Between Life and Death

A Phenomenological-Hermeneutic Exploration of the Capacities of the Human Spirit

Professor Maria Marshall

September 2, 2026

Abstract

After outlining the fundamental principles that establish Viktor E. Frankl’s Logotherapy and Existential Analysis as a holistic and compassionate therapeutic approach, this paper presents a phenomenological account of a limit situation in which the author hovered between life and death. By applying the “will to meaning” to explore what lies beyond life and death, the author reached an intuitive, spiritual insight that proved vital in processing traumatic and distressing unconscious material.

Moving beyond traditional psychological models toward a holistic conceptualization of the person, the author argues that the healthy resources of the human spirit—which often surface in extreme situations—can facilitate trauma recovery, self-acceptance, and deep empathy for the human condition. Ultimately, activating these intact spiritual resources allows individuals to view their reality through a transformative lens, demonstrating that discovery beyond the self is central to healing.

Introduction

The trials and crises of life present opportunities for transformational experiences. While one does not seek out suffering for the sake of personal growth—which would amount to masochism—human beings retain the ability, to the extent that their faculties remain accessible, to choose their attitude toward unavoidable suffering and toward themselves. Through the resources of the human spirit, individuals may choose to pursue values to actualize, tasks to accomplish, people to love, or connection to the transcendent. Crucially, the actualization of meaning is not limited to healthy individuals with intact bodies and minds; the defiant power of the human spirit—a person’s capacity to choose a stance toward their predicament—is unconditional. The resources of the spirit, representing a person’s very core and healthy essence, do not depend on external circumstances.

This insight within psychotherapy, psychiatry, and medicine was first formulated by the Viennese neurologist and psychiatrist Viktor Frankl, MD, PhD (1905-1997) who proposed that individuals can still—despite hardship, physical or mental illness, or the horrors of concentration camps—“say yes to life in spite of everything” (1). Building on the theories of Sigmund Freud and Alfred Adler, as well as his own clinical experience and years spent in Nazi concentration camps, Frankl posited that the resources of the human spirit exist as a latent potential from conception. These resources gradually unfold through the actualization of experiential values, emotional bonds, creative endeavors, and attitudinal achievements.

Even young children are capable of remarkable empathy, kindness, love, joy, and humor. Conversely, even in old age—despite physical and cognitive decline—spiritual growth remains possible (2). Experiencing crises, illness, or an existential vacuum is therefore not merely a setback, but a profound opportunity to activate the “will to meaning” and achieve personal and spiritual transformation (2, 3). Extreme circumstances, limit situations, and near-death experiences (NDEs) illuminate this potential for spiritual surgency (4–7).

Literature Review

Phenomenological studies indicate that individuals who experience NDEs have (1) “the impression of traveling to realms outside of the body” and (2) “escaping from death under the umbrella of spiritual protection.” The experience leaves them with lasting, transformative personal, spiritual, and social changes. Having found themselves “thrown into existence” in a situation they did not choose—one in which they are confronted with death and their own mortality—death is perceived as a profound transition rather than the mere cessation of existence. Thus, they no longer view death as the end of life but instead experience an “intertwining of life and death.” (4, 6, 7)

Similarly, studies in terminal lucidity confirm the potential for an unexpected return of mental capacity, memory, and communication shortly before death. This phenomenon occurs even in individuals with severe neurological and psychiatric impairments, such as brain abscesses, tumors, strokes, meningitis, dementia, Alzheimer’s disease, schizophrenia, and affective disorders. (8, 9, 10) Such an unexpected surge of clarity and energy in a person who is dying indicates that death is imminent, typically occurring within the following days, weeks, or months. Consequently, it is also termed “paradoxical lucidity,” which is hypothesized to exist as a reversible aspect of pathophysiology under severe conditions. (11)

Core conversational themes during these episodes include reminiscing, practical preparations, last wishes, personal concerns, and an awareness of impending death. (12) In line with a holistic model of the person, Batthyány argues that beyond strict materialist models, the brain may act as a filter for consciousness rather than its sole generator, allowing the person’s core identity to remain intact despite physical neurodegeneration. (12,13)

