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<journal-id journal-id-type="publisher-id">Front. Psychol.</journal-id>
<journal-title>Frontiers in Psychology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Psychol.</abbrev-journal-title>
<issn pub-type="epub">1664-1078</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fpsyg.2022.790300</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Psychology</subject>
<subj-group>
<subject>Conceptual Analysis</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Defining Transformative Experiences: A Conceptual Analysis</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<name><surname>Chirico</surname> <given-names>Alice</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/215303/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Pizzolante</surname> <given-names>Marta</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1507138/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Kitson</surname> <given-names>Alexandra</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/284489/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Gianotti</surname> <given-names>Elena</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
</contrib>
<contrib contrib-type="author">
<name><surname>Riecke</surname> <given-names>Bernhard E.</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/76354/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Gaggioli</surname> <given-names>Andrea</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/229274/overview"/>
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<aff id="aff1"><sup>1</sup><institution>Department of Psychology, Research Center in Communication Psychology, Universit&#x00E1; Cattolica del Sacro Cuore</institution>, <addr-line>Milan</addr-line>, <country>Italy</country></aff>
<aff id="aff2"><sup>2</sup><institution>School of Interactive Arts and Technology (SIAT), Simon Fraser University</institution>, <addr-line>Surrey, BC</addr-line>, <country>Canada</country></aff>
<aff id="aff3"><sup>3</sup><institution>Department of Psychology, Universit&#x00E1; Cattolica del Sacro Cuore</institution>, <addr-line>Milan</addr-line>, <country>Italy</country></aff>
<aff id="aff4"><sup>4</sup><institution>Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano</institution>, <addr-line>Milan</addr-line>, <country>Italy</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: R. David Hayward, Ascension St. John Hospital, United States</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: David Harris Smith, McMaster University, Canada; Barbara Neuhofer, University of Applied Sciences Salzburg, Austria</p></fn>
<corresp id="c001">&#x002A;Correspondence: Alice Chirico, <email>alice.chirico@unicatt.it</email></corresp>
<fn fn-type="other" id="fn004"><p>This article was submitted to Emotion Science, a section of the journal Frontiers in Psychology</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>24</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="collection">
<year>2022</year>
</pub-date>
<volume>13</volume>
<elocation-id>790300</elocation-id>
<history>
<date date-type="received">
<day>07</day>
<month>10</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>05</month>
<year>2022</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2022 Chirico, Pizzolante, Kitson, Gianotti, Riecke and Gaggioli.</copyright-statement>
<copyright-year>2022</copyright-year>
<copyright-holder>Chirico, Pizzolante, Kitson, Gianotti, Riecke and Gaggioli</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>The concept of transformative experience (TE) has been widely explored by several disciplines from philosophy to neurobiology, and in different domains, from the spiritual to the educational one. This attitude has engendered heterogeneous models to explain this phenomenon. However, a consistent and clear understanding of this construct remains elusive. The aim of this work is to provide an initial comprehensive interdisciplinary, cross-domain, up-to-date, and integrated overview on the concept of TEs. Firstly, all the models and theories on TEs were reviewed to extract and analyze TEs&#x2019; main components emerging from different disciplines. Then, this preliminary analysis was integrated with an in-depth examination of redundancies and particularities across domains and disciplines, to provide an integrated theoretical framework of TEs and a preliminary interdisciplinary operational definition of TEs. This examination, in turn, can help organize current research and theories, thus providing suggestions for operationalizing TEs as well as encouraging new interdisciplinary research endeavors.</p>
</abstract>
<kwd-group>
<kwd>transformative experiences</kwd>
<kwd>psychological change</kwd>
<kwd>conceptual analysis</kwd>
<kwd>complex emotions</kwd>
<kwd>transcendence</kwd>
</kwd-group>
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<equation-count count="0"/>
<ref-count count="211"/>
<page-count count="19"/>
<word-count count="15628"/>
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</front>
<body>
<sec id="S1">
<title>All the Facets of Transformative Experiences: Toward an Integrated Picture</title>
<p>As early as 1622, an example of a memorable transformation can be identified, in the work of renowned sculptor Bernini, in his representation of the precise moment in which Daphne, while fleeing from Apollo, physically transformed herself into a laurel tree. In Ovid&#x2019;s Metamorphoses (<xref ref-type="bibr" rid="B49">Fantham, 2004</xref>), which inspired Bernini, transformation was conceived as a sudden and unexpected phenomenon, which irreversibly changes the state of things. More recently, in 1999, the Wachowskis staged one of the most famous transformative moments in the history of cinema, within their masterpiece &#x201C;The Matrix.&#x201D; Red or blue pill? The main character, Neo, faced the choice of whether to continue living in his habitual illusory world, or to discover the true reality, thus, embarking upon a change with no way back.</p>
<p>Although these fascinating examples of transformation may suggest that this phenomenon could pertain more to the domain of art and fiction than to that of reality, evidence has shown that transformation &#x2013; at least, several instances of it &#x2013; may occur in any moment of an individual&#x2019;s life (e.g., <xref ref-type="bibr" rid="B148">Pearsall, 2007</xref>). The current COVID-19 pandemic could be taken as an example, in terms of events and consequences deriving from it that may be considered <italic>transformative</italic>. For instance, suddenly and unexpectedly, the pandemic has prompted people to change their daily routine as well as their personal view of the world, themselves, and of others (<xref ref-type="bibr" rid="B116">Marmarosh et al., 2020</xref>; <xref ref-type="bibr" rid="B200">Vos, 2021</xref>). It is not unusual to read about people changing their lives, their jobs, divorcing, or moving away from home.</p>
<p>Anecdotally, many readers could identify with the above descriptions of transformative experiences (TEs), and several definitions and types of TEs already exist; nevertheless, an interdisciplinary cross-domain operational definition of this complex phenomenon is yet lacking. However, given the consequences of personal transformation, understanding its underpinnings, its elicitors, as well as the boundaries of this process has become an urgent scientific issue.</p>
<p>The complexity within the scientific investigation of TEs unfolds through three levels. First, the exceptional and fascinating nature of this topic has garnered the interest of different disciplines across the years (e.g., <xref ref-type="bibr" rid="B85">James, 1902</xref>; <xref ref-type="bibr" rid="B118">Maslow, 1962</xref>; <xref ref-type="bibr" rid="B123">Mezirow, 1978</xref>; <xref ref-type="bibr" rid="B194">Turner et al., 1986</xref>; <xref ref-type="bibr" rid="B23">Bruner, 1991</xref>; <xref ref-type="bibr" rid="B25">Calhoun and Tedeschi, 1995</xref>; <xref ref-type="bibr" rid="B127">Miller and C&#x2019;de Baca, 2001</xref>; <xref ref-type="bibr" rid="B20">Brown, 2009</xref>; <xref ref-type="bibr" rid="B182">Stone, 2014</xref>; <xref ref-type="bibr" rid="B53">Gaggioli, 2015</xref>; <xref ref-type="bibr" rid="B209">Yaden et al., 2017</xref>; <xref ref-type="bibr" rid="B93">Kason, 2019</xref>), but this endeavor has yet to establish an integrated operational interdisciplinary definition of the term TEs. Specifically, most researchers agree that TEs can be conceived as phenomena able to engender long-lasting, irreversible, pervasive consequences on individuals&#x2019; beliefs, perceptions, identity, and values (for an overview, see <xref ref-type="bibr" rid="B202">White, 1993</xref>; <xref ref-type="bibr" rid="B21">Brown, 2000</xref>; <xref ref-type="bibr" rid="B147">Paul, 2014</xref>; <xref ref-type="bibr" rid="B54">Gaggioli, 2016</xref>). However, this definition captures just one side of the process. Conversely, phenomenological features, elicitors or facilitating conditions enabling a transformative change are still open issues, which have been investigated separately.</p>
<p>Secondly, each discipline (e.g., anthropology, philosophy, psychology, neurobiology, education) has defined and investigated this construct at different levels of analysis. For instance, anthropology has defined this phenomenon at a meso-level of analysis, as strictly related to the specific experience of passage rites in which the central component would concern the break between past and future identities (<xref ref-type="bibr" rid="B197">Van Gennep, 1908</xref>). Philosophy has adopted a broader and a higher-level view of TEs&#x2019; analysis by focusing on their definitory characteristics (<xref ref-type="bibr" rid="B147">Paul, 2014</xref>; <xref ref-type="bibr" rid="B29">Carel and Kidd, 2020</xref>). Psychology has addressed mainly the micro-level of analysis, by elucidating elicitors, correlates, and effects, which have been also used to categorize and distinguish various types of TEs. Finally, a recent neurobiological model by <xref ref-type="bibr" rid="B19">Brouwer and Carhart-Harris (2020)</xref> suggested specific neurological correlates and mechanisms. Education has adopted a separate view on TEs, mainly relying on transformative learning theory (<xref ref-type="bibr" rid="B124">Mezirow, 1997</xref>, <xref ref-type="bibr" rid="B125">2000</xref>), which outlines the steps to make core frames of references malleable to change. Finally, a recent neurobiological model by <xref ref-type="bibr" rid="B19">Brouwer and Carhart-Harris (2020)</xref> introduced the construct of &#x201C;pivotal mental states&#x201D; (PiMSs), defined as &#x201C;transient, intense hyper-plastic mind and brain states&#x201D; (p. 320), to indicate unique states mediating psychological transformation. While the perspectives of various disciplines can contribute to the richness of the understanding of TEs, a synthesis of diverse insights can facilitate research efforts and results.</p>
<p>Different disciplines have focused more on some instances of TEs, instead of others. For instance, in clinical psychology, an increasing attention has been devoted toward traumatic experiences and, recently, to post-traumatic and post-ecstatic experiences (<xref ref-type="bibr" rid="B26">Calhoun and Tedeschi, 2006</xref>; <xref ref-type="bibr" rid="B160">Roepke, 2013</xref>). In experimental psychology the focus has been placed on the concept of complex emotions (<xref ref-type="bibr" rid="B53">Gaggioli, 2015</xref>; <xref ref-type="bibr" rid="B32">Chirico et al., 2016</xref>). In anthropology, there is a long tradition in the study of rites of passage (<xref ref-type="bibr" rid="B197">Van Gennep, 1908</xref>). In the field of education, the focus has been on the process of transformative learning as achieved by means of disorienting dilemmas (<xref ref-type="bibr" rid="B124">Mezirow, 1997</xref>, <xref ref-type="bibr" rid="B125">2000</xref>).</p>
