Groth-Marnat & Summers, 1998;
Musgrave, 1997; Noyes, 1980; van Lommel, van Wees, Meyers, & Elfferich,
2001; Sutherland, 1995).
Loss of the fear of death

Perhaps the most intriguing after-effect reported by virtually all who have an
NDE, is a reduction in or complete loss of the fear of death. Research over the
past several decades assessing the after-effects of NDEs indicates those who
have a close brush with death and experience an NDE overwhelmingly report
feeling less threatened by death, in addition to reporting a reduction or elimina-
tion of the fear of death. This cannot be solely attributed to the experience of
coming close to death, as those in life-threatening situations that do not have
an NDE, do not report the same level of change.
Ring (1984) claimed 80% of his NDE participants reported decreased or
vanished fear of death, as opposed to 29% of the non-NDE control group.
Sabom (1982) recorded 82% reduced fear of death in NDErs, compared to 2%
of the control group. Sabom also conducted a six-month follow-up with the
Death Anxiety Scale (Templer, 1970) and Death Concern Scale (Dickstein,
1972), finding near-death experiencers (NDErs) still scored significantly lower
on death fear, than non-NDErs. Sutherland (1990) and Flynn (1986) reported
a 100% decreased fear of death in NDE participants. Sutherland claimed
before the NDE, over three-quarters of her respondents said they feared death.
In Flynn’s study, the 100% decreased fear of death in NDE participants was
compared with a 42% decrease in non-NDErs who also had a close brush with
death.
Greyson (1992a) conducted a quantitative study with 135 NDE survivors
using the Death Threat Index (Krieger, Epting, & Leitner, 1974). He found
significantly lower death threat amongst NDE survivors, with the degree of
death threat inversely correlated with NDE depth. Similarly, Greyson (2003b)
in a later study, found NDErs were more likely to report increased death accep-
tance, in comparison to matched controls. As measured by the death attitude
profile (Gesser, Wong, & Reker, 1987), Greyson discovered NDErs exhibited
significantly higher levels of approach-oriented death acceptance. That is,
NDErs were more likely to view death as a positive transition to a pleasant state
of being.
Furthermore, this loss of the fear of death appears to be maintained over
time (Sabom, 1982; Sutherland, 1990; van Lommel et al., 2001). In their
seminal longitudinal study of NDEs in cardiac arrest survivors, van Lommel
et al. (2001) found the majority of the 62 patients reporting an NDE after
cardiac arrest, and who were interviewed shortly after the experience, did not
indicate any fear of death. Two years after the NDE, patients reported signifi-
cantly less fear of death in comparison to cardiac arrest survivors who had not
had an NDE. At eight-year follow-up, the significant difference in reduced
death fear between those who had an NDE and those who had not, was still
evident.
What it is exactly about the NDE prompting such radical change is less clear.
NDE researchers have tended to attribute this loss to a new or strengthened
belief in the afterlife, claiming NDErs frequently report they now know their
soul survives bodily death – a belief perhaps derived from the subjective experi-
ence of separation of consciousness from the physical body during the NDE.
Moody (1975) and Ring (1984), for example, attributed this finding to the
NDErs construction of a new model of death that involves transition into
another state of being, rather than annihilation. As Ring (1984) explains:

‘When an individual knows with a sense of unshakable certitude that he can
exist outside of his own body, he intuitively understands that physical death is
not an end …’ (p. 110).
In support of this, research has indicated a concomitant increase in afterlife
beliefs amongst NDErs (Flynn, 1986; Grey, 1985; Greyson & Stevenson, 1980;
Ring, 1980; Sabom, 1982; Sutherland, 1990). van Lommel et al. (2001) dis-
covered NDErs were likely to report a new or strengthened belief in the after-
life, in comparison to the non-NDE control group (who also came close to
death). Lai et al. (2007) found 75% of Taiwanese dialysis patients who had an
NDE reported a decreased fear of death, and 56% reported a belief in ‘life after
life’. When questioned further about their changed attitude to death, 43% sta-
ted they no longer feared death because they had already died once, and 43%
claimed it was related to a belief in life after life (reincarnation). Despite a
reduced fear of death being found to lead to an increase in suicide attempts
(Shneidman, 1971), Greyson (1992b) found suicide survivors who experienced
an NDE were far less likely to suffer from subsequent suicidal ideation or to
reattempt suicide, than those who did not experience an NDE. In contrast, the
NDErs were, somewhat paradoxically, more likely to express strong objections
to the concept of suicide, which Greyson attributed to increased transpersonal
or transcendental beliefs.
While studies indicate an increase in post-mortem continuation beliefs corre-
spond with decreased fear of death, it is not yet known whether afterlife belief
is a causative agent [of changed death attitudes] or simply a correlational factor
of the NDE. Despite there being some theoretical propositions as to why this
loss of the fear of death may occur as a result of the NDE, to our knowledge
no detailed empirical studies have been conducted to determine exactly why
and how this change manifests. With the exception of Sabom (1982) and
Greyson (1992b, 2003b), what we know about death attitudes in NDErs is
primarily formed on the basis of answers to one or two questions concerning
death fear, and on spontaneous anecdotal evidence – often criticised as
unreliable (e.g. Krieger et al., 1974).
Death-related research in general indicates death anxiety is a multidimen-
sional issue and not a unitary construct. Simply noting NDErs have signifi-
cantly reduced death fear serves little use beyond identifying a correlational
pattern. If we do not understand the mechanisms behind this marked reduc-
tion, then we are denying ourselves the opportunity to harness the profound
therapeutic, clinical and personal benefits stemming from these unusual, yet
life-changing experiences.
The literature on death-related attitudes has indicated a number of factors
associated with reduced death fear. For example, involvement in compassionate
activities, greater self-actualisation, higher levels of self-esteem, a deepening of
spiritual focus and belief one is living a more meaningful life, are related to
greater death acceptance and reduced death anxiety. Research shows NDErs
frequently report such changes at some stage after their NDE (Atwater, 1988;
Fenwick & Fenwick, 1995; Greyson, 1983b; Groth-Marnat & Summers, 1998;
Musgrave, 1997; Ring, 1984; Schwaninger, Eisenberg, Schechtman, & Weiss,
2002; Sutherland, 1992; van Lommel et al., 2001). A greater feeling of ‘alive-
ness’ or vitality is commonly felt by NDErs, as well as the experience of ‘living
more fully in the moment’. Wren-Lewis (1994) suggested this heightened abil-
ity to be ‘mindful’, or more present in the moment, may explain the decreased
death fear. He claims: ‘a shift in consciousness whereby life in each moment
becomes so vivid that anxiety about future survival … ceases to be important’
(p. 108).
However, prospective studies measuring attitude change immediately after an
NDE suggest the reduced death fear is instantaneous (e.g. Sabom, 1982;
Schwaninger et al., 2002; van Lommel et al., 2001). This indicates it is likely
not a consequence of other changes in attitude and behaviour affected by the

NDE, although a logical assumption is it is enhanced and maintained by these
changes. Despite the correlational nature of the relationship between having an
NDE and subsequent life changes, including a reduced fear of death, the ques-
tion remains as to whether reduced death fear results from the aforementioned
behavioural/attitude changes, or whether the loss of the fear of death prompts
these changes? Noyes (1980) and Flynn (1986) suggest it may be the latter
explanation. Both claim decreased fear is the precursor to altered life goals, a
greater sense of wellbeing and an increased zest for life. According to Flynn,
the dramatic personality transformation NDErs undergo, stems from this
profoundly decreased fear of death. For when death is not feared, there is
nothing to lose.
More research is needed to better explicate the relationship between elements
of the NDE and death fear loss, as well as the relationship between this loss
and other after-effects typically associated with an NDE. In this article, we sug-
gest a starting point for potential future studies, by proposing several commonly
reported features of NDEs contribute to the significant reduction of death fear,
and this change is instantaneous. Because this psychological experience is so
extraordinary and removed from everyday conscious experience, it prompts a
fundamental shift in the individual’s existing concept of self. This ‘new self’
emerges from the construction of a new model of reality in which death no
longer holds the same relevance. We propose there are four particular aspects
of the NDE contributing to this construction.
Disembodiment. Many experiencers often report that during their NDE, they felt
their consciousness was disembodied, and believe some aspect of their self left
their physical form. In particular, the out-of-body experiences (OBEs) typical
of some NDEs imply when our physical bodies die, there might be a non-physi-
cal aspect that survives, at least temporarily. Research into OBEs as a discrete
syndrome (without NDE) has indicated a markedly reduced fear of death
amongst experiencers. An OBE (without NDE) occurs either spontaneously or
voluntarily and is defined as an episode in which the mind or perception of