Methodology

To understand what is described in the phenomenological experience of “an existence beyond the physical body” and “spiritual awareness, or spiritual surging,” one must rely on research methodology that accommodates looking at the human person and their existential experience from a holistic perspective. A holistic lens allows researchers to consider a person in their totality—body, mind, and spirit—operating within their respective social milieu. (14, 15, 16) Hermeneutics allows us to tie subjective, personal phenomenological, lived experience with systems of knowledge, enriching previous knowledge and yielding new understanding. (17, 18, 19)

Wholistic Framework vs. Reductionistic Model

Viktor Frankl’s Logotherapy and Existential Analysis conceptualizes human beings as three-dimensional entities composed of body, mind, and spirit. (20) This view differs radically from Sigmund Freud’s Psychoanalysis, in which only the dimensions of the body and mind receive attention.

In Psychoanalysis, the mind is described along levels of awareness—such as the conscious, subconscious, and unconscious—and a structural division of personality consisting of the id, ego, and superego. (21, 22) The ego acts as the mediator negotiating between conscious and unconscious drives, instincts, and the demands of reality. The unconscious mind is viewed as a reservoir of repressed or suppressed content, drives, and instincts, such as the death drive, “Thanatos,” and the life force, “Eros.” (23) The id is the reservoir of painful, traumatic memories, socially unacceptable contents, that are repressed and suppressed into the unconscious mind so as not to overwhelm the ego. (21) These forces shape human behavior by demanding satisfaction while being mediated by the ego and the demands of the superego, which can be conceptualized as moral and ethical principles resulting from introjected expectations of parents, caregivers, and society. (21)

There is no notion of the dimension of the spirit in Freud’s writings, nor any description of the dynamics and capacities of the human spirit. Psychoanalysis presents no theoretical framework for the capacities of the spirit. (20)   

According to Frankl, including the dimension of the human spirit is of heuristic significance, as it serves as a mostly unconscious seat of the will to meaning, the source of the freedom of will, and the seat of conscience as a meaning-organ. (24) Meaning in Frankl’s terminology refers to the person-, place-, and situation-specific promptings of life that an individual can respond to through existential dynamics rather than psychodynamics—specifically through the human spirit’s capacity for reaching for meaning and the actualization of values. (24)

Frankl identified three avenues to finding meaning: creative, experiential, and attitudinal values. (25) Values serve as universal placeholders for meaning, standing in direct relation to a person in any given situation. Consequently, universal values—rather than introjected societal or parental expectations—are the guiding principles that enable a free and responsible human response, rather than a learned or forced action, or an instinctual reaction. (24, 25)

Frankl distinguished between several types of meaning toward which, “like iron filings in a magnetic field,” the human will naturally orients itself. (59:21) For this reason, Frankl stated, the human will cannot be demanded or forced, nor can meaning be prescribed. (25) He believed that “…For the will to be elicited, meaning must be elucidated” (26:24); meaning cannot be invented or fabricated, but only intuited and discovered. (24, 25)

In his book Man’s Search for Ultimate Meaning, Frankl distinguished between different types and levels of meaning: (27)

1. Concrete meaning, or the meaning of the moment, which is always person-, place-, and situation-specific; it is the objective reality of a subjective value standing in relation to the person in any situation.
2. Supra-meaning, which consists of higher values and universal principles pointing to an ultimately meaningful design and the unconditional meaning of the universe as a whole.
3. Meaning contents of a life, which are comprised of instances when meaning was actualized through devotion to a task, dedication to a person, or reaching into transcendence.
4. Ultimate Meaning, which is the least concrete and most abstract type of meaning according to Frankl. It refers to a coherent and overarching meaning of the universe that is not possible to fully comprehend through human reason and understanding. However, it forms the basis of an unconditional trust in the meaningfulness of life under any circumstances—even those that involve unavoidable suffering. The meaning of the moment, which is immanent, is thus rooted in the ultimate realm of the transcendent.

