A COMPARATIVE VIEW OF TIBETAN AND WESTERN NEAR-DEATH EXPERIENCES LAWRENCE EPSTEIN UNIVERSITY OF WASHINGTON The 'das-log is a figure in the literature of Tibetan popular religion who "dies," goes to bar-do, hell and other realms of existence, returns to life and reports his findings. These typically include injunctions from the Dharmaraja to lead moral lives so as to avoid the sufferings of hell-bound beings witnessed by the 'das-log'; messages from suffering souls to their friends and kinsmen; and preachings on ethical causation by the 'das-log himself. In a previous paper (Epstein 1982) I have explored these and other themes, including the psychological conversion experience undergone by the 'das-log. Employing both literary and ethnographic material, I found that the 'das-log experience was most profitably viewed as a Tibetan Buddhist transformation of a shamanistic trance state (Wylie 1969), widely recognized as a form of dissociation (altered state of consciousness). Using evidence in the biograph- ical materials to reconstruct social-psychological portraits of the 'das-logs, I determined that the onset and course of their near-death experience (NDE) could be explained as a struggle to achieve maturity in a Buddhist sense. Utilizing concepts from the psychology of object relations, I found that, de- spite their widely varying social backgrounds, a common ground could be found in their failure to achieve a socially satisfying role in either a religious framework or role relationships with significant others, due to a psychologi- cal history of ambivalence stemming from separation anxieties(1) As I noted in this earlier paper, the failure to achieve unambivalent social or religious maturity appears to be the key to understanding the 'das-log experience. In Eriksonian terms, I think there is in the 'das-log biographies evidence which shows that they suffer from an identity crisis in young adulthood (most of them are approximately twenty-five to thirty years old), triggered by their failure to form relationships of shared intimacy with real or fantasied figures. This crisis resolves in a regression in the service of the ego, eventuating in the 'das-logs' being reparented by culturally appropriate fantasy figures and in their "rebirth" as religiously mature figures. I also noted that there were historical circumstances in the which the 'das- log appeared to flourish. Utilizing internal evidence from the biographies, I postulated that the 'das-log experience (DLE) seemed linked not only to personal etiologies, but to a historic environment in which there was evident a nativistic call to basic Buddhist morality, due to the stresses of internecine sectarian-political struggle, or for a grounding of Buddhist ethics in missionized regions. I would now like to expand some of these earlier comments, comparing recent developments in Western (American) research into yet other models of the near-death experience. I will first briefly compare the DLE with Western neardeath experiences (NDEs). I will contrast the two and offer preliminary comments on the sociocultural values that may produce, and be discernable in them. In my previous paper, I referred to the DLE as a state of dissociation or an altered state of consciousness. The NDE has found recent prominence in American clinical writings and research. Basically, NDEs and altered states of consciousness have much in common; the latter is generally regarded as a subtype of the former (Sabom 1982: 174 ff.). While the psychological mechanisms which induce such states are by no means clear, what appears to happen is that the NDE is a response to some sort of psychic or somatic stress, which "in turn activates 'unconscious matrices' (possibly associated with archaic parts of the brain) containing the 'elements' that comprise the core [near-death] experience" (e.g., Ring 1982: 214 ff.; Grof and Halifax 1977: 183).(2) However, while such psychologically based programs might be stored in all or just some of us, the NDE/DLE cannot be reduced to mere physiological explanation. Rather, the release of such stored information permits the individual to become sensitized to a "new reality." The NDE is a perception of that reality and not merely a by-product of the physiological state (Ring 1982: loc. cit.). If this is indeed the case, we may then expect that the objective phenomena which appear as episodes in the structure of the NDE remain relatively stable cross-culturally, whereas the content and evaluation of the experience vary widely. First, to examine and compare the structures of the NDE and the DLE I have used a composite model which emerges from the Tibetan 'das-log biographies and three Western works. Among the latter, Ring (1982) and Sabom (1982) represent clinically derived portraits of the NDE, while Moody (1975) presents a generalized and nonclinical picture from narrative and other sources. Typically, the subjects of the clinical studies are persons who have undergone a. serious, often life-threatening, medical or traumatic emergency, such as heart failure. The mean age of their sample is around fifty years of age. (I believe that age difference between the 'das-log and the Western near-death experiencer may be significant and I return to this point below.) Moody divides the NDE into the following episodes: (1) Ineffability, (2) Hearing the news, (3) Feelings