‘self’ appears to temporarily exist outside the physical body (Irwin, 1985).
OBE’s increase belief in life after death almost as much as the NDE
(Gabbard, Twemlow, & Jones, 1981; Irwin, 1983; Tiberi, 1993). Tiberi (1993)
compared an OBE group with an NDE group, finding both groups underwent
statistically comparable changes with regard to positive psychological and beha-
vioural after-effects. Both groups reported being less afraid of death. This led
Tiberi to suggest the sense of disembodiment (and associated positive affect)
analogous to both populations is responsible for the marked reduction in death
fear, due to the perception mind exists in a continuum and is not dependent
upon the body.
Numerous OBEs have been reported by NDErs, where they describe perceiv-
ing events occurring around their physical body at a time when they felt their
physical being was unconscious, but some non-physical aspect of them was very
conscious. Whether the OBE is an example of actual disembodied conscious-
ness, or the result of a complex hallucination or some other condition, has been
and continues to be the subject of vigorous debate (e.g. Augustine, 2007;
Ehrsson, 2007; Greyson, Fountain, Derr, & Broshek, 2014; Mobbs & Watt,
2011). Yet, numerous reports of OBE during NDE have been independently
corroborated by others. The most compelling cases come from those related to
medical procedures, where controlled monitoring of physiological signs was
possible. These suggest during periods of severe physiological impairment or
lack of obvious physiological functioning, complex conscious abilities – as
indicated by an OBE – appear to have been operative.
For example, Sabom (1998) reported the case of Pam Reynolds, who under-
went a rare surgical procedure to remove a giant basilar artery aneurysm in
1991. The location and size of the aneurysm prohibited the use of standard
neurosurgical techniques, necessitating the use of a more radical approach,
involving the induction of cardiac arrest, deep hypothermia and draining of
blood from the brain. All brain wave activity ceased during the procedure,
which according to established convention, suggested conscious activity could
not have been possible. Yet upon resuscitation, Pam reported hearing a buzzing
sound shortly after the surgery commenced, and viewing the surgery from a
position located on or near the surgeon’s shoulder. The surgical tool used to
saw open her skull, in addition to a number of other details regarding the
operating procedures, were accurately described by Pam and later verified by
the surgical staff and notes.
In their prospective study of NDEs in cardiac arrest, van Lommel et al.
(2001) describe a case of veridical perception of a resuscitated patient, as
reported by a coronary care nurse. The patient was admitted to hospital coma-
tose and cyanotic. During the process of intubation, it was discovered the
patient had dentures. The nurse removed the dentures from the patient’s mouth
and placed them on a ‘crash cart’. Eventually, the patient stabilised, and one
week later the nurse encountered the patient again for the first time since his
admission. The patient stated the nurse knew where his dentures were, having
removed them from his mouth when he was admitted to hospital. The patient
goes on to describe how, despite being comatose, he had observed the resuscita-
tion efforts on his body from a disembodied position. He also described witness-
ing the nurse removing his dentures and placing them in the ‘crash cart’.
Another case was identified by Beauregard, St-Pierre, Rayburn, and Demers
(2012), in their retrospective study conducted between 2005 and 2011, of
patients undergoing deep hypothermic cardiocirculatory arrest. A 31-year-old
woman, who was 31 weeks pregnant at the time, reported a detailed account of
observation while undergoing surgery to replace an ascending aorta. After
successfully delivering her baby by emergency caesarean section, she was trans-
ferred to the surgery room. She was given general anaesthesia, her eyes were
taped shut and she did not see or talk to members of the surgical team, nor was
it possible for her to see any of the machines located behind her head as she was
wheeled into surgery. Yet, she was able to accurately relay the surgical instru-
ments the nurse passed to the cardiothoracic surgeon, and described the anaes-
thesia and echography machines located behind her head. The cardiothoracic
specialist who performed the surgery later verified the details.
More recently, Parnia et al. (2014) published the results of their four-year
multi-centre prospective study of awareness during cardiac arrest. Of the 101
patients interviewed a second time, 9% reported experiences consistent with
NDEs. Of these, two patients reported specific and verifiable auditory and visual
awareness. One patient in particular, a 57-year-old man who had suffered ven-
tricular fibrillation, described perceiving events related to his resuscitation, from
a position external to his body and above and to the corner of the room. His
report accurately described people and equipment used in his resuscitation, as
well as specific sounds occurring approximately three-minutes after cardiac
arrest. His medical records corroborated his account as an accurate representa-
tion of the events and sounds that had occurred during his resuscitation.
These cases suggest the possibility of consciousness existing in the absence of
detectable physiological activity. More importantly, such episodes provide
experiential evidence for those who have them, of consciousness existing out-
side the body during severe physiological impairment. This knowledge could be
a main contributor to eliminating the fear of death, as the person who had the
NDE may now endorse the possibility of existing external to one’s physical
form, thus making the annihilation hypothesis of death null and void. If the
subjective experience of conscious continuation is felt during temporary death
or extreme impairment, the possibility of continued conscious existence beyond
permanent irreversible death becomes a logical next step.
Positive emotions. Positive emotions such as painlessness, tranquillity, joy and