The Unconditionally Healthy Core Identity of the Existential Person

Frailty, finiteness, and vulnerability are all part of the human condition—they represent what a person has, but not what a person essentially is. (25) Frankl introduced a holistic view of the person that allows for the mobilization of inner resources, such as the will to meaning, to realize specifically human capacities: self-distancing (observing oneself and one’s situation from the outside) and self-transcendence (the ability to reach beyond the self toward the world of values). He asserted that through these capacities, human beings can choose to be loving, forgiving, kind, merciful, compassionate, dedicated, loyal, courageous, and persistent—driven not by hidden, unconscious motives that push them, but by an authentic human yearning to stand for truth, beauty, and goodness in the world. (24, 25, 26, 28)

While the mind is the seat of conscious awareness, perception, and cognition, much of the spirit is unconscious spirit. Frankl posited that “Spiritual phenomena may be unconscious or conscious; the spiritual basis of human existence, however, is ultimately unconscious. Thus, the center of the human person in his very depth is unconscious. In its origin, the human spirit is unconscious spirit.” (60:26)

The spiritual unconscious is not the seat of instinctual drives, hidden motives, and instincts, such as the psychological unconscious posited by Freud. Rather, the spirit is the seat of the will to meaning, conscience, the origin of the dynamics of the human spirit and its specifically human resources, as well as the realm of intuitive conscience, moral conscience, and aesthetic conscience. (60)

The task of the existential analyst and the logotherapist is therefore not to pursue unconscious psychological contents, but to help to bring to conscious awareness these conscious and by large and far even more unconscious dynamics and capacities of the human spirit in order to illuminate an area of freedom with meaning possibilities, only to let them sink back into the unconscious. (60) Free and responsible action presupposes capacity and choice and is therefore of a different nature than reaction. It is a chosen response. (25)

Frankl tested his ideas in limit situations within his own life while incarcerated in concentration camps. (25) He was convinced that, all else being equal, having a strong sense of meaning in life was a key factor in survival. Those prisoners who had a strong “why” to go on living—a compelling reason—were more likely to endure the brutality and inhuman conditions of the camps than those who held no such sense of purpose. (25) Consequently, he believed that saying “yes to life,” regardless of circumstances, depended heavily on a sense of trust in being, on Ultimate Meaning, on seeking to live according to universal values as guiding principles, and on actualizing the concrete meaning of the moment. (1)

Extreme or limit situations are those where the search for meaning is most intense. Suffering in the form of pain, guilt, or death and loss—which Frankl termed the “Tragic Triad of Human Existence”—elicits the search for a response through which values can be lived. (25) According to Frankl, once meaning is actualized, it becomes eternal; it remains. Similarly, at the time of one’s death, one is—meaning that all the meaning potential one brought into the world remains recorded for eternity. (25, 28)

Here, we see how significantly Frankl digresses from Freud’s notion of death as the unconscious urge of all living things to return to an inorganic, lifeless state and complete homeostasis or peace. (23) Frankl saw death as the point of completion of a life task and life project—achieved through a state of productive tension between what is and what ought to be—and the moment of death as the finite boundary that gives life its unique urgency, value, and permanence. (25, 27)

Accompanying the Dying

Between life and death is how we can conceptualize the physical trajectory of a human life from the moment of its conception to its end. (29) It is also our way of using mental categories—life versus death—to express an in-between state: a critical, dangerous condition where a person’s survival is at stake and it remains uncertain whether they will live or die. (30) People tend to reorganize their priorities in the face of death, focusing on emotional integration over long-term goals. They prioritize present-moment emotional meaning, the deepening of core relationships, and the optimization of immediate well-being through quality of life, personal autonomy, and the nurturing of significant bonds. (31, 32)

Elisabeth Kübler-Ross viewed death not as an abrupt ending of physical existence, but as the final, natural stage of growth within the human life cycle. (33) She explained that when faced with the certainty of death, people do not experience it passively; rather, they navigate their mortality through an active psychological cycle that may involve initial denial, followed by anger, bargaining, depression, and, ultimately, acceptance. (33) These stages are not rigid, linear steps, but fluid, unpredictable psychological states that characterize the dying process. (34)

Listening to patients with undivided attention, validating their feelings, and helping them complete their life tasks are the central tenets of Dignity Therapy—an evidence-based approach to accompanying the dying that draws from Kübler-Ross’s work as well as Frankl’s logotherapy. (35) A logotherapeutic approach further emphasizes confirming patients in their core identity, reviewing the meanings accomplished throughout their lives that remain, and accompanying them as they fulfill whatever meaning potentials are still available until their final breath. (36)