of peace and quiet, (4) Noise, (5) Dark tunnel, (6) Out-of-body experience (OBE), (7) Meeting others, (8) Seeing and enter- ing light, (9) Life review, (10) Border, (11) Coming back, (12) Telling others, (l3)Effects on lives,(14)New views of death, and (15) Corroboration. Gen- erally speaking, Ring and Sabom corroborate and round out Moody's general picture with clinical data, with only seemingly minor disagreements in the sequence of the episodes. However, these minor discrepancies, I believe, turn out to have major cultural implications. Episode 1: While some reactions of fear have been noted in analysands, they generally report a sense of ineffability, timelessness and a sense of reality about the experience. Since the onset of the conditions which trigger the NDE is usually sudden, analysands have little or no time to consciously anticipate what might be happening to them. Episode 2: In this "stage," analysands infer their own "deaths," or "hear the news" that they have died (at least undergone clinical death). This inference is usually drawn on the cessation of normal sensory input and pain; it is usually accompanied by overriding feelings of peace. Episode 3: Feelings of peace and quiet are experienced by large numbers of near-death analysands. Some 70% of those in Ring's sample who progress to episode 5 do so, while only 5% express transient fears. Episode 4: A small percentage of persons in clinical samples report whis- tling and buzzing sounds. Episode 5: The "tunnel experience, during which analysands feel them- selves floating in or through dark space, through which they transit from "this world" to the "next," occurs in about 23% of Ring's respondents. Episode 6: Whereas the out-of-body experience (OBE) is listed in this position by Moody, Ring lists it after Episode 3. About 37% of his respon- dents undergo an OBE. This is characterized by the analysand usually finding himself in an elevated position viewing his own body. He is also cognizant of the actions and speech of others around him, not only in the immediate vicinity, but even at some remove. This episode is characterized by sharp, but detached and rational ideation, as if the analysand were constituted of "mind only" released from somatic constraints. Sabom also reports the ab- sence of physical constraints (such as the presence of pain) and the ability to "travel" instantly to new locations. He reports that it is during this episode that analysands may attempt to communicate (always unsuccessfully) with "living" others. Episode 7: This consists principally in meetings with long or recently dead figures known to the analysand. In the clinical analyses this episode generally occurs as part of the next episode. Episode 8: In Ring's sample about 33% of the analysands report seeing a brilliant light which brings them peace and comfort. This phenomenon is highly susceptible to symbolic loading with religious overtones. It is often interpeted as the termination of the experience of "dying," and as the start of a vision of the "afterlife." About 20% of the analysands enter the light where they experience further preternatural illuminations -- vivid colors, unusual structures, bucolic scenery, music and gushing sounds. During this episode they may meet deceased kin. Episode 9: About 25% of the analysands experience either a whole or a selective review of incidents from their life. Many of these incidents do not seem crucial to fathoming the present experience. Episode 10: About 33% of the analysands feel that if they proceed any further into the experience they will "die" absolutely. Instead, they elect to return to "life" of their own volition. About 15% believe they are "sent" back. These decisions are usually taken (or given) as the result of counsel with deceased kin or friends, or a supernatural figure whom they meet or who appears as a disembodied voice. Analysands commonly report that they return because they feel the pull of loved ones or the need to accomplish unfinished tasks. Episode 11: The analysand's return to the body is often sudden and blank, free of cognitive content. Occasionally people report a painful jolt. I shall generally discuss the remaining episodes below. In the DLE, the episodes are ordered in the following way: Episode 1: Generally, the 'das-log is afflicted by an illness, and unlike the Western cases, has some time to contemplate its possible results. Although the onset of the DLE may be ineffable, it is characterized as painful and confusing. Episode 2: Whether or not the 'das-log recognizes the signs of elemental dissolution as given in the 'chi-kha 'i bar-do texts, the excruciating psychic and physical pain of the experience is emphasized. The 'das-log usually docs not recognize he has "died" for some time, perhaps until he has reached bar-do. Episode 3: The 'das-log encounters the primary light, secondary lights colors and sometimes the "dark tunnel" structure. Depending on the state of his knowledge he might recognize these signs for what they are, as he recollects the bar-do teachings. More often, he is confused and frightened by them. A partial life review may appear at this stage, emphasizing the 'das-log's remorse at not having led a better life. Episode 4: The 'das-log hears the noises associated with the chos-nyid bar-do, such as the roaring of dragons, the shouts of yamas, or the