<p>This has brought forth &#x201C;varieties of transformative experience,&#x201D; which still need to be captured within a comprehensive picture including efforts to elucidate their underpinnings. Moreover, some efforts have focused only on specific types of TEs. For instance, <xref ref-type="bibr" rid="B202">White (1993)</xref> and <xref ref-type="bibr" rid="B21">Brown (2000)</xref> introduced a model on &#x201C;exceptional human experiences&#x201D; including near-death experiences (NDEs), encounter-type experiences, and out-of-body experiences (OBEs) analyzed at the psychological and phenomenological level.</p>
<p>In this conceptual analysis, we built upon these theoretical contributions, which were integrated with a more grounded approach, focusing on specific interdisciplinary and cross-domain types of TEs. By elucidating wide varieties of TE, we moved toward an integrated picture of these phenomena, involving a preliminary interdisciplinary operational definition of TEs, using the following methodology. First, all models, theories, and empirical evidence on TEs across specific disciplines (anthropology, philosophy, psychology, neurobiology, and education) and domains (spiritual, religious, technological, educational) were analyzed and integrated with specific instances of TEs that cannot be framed within a specific discipline or domain. Then, the analysis focused on distinctiveness and commonalities among these types of TEs. This turned into indications for achieving a preliminary integrated operational definition of the varieties of TE. Finally, new research directions to improve our understanding of transformative change were presented and discussed.</p>
<sec id="S1.SS1">
<title>A Theoretical Overview</title>
<p>The need for the scientific study of transformation can be traced back to basic evidence. Some types of change can appear as different from others because they occur suddenly, unexpectedly, and without clear clues (<xref ref-type="bibr" rid="B74">Hayes et al., 2007</xref>; <xref ref-type="bibr" rid="B147">Paul, 2014</xref>). Crucially, these types of changes can deeply impact an individual&#x2019;s life in an unpredictable manner (<xref ref-type="bibr" rid="B74">Hayes et al., 2007</xref>); they also can occur in different cultures (<xref ref-type="bibr" rid="B29">Carel and Kidd, 2020</xref>), stages of life (<xref ref-type="bibr" rid="B124">Mezirow, 1997</xref>), and in response to different (potential) elicitors (<xref ref-type="bibr" rid="B54">Gaggioli, 2016</xref>) or apparently spontaneously (<xref ref-type="bibr" rid="B83">Hood, 2014</xref>).</p>
<p>Given the multifaceted, universal, and impactful nature of these phenomena, it is not surprising that several disciplines have sought to understand their essence, describing their functioning, their elicitors, and how to reproduce them. Here, first, we focus on specific disciplines that provide well-established accounts of TEs. Then, examples of acknowledged interdisciplinary instances of TEs are presented and examined.</p>
<sec id="S1.SS1.SSS1">
<title>Anthropology</title>
<p>An anthropological account of transformative change provided in Van Gennep&#x2019;s theory &#x201C;rites of passage,&#x201D; can evidence the intrinsically paradoxical or ambiguous nature of TEs elicitors. Specifically, these unusual circumstances would be able to trigger a <italic>liminality</italic> space (<xref ref-type="bibr" rid="B197">Van Gennep, 1908</xref>) &#x2013; &#x201C;a transformative middle-space in which individuals find themselves in between past and future identities&#x201D; (<xref ref-type="bibr" rid="B53">Gaggioli, 2015</xref>, p. 115) &#x2013; enabling transformation. Turner expanded the concept of liminality by introducing the concept of <italic>liminoid spaces</italic> (<xref ref-type="bibr" rid="B192">Turner, 1974</xref>) &#x2013; out-of-the-ordinary experiences &#x2013; that can be found in leisure, arts, and sports, aside from productive labor. Crucially, these are moments of freedom in which a &#x201C;ludic recombination&#x201D; (<xref ref-type="bibr" rid="B192">Turner, 1974</xref>, p. 61) of cultural factors occurs. Contemporary instances of liminoid spaces could be exceptional experiences far from the ordinary routine, which are highly memorable, very special, emotionally charged, and potentially life altering (<xref ref-type="bibr" rid="B86">Jefferies and Lepp, 2012</xref>, p. 38). For example, these could be unusual journeys (e.g., pilgrimages) (<xref ref-type="bibr" rid="B102">Kirillova et al., 2017</xref>) or extreme sports (e.g., white water rafting, spelunking, or base jumping) (<xref ref-type="bibr" rid="B4">Arnould and Price, 1993</xref>; <xref ref-type="bibr" rid="B53">Gaggioli, 2015</xref>). According to this perspective, then, there should be an out-of-ordinary elicitor/facilitating condition, acting as a liminoid space, to enable transformation. These moments would create a unique space as a potential for recombining existing cultural norms and factors into new patterns.</p>
</sec>
<sec id="S1.SS1.SSS2">
<title>Philosophy</title>
<p>According to <xref ref-type="bibr" rid="B147">Paul (2014)</xref>, out-of-ordinary elicitors should involve the choice to profoundly live a new experience, able to change our life in important ways. However, a TE entails opacity regarding the effects of being involved in such experiences. We do not know what it will be like since we dwell in a mid-suspended moment and we &#x201C;only learn what we need to know after we&#x2019;ve done it, and we change ourselves in the process of doing it&#x201D; (<xref ref-type="bibr" rid="B147">Paul, 2014</xref>, p. 4). Specifically, the seminal model proposed by <xref ref-type="bibr" rid="B147">Paul (2014)</xref> suggested that each TE would encompass both an <italic>epistemic</italic> and a <italic>personal</italic> dimension. At the epistemic level, a TE would allow individuals grasping forms of knowledge unreachable before (&#x201C;only learn what we need to know after we&#x2019;ve done it&#x201D;; <xref ref-type="bibr" rid="B147">Paul, 2014</xref>, p. 4). At the personal level, a TE can deeply change people&#x2019; values, priorities, and self-conception deeply, thus transforming an individuals&#x2019; identity (&#x201C;we change ourselves in the process of doing it&#x201D;; <xref ref-type="bibr" rid="B147">Paul, 2014</xref>, p. 4). This personal dimension consists of an irreversible cognitive shift leading to new frameworks of reference for differently viewing ourselves and others, thus, marking a clear &#x201C;before&#x201D; and &#x201C;after.&#x201D;</p>
<p>Recently, Carel and Kidd &#x2018;s (2020) work broadened Paul&#x2019;s conception on the role of human agency in TEs&#x2019; emergence, by elaborating more on personal and contextual constraints and affordances that can limit human control over choices. The two scholars framed Paul&#x2019;s TEs within the category of (1) <italic>voluntary</italic> TEs, adding two more types of TEs imposed by life: (2) <italic>non-voluntary</italic> (e.g., being arrested and sent to Nazi concentration camps, as in the case of Primo Levi), and (3) <italic>involuntary TEs</italic> (e.g., saving a child who was being hit by a car remaining severely injured).</p>
<p>This dimension &#x2013; namely, <italic>intentionality</italic> &#x2013; allowed for a more detailed nature of TEs&#x2019; elicitors. These inductors entail a dimension of <italic>contingency</italic> (i.e., the occurrence of casual and unpredicted situational conditions); <italic>vulnerability</italic> (i.e., the helpless and unavoidable exposure to many kinds of affliction); and <italic>subjection</italic> (i.e., the condition of undergoing a certain event with a lack of control over it). Moreover, this broader view on TEs included also negative and ambivalent forms of transformation. Finally, and importantly, according to this model, TEs cannot be seen just as sudden life-changing moments, instead, also as the apical result of a sequence of cumulative small ordinary changes.</p>
</sec>
<sec id="S1.SS1.SSS3">
<title>Psychology</title>
<p>Contrary to <xref ref-type="bibr" rid="B29">Carel and Kidd&#x2019;s (2020)</xref> work &#x2013; which also endorsed a gradual path to TEs &#x2013; in the clinical psychological domain, <xref ref-type="bibr" rid="B127">Miller and C&#x2019;de Baca (2001)</xref>, drawing from the lexicon and models of quantum physics, preferred the label &#x201C;quantum change,&#x201D; focusing more on the impacting nature of TEs. Specifically, a quantum change would consist of a breaking point in which a radical change must occur irreversibly. According to the two scholars, there would be two types of quantum changes, as two instances of TEs: (1) <italic>insightful</italic> quantum changes, that are mainly <italic>cognitive</italic> in nature and can be associated with insight; (2) <italic>mystical</italic> quantum changes, having a more <italic>emotional</italic> character and similar to mystical experiences (MEs) (<xref ref-type="bibr" rid="B126">Miller, 2004</xref>). These categorizations suggested the need for emphasizing the cognitive side over the emotional one or vice versa, according to the type of TE.</p>
<p>Building upon previous psychological contributions on TEs, <xref ref-type="bibr" rid="B204">White (2004)</xref> outlined some key psychological features of transformational change. TEs were defined as unexpected, brief experiences, usually remembered vividly, entailing enduring, and comprehensive effects (i.e., they represent a &#x201C;revolution in character&#x201D;; <xref ref-type="bibr" rid="B204">White, 2004</xref>, p. 465), in which the person acts more as a &#x201C;recipient,&#x201D; rather than an &#x201C;initiator&#x201D; (p. 464), and which are positive in nature. However, this last feature has emerged as the most questionable.</p>
<p>For instance, the impacting - whether cognitive or emotional - nature of TEs was further elaborated by <xref ref-type="bibr" rid="B26">Calhoun and Tedeschi (2006)</xref> who focused on stressful and traumatic events as key elicitors of both negative (traumatic) and positive (&#x201C;posttraumatic growth,&#x201D; PTG) changes that have &#x201C;quality of transformation&#x201D; (p. 2). (<xref ref-type="bibr" rid="B25">Calhoun and Tedeschi, 1995</xref>, <xref ref-type="bibr" rid="B26">2006</xref>). Specifically, traumatic events can result in deep, sometimes irreversible, and negative change, in which suffering disrupts individuals&#x2019; functioning. Moreover, traumas can impact individuals&#x2019; schemas and beliefs, leading also to structured syndromes such as the posttraumatic stress disorder (PTSD). Crucially, the appraisal of these events, in terms of controllability, expectancy, and probability plays a key role in the process of coping with it (<xref ref-type="bibr" rid="B101">Kira, 2001</xref>). After the occurrence of those traumatic events, sense of time distortion and bodily distortion are considered precursors of posttraumatic disorder in specific circumstances (<xref ref-type="bibr" rid="B121">McNally, 2003</xref>).</p>