love are usually the most salient aspects of the NDE, with studies indicating
approximately 80–100% of individuals experiencing intensified positive affect
during their NDE, in particular a feeling of deep peace (e.g. Greyson, 2003b;
Schwaninger et al., 2002). Blackmore (1993) and Carr (1982) claim natural
opiate release under circumstances of extreme stress, is responsible for the posi-
tive affect reported by NDErs. However, in contrast to the longer lasting effects
of opioid release for pain control (often many hours), the positive affect felt by
NDErs occurs over a much shorter timeframe, frequently only seconds or min-
utes (Fenwick, Lovelace, & Brayne, 2007), and is usually deemed to be of a
profound nature, outside the realms of ordinary emotional experience. Facco
and Agrillo (2012) suggest the adverse effects of opioid use for pain relief are
phenomenologically distinct from that of NDEs, implying opioids cannot
adequately account for NDEs.
Tiberi (1993) terms these ‘extrasomatic’ emotions, and notes they are similar
in nature to those normally experienced in the body – somatic emotions. How-

ever, because they are perceived as occurring out of the body and under such
unusual circumstances, the emotional intensity is heightened due to cognitive
awareness of experiencing something extraordinary. Tiberi suggests this demon-
strates a consistent pattern, whereby extreme positive emotions are repeatedly
associated with transformational after-effects, such as a changed attitude to
death. Because of the mediation of the NDE through emotion channels, Tiberi
believes subsequent personality and belief change becomes all the more pro-
found. These emotions are so intense and all encompassing, NDErs often have
difficulty finding words to appropriately capture the essence of how they felt
during their experience, and indicate any descriptives they do use, do not accu-
rately capture the emotions of the NDE: ‘It was nothing I can ever adequately
describe, nor anything I have ever experienced on earth’ (Sartori, 2014, p. 11).
The positive affect felt during the NDE suggests physiological closeness to
death, or at least the perception one is close to death or has indeed died, may
be psychologically enriching, catalysed by positive emotions, sensations and
cognitions. The experience is likely to contravene many people’s expectations
of death and the dying process (at least in Western cultures). If death – at least
in its initial stages – or closeness to it, is as affirmative and intoxicating as many
accounts suggest, then the loss of the fear of death reported by those who
experience an NDE, becomes a lot less surprising.
Meet and greet. The seeing, hearing or sensing of spiritual beings is a core
feature of NDEs, described by approximately 50% of NDErs (Greyson, 2003b;
Greyson & Stevenson, 1980; Kelly, 2001; Schwaninger et al., 2002; Sutherland,
1989). Spiritual beings encountered are often deceased relatives, friends, reli-
gious or holy figures or what is understood to be a spirit guide – a benevolent
figure the NDEr does not recognise, yet inherently understands is intimately
concerned with their welfare. This is highlighted by a participant in the Parnia
et al. (2014, p. 5) study: ‘… up in (the) corner of the room there was a (woman)
beckoning me … I felt that she knew me, I felt that I could trust her, and I felt
she was there for a reason …’ According to the accounts of many NDErs, the
primary role of these beings is to provide knowledge, comfort and support in the
initial stages of their experience.
This feature of the NDE is often attributed, at least by sceptics, to psycho-
logical constructions that deceased others will be met at the moment of death.
However, not all beings met during NDEs are known to the individual, as the
participant in the Parnia et al. (2014) study indicates. Also countering this are
the NDE reports of young children who have little or no knowledge regarding
the permanency of death, and few cultural expectations of the dying process
(Bush, 1983; Morse, Conner, & Tyler, 1985). There are also many cases of
those who suddenly find themselves in a life-threatening situation without being
aware of it (e.g. cardiac arrest). The onset of cardiac arrest is so rapid the
individual is unaware of what happened until they regain consciousness, so is

