The continuity of consciousness

Cardiologist Pim van Lommel on his interest in Near Death Experience, the research, and what it might mean for Psychologists and our understanding of consciousness.

02 January 2026




'This blessing experience was decisive in convincing me that consciousness lives on beyond the grave'

As a medical student, I learned that it was obvious that consciousness was a product of a functioning brain, and as a young cardiologist, I was still convinced that death was the end of our consciousness. But after reading George Ritchie's 1979 book Return From Tomorrow, a psychiatrist's account of his own Near-Death Experience (NDE) as a medical student in 1943, I started to ask patients who had survived a cardiac arrest if they had memories from their period of unconsciousness.

As a cardiologist, I was privileged to meet patients who survived their period of 'clinical death' – a period of unconsciousness caused by lack of oxygen in the brain due to the arrest of circulation and breathing that happens in cardiac arrest during an acute myocardial infarction. These patients will ultimately die from irreversible damage to the brain if cardio-pulmonary resuscitation (CPR) is not initiated within 5 to 10 minutes. It is the closest model of the process of dying.

To my great surprise, within two years, 12 patients out of 50 survivors of cardiac arrest told me about their NDE. That piqued my scientific curiosity. According to our current medical concepts, it is not possible to experience consciousness during a cardiac arrest, when circulation and breathing have ceased, and the electrical activity in the brain, normally thought to be essential for conscious experiences, has ceased as well. Those patients should have no memories at all!

And so the phenomenon of NDE raised a number of fundamental questions for me: What are NDEs? How and why do they occur? Why does a person tend to change so radically after an NDE? And what does all this mean for the traditionally materialistic view of the relationship between the brain and consciousness?


An introduction to NDEs

Experiences of enhanced consciousness have been mentioned across all times and all cultures, usually called 'experiences of enlightenment' or 'mystical experiences'. Raymond Moody's 1975 book Life after Life associated those experiences with the possibility of imminent death and popularised the term 'Near-Death Experiences'. Interestingly, though, the equivalent French term expérience de mort imminente was used as far back as the 1890s by the psychologist Victor Egger.

The NDE can be defined as the reported memory of a range of impressions during a special state of consciousness, including several commonly occurring elements such as an out-of-body experience, unusually happy feelings, seeing a tunnel, a (being of) light, beautiful colours or a celestial landscape, hearing music, meeting with deceased relatives, having a life review, approaching a border of no return, and finally a conscious return into the body. NDEs are reported during many situations such as cardiac arrest, shock after loss of blood, coma, near-drowning or asphyxia.

However, NDE-like experiences can also be reported during severe depression, imminent traffic accidents, meditation, or without any obvious reason. So, apparently, you don't always need a non-functioning brain to report experiences associated with an NDE. Some polls suggest that at least 4 per cent of the total population in the Western world are likely to have experienced an NDE (Gallup, G. & Proctor, W., 1982). and modern techniques of resuscitation and better treatment for cerebral trauma may make them more likely.

NDEs are always transformational, often causing profound changes in life-insight, the loss of fear of death, and enhanced intuitive sensitivity (Van Lommel, 2010). So why do psychologists or physicians hardly ever hear a patient talk about their NDE? For the simple reason that patients are reluctant to share their experience, given the negative responses they are likely to get. Patients must feel that you trust them and that you can listen without any comment or prejudice. But for most psychologists and other healthcare workers, the NDE is still an incomprehensible and unknown phenomenon.


Our studies

So, in 1988, we started a prospective study of 344 consecutive survivors of cardiac arrest in ten Dutch hospitals, which aimed to investigate the frequency, cause and content of an NDE. Our study was published in The Lancet (Van Lommel et al., 2001). We wanted to know if there could be a physiological, pharmacological, psychological, or demographic explanation for why people experience enhanced consciousness during a period of cardiac arrest.

We found that 82 per cent of patients had no recollection of the period of cardiac arrest, i.e., of their period of unconsciousness. However, the remaining 18 per cent of patients reported some recollection during the time of clinical death. Of these patients, 41 (12 per cent of the sample) had a 'core experience' with a score of 6 or higher, and 6 per cent had a superficial NDE. Across the group, all the well-known elements were reported.

We found, to our surprise, that neither the duration of cardiac arrest (between 2 minutes and 8 minutes) nor the duration of unconsciousness (from 5 minutes to 3 weeks in coma), nor the need for intubation in complicated CPR, nor a brief, induced cardiac arrest during electrophysiological stimulation (EPS), had any influence on the frequency of NDE.

