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2019

 

“Death is reversible.” So began NYU medical center’s director of Critical Care and Resuscitation Research Science, Sam Parnia, at a recent research consultation on people’s death experiences during and after cardiac resuscitation.

 

Biologically speaking, he explained, death and cardiac arrest are synonymous. When the heart stops, a person will stop breathing and, within 2 to 20 seconds, the brain will stop functioning. These are the criteria for declaring someone dead. When there’s no heartbeat, no breathing, and no discernible brain activity, the attending physician records the time of death.

 

Yet recent advances in science reveal that it may take many hours for individual brain cells to die. In a 2019 Nature report, slaughtered pigs’ brains, given a substitute blood infusion 4 hours after death, had brain function gradually restored over a 6-10 hour period. For many years now, brain cells from human cadaver biopsies have been used to grow brain cells up to 20 hours after death, explained Parnia. His underappreciated conclusion: “Brain cells die very, very slowly,” especially for those whose brains have been chilled, either medically or by drowning in cold water.

 

But what is death? A Newsweek cover showing a resuscitated heart attack victim proclaimed, “This man was dead. He isn’t any more.” Parnia thinks Newsweek got it right. The man didn’t have a “near death experience” (NDE). He had a death experience (DE).

 

Ah, but Merriam-Webster defines death as “a permanent cessation of all vital functions.” So, I asked Parnia, has a resuscitated person actually died? Yes, replied Parnia. Imagine two sisters simultaneously undergoing cardiac arrest, one while hiking in the Sahara Desert, the other in a hospital ER, where she was resuscitated. Because the second could be resuscitated, would we assume that the first, in the same minutes following the cessation of heart and brain function, was not dead?

 

Of 2.8 million CDC-reported deaths in the United States annually, Parnia cites estimates of possibly 1.1 million attempted U.S. cardiac resuscitations a year. How many benefit from such attempts? And of those who survive, how many have some memory of their death experiences (cognitive activity during cardiac arrest)?

 

For answers, Parnia offers his multi-site study of 2060 people who suffered cardiac arrests. In that group, 1730 (84 percent) died and 330 survived. Among the survivors, 60 percent later reported no recall of their death experience. The remaining 40 percent had some recollection, including 10 percent who had a meaningful “transformative” recall. If these estimates are roughly accurate, then some 18,000 Americans a year recall a death experience.

 

NDEs (or DEs) are reportedly recalled as a peaceful and pleasant sense of being pulled toward a light, often accompanied by an out-of-body experience with a time-compressed life review. After returning to life, patients report a diminished fear of death, a kinder spirit, and more benevolent values—a “transformational” experience that Parnia is planning to study with the support of 17 major university hospitals. In this study, cardiac-arrest survivors who do and don’t recall cognitive experiences will complete positive psychology measures of human flourishing.

 

One wonders (and Parnia does, too), when did the recalled death experiences occur? During the cardiac-arrest period of brain inactivity? During the moments before and at cardiac arrest? When the resuscitated patient was gradually re-emerging from a coma? Or even as a later constructed false memory?

 

Answers may come from a future Parnia study, focusing on aortic repair patients, some of whom experience a controlled condition that biologically approximates death, with no heartbeat and flat-lined brain activity. This version of aortic repair surgery puts a person under anesthesia, cools the body to 70 degrees, stops the heart, and drains the blood, creating a death-like state, during which the cardiac surgeon has 40 minutes to repair the aorta before warming the body and restarting the heart. Functionally, for that 40 or so minutes, the patient is dead . . . but then lives again. So, will some of these people whose brains have stopped functioning experience DEs? One study suggests that at least a few aortic repair patients, despite also being under anesthesia, do report a cognitive experience during their cardiac arrest.

 

Parnia hopes to take this research a step further, by exposing these “deep hypothermia” patients to stimuli during their clinical death. Afterwards he will ascertain whether any of them can report accurately on events occurring while they lacked a functioning brain. (Such has been claimed by people having transformative DEs.)

 

Given that a positive result would be truly mind blowing—it would challenge our understanding of the embodied person and the mind-brain connection—my colleagues and I encouraged Parnia to

  •      preregister his hypotheses and methods with the Open Science Framework.
  •      conduct the experiment as an “adversarial collaboration” with a neuroscientist who would expect a null result.
  •      have credible, independent researchers gather the data, as happens with clinical safety trials.