disem- bodied voices of supernaturals. Episode 5: The OBE systematically stresses the 'das-log's discomfiture, pain, disappointment, anger and disillusionment with others and with the moral worth of the world at large. The acquisition of a yid-lus and the ability to travel instantaneously are also found here. Episode 6: The 'das-log, usually accompanied by a supernatural guide, tours bar-do, where he witnesses painful scenes and meets others known to him. They give him messages to take back. Episode 7: The 'das-log witnesses trials in and tours hell. The crimes and punishments of others are explained to him. Tortured souls also ask him to take back messages to the living. Episode 8: The Dharmaraja explains matters to the 'das-log, exhorting him to lead a moral life and spread the word among the quick. The 'das-log is sent back by the Dharmaraja. Episode 9: The 'das-log returns to his own body, with the same fear and revulsion with which he left it. Two things are immediately apparent even in this cursory comparison. First, the structural elements of the NDE/DLE appear to be the same cross- culturally, even though their order is variable.(3) Second, the values inhering in the experience digress radically. Principally, the typical triadic structure of the rite of passage appears in both. The third part of this structure, the aftereffects of this experience, we will leave in abeyance for the moment. The remaining two parts are separated by a central division occuring after the OBE episode. The first part is occasioned by psychophysiological stress, either a severe illness or trauma. But the course of this first part is cognitively and affectively different in Western and Tibetan literature. Structurally, ineffability, timelessness and the heightened sense of reality are present in both.(4) But whereas the Western experience emphasizes feelings of peace, comfort, painlessness and mellow euphoria, the Tibetan emphasizes remorse, pain, fear, disappointment and disillusionment. The Western OBE seems so closely grounded in empirical reality, in fact, that Ring and Sabom, the two major researchers, have both felt compelled especially to address the problem of how this can possibly occur. Ring proffers a "parapsychological holographic explanation," maintaining that a state of consciousness may be functioning independently of the brain in a new order of reality (Ring 1982: 183). Others, e.g., Grosso (1982) and Osis and Haraldson (1977), offer up explanations which rest on our accepting material ("psi") components of consciousness or ontologically real life-after-death survival of a soul or spirit. Such explanations we are compelled to question since they do not conform to the requirements of falsifiability. An emic Tibetan explanation might concur with any one of these foregoing ones in whole or in part. But if one were to apply the Tibetan model to the Western experience or the Western model to the Tibetan experience, one would still be faced with explaining the clear disjunction in values: Why is the Western experience beatific, the Tibetan terrifying? The transitional episode between the "reality-bound" Western OBE and the Tibetan one also differ in the clinical models. (Moody's nonempirical one corresponds to the Tibetan sequence.) The Tibetan sequence is Tun- nel/Lights -- OBE -- bar-do; the Western sequence is OBE -- Tunnel -- Light. The two sequences are patently in accord with respective beliefs about the rnam-shes, whose departure from the body may occasion a death-like state without the "real thing," and the Western soul, whose typical choice is only between this world and the next, without intervening or intermediate states. Not only are the differences in the episodic sequences important to rec- ognize, but so are their differing qualities. Again, the Western experience is predominantly peaceful and beatific. Analysands report bucolic scenery, music, greetings by dead kin, a presence believed by many to be God or Jesus, etc. Tibetans, on the other hand, speak of the terrible tribulations of bar-do, and the horrors of hell.(5) The third stage of the NDE/DLE is the aftermath of the "return." Here again there are similarities and differences. Westerners undergo a kind of conversion, a "raising of consciousness" and a change in personal values (Ring 1982: 8 ff.). These are changes which can be characterized as affectively positive: increased appreciation of life, a renewed sense of purpose, greater feelings of personal strength, a stronger commitment to universal love, a reduced fear of death, a heightened religious feeling which manifests not in the institutional but in the mystical-cosmic sense, and a strong belief in the afterlife. The 'das-log shares some of these attributes. Certainly he has a renewed sense of purpose, personal strength and commitment to work for the salvation of all sentient beings, while his ambivalence over belief in the afterlife and the operations of karma that condition it has been resolved. However, one can say that his fear of death has increased, in that human life he does not actually welcome death, no longer fears it. He vows to live life to the fullest, especially in its social sense. Loving relationships with family, friends and mankind at large are now sacralized. The 'das-log, on the other hand, is now convinced that death is a most fearful prospect in light