<p>Instead, PTG occurs when the individual, after facing a traumatic struggle, changes permanently and positively, going above and beyond resilience and finding durable benefits (<xref ref-type="bibr" rid="B31">Carver, 1998</xref>). PTG is defined as a &#x201C;positive change experienced as a result of the struggle with trauma&#x201D; (<xref ref-type="bibr" rid="B25">Calhoun and Tedeschi, 1995</xref>; <xref ref-type="bibr" rid="B100">Kilmer, 2006</xref>). This definition emphasizes the transformative quality of responding to highly stressful and/or traumatic events (<xref ref-type="bibr" rid="B26">Calhoun and Tedeschi, 2006</xref>). The intense and dramatic experience of trauma, indeed, fosters a powerful potential for psychological transformation, as it alters the normal stable structure of the mind (<xref ref-type="bibr" rid="B71">Grof, 2000</xref>). A person&#x2019;s pretrauma beliefs concerning the world as a just, benevolent, and controllable place can be replaced by new views, in which the negative and the positive effects of a traumatic event are combined, thus turning into a more elaborated, and complex conception of themselves and of the world (<xref ref-type="bibr" rid="B146">Park, 2004</xref>). In this sense, adverse events, or potentially traumatic events (e.g., developmental adversity, disability, and mental health problems) have been indicated as diversifying experiences &#x2013; highly unusual and not predictable but being able to push individuals &#x201C;outside the realm of normality&#x201D; (<xref ref-type="bibr" rid="B155">Ritter et al., 2012</xref>) &#x2013; able to promote forms of creative adaptation in terms of reframing an experience using new cognitive and emotional lenses (<xref ref-type="bibr" rid="B141">Orkibi and Ram-Vlasov, 2019</xref>). In the end, it should be noted that not all traumas and PTGs are transformative: when they lead individuals to a relevant and permanent psychological transformation, they could be considered as TEs. Research on traumatic and stressful events has generally focused on individuals&#x2019; transformation related to suffering and turmoil events (<xref ref-type="bibr" rid="B97">Kesimci et al., 2005</xref>; <xref ref-type="bibr" rid="B91">Kashdan and Kane, 2011</xref>), thus excluding perceived positive events as potential triggers of transformative growth.</p>
<p>Conversely, the framework of post-ecstatic growth (PEG) (<xref ref-type="bibr" rid="B160">Roepke, 2013</xref>) considers life events that enhance positive emotions, such as elevation and awe, as new possible triggers able to boost personal growth (<xref ref-type="bibr" rid="B96">Keltner and Haidt, 2003</xref>; <xref ref-type="bibr" rid="B51">Fredrickson, 2004</xref>; <xref ref-type="bibr" rid="B186">Taubman-Ben-Ari et al., 2012</xref>). Indeed, PEG concerns the idea of thriving also after highly impacting and positive experiences, giving as a result moral growth as well as deeper and closer relationships (<xref ref-type="bibr" rid="B114">Mangelsdorf and Eid, 2015</xref>).</p>
<p>Thus, in terms of factual post-event growth, there is a significant overlap in the perceived benefits of PTG and PEG, even though they are opposite in terms of valence and triggers (<xref ref-type="bibr" rid="B160">Roepke, 2013</xref>). However, for the purposes of this analysis, the valence of eliciting factors and outcomes is crucial to distinguish among these experiences, which consist mainly of the same processes. More specifically, triggers can have different valence and outcomes: (1) negative valence and outcomes for traumatic events that individuals were not able to accommodate and to cope with; (2) positive valence and outcomes for PEGs; (3) a negative valence but a positive outcome for PTGs, as in this case, individuals who lived a trauma were able to accommodate and to cope with it, gaining a positive as well as transformative outcome.</p>
</sec>
<sec id="S1.SS1.SSS4">
<title>Human&#x2013;Computer Interaction</title>
<p>Recently, the interest toward transformative and self-transcendent experiences (STEs) has grown also in the field of human computer interaction (<xref ref-type="bibr" rid="B54">Gaggioli, 2016</xref>; <xref ref-type="bibr" rid="B104">Kitson et al., 2019</xref>), and experience design (<xref ref-type="bibr" rid="B13">Blythe and Buie, 2021</xref>). Specifically, <xref ref-type="bibr" rid="B54">Gaggioli (2016)</xref> collected all these endeavors and developed a novel framework concerning how interactive technologies [e.g., virtual reality (VR)] can be used to elicit TEs. This is the transformative experience design (TED) model (<xref ref-type="bibr" rid="B54">Gaggioli, 2016</xref>). Transformative features associated to effective elicitors of TEs were identified on the basis of three technological assets: (1) medium, (2) content, and (3) purpose.</p>
<p>Regarding the medium, immersive VR was suggested as the best candidate to invite these <italic>technologically mediated</italic> TEs by enhancing the ecological validity of even complex experiences in the lab, thanks to the sense of presence (<xref ref-type="bibr" rid="B6">Barfield and Weghorst, 1993</xref>; <xref ref-type="bibr" rid="B157">Riva et al., 2004</xref>, <xref ref-type="bibr" rid="B158">2011</xref>). Specifically, VR can be (and it has already resulted as) a valid source for experiencing new worlds, for challenging and restructuring individuals&#x2019; cognitive schemas, and as key mechanisms and correlates of TEs (<xref ref-type="bibr" rid="B54">Gaggioli, 2016</xref>; <xref ref-type="bibr" rid="B156">Riva et al., 2016</xref>; <xref ref-type="bibr" rid="B42">Chirico., in press</xref>). VR, indeed, allows individuals to alter their own bodily self-consciousness, providing the illusion of being placed in a different body. This is a useful asset for generating a sense of detachment from the actual body, as in the case of OBEs, later discussed. Further, VR can also cause modulation and recalibration of time perception (<xref ref-type="bibr" rid="B5">Bansal et al., 2019</xref>), which is a common feature of TEs.</p>
<p>Crucially, drawing from <xref ref-type="bibr" rid="B147">Paul (2014)</xref> philosophical model on TEs, the TED model suggested that technology-based TE content should involve both epistemic and emotional affordances (<xref ref-type="bibr" rid="B54">Gaggioli, 2016</xref>). The former is included within circumstances designed to stimulate reflection and trigger insight (<xref ref-type="bibr" rid="B53">Gaggioli, 2015</xref>), as the artificial representation of disorienting dilemmas, recalling <xref ref-type="bibr" rid="B125">Mezirow (2000)</xref> pedagogical theory. The latter are defined as perceptual stimuli aimed to boost a deep emotional engagement by evoking feelings of interest, curiosity, inspiration, or awe.</p>
<p>Finally, the general purpose of a technologically mediated TE is the creation of new transformative possibilities. In this regard, such TEs should let individuals enter a space of liminality, as suggested by anthropology perspective, described, according to the definition of <xref ref-type="bibr" rid="B192">Turner (1974)</xref> as an unfamiliar and disorienting place that creates room for reviewing and deconstructing life meaning (<xref ref-type="bibr" rid="B193">Turner, 1985</xref>). In other words, allowing people to experience impossible internal and external realities through VR (i.e., by modifying their own body perception, or by letting them experience the body and the perspective of another person, or again by allowing them to explore impossible and unknown environments where physics&#x2019; laws are violated) can lead them to destabilize their own mental schemes, deconstructing and reconstructing them in a new way. To date, this approach has been effective in eliciting specific transformative emotional states (<xref ref-type="bibr" rid="B38">Chirico et al., 2018a</xref>), as well as key micro-mechanisms related to the emergence of a TE, such as schema violations (<xref ref-type="bibr" rid="B155">Ritter et al., 2012</xref>).</p>
<p>However, further technological media can also be deemed as possible means to elicit TEs (<xref ref-type="bibr" rid="B57">Gaylinn, 2005</xref>). A more traditional medium, like movies, can be considered as a catalyst for personal and social growth and development (<xref ref-type="bibr" rid="B129">Morin, 2005</xref>; <xref ref-type="bibr" rid="B90">Kaplan, 2013</xref>). Transformative potential of movies has been widely explored in the education domain, by focusing on impactful masterpieces, such as Dead Poets Society<sup><xref ref-type="fn" rid="footnote1">1</xref></sup> (<xref ref-type="bibr" rid="B178">Spirou, 2016</xref>) or Billy Elliot<sup><xref ref-type="fn" rid="footnote2">2</xref></sup> (<xref ref-type="bibr" rid="B169">Schwarz-Franco, 2016</xref>). Finally, recently, also artificial intelligence (AI) has been proposed as a powerful technology able to trigger a societal change from a narrower sectorial level to a higher radical one, and always in an irreversible way (<xref ref-type="bibr" rid="B72">Gruetzemacher and Whittlestone, 2022</xref>). For instance, at the narrower level, the artistic domain has been increasingly influenced by different AI applications, including more collaborative forms of artistic production in music (<xref ref-type="bibr" rid="B120">McCormack et al., 2020</xref>), in figurative art (<xref ref-type="bibr" rid="B168">Schr&#x00F6;ter, 2019</xref>), and in fashion (<xref ref-type="bibr" rid="B95">Kautish and Khare, 2022</xref>).</p>
</sec>
<sec id="S1.SS1.SSS5">
<title>Neurobiology</title>
<p><xref ref-type="bibr" rid="B19">Brouwer and Carhart-Harris (2020)</xref> provided a neurobiological explanation for the emergence of PTG or traumatic potential consequences of transformation, by relying on the theory of dynamical systems (<xref ref-type="bibr" rid="B99">Kielh&#x00F6;fer, 2011</xref>). Specifically, they suggested that when an individual is involved in a long-lasting period of crisis (chronic stress), acute stress can trigger PiMSs &#x2013; i.e., &#x201C;transient, intense hyper-plastic mind and brain states&#x201D; (<xref ref-type="bibr" rid="B19">Brouwer and Carhart-Harris, 2020</xref>, p. 320) &#x2013; able to mediate psychological transformation. Crucially, also the surroundings and the relational context were indicated as key factors interacting with the neurobiological system to define the quality and outcomes of a PiMS.</p>
<p>Pivotal mental states involve the serotonin system and its 2A receptor subtype (5-HT2AR). Various acute stressors consistently induce serotonin release, upregulating 5-HT2AR expression specifically in the cerebral cortex (<xref ref-type="bibr" rid="B3">Anju et al., 2010</xref>; <xref ref-type="bibr" rid="B8">Benekareddy et al., 2011</xref>; <xref ref-type="bibr" rid="B60">Godar et al., 2019</xref>). Further, direct stimulation of the 5-HT2AR can induce enhanced associative learning and psychological transformation, and it can be stimulated by both spontaneous extreme stress and relevant doses of psychedelic drugs (<xref ref-type="bibr" rid="B87">Jo&#x00EB;ls et al., 2006</xref>; <xref ref-type="bibr" rid="B75">Hefferon et al., 2009</xref>; <xref ref-type="bibr" rid="B18">Briere et al., 2015</xref>). The mechanisms underlying PiMSs would aid rapid and deep learning in situations of existential crisis, catalyzing psychological change when circumstances demand this. Thus, according to this perspective, <italic>learning</italic> &#x2013; rapid and associative &#x2013; was considered as an essential consequence of transformation, both stemming from spontaneous acute stress (as in traumatic and PTG experiences) or induced, for instance, by psychedelics.</p>
</sec>
<sec id="S1.SS1.SSS6">
<title>Education</title>
<p>A full, comprehensive model of how transformation works and can be facilitated in the learning process can be found in the domain of education. <xref ref-type="bibr" rid="B123">Mezirow (1978)</xref> elaborated on the theory of transformative learning as a specific transformative process taking place in education and resulting in both a deep change in a frame of reference (<xref ref-type="bibr" rid="B124">Mezirow, 1997</xref>, <xref ref-type="bibr" rid="B125">2000</xref>; <xref ref-type="bibr" rid="B165">Sawatsky et al., 2018</xref>) and a shift in thinking, which irreversibly alters the way individuals are and act (<xref ref-type="bibr" rid="B44">Coghlan and Gooch, 2011</xref>; <xref ref-type="bibr" rid="B182">Stone, 2014</xref>). The main elicitor of a transformative learning process can be a &#x201C;disorienting dilemma&#x201D; (<xref ref-type="bibr" rid="B124">Mezirow, 1997</xref>) (e.g., a field trip) (<xref ref-type="bibr" rid="B77">Herbers and Mullins Nelson, 2009</xref>) that challenges usual mental schemas. The disorienting dilemma would lead to a cognitive self-examination, along with feelings of guilt or shame. This leads to recognizing discontentment, thanks to which individuals can express and negotiate their change through discourse, moving to explore new options for roles, relationships, and actions. According to this view, emotions and feelings would provide not only the trigger to reflect critically, but also the substance on which to reflect deeply, so that the cognitive and emotional components become strictly related. Expected outcomes entail learners become &#x201C;more inclusive, discriminating, open, emotionally capable of change, and reflective so that they may generate beliefs and opinions that will prove truer or justified to guide action&#x201D; (<xref ref-type="bibr" rid="B125">Mezirow, 2000</xref>, p. 7). Main interdisciplinarity reported outcomes concern the following typologies: worldview; self; epistemology; ontology; behavior; capacity (<xref ref-type="bibr" rid="B79">Hoggan, 2016</xref>).</p>