Between Life and Death in the Clinical Setting

In clinical settings, “between life and death” refers to a person in a critically unstable physical condition whose survival is uncertain and hanging in the balance. (37) Strict and precise protocols guide the stabilization of such patients, helping healthcare professionals focus on the most life-threatening clinical problems in an attempt to prevent or reverse organ failure. (38) Access to the phenomenological experience—the existential core of the person—is limited or impossible when the patient is in an unresponsive or minimally responsive state. (38)

However, modern neuroimaging studies, such as fMRI and EEG evaluations, have revealed that up to 15 to 20 percent of patients who appear entirely unresponsive in a coma can actively modulate their brain activity when spoken to, and that the auditory cortex often responds to familiar sounds, voices, or emotional stories. (39) Thus, while a patient may not be able to move, speak, or open their eyes, complex neural networks responsible for internal thoughts, memories, and abstract processing can remain structurally intact and active. (40) Patients may later report expanded spatial awareness, recall conversations or the presence of loved ones, experience vivid, structured, and archetypal dreams, or describe clear narratives such as undertaking a long journey, seeing geometric structures, or navigating transitional spaces. (41)

Studies of individuals who have had near-death experiences (NDEs)—whether due to severe trauma, major surgical complications, or organ failure—show that even under physically uncertain conditions, people experience consistent and highly structured psychological and perceptual events, proving that these are organized experiences rather than random hallucinations. (44) Awareness often persists even while in a comatose state, though individuals may later present with PTSD symptoms and cognitive deficits following resuscitation. (45)

A significant number of individuals with NDEs report intense spiritual experiences, a sense of profound peace, encounters with deceased loved ones, radiant light, and a distinct sense of consciousness existing outside the physical body. (46, 47, 48) Some of these include supernatural events, out-of-body experiences, passing through a tunnel, or heightened senses. (47, 49) Other frequently mentioned elements are seeing or hearing independently of the physical body, entering or passing through a tunnel, encountering a mystical light, feeling intense and generally positive emotions, experiencing a reduced fear of death, reviewing prior life events, meeting deceased loved ones, and eventually returning to earthly life. (49)

Friends and family are therefore encouraged to speak to the patient as if they were fully awake. (44) Sensory and spiritual stimulation—in the form of familiar music, gentle touch, and spiritual or religious practices—may provide comfort and stimulate neurological recovery pathways. (44)

A related line of inquiry into terminal lucidity demonstrates that individuals with prolonged and severe mental decline or unresponsiveness can experience brief episodes or sudden bursts of memory, coherent speech, and awareness shortly before death, lasting anywhere from a few minutes up to a day. (46) During these episodes, individuals near death can interact with loved ones, speak coherently, express their wants and needs, recognize people they had forgotten, recollect past experiences, and participate in favorite activities like singing or playing a musical instrument they have not touched in years. (46, 47, 48, 49)

While the physiological mechanisms explaining these phenomena are still in their infancy, terminal lucidity is hypothesized to result from specific brain changes: namely, that oxygen-deprived regions briefly receive an influx of oxygen, contributing to regained access to memories once thought lost. (50, 52) Alternatively, as glucose and oxygen levels fluctuate or drop, “…rapid neurochemical discharge can result in transient, metastable activation of the central nervous system, temporarily overcoming profound neurodegeneration.” (51) Animal models have similarly explored spikes in gamma waves—associated with alertness and memory—during near-death events such as cardiac arrest. (53, 54, 55)

Regardless of the underlying physiological mechanisms, the accompanying phenomenological experiences exhibit organized patterns pointing to the core and essence of existence. (56) This surge of energy appears to allow consciousness to filter a reality that is “more real than everyday walking reality,” reflecting a universal human phenomenon. (12, 13, 56)

Beyond Life and Death Experience

A few days ago, I happened to unwittingly experience a situation in which I felt myself between life and death. I had undergone surgery related to the removal of a cancerous tumor from my breast, a lumpectomy with breast reconstruction and axillary lymph node dissection. After local a local anesthetic was applied to the infusion site, a “cocktail” of medications was administered, followed by general anaesthesia.