So, the degree of the lack of oxygen in the brain (anoxia) appeared to be irrelevant and could, therefore, be excluded as an explanation. Moreover, all patients had been unconscious due to anoxia of the brain, and only a small percentage of patients reported an NDE. Nor could we find any relationship between the frequency of NDE and administered drugs, fear of death before the arrest (a psychological explanation), nor foreknowledge of NDE, gender, religion (being a Christian or atheist did not matter at all), or education.

We additionally performed a longitudinal study with taped interviews 2 and 8 years following the cardiac arrest of all long-term survivors with NDE, along with a matched control group of survivors of cardiac arrest who did not report an NDE. This study was designed to assess whether any psychological changes were the result of having an NDE, or just of the cardiac arrest itself. This had never been studied before in a prospective design.

Only patients with an NDE showed the typical transformation – loss of fear of death, transformation in attitude toward life, and enhanced intuitive sensitivity. This transformation seemed the most potent and objective evidence for this subjective experience. People were less afraid of death and had a stronger belief in an afterlife.


'It is outside my domain to discuss something that can only be proven by death. For me, however, this blessing experience was decisive in convincing me that consciousness lives on beyond the grave, and I know now for sure that body and mind are separated. Death was not death, but another form of life'.

We saw in them a greater interest in spirituality and questions about the purpose of life, as well as a greater acceptance of and love for oneself, in combination with a feeling of oneness with others and with nature. The conversations we had in our longitudinal study revealed that people, often to their own amazement and confusion, had acquired enhanced intuitive feelings after their NDE.

For me, it was quite a remarkable and unexpected finding to see a cardiac arrest lasting just a few minutes give rise to such a lifelong process of transformation. The longer the interval between NDE and our interview, the more positive changes are usually reported, and, ultimately, integration of the NDE will follow (Van Lommel, 2021). But I have also met people who had been silent about their NDE for more than 50 years!


'I couldn't even talk about it, or I would have been committed to an institution'.

And the integration and acceptance of an NDE is a process that may take a long time, because of its far-reaching impact on people's pre-NDE understanding of life and value system. Despite its mostly positive content, the NDE is also a traumatic event in itself. There is hardly any acceptance by physicians, psychologists and nurses, as well as friends, family members and partners, with a divorce rate subsequent to an NDE of more than 70 per cent (van Lommel, 2010), which makes the process of acceptance and integration very difficult.

The NDE is, for most patients, then, a real psychological trauma. Unfortunately, there seems to be hardly any knowledge about NDE by most psychologists, presumably because of a widespread unfamiliarity with the scientific literature on NDE. More knowledge about the NDE amongst psychologists could be helpful for the significant number of people who have experienced one.
Other studies and their significance

Other researchers – psychiatrists, physiologists and medical scientists – have reported around the same prevalence of NDEs in prospective studies on NDE in survivors of cardiac arrest as in our study, and they have all concluded that no one physiological or psychological model by itself could explain all the common features of an NDE.

American Psychiatrist Bruce Greyson writes that the paradoxical occurrence of heightened, lucid awareness and logical thought processes during a period of impaired cerebral perfusion raises particular perplexing questions for our current understanding of consciousness and its relation to brain function. A clear sensorium and complex perceptual processes during a period of apparent clinical death challenge the concept that consciousness is localised exclusively in the brain.

In the UK, Sam Parnia and Peter Fenwick wrote that the data from several NDE studies suggest that the NDE arises during unconsciousness, and that this is a surprising conclusion, because when the brain is so dysfunctional that the patient is deeply comatose, those cerebral structures, which underpin subjective experience and memory, must be severely impaired. Complex experiences such as are reported in the NDE should not arise, nor be retained in memory. Such patients would be expected to have no subjective experience at all.

British biomedical scientist Penny Sartori concludes that, according to mainstream science, it is quite impossible to find a scientific explanation for the NDE if we 'believe' that consciousness is only a side effect of a functioning brain. And perhaps because of this, the conclusion about conscious experiences during a flatline EEG is often called impossible and unscientific.

How do we really know that with cardiac arrest, the EEG, the registration of electrical activity of the cortex, is flat? Many studies have shown that during cardiac arrest, there is complete cessation of cerebral flow within one second, causing sudden loss of consciousness within seconds, loss of breathing, loss of all body reflexes (a function of the cortex), along with the loss of all brainstem reflexes like the gag reflex, the corneal reflex, and fixed and dilated pupils.