unlikely to have had time to recognise the seriousness of their physiological
condition, and make psychological expectations of dying. Interestingly, a study
by Kelly (2001) found those in situations where the critical physiological
incident was immediate and unexpected (i.e. accident or cardiac arrest), were
significantly more likely to encounter deceased relatives as part of their NDE.
Particularly intriguing cases also reported by NDErs are ‘Peak in Darien’
experiences. These can involve the individual seeing a recently deceased person
during their NDE, of which they had no previous knowledge the deceased had
died. In fact, many report surprise at seeing someone they assumed was still liv-
ing, only to be told or to eventually find out, the person died, in some cases at
very distant locations, just minutes or hours prior to the individual having their
NDE. The example of 9-year-old Eddie Cuomo highlights this:
As soon as he opened his eyes, at 3:00 in the morning, Eddie urgently told
his parents he had been to heaven, where he saw his deceased Grandpa
Cuomo, Auntie Rosa, and Uncle Lorenzo … Then Eddie added that he also
saw his 19-year-old sister Teresa, who told him he had to go back. His father
then became agitated, because he had just spoken with Teresa, who was
attending college in Vermont, two nights ago … when Eddie’s parents tele-
phoned the college, they learned Teresa had been killed in an automobile
accident just after midnight, and that college officials had tried unsuccessfully
to reach the Cuomos at their home to inform them of the tragic news.
(Greyson, 2010, p. 167)
Peak in Darien experiences can also involve seeing unknown individuals. It is

only after many weeks, months or even years the person who had the NDE
eventually becomes aware of the identity of the mystery person. van Lommel
(2004) describes how during a cardiac arrest, a young man saw his deceased
grandmother, but also another man who looked at him lovingly, but whom he
did not know. While on her deathbed more than a decade later, his mother
confessed to him her husband was not the man’s biological father, and he had
instead been born out of her extramarital relationship with another man. The
man was shown a photograph of his biological father, whom to his surprise, he
recognised as the man present during his NDE who looked so lovingly at him.
Due to the extraordinary nature of these types of experiences, they often

serve as verification to the individual the NDE was real and not a hallucination
manufactured by the dying brain. But they may also be verification of deceased
loved ones’ continued persistence, after the demise of their physical body. By
logical extension, this understanding must also apply to the self; shaping or
reinforcing a concept of post-mortem existence and the nature of conscious-
ness, thus facilitating a loss of the fear of death in people who have NDEs.
Bright light. The appearance of a non-blinding white light is recognised as a

core NDE feature. Frequently described as magnetic and ineffable, it some-
times appears as a being of light, a luminous being or a spiritual being. It is
commonly perceived as an all-encompassing, all-embracing and ineffable
almighty presence or some powerful being or entity. According to NDE

accounts, the light may impart unconditional love and comfort to the
individual, and play a role in other aspects of the experience (von Haesler &
Beauregard, 2013). For example, it may facilitate the life review typical of
many NDEs, provide knowledge of one’s life purpose and offer a choice to
return to earthly existence. Usually, communication with the light is non-verbal
and described as telepathic.
Kelly (2001) noted those who encountered spirits of deceased loved ones
were significantly more likely to experience a bright light during their experi-
ence. As with the encountering of deceased relatives during an NDE, experi-
ence of the light may be dependent on proximity to death. Those deemed close
to death as evidenced by medical records, are significantly more likely to report
an enhanced perception of a bright light (Owens, Cook, & Stevenson, 1990).
Experience of the light, regardless of the form it may take, is without excep-
tion perceived in a positive way. The encounter is frequently interpreted as
contact with the divine and has been regarded as the most powerful element of
the NDE (Morse, 1992; Ring, 1984). Such an experience appears to catalyse a
change in the individual’s belief system, with studies showing individuals are
far more likely to believe in the existence of God or some kind of universal
order after their NDE (Ring, 1984). Morse (1992) and Ring (1984) claim the
direct experience of the light is the essence of the NDE’s ability to bring about
transformational change, noting those who encountered the light also under-
went the greatest change. Perhaps the feeling of connection with divinity facili-
tates the loss of the fear of death. Maybe the NDEr is now able to understand
oneself in context to a universal order; as part of a greater whole. As Moody
(1986) argues, a sense of cosmic purpose is the path to finding true meaning in
life, which leads to a greater acceptance of death.
Discussion
TMT (Solomon et al., 1991) proposes the fear of death is the utmost basic
and pervasive motivator of all human behaviour. Yet, it can be eliminated by
an experience as fleeting as an NDE. This suggests the fundamental
propositions of TMT may be incomplete, or may not account for the