[I am relying on the anesthesiologist’s words prior to the surgery. The exact content and the dose of the substances administered are not known to me. The Anesthesiology Report, which was available to view on MyChart—a platform to share documents with patients–has been removed a few hours after my surgery was complete. While I managed to superficially scroll through it, I do not recall the exact items, or doses listed, except that it mentioned fentanyl, which is a substance routinely administered. A formal written request had to be submitted in-person to the hospital to request access to this document. This request has not been processed at the time of the writing of this article]. 

The surgery went well, and my condition during the procedure was reportedly stable and unremarkable. Following some time in the postoperative care unit, I was transferred to the Day Surgery Unit, where I experienced delayed emergence from anesthesia. My body took several hours longer than expected to return to an alert and responsive state. When I was given a hydromorphic tablet for pain control, I returned into an unresponsive state for the next few hours.

When I was discharged, I was told that I was likely responding to the narcotics that had been administered, but my condition was not severe enough to warrant requesting a transfer back to the Post-Operative Care Unit for the administration of Naloxone to reverse the effects of the narcotics. I was dizzy, I could not walk unassisted, and I could not yet eat a standard diet.

Over the course of traveling home and during a brief stay there, I experienced post-surgical bleeding and had to return to the emergency department. The trip home took two hours in high traffic. The trip back took less time, about forty minutes. By that time, I had been fasting for over a period of twenty-four hours but was denied any food or drink while the nurses expected the surgical team to make a decision if any post-operative interventions will be warranted. A tight bandage was placed all around my chest. Subsequently, it was removed, and a photo was taken. Blood work was done as ordered by the attending surgeon. The bleeding stopped, and shortly past midnight of that day, I was discharged home once again.

[The report of this intervention was missing form MyChart and a formal report had to be submitted to the Health Records Office, in person, to request that the attending doctor to sign off on the report and make it available. This request has not been processed at the time of writing this article].

In the middle of the night, I woke up to severe dizziness. My entire body was swollen; I was in excruciating pain but did not want to take anything stronger that Tylenol not to precipitate another episode of unconsciousness. I remarked that my surgical drain needed to be emptied. It was placed during surgery to collect blood from the wound and prevent its pooling in the body.

Attempting to get out of bed, I went to the ground and could no longer use my muscles to stand. I remained on the floor experiencing confusion, distress, and nausea, while re-experiencing intense and traumatic memories from the past. I was agitated, continuously talking about these past events and expressing how I felt that my body in such situations was unable to move, unable to act, and unable to do “better” or “more.” Coupled with a rapid heartbeat, the experience was tantalizing and agonizing. I was on the floor, unable to move.

Neither the diagnosis of cancer nor the surgery itself had initially triggered the countless instances where I had been in dangerous situations involving death, loss, and grief. These painful contents—memories from my life—were not consciously in my mind prior, nor was I actively thinking or talking about them. Now, it was as if all my pain had suddenly flung open, and all my previous illnesses, losses, hospitalizations, and surgeries fused into one painful weight that made my mind numb with pain while my body lay as if in a paralyzed state. I physically and mentally re-experienced loss, grief, and pain.

My husband, who was with me this entire time, stayed by my side until some time passed and I began to regain the ability to move my legs. Eventually, I was able to crawl across the floor to reach the window of our bedroom. Opening it, my husband encouraged me to take deep breaths and fill my lungs with fresh air. Looking up, I noticed the stars. I noticed the beauty of the peaceful backyard. But the pain was still immense. The dizziness was relentless, and as I left the window, I ended up back on the floor, fully faced with a subjective experience of being between life and death.

Objectively, I was not in immediate danger of death; I was still suffering from the delayed effects of the anesthesia and experienced rapid orthostatic changes as result of the surgery. Subjectively, however, I felt myself in a “twilight zone.”

I was unable to concentrate or follow a conversation, and I was highly agitated. My senses were heightened toward these past contents, which I was re-living in the present. Gradually, the symptoms began to fade, and I was able to crawl to the window a second time. I filled my lungs with fresh air before another wave of dizziness forced me back down. In this state, I noticed that while my body was in pain and my mind was occupied with re-processing these painful events—which only amplified the physical suffering—I gained an insight: presently, I am BETWEEN life and death.

As soon as I was able to articulate this thought to myself, I tried to find a way to listen to my husband, who was coaching me to take slow, deep breaths. “But how?” I thought to myself.