of a life lived without religion. Toward such an end, he must undertake the personal sacrifice of renouncing familial and personal love for the highly abstract, hard-to-achieve, and sometimes painful love of a bodhisattva. The questions we must now ask are: (1) Can such divergent values be accomodated within the same experience? (2) What can be said of the social and psychological conditions which shape the contrasting Western and Tibetan experiences? The tendency in Western studies of the NDE has been to concentrate on the psychological substrate of the experience; inasmuch as no single psychophysiological explanation has proven satisfactory, Western students have typically turned to idealist abstractions: souls, psi particles) and other equally nonconfirmable whatnot (see e.g., Widdison 1982; Audette 1982). There has also been a tendency to treat the NDE as a state-specific, inde- pendant and culture-free phenomenon whose cross-cultural manifestations are invariable. Here we can either deny that the DLE is an NDE -- a move that flies in the face of the evidence -- or be forced to consider why NDEs, no matter whose they might he, are in fact culture-bound. Unfortunately, attempts at garnering longitudinal social-psychological background information on analysands have been rather paltry. Ring, Sabom and others have limited their queries to standard sociological questions: de- mographic data, religious background and affiliation, church attendance, ed- ucational level, occupational background and so on, before flying off into the wide blue yonder of speculation. They have shown however that differences in these data have no apparent effect on the core NDE. But because of this, they conclude the experience is not culture-dependent. I concur in the first half of this statement; in the latter I most emphatically do not. What has been roundly ignored is that these sociological data are merely surface phe- nomena, pale transforms of a culture's "deep structure." Similarly the ego which undergoes the NDE, narrates, interprets and makes meaningful such a powerful experience as the NDE appears to be, is not merely an indepen- dent kernel wrapped in a husk of culture. Ego and its processes are cultural constructs as well.(6) The individual, his system of meanings, values, indeed his concepts and precepts, is the product of his culture as well as his soma. Clearly, it is among these depths that cultural values and personal constructs of them must be sought with regard to the course of the NDEs and how they are diversely experienced. We must look, therefore, beyond such factors as the analysand's religious convictions, church membership and so forth, as well as beyond the culture-boundedness of the analyst, to discover the culturally constructed ground upon which these similar, yet different, experiences lie. If we assume, as we can only do at this point, that the neurophysiology of the NDE produces the same structural elements all around the world, then we are still left with the problem of explaining the values that transform the NDE across cultures (see e.g., Zalesky 1987: 86-87, 178-180). The Tibetan values that seem to produce and emerge from the DLE I have discussed in my earlier paper. The basic assumptions are, to no one's surprise, Buddhist and Tibetan. Life is suffering. Human happiness is cir- cumscribed by its limits, and its negation will sooner or later come into evidence. Happiness, defined in social terms as health, wealth and love, is impermanent. Each of these goods fades and causes eventual disillusion- ment (Lichter and Epstein 1983). During the DLE the once healthful body is seen as a repulsive, rotting animal corpse; wealth is seen to engender greed and hate; love and friendship are seen as illusions that stand in the way of salvation. To die without devoting oneself to one's own and others' salvation wholly and unobstructedly is a terrible waste of time, since one will be reborn endlessly to suffer further despair. Sooner or later, one must stop wasting lives and follow a religious career. This means abandoning this-worldly human relationships: nonattachment to all objects -- the body, persons, things, hard work and sacrifice. None of this is very easy to ac- complish, made particularly hard because hate, ignorance and attachment are phylogenetic characteristics of the human psyche, and these, especially attachment, keep us embedded in our wretched illusions. The value-laden concept of attachment seems especially appropriate to the anxieties surrounding separation which I discussed before. I noted that separation anxieties appeared to be especially prominent in the etiology of the DLE. The 'das-log suffers a profound ambivalence over his ordinary this- worldly life, and this, in turn, seems to be related to his failure to properly mature in finding satisfaction or fulfillment in this-worldly tasks, be they religious or laic. Their failures result from keenly felt stresses occasioned by a lack of fit between their personal values and the mundane facts of their lives, at a time when ego-mastery should be at its peak. As a result they undergo during their DLEs a regression in the service of the ego. The DLE is an exercise in retooling the ego through fantasied parental figures and it culminates in an unambivalent, integral and adaptive adult religious career. In contrast to the high