transformative effect of belief in or experience of extraordinary occurrences
such as NDEs. The elimination of death anxiety accompanying an NDE also
suggests there are elements inherent to these experiences providing a basis for
instantaneous transformation. There have been no reported cases of identical
NDEs, and each experience is believed to be unique. However, cross-cultural
research suggests universality in the content of NDEs, and a number of features
appear typical to such experiences. We propose some of these features
contribute to, or indeed facilitate, the elimination of the fear of death.
While some theoretical propositions suggest the sense of disembodiment
facilitates a change in the self-model as well as renewed belief in an afterlife,
and these may be associated with the elimination of death fear, empirical stud-
ies have yet to investigate this. We agree these previously suggested elements
are important components of death fear loss after an NDE, but take an
expanded approach by proposing other NDE elements are influential. We sug-
gest the sense of disembodiment, positive emotional content, meeting and
greeting with deceased others and spiritual beings and exposure to a bright
otherworldly light, make a combined contribution to the loss of the fear of
death.
While studies indicate death fear loss is one of the most prevalent and perva-
sive after-effects of an NDE, there is a dearth of investigations into exactly what
it is about NDEs catalysing this change. No literature exists highlighting which
specific NDE elements eliminate death fear. While this article presents a theo-
retical proposition, we propose future studies are necessary to better explicate
the relationship between the elimination of death fear and NDEs. As previously
mentioned, death-related research in general indicates loss of the fear of death
is a multidimensional issue and not a unitary construct. Studies have yet to
examine what the ‘loss of the fear of death’ construct entails for those who have
NDEs. Whether such a loss equates to a reduction in death threat, a reduction
in death anxiety or an increased acceptance of death, should be investigated.
Any future endeavours should utilise a mixed-methods approach of qualita-
tive and quantitative designs. In terms of a quantitative approach, the Greyson
(1983a) NDE Scale could measure the specific NDE components, and make
correlations with death-related constructs (i.e. death threat, death avoidance,
death acceptance). It is possible the four elements we identified may be associ-
ated with specific aspects of death fear loss. For example, perhaps the positive
emotional content of NDEs is correlated with a reduction in death threat, as
death is now perceived as a positive experience thus reducing the potential
threat it poses. Meeting and greeting deceased others could correlate with
increased death acceptance, as the belief that loved others persist after death
and one will be re-united with them, may heighten acceptance for one’s own
death. Semi-structured qualitative interviews should be conducted with NDErs
to ascertain the role of specific NDE elements in death fear loss in general, and
for gathering additional in-depth information to elucidate these relationships.
However, it will also be important to determine whether those who report
death fear loss report all four elements proposed here; or whether only one of
these elements need be experienced during the NDE to facilitate this funda-
mental loss of death fear.
Providing empirical evidence about which specific NDE elements contribute
to loss of the fear of death could have multiple implications, for conventional
areas of the health system where death is frequently encountered, and mental
health services. For example, a greater understanding of which aspects of the
NDE contribute to death fear elimination could be beneficial for terminally ill
and palliative patients. In particular, knowledge of the NDE, its phenomenol-
ogy and after-effects could provide terminal patients with a sense of psychologi-
cal comfort about their impending death. Learning about the disembodiment
experienced by many NDErs could comfort by suggesting the terminal patient’s
sense of self-consciousness may persist after the demise of their physical body.
Learning about meeting and greeting deceased others could reduce death anxi-
ety, by suggesting the terminal patient’s physical demise will reunite them with
significant others who have passed before them.
Such information could also be used to assist the grieving process for recently
bereaved individuals. Specifically, learning about the positive emotions experi-
enced during NDEs could provide a sense of assurance the death experience
incurred by their loved one was not fearful. The meeting and greeting with
deceased others characteristic of many NDEs could comfort the bereaved by
suggesting they too will meet their loved one again at some stage, providing a
basis for a continued relationship with the deceased, as highlighted by Continu-
ing Bonds (Klass, Silverman, & Nickman, 1996). Knowledge of the experience
of the bright light may facilitate or affirm a belief the loved one is now in the
presence of the divine creator, which could also be comforting for the
bereaved.
From a clinical psychology perspective, knowledge of the NDE and particu-
larly the loss of the fear of death, provides promise for a range of pathological
conditions. ‘Fear of doom’ is a symptom characteristic of many anxiety disor-
ders defined by the Diagnostic and Statistical Manual of Mental Disorders
(American Psychiatric Association, 2013). Understanding the elements of the
NDE associated with death fear loss could provide insight into how the ‘fear of
doom’ could be managed therapeutically, potentially complementing some
already established therapies. The NDE elements associated with the loss of
death fear may also facilitate other numerous beneficial after-effects reported
post-NDE. If so, understanding exactly what these are could inform current
clinical psychology practices, by potentially mimicking aspects of the NDE
therapeutically, in an effort to replicate the same effects.
Conclusion
The fear of death is one of the most profound anxieties, and is highly impervi-
ous to change. And yet, an experience as fleeting as an NDE can reportedly
eliminate this fear completely, indicating their incredibly powerful nature. What
it is about NDEs producing such extreme and pervasive shifts is still to be bet-
ter understood. But, the implications of gaining such an understanding are
immense, and could be potentially transformative in a number of ways, not
least for improving health service delivery, particularly at the end-of-life.
Disclosure statement
No potential conflict of interest was reported by the authors.
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Biographical Notes
Natasha Tassell-Matamua, PhD, is a lecturer with the School of Psychology at Massey Univer-
sity, Palmerston North, New Zealand. Her research interests include how near-death experiences
(NDEs) contribute to ongoing debates about the nature of consciousness, the potential psycho-
logical benefits of NDEs for experiencers and understanding how NDEs are explained across dif-
ferent cultural contexts. She was co-principal researcher of the first large-scale research on NDEs
in New Zealand.
Nicole Lindsay is a graduate student with the School of Psychology at Massey University,
Palmerston North, New Zealand. She is a clinical hypnotherapist and has been interested in
altered states of consciousness, and their potential for enhancing psychological wellbeing, for
many years. Her research interests include near-death experiences, mystical experiences, con-
sciousness, hypnosis and other unusual psychological states.