This was the exact sentence that had first come to my lips just a few hours prior when the nurse came to prompt me to wake up, stating that “my shift is over…everyone is gone home…and the bed is needed by other patients,” and began giving instructions for my post-operative care. Her voice had felt distant, and my eyes were still shut. Under my eyelids, there was bright white light, brighter than in a room but not painful or uncomfortable. When I opened my eyes, I could barely tolerate any light. The contrast of dark and bright patterns and shapes felt overwhelming. I was aware that I was in a room, but I was unable to lift a finger or move my body.  It lay flat in the bed despite my best efforts to force my eyes to open and repeated instances of the will to comply. –“But how?” I had kept repeating it over and over again, until the nurse left my bedside and realized that I needed more time.

Lying there, I was still able to reply to simple questions even though I could not yet move or open my eyes. The nurse’s demeanor changed. She returned and asked me about where I lived and she said that she lived not far from where I am from. I was able to tell her that no matter how much I am trying to force myself, there is something wrong. My body does not comply. She said I probably was still under the influence of the drugs. “Has this happened to you before,” she asked, “…that you needed so much time? I replied, “Yes, it did, but not so badly.” Then she told me that next time I need to explain this to the doctors ahead of the time. “I did and they did not listen,” I stated. “I am a little person, and they give me a lot of medications…,” I replied in a weak voice…. “Something is definitely wrong” …” I think they do not take me seriously…” –I continued attempting to explain my situation. After a pause, the nurse turned to me. There was a slight smile on her face and bit of warmth in her voice that I could detect. She said, “I am the same as you…I am very sensitive to medications.” Then she continued to type something on a keyboard, and I closed my eyes as the light still hurt. I felt exhausted.

[From that moment on, we were not just “nurse” and “patient” anymore. It did not feel like it. We were two comrades and fellow human beings. She cared for me and I thanked her. In a brief moment, I kissed her hand in gratitude. She stayed over time to see me off, even through her shift was over.]

My husband was called to come to the bedside, and I could hear his voice from the distance. It seemed like coming from miles away, but increasingly, I could hear that he was talking with the nurse. His voice came closer and closer to me, and soon, he spoke to me in soft tones. He touched my cheeks. I opened my eyes. Slowly, very slowly, I kept repeating the command for my eyes to remain open. I was gradually able to move my head, and within that same hour, started to be able to move my legs….

“How?” I kept repeating to myself while lying on the floor of our bedroom. In that moment, I became aware of something more than just my body and mind. It was a sense of awareness that I could perhaps direct with my will. In one instance, it occurred to me that it was possible to direct my attention away from being between life and death and orient my awareness toward what is BEYOND life and death.

[Was this similar to Frankl’s notion of turning toward the Ultimate Meaning of my life and seeking to find solace in transcendence? We need to recall that Frankl posited that ultimate meaning is abstract and cannot be fully grasped with human intellect. However, we can reach the threshold, the limit, or the boundaries of this domain if we truly seek its door.]

I was not able to undertake any sophisticated philosophical thinking at the time; there was only an intuitive awareness of the possibility of mobilizing my will. I repeated this question to my conscience: “What is BEYOND life and death?”

I let my intuitive conscience listen to the voice that came from within, which became clear to my mind. My answer was that beyond life and death is “Everlasting Life in Everlasting Love.”

I contemplated this idea, and its beauty filled me with a sense of wonder and awe. Beyond life and death is everlasting life and everlasting love.

I thought to myself that when answering the question of what something is, we can also ask what it is not. And so, the answer repeated within me again: what is beyond life and death IS “Everlasting Life in Everlasting Love.” What it IS NOT is “…everything that is ephemeral, fleeting, ‘earthly,’ vulnerable, fallible, partial, frail, and finite.”

In this light, I returned to the experience of being “between life and death.” Life and death were no longer two abstract categories. In the light of understanding what is BEYOND life and death, life and death became like companions.

Usually, we think of them in this way: If there is life… then what? What kind of life do we want to live? And if it is death… what then? What will remain after us?

In the light of eternal life and eternal love, these two ideas became intertwined: everything that is good, beautiful, true, or valuable—everything of worth—is preserved. Beyond life and death, life continues, albeit in a qualitatively different way. –Beyond life and death, love lives on: those whom we have lost through death are alive. Those whom we have loved never die. Life exists beyond earthly boundaries and human conceptions.