degree of fit between what a 'das-log learns in his fantastic sojourn and the dominant values of his culture, postindustrial Western ideologies have been dominated by the denial of death (Garfield 1975: 147ff.). In essence, Westerners live within an existential vacuum which postulates death as an irrational finality. Western consciousness is also dominated by a hyperrational, demythologized attitude that death is a medical or social problem, soon to be overcome or at least satisfactorily modified by appropriate technologies. Part of this attitude is expressed in Western assumptions that ego remains firmly in control of its environment; out-of-order phenomena, such as death, NDEs or altered states of conscious- ness, are antithetical. A powerful dissonance inheres in these attitudes. The myths of technology have all but replaced any compensatory view of life after death, whose outcome is uncertain. Since Western thought also postulates a linear and irreversible model of time, which ends once and for all with death, it is major life events which are therefore sanctified, in opposition to Buddhist values. Health, wealth and love are traditionally viewed as gifts for which heaven is, at least in part, responsible; or, they are gained by action in the world, an ethic strongly sanctified by religious values. In gaining such goods as these, free will and the freedom of choice play an important part, along with this-worldliness, competitive achievement, ac- tivism and social conformity. These are the Western (specifically American) values that underlie what Berger (1961) has called the "OK world." All in all, the peaceful, beatific and harmonious content of western NDEs would seem to reflect the values that Berger assigned his "OK world." However, as I tried to determine the historical context of the DLE, it is important also to understand the context of the Western NDE. Since the "OK world" of the 1960s, enormous social and cultural upheavals have occurred. The adult generation of the 1960s and 1970s were parents to a new generation of antinomian children, for whom, as has often hap- pened before, traditional values had become inadequate and who renounced traditional family roles, social ties, jobs and attitudes. Traditional values and everyday facts had interfaced comfortably for the parental generation. But many of the filial generation repudiated what they perceived to be a dehumanized, unresponsive technocracy and bureaucracy -- those very in- stitutions which had made their parents' lives comfortable and stable to begin with. Instead of following in their parents' footsteps, due to the perceived or real lack of fit between traditional values and the now-changing facts of social, economic and political life, the children of the 1960's and 1970's turned instead to an antinomian set of values: intuitive gnosis and altered states of consciousness for rationality, nature for culture, pseudocommunitas for com- munity, passive cosmic tripping-out for activism, hippiedom for conformity, emotion for cognition and self-indulgence for hard work (Adler 1974; Lasch 1978). Indeed an examination of the content of the Western NDE should reveal a synthesis of these and traditional values. While interest in and partial acceptance of the altered state of consciousness and the NDE itself, and an apparent shift in time orientation from the future to the here-and-now reflect such an attitudinal change, most of the experiential content of the NDE might best be viewed as upholding those other values of an earlier ver- sion of Western-American culture. Americans undergoing the OBE remain reality oriented, as opposed to the terrifying confusion, even paranoia, of the DLE. The vision of the afterworld is predominantly blissful and beatific. Analysands report bucolic scenery, pleasant music, and friendly greetings by their deceased kin, rather than the barrens of bar-do and the horrors of hell. Their "return" is predominantly inspired by the wish to fulfill obligations to their loved ones or to complete tasks left unfinished (those very attach- ments we are enjoined to renounce in the DLE), and their promise is to live humanely and fully all of life's golden and sanctified opportunities, rather than to pursue a religious career of renunciation. Here also we encounter a decision point, a matter of freedom of choice. The Western NDE analysand most often "chooses" to return. The choice is not give the 'das-log, who is sent back by the Dharmaraja. The contrast obviously reflects deep un- derlying cultural values: in an urban society with complex institutions and multiple role settings, the notion of freedom of choice is both adaptive and religiously legitimated. In a hierarchical society, such as that of Tibet's in the sixteenth-eighteenth centuries, the notion and role choices would have been rather limited. Finally Westerners no longer fear death and dying, whereas the 'das-logs most emphatically do. NDEs, no matter whose they are, transform those who undergo them. Both Westerners and Tibetans return to live in accordance with one value- set within a competing set of traditional values. The Tibetan value-set involves a renunciation of the world's social goods and the American an other-oriented involvement in them. Westerners typically expect to enjoy a more satisfying life through lowered death anxieties by living through others, especially loved ones, and via a merging of the self into this-world's affectively positive natural beauties and enjoyments: increased appreciation of life, a renewed sense of purpose, greater feelings of personal power to transform the world and tune into it in a cosmic sense, etc. All this, it is felt, somehow reflects a divine handiwork. At a still more abstract level of cultural contrast we may also note that while the Tibetan worldview seems grounded in an acceptance of the Buddhist notion of suffering -- the passing of worldly relationships -- the typical Westerner anticipates an even-better-than-OK- world in the future, a secularized and humanist worldview which originates in nineteenth century notions of technological progress, utilitarian sociology and Darwinian evolution.