 

If this experiment happens, what do you predict: Will there be someone (anyone) who will accurately report on events occurring while their brain is dormant?

 

Sam Parnia thinks yes. I think not.

 

Parnia is persuaded by his accumulation of credible-seeming accounts of resuscitated patients recalling actual happenings during their brain-inactive time. He cites the case of one young Britisher who, after all efforts to restart his heart had failed and his body turned blue, was declared dead. When the attending physician later returned to the room, he noticed that the patient’s normal color was returning and discovered that his heart had somehow restarted. The next week, reported Parnia, the patient astoundingly recounted events from his death period. As Agatha Christie’s Miss Marple, reflected “It wasn’t what I expected. But facts are facts, and if one is proved to be wrong, one must just be humble about it and start again.”

 

My skepticism arises from three lines of research: the failure of parapsychology experiments to confirm out-of-body travel with remote viewing, the mountain of cognitive neuroscience evidence linking brain and mind, and scientific observations showing that brain oxygen deprivation and hallucinogenic drugs can cause similar mystical experiences (complete with the tunnel, beam of light, and life review).

 

Nevertheless, Parnia and I agree with Miss Marple: Sometimes reality surprises us (as mind-boggling DE reports have surprised him). So stay tuned. When the data speak, we will both listen.

 

(For David Myers’ other essays on psychological science and everyday life, visit TalkPsych.com.)

 

P.S. For those wanting more information: Parnia and other death researchers will present at a November 18th New York Academy of Sciences symposium on “What Happens When We Die?” (see here and here)--with a live stream link to come.

 

For those with religious interests: My colleagues, British cognitive neuroscientist Malcolm Jeeves and American developmental psychologist Thomas Ludwig, reflect on the brain-mind relationship in their recent book, Psychological Science and Christian Faith. If you think that biblical religion assumes a death-denying dualism (thanks to Plato’s immortal soul) prepare to be surprised.

A tweet from my colleague Jean Twenge—a world-class expert at tracking youth well-being in massive data sets—alerted me to the recently released 2018 National Survey on Drug Use and Health. Among its dozens of results, which you can view here, several struck me as worthy of note by high school and college teachers, administrators, and counselors. 

First some good news: From 2002 to 2018, cigarette smoking plummeted and is now but 2.7 percent of U.S. 12- to 17-year-olds. Reaching back to 1976, high school senior smoking has plunged even more, from 28.8 percent to 3.6 percent. Although smoking has become gauche, seniors’ e-cigarette use has soared—from 1.5 percent in 2010 to 26.7 percent in 2018. (Will widely publicized news of vaping-related lung illnesses and deaths reverse this trend?)

 

The not-so-good news: From 2011 to 2018, major depressive episodes increased from 11 to 14 percent among 12- to 17-year-olds, and, similarly, from 8 to 14 percent among 18- to 25-year-olds.

 

 

 

Not surprisingly, youth and young adults’ increased rate of depression has been accompanied by an increase in suicidal thoughts (shown below), suicide attempts, and actual suicides (see new CDC data here).

 

 

As I explained in a previous TalkPsych.com essay, the increase in teens’ (especially teen girls’) vulnerability to depression, anxiety, self-harm, and suicide has occurred in other Western countries as well, and it corresponds neatly with the spread of smart phones and social media. That fact of life has stimulated new research that 

  • correlates teens’ social media use with their mental health.
  • follows teens longitudinally (through time) to see if their social media use predicts their future mental health.
  • experiments by asking if volunteers randomly assigned to a restrained social media diet become, compared with a control group, less depressed and lonely. 

 

Stay tuned. This scientific story is still being written, amid some conflicting results. As Twenge summarizes in a concise and readable new essay, up to two hours of daily screen time predicts no lessening of teen well-being. But as daily screen time increases to six hours—with associated diminishing of face-to-face relationships, sleep, exercise, reading, and time outdoors—the risk of depression and anxiety rise. 

 

The alarming rise in youth and young adult depression, especially over such a thin slice of history, compels our attention. Is screen time the major culprit (both for its drain on other healthy activities and for the upward social comparisons of one’s own mundane life with the lives of cooler-seeming others)? If not, what other social forces are at work? And what can be done to protect and improve youth and young adult well-being?