</sec>
<sec id="S1.SS1.SSS7">
<title>Grounding Transformative Experiences: Specific Instances of Transformation</title>
<p>Since not all studies on TEs can be framed within a specific discipline, we also chose a more grounded approach to capture all the studies conducted on this phenomenon, that is, we focused on instances of TEs occurring in specific domains and acknowledged as TEs. For instance, interdisciplinary works, combining psychological, neurobiological, sociological, and philosophical approaches, focusing only on a peculiar type of TE are discussed.</p>
<sec id="S1.SS1.SSS7.Px1">
<title>Religious Conversion</title>
<p>Within the religious domain, the transformation par excellence coincides with the phenomenon of religious conversion. Several sociological and psychological endeavors have successfully accounted for their emergence, features, underlying mechanisms, timeframes, role of the individual, and effects, but several open questions still remain (<xref ref-type="bibr" rid="B175">Snook et al., 2019</xref>). At a micro-level of analysis conversion is conceived as a core identity change (beliefs and personality). For instance, recently, it has been shown that religious conversion phenomena entail personality changes as a key effect (<xref ref-type="bibr" rid="B183">Stronge et al., 2021</xref>). In psychology, religious conversion has been investigated using the first-hand experiences of Tolstoy, Bunyan, Edwards (etc.). <xref ref-type="bibr" rid="B85">James (1902)</xref>, in the <italic>The Varieties of Religious Experience</italic> identified two types of conversions. The <italic>volitional type</italic> concerned situations in which &#x201C;the regenerative change is usually gradual, and consists in the building up, piece by piece, of a new set of moral and spiritual habits&#x201D; (<xref ref-type="bibr" rid="B85">James, 1902</xref>, p. 189). The <italic>self-surrender type</italic>, emerged as an unconscious and involuntary surrender of the individual, after an intense internal struggle between one&#x2019;s aspirations and an internal hindrance. A paradigmatic example concerns the transformation of Saul (the persecutor) into Paul, the saint, as a <italic>Road to Damascus Moment</italic>, which stemmed from a supernatural experience of <italic>calling</italic> (<xref ref-type="bibr" rid="B208">Yaden and Newberg, 2015</xref>). Crucially, as in Carel and Kidd&#x2019;s philosophical model, also in William James&#x2019; vision, it would be possible to identify a more gradual view of TE emergence. Anthropological accounts of religious conversion have acted as a key trait d&#x2019;union among different disciplines, including psychology (<xref ref-type="bibr" rid="B162">Rotman, 2021</xref>).</p>
<p>Finally, mainly the sociological perspective, at a macro-level, focused on how cultural and social factors (e.g., economy, socioeconomic status, ethnicity, etc.) can influence the identities and beliefs of a potential convert (<xref ref-type="bibr" rid="B175">Snook et al., 2019</xref>). Generally, current accounts of conversion suggest an active role for the convert and a low impact of external, supernatural, and irresistible forces (<xref ref-type="bibr" rid="B175">Snook et al., 2019</xref>).</p>
</sec>
<sec id="S1.SS1.SSS7.Px2">
<title>Self-Transcendent, Emotionally Complex, Peak, and Mystical Experiences</title>
<p>Spirituality is a wide domain of study, which goes beyond the realm of religion, even though the two overlap to some extent. Within this intersection, it would be possible to include STEs, which have a strong spiritual character and can be detached from any religious tradition. These experiences can be defined as transient mental states marked by decreased self-salience and increased feelings of connectedness (<xref ref-type="bibr" rid="B209">Yaden et al., 2017</xref>), although as for TEs, the definition of self-transcendence varies across disciplines (<xref ref-type="bibr" rid="B105">Kitson et al., 2020</xref>). When a STE is highly intense, it also shows a high transformative potential (<xref ref-type="bibr" rid="B210">Yaden et al., 2016a</xref>,<xref ref-type="bibr" rid="B209">2017</xref>). Potential conditions facilitating the emergence of these states can be paradoxical VR environments (<xref ref-type="bibr" rid="B103">Kitson and Riecke, 2018</xref>), psychedelic substances (<xref ref-type="bibr" rid="B56">Garcia-Romeu et al., 2015</xref>), spiritual instructions, dance, prayer (<xref ref-type="bibr" rid="B56">Garcia-Romeu et al., 2015</xref>), meditation (<xref ref-type="bibr" rid="B73">Hanley et al., 2020</xref>). Also peculiar social events, such as festival and parades, designed <italic>ad hoc</italic>, could bring forth self-transcendent shared experiences (<xref ref-type="bibr" rid="B135">Neuhofer et al., 2020</xref>). Therefore, STEs do not always occur as private moments, instead, the social sharing of this experience, here, emerges as a key trigger (and not just effect or correlate) for these phenomena. At the physiological level, lower respiration rate has been found to be positively correlated to a higher level of mindfulness (<xref ref-type="bibr" rid="B2">Ahani et al., 2014</xref>), while on the contrary, STEs have been found to induce an increase in alpha and theta EEG power (<xref ref-type="bibr" rid="B24">Cahn and Polich, 2006</xref>).</p>
<p>Self-transcendent experiences could be placed on a continuum, as they encompass a collection of phenomena ranging from mindfulness, flow, and ST emotions to TEs of awe, peak experiences, and MEs (<xref ref-type="bibr" rid="B209">Yaden et al., 2017</xref>).</p>
<p>First, as core transformative elements of a STE, it would be possible to identify special emotional states deemed as complex and transformative (<xref ref-type="bibr" rid="B34">Chirico and Gaggioli, 2021b</xref>; <xref ref-type="bibr" rid="B41">Chirico et al., 2021c</xref>), such as the emotion of awe (<xref ref-type="bibr" rid="B35">Chirico and Yaden, 2018c</xref>; <xref ref-type="bibr" rid="B43">Clewis et al., 2022</xref>). These specific emotions encompass the two main dimensions of STE, that is, connectedness and the small self. Moreover, they can be elicited by a variety of inductors, including specific VR simulations (<xref ref-type="bibr" rid="B37">Chirico et al., 2021a</xref>). At the physiological level, for example, awe results as a mixed valenced emotional state, as captured by electromyographic measures (EMGs) and testified by a concurrent activation of the parasympathetic nervous system and withdrawal of the sympathetic one (<xref ref-type="bibr" rid="B33">Chirico et al., 2017</xref>). Positive awe has been positively related to the central alpha and the beta band. It also showed negative correlations with the gamma band (<xref ref-type="bibr" rid="B84">Hu et al., 2017</xref>). After an experience of awe, indeed, individuals have shown more prosocial attitudes and behaviors toward other people and nature, as well as decreased aggressivity, increased generosity (<xref ref-type="bibr" rid="B149">Piff et al., 2015</xref>; <xref ref-type="bibr" rid="B181">Stellar et al., 2018</xref>), enhanced creative thinking abilities (<xref ref-type="bibr" rid="B39">Chirico et al., 2018b</xref>), and decreases in the cognitive emotion regulation strategy of rumination (<xref ref-type="bibr" rid="B110">Lopes et al., 2020</xref>). At the same time, when the awe experience is negatively connotated, it has been associated with the feeling of fear and powerlessness, loss of self-control, uncertainty, and lowered sense of situational control (<xref ref-type="bibr" rid="B149">Piff et al., 2015</xref>; <xref ref-type="bibr" rid="B180">Stellar et al., 2017</xref>).</p>
<p>Secondly, peak experiences can be seen as prototypical transformative examples of STEs (<xref ref-type="bibr" rid="B119">Maslow, 1964</xref>) consisting in a moment of elevated inspiration and enhanced well-being that can permanently influence individuals&#x2019; attitudes toward life and that can occur in all cultures (<xref ref-type="bibr" rid="B118">Maslow, 1962</xref>). Several characteristics are associated with peak experiences, including the perception that the world is good, beautiful, and desirable. Additional features are mainly emotional, such as feelings of being lucky, fortunate, or graced. Other features are more related to space and time dimensions, describing usual disorientation and strain for both. Peak experiences are also known for their short duration, although time perception could be expanded. They can be observed during a learning process (<xref ref-type="bibr" rid="B107">Lanier et al., 1996</xref>), during peak performance, sports activities (<xref ref-type="bibr" rid="B151">Privette, 1983</xref>), and within the musical domain (<xref ref-type="bibr" rid="B52">Gabrielsson et al., 2016</xref>). They can be triggered in various contexts, also in response to psychological turmoil (<xref ref-type="bibr" rid="B187">Taylor, 2012</xref>), and nature exposure (<xref ref-type="bibr" rid="B131">Naor and Mayseless, 2020</xref>). Among frequent aftereffects, there are heightened feelings of happiness, joy, and ecstasy, as well as fulfillment, peak performance; and, generally, psychological effects are seen as dependent on the context of emergence of peak experiences (<xref ref-type="bibr" rid="B107">Lanier et al., 1996</xref>; <xref ref-type="bibr" rid="B176">Solberg and Dibben, 2019</xref>).</p>
<p>Finally, MEs can also occur during structured spiritual or religious practices or even unintentionally (<xref ref-type="bibr" rid="B7">Barrett and Griffiths, 2017</xref>). These phenomena have been deemed as a particularly intense variety of self-transcendent TEs (<xref ref-type="bibr" rid="B209">Yaden et al., 2017</xref>) that hinge on a sense of reality far from ordinary experiences and that are characterized by feelings of unity with the whole reality (<xref ref-type="bibr" rid="B28">Carde&#x00F1;a et al., 2017</xref>). Initial characterizations of MEs suggested &#x2013; within the variety of MEs &#x2013; either a mysticism of introspection or of unifying vision (<xref ref-type="bibr" rid="B143">Otto, 1932</xref>). Indeed, MEs alter some key aspects of consciousness, such as the sense of time and space (<xref ref-type="bibr" rid="B81">Hood, 1975</xref>; <xref ref-type="bibr" rid="B85">James, 1902</xref>; <xref ref-type="bibr" rid="B137">Newberg and d&#x2019;Aquili, 2008</xref>; <xref ref-type="bibr" rid="B113">MacLean et al., 2012</xref>). In addition, if they are induced by psilocybin, they also encompass the dimensions of sacredness and positive moods (<xref ref-type="bibr" rid="B113">MacLean et al., 2012</xref>). For instance, <xref ref-type="bibr" rid="B179">Stace (1960)</xref> stated that an ultimate unity &#x201C;is the very essence of all mystical experiences&#x201D; (p. 132), which can be further detailed as introvertive (characterized by a pure consciousness overcoming the boundaries of space and time) vs. extrovertive (featuring an &#x201C;inner subjectivity of life in all things&#x201D;; <xref ref-type="bibr" rid="B179">Stace, 1960</xref>, p. 131). These two types of MEs also share a sense of objectivity, peace, sense of sacredness, paradoxicality, and supposed ineffability (<xref ref-type="bibr" rid="B207">Wulff, 2014</xref>). At the emotional level, MEs entail mixed feelings ranging from fear to intense positive feelings (<xref ref-type="bibr" rid="B196">van der Tempel and Moodley, 2020</xref>). At the phenomenological level, these experiences have been described as brief, ineffable, and overwhelming (<xref ref-type="bibr" rid="B209">Yaden et al., 2017</xref>). <xref ref-type="bibr" rid="B85">James (1902)</xref> particularly highlighted that MEs possess <italic>ineffability</italic> and <italic>noetic</italic> quality (i.e., they reveal an otherwise hidden or inaccessible knowledge), and, sometimes, a sense of passivity and transiency. Other authors stated that MEs entail the perception that the self is perfectly integrating with one&#x2019;s surroundings (<xref ref-type="bibr" rid="B85">James, 1902</xref>; <xref ref-type="bibr" rid="B179">Stace, 1960</xref>; <xref ref-type="bibr" rid="B136">Newberg and d&#x2019;Aquili, 2000</xref>; <xref ref-type="bibr" rid="B82">Hood, 2002</xref>). Overall, MEs are associated to positive psychological outcomes, such as an enhanced sense of connectedness, meaning in life, positive affect (e.g., more compassion toward self and the others), or a deeper sense of identity (<xref ref-type="bibr" rid="B17">Brett, 2010</xref>; <xref ref-type="bibr" rid="B138">Nixon, 2012</xref>; <xref ref-type="bibr" rid="B56">Garcia-Romeu et al., 2015</xref>; <xref ref-type="bibr" rid="B40">Chirico et al., 2022</xref>).</p>