In studies of human cardiac arrest, EEG activity has also been shown to be absent after 10-20 seconds. This is important because in an acute myocardial infarction, the duration of cardiac arrest is always longer than 20 seconds, as successful CPR usually takes at least 2-4 minutes. So, all survivors of cardiac arrest in the several prospective studies on NDE must have had a flatline EEG. In spite of this, about 20 per cent of those patients reported an NDE (van Lommel, 2010).

The often proposed objection – that a flatline EEG does not rule out any brain activity, because it is mainly a registration of electrical activity of the cerebral cortex – misses the mark. The issue is not whether there is any brain activity of any kind whatsoever, but whether there is measurable brain activity of the specific form regarded by contemporary neuroscience as the necessary condition of conscious experience, with visible activities in many neural centres, the so-called global neural workspace.

It has been proven that there is no such specific and dynamic brain activity at all during cardiac arrest. Given this, one has to be open to the possibility that, during NDE, enhanced consciousness is experienced independently from the normal body-linked waking consciousness.


The Out-of-Body Experience and the Life Review

I would now like to reconsider certain elements of the NDE which might be of particular interest to psychologists. First, the Out-of-Body Experience, or OBE. In this experience, people have veridical perceptions from a position outside and above their lifeless body.

People have the feeling that during their NDE they have apparently taken off their body like an old coat, and to their surprise they appear to have retained their own identity with the possibility of perception, emotions, and a very clear consciousness. This out-of-body experience is scientifically important because physicians, nurses and relatives can verify the details of the reported perceptions, and they can also corroborate the precise moment the NDE with OBE occurred during the period of CPR.

In two reviews with a total of more than 200 corroborated reports of potentially verifiable out-of-body perceptions (Holden, 2009; Rivas et al., 2016), it was found – through the verification of those in the operating theatre – that more than 95 per cent of the reported perceptions during coma, cardiac arrest or general anaesthesia were about details that really had happened. Can an OBE really be a hallucination, delusion or illusion, given these veridical aspects? And doesn't one need a functioning brain to have a hallucination, delusion, or illusion?

Next, another common experience, the Life Review. During such a life review, one feels connected to the memories, emotions and consciousness of those with whom they have interacted in the past, thereby experiencing the consequences of their own thoughts, words, and actions and more generally, their interconnectedness with others.

Patients also report experiencing their whole life in one glance and that time and space do not seem to exist during such an experience ('nonlocality'). All that has been done, said and thought seems to be significant and stored forever.


'And all the time during the review, the importance of love was emphasised. Looking back, I cannot say how long this life review and life insight lasted; it may have been long, for every subject came up, but at the same time, it seemed just a fraction of a second, because I perceived it all at the same moment. Time and distance seemed not to exist. I was in all places at the same time, and sometimes my attention was drawn to something, and then I would be present there.'

These, and other commonly occurring elements of an NDE – like the tunnel experience, light, a meeting with deceased relatives and a conscious return in the body – have been described in greater detail in the literature (van Lommel, 2010; van Lommel, 2021).


Other experiences of enhanced consciousness

Scientific study of NDE pushes us to the limits of our medical and neurophysiological ideas about the range and potential of human consciousness and the mind-brain relation. Based on the scientific literature about NDE, and on our Dutch prospective study on NDE in survivors of cardiac arrest, my own view is that an NDE might be considered a changing state of consciousness that continues in spite of a non-functioning brain, in which memories, identity, and aspects of emotion, cognition and perception function independently from the unconscious body.

An NDE, or an experience of an enhanced or nonlocal consciousness during a life-threatening situation like cardiac arrest, coma or during general anaesthesia, makes it extremely unlikely that consciousness could entirely be a product of the function of the brain. Based on these experiences, I suggest that there will be a continuity of consciousness after death.

Other reported forms of enhanced consciousness just before, during or after death also support this conclusion. These include the frequently occurring end-of-life experiences, or ELE, during the terminal phase of illness; terminal lucidity, which is the unexpected return of mental clarity and memory shortly before death in the end-stage of Alzheimer disease; shared-death experiences which can be reported by healthy people who are present at the bedside of a dying relative; and after-death communication, or ADC, which is the feeling or inner knowing to be in contact with the consciousness of a deceased loved one in the first days, weeks or months following their death.

According to research, about 125 million people in Europe, and more than 175 million people in the USA, must have had an ADC (Guggenheim & Guggenheim, 1995; Tevington & Corichi, 2023). These experiences of enhanced consciousness just before, during or after death have been described in greater detail in the literature (van Lommel, 2010; van Lommel, 2021).
A paradigm shift

The phenomenon of the NDE can no longer be scientifically ignored. An NDE during a cardiac arrest of only a few minutes' duration can change people permanently. It is an authentic experience which cannot be simply reduced to imagination, fear of death, hallucination, psychosis, the use of drugs, or oxygen deficiency. It is my belief that the current materialistic view of the relationship between the brain and consciousness held by most physicians, philosophers and psychologists is too restricted for a proper understanding of an NDE or of another experience of enhanced consciousness.