(7) The 'das-log, on the other hand, wishes others to live a better life through him, and his preachings renounce untutored nature. While the DLE seems principally an exercise in gaining religious maturity or final mastery over a mature role engaging the new cosmic perspective gained during the DLE, Westerners seem more to be concerned with the restoration of their tradi- tional values and the integrity of their adult lives. Their expanded conscious- ness concerns the quality of their being-in-the-world, at which they get a single chance. Their adult integrity and life project, threatened by changing times that in turn threaten to make a mockery of closely held and culturally appropriate unconscious values, is recaptured in their visions, from which they emerge with renewed commitment to the threatened values, and with reduced dissonance between current facts and values through an avowed al- teration in their personal behavior. In doing so they seem also to acquire a contemplative, rather than action-oriented, mode of action-in-the-world. This allows them to retain the values of the OK world, while making the most of it. In contrast, the Tibetan's everyday passive or contemplative mode, as an observer of a world that imposes against his will those roles he wishes to reject, ends up, as a result of the DLE, as an active participant in shaping his surroundings (Deikman 1971). In relation to their historical context, why, in the past decade or so, has there been such an outpouring of interest in the NDE, when so obviously they have been reported throughout history? There has been in the past a reluctance on the part of Western science and the general public to consider altered states of consciousness. Why this change of heart? Several decades ago, the promise of science and technology for constructing a better world was virtually unchallenged. With this failed hope has come an attitudinal change that considers alternatives such as psychic self-improvement. If so- ciety's hopes could not be fulfilled technologically, then perhaps one's own self-centered ones could. The interest in NDEs seem to be generally related to the growth of all the "sciences and pseudosciences that concern them- selves specifically with aging and death: geriatrics, gerontology, thanatology, cryonics and 'immortalism'" (Lasch 1978: 207). It is also distinctly related to the "how-to" pseudotechnologies, and in fact, the bulk of clinical interest in NDEs seems to center around their applicability as a technique in death and dying research. In a society deprived of religion and myth) as well as its interest in history and posterity, one might well expect a spasm of works on those areas of human living that are treated as integral parts of life in traditional societies: how to live, how to get in touch with yourself and with others, how to make love and how to die. The lacuna left by Western cul- tural demythologization leaves a vacuum which human nature apparently abhors. Perhaps the NDE is a statement that promises to fill this gap by promising to restore the "OK world," not through technological progress, but through a changed outlook on its operations, a remythologization with a secular-humanist ring. Its frequency and the widespread interest in the NDE may be a general reaction against the mechanics of the object world that has become increasingly separated from the individual, in which life has become a technique rather than a process of self-cultivation. Many years ago, George Simmel pointed out that the more the object world becomes cultivated, the less men are able to gain from the perfection of objects a perfection of subjective life. If this is the context for the NDE, what of its etiology? Unhappily, one cannot comment extensively upon this topic, inasmuch as the in-depth lon- gitudinal psychological studies necessary to do so are simply not available. Commentators on the Western NDE have tended to concentrate on the uni- formity of the experience instead. However, I believe there exists an import- tant hint which lies in the mean age differences between those undergoing the DLE and the western NDE. The former are young adults in their twen- ties and thirties. I have shown in my earlier paper that the DLE involves a crisis of identity associated with this life-stage. Failing to find fulfillment in this stage the 'das-log undergoes an apparent regression to the stages where autonomy is first established. He is retooled in hell and returns a religious figure to renounce social life and do good works. In contrast, the mean age of those