<p>When MEs are spontaneous they can maximally challenge an individual&#x2019;s worldview, sometimes triggering emotional distress, confusion, and increased severity of previous psychological problems (for an overview, see <xref ref-type="bibr" rid="B196">van der Tempel and Moodley, 2020</xref>). When MEs are induced, they tend to reinforce previous religious schemas (<xref ref-type="bibr" rid="B145">Pargament et al., 2005</xref>).</p>
<p>Crucially, MEs can emerge in different ways, such as during sacred ritual, aesthetic experiences, physical illness, and meditation. Recently, <xref ref-type="bibr" rid="B47">Evans and Lynn (2021)</xref>, showed that even a brief 5-min hypnosis induction could foster MEs in the lab. Longer hypnotic inductions can result in high levels of MEs in the lab (from a moderate to a great degree) in one-third of participants, as a function of their hypnotic suggestibility. MEs can be occasioned also by the psychedelic substance psilocybin in laboratory settings (for an overview, see <xref ref-type="bibr" rid="B88">Johnson et al., 2019</xref>), resulting in experiences comparable to those occurring in other settings both deliberately facilitated and occurring apparently spontaneously (<xref ref-type="bibr" rid="B83">Hood, 2014</xref>; <xref ref-type="bibr" rid="B211">Yaden et al., 2017b</xref>). At the neural level, the disintegration of different brain networks has been associated to a sense of dissolved self and altered salience processing (<xref ref-type="bibr" rid="B30">Carhart-Harris et al., 2016</xref>; <xref ref-type="bibr" rid="B201">Wahbeh et al., 2018</xref>).</p>
</sec>
<sec id="S1.SS1.SSS7.Px3">
<title>Exceptional Bodily Experiences</title>
<p>The role of the body represents a crucial aspect that has not emerged before from the analysis of TEs provided within each discipline. Specifically, there is a class of TEs in which the body acquires a central role. It is the case of exceptional bodily experiences, in which the transformation is canalized and expressed through the body. This class of TEs can include: (1) kundalini awakenings; (2) NDEs; (3) OBEs.</p>
<p>In Hinduism, <italic>Kundalini awakenings</italic> reflect the release of inner energies through various forms, accompanied by several specific physical phenomena, such as feelings of energy in the hands, deep ecstatic sensations, and awareness of energy currents flowing through the body (<xref ref-type="bibr" rid="B188">Taylor, 2015</xref>; <xref ref-type="bibr" rid="B206">Woollacott et al., 2020</xref>) from the base of the spine (<xref ref-type="bibr" rid="B62">Greyson, 1993</xref>). These physical sensations are associated with a sense of joy and deep interconnectedness with others (<xref ref-type="bibr" rid="B61">Grey, 1985</xref>; <xref ref-type="bibr" rid="B154">Ring and Agar, 1986</xref>; <xref ref-type="bibr" rid="B142">Ossoff, 1993</xref>; <xref ref-type="bibr" rid="B94">Kason and Degler, 1996</xref>; <xref ref-type="bibr" rid="B46">De Lubac, 1999</xref>; <xref ref-type="bibr" rid="B93">Kason, 2019</xref>). The energetic awakening involves feelings of expansion and a dissociative and conscious awareness of leaving the body, and a sense of being enveloped in light or love (<xref ref-type="bibr" rid="B206">Woollacott et al., 2020</xref>). It can range from mild to intense feelings of joy to dramatic states (<xref ref-type="bibr" rid="B189">Taylor, 2017</xref>). As a result, kundalini awakenings entail long-term transformations in <italic>beliefs</italic> and <italic>values</italic>, including an increase in love for family, the desire to serve others, a belief in spiritual immortality, as well as deeper spiritual insights (<xref ref-type="bibr" rid="B206">Woollacott et al., 2020</xref>). According to western researchers, kundalini awakenings can occur in several circumstances, either spontaneously or induced (e.g., meditation, psychological turmoil, psychedelics), and they show a certain degree of overlap with NDEs (<xref ref-type="bibr" rid="B153">Ring, 1984</xref>; <xref ref-type="bibr" rid="B62">Greyson, 1993</xref>, <xref ref-type="bibr" rid="B64">2000</xref>; <xref ref-type="bibr" rid="B164">Sanches and Daniels, 2008</xref>; <xref ref-type="bibr" rid="B187">Taylor, 2012</xref>).</p>
<p>In NDEs, &#x2013; an acronym coined by Dr. Raymond <xref ref-type="bibr" rid="B128">Moody (1975)</xref> &#x2013; the body is a key element (<xref ref-type="bibr" rid="B80">Holden et al., 2009</xref>). This non-ordinary state of consciousness emerges in response to a real or perceived proximity to death and entails &#x2013; among other phenomenological correlates (<xref ref-type="bibr" rid="B63">Greyson, 1983</xref>) &#x2013; the perception of leaving the body boundaries, traveling through a tunnel, and of being in front of an irreversible threshold (<xref ref-type="bibr" rid="B117">Martial et al., 2020</xref>). Individuals who survive them share a transformative sense of cosmic unity, transcendence of time and space, deep positive mood, sense of sacredness, noetic quality of intuitive illumination, paradoxicality, ineffability, transiency, and persistent positive aftereffects (<xref ref-type="bibr" rid="B139">Noyes and Slymen, 1979</xref>; <xref ref-type="bibr" rid="B65">Greyson, 2006</xref>). NDEs&#x2019; transformations are deep and long-lasting, with permanent and usually positive results (<xref ref-type="bibr" rid="B130">Morse, 1994</xref>; <xref ref-type="bibr" rid="B171">Simpson, 2001</xref>). For a comprehensive overview of NDEs, see <xref ref-type="bibr" rid="B66">Greyson (2015)</xref>.</p>
<p>Although NDEs share many similarities with OBEs &#x2013; and actually, may include OBEs (<xref ref-type="bibr" rid="B11">Blanke and Arzy, 2005</xref>; <xref ref-type="bibr" rid="B12">Blanke et al., 2016</xref>), they are quite different. Their major point of difference is that OBEs, conversely to NDEs, are not necessarily perceived as a threat to one&#x2019;s life, conversely to NDEs (<xref ref-type="bibr" rid="B134">Nelson et al., 2006</xref>). OBEs are states during which the self appears to occupy a position spatially apart from the experiencer&#x2019;s body (elevated extracorporeal location) (<xref ref-type="bibr" rid="B12">Blanke et al., 2016</xref>), involving both visual and somesthetic perception in which one&#x2019;s own physical body is illusory (<xref ref-type="bibr" rid="B174">Smith and Messier, 2014</xref>). OBEs&#x2019; transformative impact on an individual&#x2019;s psychological well-being has been recognized (<xref ref-type="bibr" rid="B156">Riva et al., 2016</xref>), followed by an increasing interest in their healing potential (<xref ref-type="bibr" rid="B170">Sellers, 2019</xref>). OBEs and NDEs are similar both for their transformative outcomes and their nature, as they involve a dissociation from the body and hyper-real sensorial, perceptual, cognitive as well as affective processes (<xref ref-type="bibr" rid="B12">Blanke et al., 2016</xref>). NDEs are even less common than OBEs, with OBEs generally occurring rarely in lifetime (no more than once or twice) (<xref ref-type="bibr" rid="B12">Blanke et al., 2016</xref>).</p>
<p>Kundalini awakenings, NDEs, and OBEs can be considered three different manifestations of a sudden transformation unfolding through the body. However, the elicitors (or triggers) most frequently associated to these kinds of TEs are different. For example, elicitors could be traumatic events for NDEs (<xref ref-type="bibr" rid="B64">Greyson, 2000</xref>), e.g., cardiac arrest (<xref ref-type="bibr" rid="B199">Van Lommel et al., 2001</xref>), and meditation for kundalini awakenings (<xref ref-type="bibr" rid="B206">Woollacott et al., 2020</xref>). Crucially, OBEs can be caused, besides specific pathological conditions (e.g., depression, personality disorders), pharmacological substance consumption (e.g., LSD, marijuana, etc.), stimulation of specific brain areas (i.e., the temporoparietal junction, TPJ; <xref ref-type="bibr" rid="B15">Bos et al., 2016</xref>) or general anesthesia, also by the simulation of multisensory conflicts between a visual stimulus and a tactile, vestibular, or cardiac stimulus induced in a VR setting, by means of videos or robotic devices (<xref ref-type="bibr" rid="B10">Blanke, 2012</xref>; <xref ref-type="bibr" rid="B50">Fernandez-Alvarez et al., 2021</xref>).</p>
</sec>
<sec id="S1.SS1.SSS7.Px4">
<title>Psychedelically Induced Experiences or Psychedelic-Like Experiences</title>
<p>Increased attention has been given to psychedelics-induced experiences (<xref ref-type="bibr" rid="B48">Fadiman and Kornfeld, 2013</xref>), specifically, with regard to peculiar chemical triggers of TEs: psilocybin administration provided one of the first models for experimentally controlled investigation of quantum changes (<xref ref-type="bibr" rid="B7">Barrett and Griffiths, 2017</xref>). Under supportive conditions, psilocybin can foster deeply meaningful and significant experiences (e.g., mystical-type experiences, which are discussed later in detail) (<xref ref-type="bibr" rid="B144">Pahnke, 1963</xref>; <xref ref-type="bibr" rid="B70">Griffiths et al., 2006</xref>, <xref ref-type="bibr" rid="B68">2011</xref>). Follow-up studies at 2 and 14 months confirmed that psilocybin experiences enabled participants to change durably and positively their attitudes and behaviors, and consistently with what community observers stated (<xref ref-type="bibr" rid="B70">Griffiths et al., 2006</xref>, <xref ref-type="bibr" rid="B69">2008</xref>). Attributions to the psilocybin experience included changes in attitudes, mood, altruism, and other behaviors, as well as interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith, and coping (<xref ref-type="bibr" rid="B67">Griffiths et al., 2018</xref>).</p>
<p>Ibogaine was also found to have similar transformative effects too (<xref ref-type="bibr" rid="B22">Brown et al., 2019</xref>). Observational studies have described participants&#x2019; increased reflection, forgiveness, and self-forgiveness (<xref ref-type="bibr" rid="B22">Brown et al., 2019</xref>), which allowed them to enhance empathy and to attain relief from guilt (<xref ref-type="bibr" rid="B76">Heink et al., 2017</xref>), thus enabling personal transformation. Also quantitative results (<xref ref-type="bibr" rid="B22">Brown et al., 2019</xref>) sustained ibogaine&#x2019;s psychotropic effects as being psychologically profound, leading to far reaching transformations (pp. 3&#x2013;4), which is consistent with numerous other studies exploring ibogaine (<xref ref-type="bibr" rid="B132">Naranjo, 1969</xref>, <xref ref-type="bibr" rid="B133">1974</xref>; <xref ref-type="bibr" rid="B111">Lotsof and Alexander, 2001</xref>; <xref ref-type="bibr" rid="B166">Schenberg et al., 2014</xref>; <xref ref-type="bibr" rid="B76">Heink et al., 2017</xref>; <xref ref-type="bibr" rid="B27">Camlin et al., 2018</xref>; <xref ref-type="bibr" rid="B159">Rodger, 2018</xref>) and other hallucinogens&#x2019; effects, such as DMT, LSD, as well as mescaline (<xref ref-type="bibr" rid="B81">Hood, 1975</xref>; <xref ref-type="bibr" rid="B69">Griffiths et al., 2008</xref>; <xref ref-type="bibr" rid="B112">MacLean et al., 2011</xref>). For an up-to-date review of long-term effects associated to psychedelic drugs consumption, see <xref ref-type="bibr" rid="B1">Aday et al. (2020)</xref>.</p>