Remarkably, in a representative social poll in Europe, about 55 per cent of the population believed in some kind of personal survival beyond death, and in the USA this percentage is even higher (Halman, 2001). These figures are in sharp contrast with the opinion of most Western scientists, who systematically ignore and ridicule the possibility of personal survival after physical death (Larson & Witham, 1998). We desperately need a real paradigm shift in science – to expand our scientific minds to include subjective experiences.

Given the evidence of those experiences of enhanced consciousness, it seems at least plausible to suggest that there may be a continuity of consciousness after death – a clear challenge to the materialist-reductionist paradigm! Consciousness seems to be our essence. Could it be that once we leave our body and our physical world, we exist as pure consciousness, beyond time and space, enfolded in pure, unconditional love?

Pim van Lommel, Cardiologist, former Rijnstate Hospital, Arnhem, The Netherlands.
Email: pimvanlommel@gmail.com. Website: www.consciousnessbeyondlife.com

This is part of a January/February 2026 consciousness special.


References

Gallup, G. & Proctor, W. (1982). Adventures in Immortality: A Look Beyond the Threshold of Death. McGraw-Hill, New York.

Greyson, B. (2003). Incidence and correlates of near-death experiences in a cardiac care unit. General Hospital Psychiatry 25, 269-276.

Greyson, B. & James B (Eds) The Handbook of Near-Death Experiences. Thirty Years of Investigation. pp. 185-211. Praeger / ABC-CLIO, Santa Barbera, CA.

Guggenheim, B., Guggenheim, J. (1995) Hello from Heaven: A New Field of Research- After-Death Communication- Confirms that Life and Love Are Eternal. Bantam Books, New York, USA.

Halman, L. (2001)The European Values Study: A Third Wave. Sourcebook of the 1999–2000 European Values Study Surveys. Tilburg University, The Netherlands..

Holden, J.M. (2009) Veridical perception in near-death experiences. In Holden, J.M., Greyson, B. & James B (Eds) The Handbook of Near-Death Experiences. Thirty Years of Investigation. pp. 185-211. Praeger / ABC-CLIO, Santa Barbera, CA.

Larson, E. J. Witham, L. (1998). Leading Scientists Still Reject God. Nature 394 (1998).

Moody, R.A. Jr (1975). Life after Life. Mockingbird Books, Covington, G.A..



Parnia, S., Waller, D.G., Yeates, R., & Fenwick, P. (2001). A qualitative and quantitative study of the incidence, features and aetiology of near-death experience in cardiac arrest survivors. Resuscitation 48, 149-156.



Rivas, T., Dirven, A., Smit, R.H. (2016). The Self does not die. Verified paranormal phenomena from near-death experiences. IANDS, USA.

Ritchie, G.G. (1978). Return from Tomorrow. Chosen Books of The Zondervan Corp., Grand Rapids, Michigan.



Sartori, P. (2006). The Incidence and Phenomenology of Near-Death Experiences. Network Review (Scientific and Medical Network) 90, 23-25.

Tevington, P., Corichi, M. (2023) https://www.pewresearch.org/short-reads/2023/08/23/many-americans-report-interacting-with-dead-relatives-in-dreams-or-other-ways/



Van Lommel, P., Van Wees, R., Meyers, V., Elfferich, I. (2001). Near-death experiences in survivors of cardiac arrest: A prospective study in the Netherlands. Lancet 358, 2039-2045.



Van Lommel, P. (2010). Consciousness Beyond Life. The Science of the Near-Death Experience. Harper Collins, New York.

Translation from: Van Lommel, P. (2007). Eindeloos Bewustzijn. Een wetenschappelijke visie op de bijna-dood ervaring. Kampen,

Van Lommel, P. (2021) The Continuity of Consciousness. A Concept based on scientific research on Near-Death Experiences during cardiac arrest. Bigelow Institute for Consciousness Studies. Winning Essays 2023. Proof of Survival of Human Consciousness beyond Permanent Bodily Death, Volume Two, pp 1-75. https://www.bigelowinstitute.org/docs/2nd.pdf

SOURCE:

https://www.bps.org.uk/psychologist/continuity-consciousness(accessed 11.2.26)