In the light of what lies beyond life and death, I could return to the question: “If it is life, then what? And if it is death, what then?” My will was now activated to contemplate these realities, and the defiant power of the human spirit—the capacity to decide how to face a situation—was active.

Life and death became like the wings of a bird, or like two hands folded in prayer. With a firm anchor in what lies beyond life and death—“eternal life in eternal love”—it was possible to regain even footing and an anchor that helped ground me in the present moment. It brought calming to body and mind, as well as a sense of peace and serenity about what IS and what MAY BE. “What ought to be” now lit the way to everyday life.

I experienced a radical re-alignment of my will with my vulnerable body and mind, feeling an overflowing sense of care and kindness toward myself within this shell. I experienced an acceptance of what was and began to look forward to what still may be.

Reflections

In hindsight, there is no better explanation that I can give to this process than to emphasize that directly naming what is BEYOND life and death helped me to see life and death not as an either/or, but as both. It helped me to see that beyond “nothing” is “something.” Beyond what is passing and temporal is something that is ethereal.

I am sharing this experience because, through this episode, I gained awareness—albeit unwittingly—of the trauma and pain I was carrying in my unconscious mind and how it was interacting with my current experience of illness. The narcotic substance affected my body and my mind beyond my volition. However, beyond these limitations, my awareness searched for an anchor. I managed to identify that I still possessed a will. With this will, I could not activate my body, nor could I change my mental processes, because both were still under the influence of the narcotics received during anesthesia. Nevertheless, I could use my will to search through the dimension of the human spirit—to seek something beyond my present circumstances, and beyond even my life and death. When I asked myself the questions, “If life, then what?” and “If death, what then?”, the answers were initially overwhelming, uncertain, and seemingly unanswerable. They filled me with dread, which only intensified my pain.

Evoking my intuitive spirit to answer the question, “What is beyond life and death?” with a definite and resounding answer—one that filled me with awe and wonder: “It is everlasting life in everlasting love”—helped me to regain peace, compassion, and serenity.

The episodes of dizziness and loss of balance were not as strong by the next day as the anesthetic’s effect was slowly wearing off. They were still noticeable to some extent five days after my surgery, characterized by a vague sense of a hangover, mild nausea, and dizziness. A week later, my body still needed to get used to the rapid vasodynamic and orthostatic changes as a result of the surgery and I had to be careful not to overexert myself to avoid fainting spells. Yet throughout it all, my experience was “realer to me than real,” providing guidance and clarity through turbulent feelings and bodily sensations.

I thought of reporting this experience because of its potential utility in promoting holistic healthcare, preventing iatrogenic damage, advancing trauma work, and reducing the wish for hastened death. In extreme and limit situations—as well as while recalling such events or re-experiencing traumatic memories—there is a profound search for “What then?” and “Then what?” There is a thirst for a meaningful answer that satisfies the soul.

In suicide prevention, there is also a strong surge of “What for?” These fundamental human questions do not arise from the push of unconscious drives, but from a human being’s intrinsic search for meaning. They can be creatively posed to the unconscious spirit where the will resides. As long as there is conscious awareness, the will can be employed to search for meaning.

In therapy, we do not guide the will; rather, we present meaning potentials toward which the will is naturally attracted. By kindling a person’s free will, we can constructively entertain questions of life and death. What this example demonstrated to me is that by engaging the will toward the intuitive capacities of human conscience, it is possible to rise above the binary questions of life and death and attempt to derive an answer to the ultimate question: What is beyond life and death?

Each person may have their own conceptualization, vocabulary, and way of formulating the answer to this question in a manner that sounds true to them. The manifold perspectives and modes of expression do not detract from the objectivity of the overarching picture. The essential point is that something IS beyond life and death, and something is NOT beyond life and death.

When we reach clarity of understanding based on our intuitive capacity, we arrive at the realization that conceptualizing what is beyond life and death bestows our present reality of being between life and death—and being acutely aware of it—with a strong anchor. In this anchor, life and death are fully encompassed by an ideal far greater than our immediate circumstances. In that moment, we transition from a state of distress to a realm of greater peace and tranquility.