<p>Crucially, it has been showed that it was possible to experience drug-like effects without consuming a drug but just by being close to someone who did so (<xref ref-type="bibr" rid="B185">Tart, 1971</xref>). Indeed, the effects of psychedelics originated also from contextual factors, including previous expectations. In a recent single-blind between-subjects study (<xref ref-type="bibr" rid="B140">Olson et al., 2020</xref>), some participants, belonging to the placebo group, reported intense alterations in consciousness, which had been usually found associated with moderate or high doses of psychedelics.</p>
<p>These controlled drug experiences, similar to mystical ones, incorporated the dimensions of <italic>unity</italic>, sacredness, positive mood, transcendence of time/space, ineffability (<xref ref-type="bibr" rid="B113">MacLean et al., 2012</xref>), and of being overwhelming both cognitively and emotionally. Like MEs, these states could be emotionally ambivalent, as they could involve not only positive emotions but also regret, fear, anxiety, and upset (<xref ref-type="bibr" rid="B22">Brown et al., 2019</xref>).</p>
<p>Specifically, at the phenomenological level, several authors have also tried to outline the unique experiential profile of psychedelic experiences (e.g., <xref ref-type="bibr" rid="B150">Preller and Vollenweider, 2016</xref>), and this phenomenon has been conceived as a dynamic process lying on a perception&#x2013;hallucination continuum, which is characterized by an increasing arousal and by the loosing of ego boundaries (<xref ref-type="bibr" rid="B150">Preller and Vollenweider, 2016</xref>).</p>
</sec>
</sec>
</sec>
</sec>
<sec id="S2">
<title>An Interdisciplinary Integrated Picture of Transformative Experiences: What is Shared and What is Different</title>
<p>The initial comprehensive analysis conducted so far by giving voice to all the acknowledged interdisciplinary varieties of TE provides a foundation for a new integrated picture of these phenomena. Hereinafter, first, we focus on the redundant characteristics that frequently have emerged within different domains and disciplines&#x2019; discourse by applying the reasoning by analogy approach (<xref ref-type="bibr" rid="B98">Ketokivi et al., 2017</xref>). We provide an overview of the outcomes of this analysis in <xref ref-type="table" rid="T1">Table 1</xref>. Then, shared elements (at any levels, from the biological to the existential one) and distinctive features of each TE are discussed.</p>
<table-wrap position="float" id="T1">
<label>TABLE 1</label>
<caption><p>Overview TEs instances&#x2019; main features: main reference discipline(s), domain(s), phenomenological correlates, elicitors, and aftereffects.</p></caption>
<table cellspacing="5" cellpadding="5" frame="hsides" rules="groups">
<thead>
<tr>
<td valign="top" align="left">TE instance</td>
<td valign="top" align="center">Main involved discipline(s)</td>
<td valign="top" align="center">Domain</td>
<td valign="top" align="center">Main reference(s)</td>
<td valign="top" align="center">Description</td>
<td valign="top" align="center">Epistemic expansion</td>
<td valign="top" align="center">Emotional complexity</td>
<td valign="top" align="center">Elicitors/<break/>Facilitating conditions</td>
<td valign="top" align="center">Aftereffects</td>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Religious conversion</td>
<td valign="top" align="center">Psychology, philosophy, anthropology, sociology</td>
<td valign="top" align="center">Religion, spirituality</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B85">James, 1902</xref>; <xref ref-type="bibr" rid="B195">Ullman, 2013</xref>; <xref ref-type="bibr" rid="B175">Snook et al., 2019</xref></td>
<td valign="top" align="center">A moment of enlightenment, self-surrendering, and union with a new religious awareness of superiority consisting in a process through which persons move from their previously held religious beliefs to the beliefs of a new religious tradition.</td>
<td valign="top" align="center">Perception of new truths that were inaccessible before; time perceived as stopped, slowed down, or dilated; brief duration.</td>
<td valign="top" align="center">Sudden loss of all concerns, relief, sense of peace, harmony, deep happiness, faith. High emotional intensity.</td>
<td valign="top" align="center">Current theories: key active role of the convert, lower impact of external supernatural causes, more emphasis on converts&#x2019; need for meaning and purpose, despite also cultural factors play a role.</td>
<td valign="top" align="center">Key personality changes (e.g., increase in honesty-humility, conscientiousness, and neuroticism after the conversion); key identity changes; new language; new beliefs.</td>
</tr>
<tr>
<td valign="top" align="left">Self-transcendent and emotionally complex experiences</td>
<td valign="top" align="center">Psychology, neurobiology, nursing, psychiatry, design, human computer interaction</td>
<td valign="top" align="center">Miscellaneous</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B55">Garcia-Romeu, 2010</xref>; <xref ref-type="bibr" rid="B210">Yaden et al., 2016a</xref>,<xref ref-type="bibr" rid="B209">2017</xref>; <xref ref-type="bibr" rid="B105">Kitson et al., 2020</xref></td>
<td valign="top" align="center">The <italic>transient</italic> mental state marked by the transcendence from the material and physical limitations, and by a deep connection with something greater than oneself.</td>
<td valign="top" align="center">Perception of self-diminishment and decreased self-salience; time is perceived as unbounded.</td>
<td valign="top" align="center">Self-transcendent positive emotions: elevation, compassion, gratitude, love, and awe. High emotional intensity.</td>
<td valign="top" align="center">Meditation, peculiar social events hinging on connection with others, virtual reality paradoxical scenarios, nature; catalyzed with spiritual instruction, dance, prayer, and psychedelic substances.</td>
<td valign="top" align="center">Decreased anxiety, increased energy, insight, social ability, and sustained positive affect, value re-orientation, increased concern for others, increased positive affect, and disidentification from old patterns of thinking or behavior; increased prosociality (toward other people and nature); increased generosity, enhanced creative thinking; decreased ruminative strategies. The negative counterpart of ST emotions emerged as associated to highly intense fear and powerlessness, loss of self-control, uncertainty, and lowed sense of situational control.</td>
</tr>
<tr>
<td valign="top" align="left">Peak experience</td>
<td valign="top" align="center">Psychology, neurobiology</td>
<td valign="top" align="center">Miscellaneous</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B118">Maslow, 1962</xref>, <xref ref-type="bibr" rid="B119">1964</xref></td>
<td valign="top" align="center">A <italic>sudden</italic> and <italic>unexpected</italic> acceleration of personal development or self-actualization.</td>
<td valign="top" align="center">The appraisal of the world as good, beautiful, desirable, sudden certainty that polarities and dichotomies have been resolved, strain in both time and space, rapid duration while perceived time is expanded.</td>
<td valign="top" align="center">High inspiration, awe, wonder, gratitude, deep well-being, high emotional intensity.</td>
<td valign="top" align="center">Exposure to nature, sport, music, spiritual and religious context, learning.</td>
<td valign="top" align="center">Effects depends on the context in which the peak experience takes place; individuals recognized immediately this experience as a turning point, achieving peak performance; highest positive feelings (joy, happiness, and ecstasy).</td>
</tr>
<tr>
<td valign="top" align="left">Mystical experience</td>
<td valign="top" align="center">Philosophy, psychology, neurobiology</td>
<td valign="top" align="center">Religious, spiritual</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B85">James, 1902</xref>; <xref ref-type="bibr" rid="B179">Stace, 1960</xref>; <xref ref-type="bibr" rid="B136">Newberg and d&#x2019;Aquili, 2000</xref>, <xref ref-type="bibr" rid="B137">2008</xref>; <xref ref-type="bibr" rid="B82">Hood, 2002</xref></td>
<td valign="top" align="center">Particularly intense variety of self-transcendent experiences (<xref ref-type="bibr" rid="B209">Yaden et al., 2017</xref>). An experience that tends to occur suddenly, it is often transient, it appears as ineffable, joyful, it involves the perception of an ultimate unity, of oneness; transcendence of the ego; a full conviction of immortality; and it tends to be attributed supreme value. Some people interpret MEs as experiences of unity with God (<xref ref-type="bibr" rid="B191">Thalbourne, 2003</xref>).</td>
<td valign="top" align="center">Perception of vanishment of the whole self, cognitively overwhelming, ineffable, noetic quality, sacredness; strain in space and mostly in time while it has a short duration.</td>
<td valign="top" align="center">Mixed feelings raging from fear to intense positive affect.</td>
<td valign="top" align="center">Psychedelics; hypnosis; meditation; sacred ritual, aesthetic experiences physical illness.</td>
<td valign="top" align="center">Enhanced sense of connectedness, meaning in life, positive affect (e.g., more compassion toward self and the others) or a deeper sense of identity.</td>
</tr>
<tr>
<td valign="top" align="left">Kundalini awakening</td>
<td valign="top" align="center">Psychology, anthropology, sociology</td>
<td valign="top" align="center">Spirituality, self-transcendence</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B188">Taylor, 2015</xref>; <xref ref-type="bibr" rid="B93">Kason, 2019</xref>; <xref ref-type="bibr" rid="B206">Woollacott et al., 2020</xref></td>
<td valign="top" align="center">Exceptional physical experience consisting of a huge release of energy, accompanied by temporary corporeal symptoms.</td>
<td valign="top" align="center">Conscious awareness of leaving the body, increased sensory sensitivity, deep interconnection with others; time is perceived as loosened, as the sense of linear time was lost (i.e., &#x201C;out of time&#x201D; experience).</td>
<td valign="top" align="center">Deep ecstatic sensations, joy, enhanced sense of connectedness and unity, reduced fear of death, feelings of expansion, envelopment in love or light; possible dramatic negative emotions.</td>
<td valign="top" align="center">Meditation, psychological turmoil, psychedelics.</td>
<td valign="top" align="center">Change in beliefs and values, reduced tendency to aggression; possible negative cognitive outcomes that leave an indelible mark, as disruptions of psychological functioning and mental illness; new sense of identity.</td>
</tr>
<tr>
<td valign="top" align="left">Near-death experience</td>
<td valign="top" align="center">Psychology, philosophy, neurobiology</td>
<td valign="top" align="center">Miscellaneous</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B64">Greyson, 2000</xref>, <xref ref-type="bibr" rid="B65">2006</xref>, <xref ref-type="bibr" rid="B66">2015</xref>; <xref ref-type="bibr" rid="B171">Simpson, 2001</xref>; <xref ref-type="bibr" rid="B80">Holden et al., 2009</xref></td>
<td valign="top" align="center">Altered state of consciousness on the (real or perceived) threshold of death. Major focus on the peculiar feeling of leaving the physical body and encountering non-physical entities/<break/>environments.</td>
<td valign="top" align="center">Accelerated thoughts; life review; perception of understanding everything, flash from the past, perception of leaving the body boundaries, and of traveling through a tunnel and of being in front of an irreversible threshold; absence of time and space.</td>
