On the Experience of Nearly Dying

A patient with an hysterical personality unexpectedly encountered a sudden, relatively painless threat to life. As the patient was in psychoanalytic treatment, circumstances permitted the early collection of her fantasies and remembered experiences and some associations to these. The opportunity to make such observations seems rare. A momentary but strong fear was replaced by a joyous affect in association with the review phenomenon in which negation and regression were apparent. If we differentiate between the experience of dying and death as a state, it seems that the latter has many idiosyncratic or personal meanings to as many people, but that the process of suddenly, unexpectedly, and painlessly dying may move through certain crudely definable and predictable stages, even though they bear perhaps the stamp of established personality patterns and contemporary conflicts. When the patient began to respond to resuscitation, she did not want to awaken and was enjoying a markedly wish-fulfilling "dream" or hypnapompic hallucination which was idiosyncratically appropriate to her affective response to her life situation and took into account the sudden threat to her life.