undergoing the Western NDE is about fifty. Since many of the analysands in Western studies were victims of heart failure this admittedly might be simply an artifact of statistical sampling. However, I would tenta- tively suggest, it might also have significance beyond this. Is it possible that the typical content of the Western NDE has to do with a crisis in the final stages of adulthood in which the integrity of the adult life project is threat- ened? This crisis is then solved during the NDE by a regressive movement in which archaic introjects of post-oedipal childhood flood back into con- sciousness. These, according to the Eriksonian model, have to do with the formation of initiative, the formation of guilt, and purposefulness versus pas- sivity. The assertive expansion of ego into the world in this stage occasions guilt as it intrudes upon it. The solution may be recast in terms of religious integration of the ego to heal the world upon which it has imposed itself and thuse to soothe its guilt. Thus we find in the Western NDE analysand a renewed sense of life recast into a cosmic framework in which he finds a purpose to his existence through beloved others whom he first deserted and in whom he now finds joy. Notes (1) This analysis is in part corroborated by the work of Robert Paul (1970, 1982) who noted the role of separation anxieties and maturation problems in the etiology of Sherpa shamanism. One should also note here that the Tibetan concept of maturity involves much the same evaluation as in studies of the Western concept; the key markers of maturity are seriousness, to- the-pointedness (gnad-thig-pa), independence or autonomy (sems long-ba), decisiveness (thag gcod-pa), unambivalence in belief (the-tshom med-pa) and in action (rnam-thog med-pa). Tibetans consider the roles of householder and of monk as structural, if not moral, equivalents in an individual's career. Whereas the concepts associated with maturity listed above may take on different meaning in terms of their goals, they remain structurally important in the evaluation of a life career, be it religious or lay. (2) Following West (1967: 887), this stored neural program might interfere with such brain structures as the reticular activating system, which is re- sponsible for processing sensory information and arousal, integrating these with emotions, memory and other transactions between the neo- and paleo- cortex. Many other hypotheses have been put forth implicating everything from conscious and subconscious fabrication to hallucination and deperson- alization, including a number of neurophysiological dysfunctions, such as temporal and limbic lobe seizure, hypoxia and anoxia, etc. For a review of these hypotheses, see e.g., Sabom 1982 and Zaiesky 1987. An interesting hypothesis has recently been voiced by Dr. M. Morse, et al., who write that NDEs may be the result of the activation of the neu- ronal connections in the temporal lobe that specifically code for OBEs, with secondary hallucinations that the mind incorporates into the experience to make sense of them (Morse, et al.. 1986: 1112). In studies of children, ages three to sixteen, who have undergone NDEs, Morse, et al. found that while consistent with the adult core experience, children's NDEs typically lack "el- ements of depersonalization, including life review, time alteration, worldly detachment, or transcendant feelings" (ibid.: 1110). This would suggest the presence of a neuronal structure which, when activated, provides a unify- ing experience, but one whose content is embellished by social and cultural experience. (3) In her fine recent comparison of Western historical and modern NDEs, Zalesky (1987) also points out the effects of viewing these visions or testi- monies as works of the imagination, whose similarity of structure flows from their narrative integrity and didactic aim. (4) This sense of reality is, however, unusually highlighted in the visual and audial senses. These are often crosshatched and confused for one another. In both cases victims occasionally report hearing things directly, not communi- cated through the ear. They may also see sounds. Both the Western OBE and the transcendental NDE stages, the Tibetan transcendental DLE stage and, to a lesser extent, the Tibetan OBE stage, have the quality of removed rational cognition. In this we are reminded of Hildgard's "hidden observer" (1977), an executive ego function which has been uncovered during hypnotic experiments. (5) There is some disagreement here in Western case studies. Rawlings (1978) proposes that hell visions occur frequently in Western NDEs, but that they are repressed. Ring (1982: 192) has commented that this study is unreliable due to both poor methodology and the author's undisguised fundamentalist assumptions. More reliably Garfield (1979: 54) reports four groups, one of which (about 5.5% of his sample) is characterized by lucid nightmarish and demonic figures. (6) See e.g., Brent 1979 for an analysis based upon the phenomenology of how perception and imagery are constructed. (7) I am indebted to Mr. Keith Watenpaugh for this observation. See also Zalesky 1987: 189 ff. I also thank Ms. M. Vakoc, Ms. K. MacGregor and the other students (too many to name here) in my Arts and Sciences Honors class (Spring, 1988), for their cogent ideas upon which I have drawn throughout this paper.