<td valign="top" align="center">Sense of cosmic unity and sacredness, peace, positive mood, feelings of harmony, unity, joy, revelation, and connectedness.</td>
<td valign="top" align="center">Meditation, psychological turmoil, psychedelics; alternations in oxygen levels; neurological alterations.</td>
<td valign="top" align="center">New responses to life-threatening dangers, life review, sense of being controlled by an outside force, transformation of attitudes, shift to a new belief system, decreased death anxiety, heightened spiritual awareness.</td>
</tr>
<tr>
<td valign="top" align="left">Out-of-body experience</td>
<td valign="top" align="center">Psychology, philosophy, neurobiology</td>
<td valign="top" align="center">Miscellaneous</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B45">De Foe et al., 2012</xref>; <xref ref-type="bibr" rid="B174">Smith and Messier, 2014</xref>; <xref ref-type="bibr" rid="B170">Sellers, 2019</xref></td>
<td valign="top" align="center">States during which the self appears to occupy a position spatially apart from the experiencer&#x2019;s body (elevated extracorporeal location) (<xref ref-type="bibr" rid="B12">Blanke et al., 2016</xref>).</td>
<td valign="top" align="center">Disembodiment; the self appears occupy an elevated extracorporeal location; enhanced reality, hyper-real cognitive perception, extremely vivid stimuli, and settings, intensified sensory inputs that lead to transformative outcomes.</td>
<td valign="top" align="center">Highly intensified emotions, hyper-real affectivity.</td>
<td valign="top" align="center">Pathological conditions (e.g., depression, personality disorders), pharmacological substances assumption (e.g., LSD, marijuana, etc.); stimulation of specific brain areas (temporoparietal junction area, TPJ); general anesthesia, also by the simulation of multisensory conflicts between a visual stimulus and a tactile, vestibular, or cardiac stimulus induced in virtual reality (VR), by means of videos or robotic devices.</td>
<td valign="top" align="center">Changes in bodily self-consciousness (self-identification and self-location); decreased fear of death; dissociation.</td>
</tr>
<tr>
<td valign="top" align="left">Trauma</td>
<td valign="top" align="center">Psychology, philosophy, clinical medicine, neurobiology</td>
<td valign="top" align="center">Clinical</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B25">Calhoun and Tedeschi, 1995</xref>, <xref ref-type="bibr" rid="B26">2006</xref>; <xref ref-type="bibr" rid="B190">Tedeschi, 1999</xref>; <xref ref-type="bibr" rid="B71">Grof, 2000</xref></td>
<td valign="top" align="center">Radical changes given by the experiencing of a negative high-impacting event. If changes are negative, the TE leads to trauma. If changes are positive, the TE turns into posttraumatic growth.</td>
<td valign="top" align="center">Expectancy, probability, and controllability evaluations associated to the events; sense of time distorted and bodily distortion as predictors of PTSD.</td>
<td valign="top" align="center">Terror, perception of threat.</td>
<td valign="top" align="center">Negatively overwhelming psychological stressors individuals could not cope with.</td>
<td valign="top" align="center">Altered self-capacities, mood disturbance, enhanced avoidance responses, posttraumatic stress.</td>
</tr>
<tr>
<td valign="top" align="left">Posttraumatic growth</td>
<td valign="top" align="center">Psychology, philosophy, clinical medicine, neurobiology</td>
<td valign="top" align="center">Clinical</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B25">Calhoun and Tedeschi, 1995</xref>, <xref ref-type="bibr" rid="B26">2006</xref>; <xref ref-type="bibr" rid="B190">Tedeschi, 1999</xref>; <xref ref-type="bibr" rid="B71">Grof, 2000</xref></td>
<td valign="top" align="center">Positive change experienced as a result of the struggle with traumatic events.</td>
<td valign="top" align="center">Expectancy, probability, and controllability evaluations associated to the events; sense of time can be distorted.</td>
<td valign="top" align="center">Terror, perception of threat; relief.</td>
<td valign="top" align="center">Negatively overwhelming psychological stressors individuals could cope with; the perception of the triggering event depends also on individual differences, e.g., the degree of previous religiosity.</td>
<td valign="top" align="center">Personal development, enhanced authenticity responsibility toward oneself and others, accepting attitude to death, increased self-confidence, new identity, values, and perspectives.</td>
</tr>
<tr>
<td valign="top" align="left">Post-ecstatic growth</td>
<td valign="top" align="center">Psychology</td>
<td valign="top" align="center">Miscellaneous</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B51">Fredrickson, 2004</xref>; <xref ref-type="bibr" rid="B160">Roepke, 2013</xref>; <xref ref-type="bibr" rid="B114">Mangelsdorf and Eid, 2015</xref></td>
<td valign="top" align="center">Radical positive changes given by the experience of highly impacting positive events.</td>
<td valign="top" align="center">The relevance of time and space varies according to the ecstatic or peak experience, which generally involves a transcendence of these dimensions.</td>
<td valign="top" align="center">High positive emotional valence, which can be associable to the peak experience&#x2019;s one.</td>
<td valign="top" align="center">Positive affective experiences, awe moments.</td>
<td valign="top" align="center">Durable and positive changes regarding appreciation of life, relationships, enhanced spirituality, renewed life meaning, and personal strengths.</td>
</tr>
<tr>
<td valign="top" align="left">Psychedelic experience</td>
<td valign="top" align="center">Psychology, psychopharmacology, neurobiology, anthropology</td>
<td valign="top" align="center">Miscellaneous</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B7">Barrett and Griffiths, 2017</xref>; <xref ref-type="bibr" rid="B27">Camlin et al., 2018</xref>; <xref ref-type="bibr" rid="B67">Griffiths et al., 2018</xref>; <xref ref-type="bibr" rid="B22">Brown et al., 2019</xref>; <xref ref-type="bibr" rid="B19">Brouwer and Carhart-Harris, 2020</xref></td>
<td valign="top" align="center">Dynamic process lying on a perception&#x2013;hallucination continuum, which is characterized by an increasing arousal and by the loosing of ego boundaries.</td>
<td valign="top" align="center">Space and time transcendence; ineffability; overwhelming in nature; unity, ego-dissolution; perceptual illusions (alterations of the environment and of the body image; peculiar visual phenomena); deep insights into the nature and structure of the universe.</td>
<td valign="top" align="center">Gratitude, forgiveness, unity, death transcendence sacredness, positive mood, but also regret, fear, anxiety, and upset.</td>
<td valign="top" align="center">Typically elicited by psychedelic substances (e.g., psilocybin; Ibogaine; DMT; LSD).</td>
<td valign="top" align="center">Positive changes in attitudes and behaviors, increased positive coping, prosociality, and empathy. Negative long-term changes at the neurological, personality, molecular, and psychological level (see <xref ref-type="bibr" rid="B1">Aday et al., 2020</xref>).</td>
</tr>
<tr>
<td valign="top" align="left">Transformative learning experience</td>
<td valign="top" align="center">Education, psychology, philosophy</td>
<td valign="top" align="center">Learning</td>
<td valign="top" align="center"><xref ref-type="bibr" rid="B123">Mezirow, 1978</xref>, <xref ref-type="bibr" rid="B124">1997</xref>; <xref ref-type="bibr" rid="B106">Kleiber et al., 2002</xref>; <xref ref-type="bibr" rid="B182">Stone, 2014</xref></td>
<td valign="top" align="center">Process of changing accustomed assumptions, thus producing an effective shift of reference frameworks.</td>
<td valign="top" align="center">Deep and structural shift in mental schemas, beliefs, and perspective, loss of old meaning perspectives to find new selves, heightened self-reflection.</td>
<td valign="top" align="center">Emotional and social learning, hope, newness, intense emotions as drivers for self-reflection, but also guilt, shame, disorientation, dissonance.</td>
<td valign="top" align="center">Disorienting dilemma.</td>
<td valign="top" align="center">Both positive and negative outcomes, e.g., changes in worldview, schema and paradigm, changes concerning how learners conceptualize themselves, and how they related to others or to the world in general; increased empowerment/responsibility; new ways of knowing, which is more open, discriminating, extrarational. Development of new skills. Implementation of new social actions, which are consistent with epistemological changes; heightened spirituality.</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p><italic>Quantum change has not been included since it has been often considered as an overall experience encompassing mystical experiences and the phenomenon of insight. Liminality as well has been indicated as a broader anthropological framework for capturing transformative experiences, while PiMSs address mainly the neurobiological level of a transformative experience, thus, acting as an explanatory neurobiological model of a special phase of the transformative process.</italic></p></fn>
</table-wrap-foot>
</table-wrap>
<sec id="S2.SS1">
<title>Applying the Reasoning by Analogy Approach</title>
<p>As a first step, we focus on the shared aspects across different instances of TEs, at a higher level. To this end, we drew from a reasoning by analogy approach (<xref ref-type="bibr" rid="B98">Ketokivi et al., 2017</xref>). This methodological approach, which was proposed by <xref ref-type="bibr" rid="B98">Ketokivi et al. (2017)</xref>, relies on the concept of analogy, whose value has been recognized across all the sciences. (<xref ref-type="bibr" rid="B78">Hesse, 1966</xref>), since it provides links between two or more different domains of knowledge (<xref ref-type="bibr" rid="B58">Gentner and Markman, 1997</xref>), exploiting their similarities regarding one specific phenomenon, in order to make inferences that connect them (<xref ref-type="bibr" rid="B59">Gentner and Namy, 1999</xref>; <xref ref-type="bibr" rid="B98">Ketokivi et al., 2017</xref>). Analogies have proven to be effective in enabling progress for both research and theory, especially in boundedly rational and resource-constrained contexts, since they allow researchers to focus and deepen only the relevant part of the phenomenon, abstracting out other parts, and overcoming discrepancies (<xref ref-type="bibr" rid="B115">March, 1994</xref>; <xref ref-type="bibr" rid="B98">Ketokivi et al., 2017</xref>). Here, this approach permits to combine knowledge from different domains on TEs, in order to elucidate their transversal functioning. Then, we move to consider how each TE fulfills the shared elements differently, thus bringing forth varieties of TE.</p>
<p>From the implementation of the reasoning by adopting analogy approach, four specific high-level shared elements emerged that can be used to frame the multifaceted nature of TEs. Firstly, these concern, first, TEs&#x2019; phenomenological dimensions (i.e., characteristics subjectively perceived by individuals during TEs). These features can be further divided into: (1) epistemic expansion (new forms of knowledge of the self and of the world) and (2) emotional complexity, involving intense, mixed emotions, and emodiversity (<xref ref-type="bibr" rid="B9">Berrios, 2019</xref>). In addition to the phenomenological elements, two psychological elements can be identified: (3) facilitating conditions/elicitors, and (4) specific effects on the recipient (aftereffects).</p>