 

(For David Myers’ other essays on psychological science and everyday life, visit TalkPsych.com.)

Photo courtesy Virginia Welle

 

At a recent Teaching of Psychology in Secondary Schools workshop hosted by Oregon State University, I celebrated and illustrated three sets of big ideas from psychological science. Without further explanation, here is a quick synopsis.

 

Questions: Which of these would not be on your corresponding lists? And which would you add?

 

Twelve unsurprising but important findings (significant facts of life for our students to understand):

  • There is continuity to our traits, temperament, and intelligence.
    • With age, emotional stability and conscientiousness increase.
    • Yet individual differences (extraversion and IQ) persist.
  • Specific cognitive abilities are distinct yet correlated (g, general intelligence).
  • Human traits (intelligence, personality, sexual orientation, psychiatric disorders, autism spectrum) are influenced by “many genes having small effects”
  • A pessimistic explanatory style increases depression risk.
  • To a striking extent, perceptual set guides what we see.
  • Rewards shape behavior.
  • We prioritize basic needs.
  • Cultures differ in  
    • how we dress, eat, and speak.
    • values.
  • Conformity and social contagion influence our behavior.
  • Group polarization amplifies our differences.
  • Ingroup bias (us > them) is powerful and perilous.
  • Nevertheless, worldwide, we are all kin beneath the skin (we share a human nature).

 

Eleven surprising findings that may challenge our beliefs and assumptions:

  • Behavior genetics studies with twins and adoptees reveal a stunning fact: Within the normal range of environments, the “shared environment” effect on personality and intelligence (including parental nurture shared by siblings) is ~nil. As Robert Plomin says (2019), “We would essentially be the same person if we had been adopted at birth and raised in a different family.”
    • Caveats:
      • Parental extremes (neglect/abuse) matter.
      • Parents influence values/beliefs (politics, religion, etc.).
      • Parents help provide peer context (neighborhood, schools).
      • Stable co-parenting correlates with children’s flourishing.
  • Marriage (enduring partnership) matters . . . more than high school seniors assume . . . and predicts greater health, longevity, happiness, income, parental stability, and children’s flourishing. Yet most single adults and their children flourish.
  • Sexual orientation is a natural disposition (parental influence appears nil), not a moral choice.
  • Many gay men’s and women’s traits appear intermediate to those of straight women and men (for example, spatial ability).
  • Seasonal affective disorder (SAD) may not exist (judging from new CDC data and people’s Google searches for help, by month).
  • Learning styles—assuming that teaching should align with students’ varying ways of thinking and learning—have been discounted.
  • We too often fear the wrong things (air crashes, terrorism, immigrants, school shootings).
  • Brief “wise interventions” with at-risk youth sometimes succeed where big interventions have failed.
  • Random data (as in coin tosses and sports) are streakier than expected.
  • Reality is often not as we perceive it.
  • Repression rarely occurs.

 

Some surprising findings reveal things unimagined:

  • Astonishing insights—great lessons of psychological science—that are now accepted wisdom include
    • split-brain experiments: the differing functions of our two hemispheres.
    • sleep experiments: sleep stages and REM-related dreaming.
    • misinformation effect experiments: the malleability of memory.
  • We’ve been surprised to learn
    • what works as therapy (ECT, light therapy).
    • what doesn’t (Critical Incident Debriefing for trauma victims, D.A.R.E. drug abuse prevention, sexual reorientation therapies, permanent weight-loss programs).
  • We’ve been astounded at our dual-processing powers—our two-track (controlled vs. automatic) mind, as evident in phenomena such as
    • blindsight.
    • implicit memory.
    • implicit bias.
    • thinking without thinking (not-thinking => creativity).
  • We’ve been amazed at the robustness of
    • the testing effect (we retain information better after self-testing/rehearsing it)  
    • the Dunning-Krueger effect (ignorance of one’s own incompetence).   

 

The bottom line: Psychological science works! It affirms important, if unsurprising, truths. And it sometimes surprises us with findings that challenge our assumptions, and with discoveries that astonish us.

 

(For David Myers’ other essays on psychological science and everyday life, visit TalkPsych.com.)