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Mortality

Promoting the interdisciplinary study of death and dying

ISSN: 1357-6275 (Print) 1469-9885 (Online) Journal homepage: http://www.tandfonline.com/loi/cmrt20

“I’m not afraid to die”: the loss of the fear of death

Natasha A. Tassell-Matamua & Nicole Lindsay

To link to this article: http://dx.doi.org/10.1080/13576275.2015.1043252

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“I’m not afraid to die”: the loss of the fear of death

Correspondence: E-mail: n.a.tassell-matamua@massey.ac.nz

© 2015 Taylor & Francis

The near-death experience (NDE) and its associated pattern of after-effects

Loss of the fear of death

another state of being, rather than annihilation. As Ring (1984) explains:

not a consequence of other changes in attitude and behaviour affected by the

voluntarily and is defined as an episode in which the mind or perception of

Positive emotions. Positive emotions such as painlessness, tranquillity, joy and

in nature to those normally experienced in the body – somatic emotions. How-

individual is unaware of what happened until they regain consciousness, so is

Peak in Darien experiences can also involve seeing unknown individuals. It is

Due to the extraordinary nature of these types of experiences, they often

Bright light. The appearance of a non-blinding white light is recognised as a

almighty presence or some powerful being or entity. According to NDE

propositions of TMT may be incomplete, or may not account for the

GREYSON, B. (1992b). Near-death experiences and antisuicidal attitudes. OMEGA–Journal of

TASSELL-MATAMUA, N. A., & MURRAY, M. (2014). Near-death experiences: Quantitative findings

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