<p>The <bold>epistemic expansion</bold> component concerns new forms of knowledge about the self and the world. For instance, in STEs, a sense of self-diminishment and of being connected with all beings is a predominant result. Peak experiences entail the appraisal of the world as a good, beautiful, desirable, place, and the awareness that all polarities and dichotomies have been resolved. In NDEs, there is a dissolution of body boundaries, perception of being able to suddenly understand everything, and being on the edge of an irreversible threshold. Moreover, subjective time perception is recurrently expanded or dilated, while the experience itself could last even a few moments. Space perception is also often strained, distorted, and transcended, as in the case of OBEs and NDEs. This dimension of altered time perception, instead, was less relevant (if not absent) in Mezirow&#x2019;s transformative learning process. However, during transformative learning, the disorienting dilemma acted as a central moment of belief shift through the violation of previous expectancies. Finally, <xref ref-type="bibr" rid="B19">Brouwer and Carhart-Harris (2020)</xref> model on PiMSs could provide a particularly suitable framework to address the neurobiological underpinnings of this epistemic expansion component, which reflects the phenomenological transversal dimensions shared by all the types of TEs considered so far.</p>
<p>The <bold>emotional complexity</bold> component deals with the extremely intense and mixed nature of feelings, affects, and discrete emotions involved during ongoing TEs. Extremely intense feelings can be found during traumatic events, OBEs, NDEs, or STEs. Emotional complexity mainly refers to the experiencing of positive and negative states together (i.e., emotional dialecticism) (<xref ref-type="bibr" rid="B108">Larsen et al., 2001</xref>; <xref ref-type="bibr" rid="B177">Spencer-Rodgers et al., 2010</xref>) and to the experiencing of emotions with high granularity, with a wider variety of discrete emotions reported (i.e., emotional differentiation) (<xref ref-type="bibr" rid="B92">Kashdan et al., 2015</xref>). Although the literature has often evidenced generally positive emotional characteristics of TEs, a deeper overview of these experiences showed that they are characterized by mixed emotions &#x2013; involving the co-activation of opposite emotions at the same time &#x2013; or by emotional variability (<xref ref-type="bibr" rid="B108">Larsen et al., 2001</xref>; <xref ref-type="bibr" rid="B9">Berrios, 2019</xref>). There could be two main mechanisms in which mixed emotions underlying TEs could work to give rise to these experiences. According to the bipolar view (<xref ref-type="bibr" rid="B163">Russell, 2017</xref>), mixed emotions may be felt when individuals have already undergone a transformation, but they still emotionally fluctuate between rejection and acceptance of a chosen behavior. Conversely, the bivariate view by <xref ref-type="bibr" rid="B109">Larsen (2017)</xref> suggests that an event could be characterized by two simultaneous opposite feelings (e.g., fear and happiness at the same time) (<xref ref-type="bibr" rid="B161">Roseman, 2017</xref>). People living a TE are likely to experience a diverse and abundant array of emotions, ranging from ecstasy, bliss, and relief (e.g., as in religious conversions) to guilt, fear, and regret (see psychedelic-induced MEs in <xref ref-type="bibr" rid="B22">Brown et al., 2019</xref>). The breadth of TEs&#x2019; emotional repertoire can suggest that these experiences are characterized by <italic>emodiversity</italic>, which refers to the richness of emotional complexity (<xref ref-type="bibr" rid="B152">Quoidbach et al., 2014</xref>; <xref ref-type="bibr" rid="B9">Berrios, 2019</xref>).</p>
<p>Finally, TEs can usually be conceived as either spontaneous events or as induced by specific facilitating conditions, also by recognizable elicitors. <bold>Facilitating conditions/elicitors</bold> for each TE analyzed in this work are reported in <xref ref-type="table" rid="T1">Table 1</xref>.</p>
<p>Some specific state-conditions act as recurrent triggers of different TEs (psychedelics, meditation, spiritual practices), others as peculiar elicitors of specific instances of TEs (e.g., cardiac arrest for NDEs) (for a finer and up-to-date list of triggers, see <xref ref-type="bibr" rid="B203">White and Brown, 2000</xref>). In addition, recently, more stable variables (trait-like) have emerged as potential preparatory conditions for engendering specific TEs, as in the case of PTG, which is facilitated by previous religiosity (i.e., religious affiliation and strength of religious beliefs) (<xref ref-type="bibr" rid="B184">Taku and Cann, 2014</xref>). Crucially, novel technological devices, such as VR, have been proposed as valid tools for inviting even more complex TEs in the lab (see OBEs in <xref ref-type="bibr" rid="B16">Bourdin et al., 2017</xref>; <xref ref-type="bibr" rid="B198">van Heugten-van der Kloet et al., 2018</xref>). VR, indeed, allows manipulating (also separately) several components of cognition and emotion (<xref ref-type="bibr" rid="B173">Slater et al., 2010</xref>; <xref ref-type="bibr" rid="B172">Slater, 2018</xref>; <xref ref-type="bibr" rid="B14">Bolt et al., 2021</xref>) as well as overall potentially TEs (<xref ref-type="bibr" rid="B36">Chirico et al., 2020</xref>).</p>
<p>However, if basic underpinnings of TEs are not previously captured and understood, VR can turn useless. Indeed, there is always a risk of mistaking the role of this tool in promoting this class of experiences by nurturing fallacious reasoning. It should be noted that VR can easily resemble phenomenological features typical of a given TE. However, this would not guarantee that the same underlying mechanisms/underpinnings of a TE are activated during an equivalent VR experience. Therefore, a deeper comprehension of the basic mechanisms underlying each TE (starting from their facilitating conditions) is essential to reproduce it in the lab by means of VR or any other simulation tool.</p>
<p>Finally, although it may look redundant, it would be useful to demonstrate that all the experiences included in this conceptual analysis show <bold>specific effects on the recipient (aftereffects)</bold> that would be able to impact individuals&#x2019; cognition, emotions, and personality in the long run. This has always been a basic criterion used to define TEs, as mentioned at the beginning of the present work. However, even though all instances of TEs considered so far entail long-lasting, pervasive aftereffects, they also feature a high degree of variability in terms of their consequences. This, again, could support the idea that &#x2013; echoing William James&#x2019;s seminal work on religious experience &#x2013; it would be useful and appropriate to indicate TEs as &#x201C;varieties of transformative experience&#x201D; with two shared core components, elicitors/facilitating conditions particular to specific types of TEs, along with a certain degree of internal differentiation.</p>
<p>These components were summarized in <xref ref-type="table" rid="T1">Table 1</xref>.</p>
</sec>
<sec id="S2.SS2">
<title>Toward a Tentative Integrated Interdisciplinary Conceptualization of Transformative Experience</title>
<p>In line with all the evidence reviewed and analyzed so far, a new preliminary integrated definition of TEs is here advanced.</p>
<p>Transformative experiences can be defined as brief experiences, perceived as extraordinary and unique, entailing durable and/or irreversible outcomes, which contribute to changing individuals&#x2019; self-conception, worldviews, and view of others, as well as their own personality and identity by involving an epistemic expansion (as new forms of knowledge of the self, others, and the world) and a heightened emotional complexity (emotional variability, high intensity, mixed emotions), as the two core phenomenological features. They are usually remembered vividly.</p>
<p>These experiences emerge suddenly, either apparently spontaneously or they can be invited by specific elicitors/facilitating conditions encompassing both state (related to contingencies) and trait elements (related to more stable conditions of the experiencer). Elicitors, usually, are perceived as novel stimuli, able to challenge an individual&#x2019;s mental schema, thus also resulting in disruption.</p>
<p>Some TEs can also encompass transcendental elements. Some TEs (and some phases of a TE) can be marked by peculiar neuropsychophysiological underpinnings.</p>
<p>Finally, it is appropriate to conclude this section by suggesting that a more active dialog among several disciplines and domains would be not only be desirable but also especially advantageous, despite the effort that this would require.</p>
</sec>
</sec>
<sec id="S3" sec-type="conclusion">
<title>Conclusion</title>
<p>Although literature on specific types of TEs is growing and bringing forth promising results, an integrated view of this phenomenon has yet to be developed. In this conceptual analysis, we aimed to provide this interdisciplinary view by marking shared phenomenological features of TEs, as well as their intrinsic particularities, to outline a preliminary interdisciplinary operational definition of TEs.</p>
<p>This effort could turn, as a first outcome, into a more fluid dialog among scholars from different disciplines interested in examining this phenomenon at different levels of analysis, thus resulting in a finer and more comprehensive view of the phenomenon and its underpinnings. Otherwise, the risk can be a fragmentation of TEs&#x2019; conceptualization and research.</p>
<p>As a second outcome, this endeavor could lead to a paradigmatic shift, as the direction of research is moving from retrospective to predictive study of TEs. For instance, nowadays, it is only possible to sense pandemic as a <italic>potentially</italic> TE. An open issue is to scientifically predict the extent to which this will occur, that is, to measure its transformative potential. This would be possible only after having elucidated the underpinnings of transformation at different levels, from the biological to the existential level. In this regard, the results of this analysis could inform the design of novel, integrated, and comprehensive instruments to measure the potential of an event to engender a specific type of TE in a particular person. Moreover, future studies could also consider the possibility of developing a new comprehensive and interdisciplinary instrument capturing the &#x201C;minimal transformation&#x201D; embedded into an experience, also building upon the conditions for the appearance of a minimal phenomenal self (e.g., <xref ref-type="bibr" rid="B205">Windt, 2015b</xref>; <xref ref-type="bibr" rid="B89">Josipovic and Miskovic, 2020</xref>; <xref ref-type="bibr" rid="B122">Metzinger, 2020</xref>). This could be useful, for instance, in the assessment of health promotion interventions. Other possible research lines could elucidate and systematically analyze the antecedents/facilitating conditions giving forth different types of TEs, thus enriching the examination of these class of experiences. The aim of this work is to stimulate a fluid dialog among researchers to acquire a comprehensive view of this phenomenon, despite it should be noted that this work is preliminary in nature and needs to be constantly updated by new evidence, insights, and suggestions.</p>
</sec>
<sec id="S4">
<title>Author Contributions</title>
<p>AC and EG wrote the first draft. AC conceived the rational along with AG and MP. AK and BR revised the manuscript, provide relevant suggestions, and improvements. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec id="conf1" sec-type="COI-statement">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="pudiscl1" sec-type="disclaimer">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<sec id="S5" sec-type="funding-information">
<title>Funding</title>
<p>This work was partially supported by the Fondazione Cariplo, grant: &#x201C;Promoting Education of Scientific and Technological Societal Issues Through Sublime (PROMETHEUS)&#x201D; n : 2019-3536 and by the Italian Ministry of Health through the grant &#x201C;Transformative Audio Storytelling - A study protocol for assessing the efficacy of transformative audio storytelling for informal caregivers (39C101-Audio Storytelling)&#x201D;.</p>
</sec>
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