The intuitive capacity of the human spirit, powered by the will, can soar to heights far beyond the domain of instincts, drives, and repressed content that flood conscious awareness. We arrive at a place of genuine care for the thoughts, feelings, and vulnerabilities of a frail and finite human being. In that moment, we become more compassionate toward ourselves, and perhaps a bit more merciful toward the rest of our world.

According to Frankl, through self-discovery, we can learn something new about ourselves and find meaning. Contemplating what is beyond life and death goes beyond ordinary self-discovery: it helps us connect with a source of wholeness that facilitates optimal support for the healing of both body and soul. This awareness reveals to us our inner core—our healthy, undisturbed, and incorruptible essence.

When our core identity reaches for meaning, and this meaning is found in the transcendent—in Ultimate Meaning—we can name this process as the human will’s unconditional Trust in the Ultimate Being. Through reigniting the will to search the intuitive conscience, our awareness can be redirected toward what lies beyond life and death. Reconnecting with this source of trust is ultimately evidenced as divine consolation.

Conclusions and Final Analysis

My conclusions from this experience for the practice of healthcare in “between life and death” situations are as follows:

1. Every patient matters. Every life matters. Every moment matters.
2. No patient should be left behind. There are some wonderful and exceptionalhealth care professionals who show dedication and commitment above and beyond their duty not because they are mandated to do so, but more so because they choose to do so.
3. As Frankl stated, “Behind the mask of the disease, the spiritual person is always there.” (57, 58) The resources of the spirit may not be observable, measurable, or even accessible from the outside, but they are the healthy essence of the person.
4. Frankl also noted that “The spiritual person may be disturbed but not destroyed.” (57, 58) Body and mind can become ill and succumb to diseases. Spirit is the healthy resource of every person.
5. While clinicians should do their best to alleviate suffering and treat what is treatable, they must also do no harm. It is essential to listen to patients. Their lived experience does not detract from, but rather enriches, the clinician’s ability to make accurate formulations and wise treatment decisions. Even when unintended human errors occur, it is a hopeful sign when patients’ voices are not denied, ignored, or explained away, and when their totality as entities of body, mind, and spirit is respected and honored.
6. Sometimes, unwittingly, a physical or mental illness may bring a blessing in disguise. Clinical care requires one’s physical and mental faculties to be temporarily subjected to treatments that aim to bring about healing, while the spiritual dimension remains intact, open, and ready to receive this gift.
7. Clinicians should recognize their patients’ individuality and uniqueness while keeping the broader clinical picture in mind, allowing treatments to be tailored to each patient’s specific needs.
8. Failing or refusing to honor the dignity of the patient undermines their chances for a successful recovery, ultimately working against the shared intentions of both clinician and patient.
9. The exclusive reliance on reductionistic practices in healthcare is counterproductive. Propagating such practices at the expense of holistic care means that while patients may have their recovery jeopardized, clinicians risk forfeiting their own humanity.
10. When an extreme or limit situation presents the opportunity for one’s spiritual resources to surge, an Ultimate Trust in Being is reignited and kindled. This outcome contributes directly to finding solace through the realization of Meaning in suffering.
11. The moment of Divine consolation is transformative.
12. Everyone can have their own personal experience and description of what IS beyond life and death. One does not need to be ill to evoke the resources of the human spirit, such as its intuitive capacities.

The above account is consistent with previous research indicating that in extreme or limit situations, there is a distinct surge in the resources of the human spirit. (40-47, 50, 53-55) An aspect of consciousness (or deeper unconsciousness) remains awake and dynamically engaged in the search for meaning. (11-13, 43, 46, 56) The healthy inner resources of a person—the hallmark of their core identity—remain intact and undisturbed. (11, 12, 13)

The human will reaches beyond the confines of body and mind to find an answer in the transcendent world of values. Religious individuals might describe this as the soul reaching out to God; in this sounding out, there is resonance, as God—the ultimate physician—responds with unimaginable care.

In secular terms and existential concepts, this process can be described as the activation of the will and the kindling of intuitive conscience, coupled with a shift of awareness from the immanent to the transcendent.

“What lies beyond life and death” stands as a testimony to the Ultimate Trust in Being reaching toward Ultimate Meaning, and finding a home in it.

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