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expecting them and when quite relaxed. Theories such as those of Palmer35 emphasize the importance of reduction in proprioceptive input in the physically relaxed state akin to sensory deprivation. As the brain receives less proprioceptive and other sensory input, the ego theoretically becomes able to relax reality testing. Regressive components of the OBE seem to occur in the 22% of patients who are reminded of childhood experiences, thus it is tempting to invoke the psychoanalytic concept of regression in the service of the ego. But the question remains: What is the service, both from a defensive as well as an adaptive synthetic viewpoint? There is no need to find a single cause for OBEs. Multideterminism is a widely accepted concept in psychiatry. Thus our approach to the etiology of OBE is to consider there to be contributions from different levels of explanation. Each OBE experience might thus be determined by a number of factors (psychopathological, toxic/organic, evolutionary, developmental, and perceptualcognitive), each making a contribution. The same individual would likely have a different etiological combination under different circumstances and the experience would have a different impact. This concept is elaborated in a paper we have in preparation.‡ In the Republic, Plato delineates four levels of experiential reality: imaginary, physical, conceptual, and direct transcendental cognition, which he calls direct seeing or “the Good.” In the story of Er (Republic, 616–17) the story is told of a valiant man, Er, who died in battle and who later revived and told a story whereby his soul had departed from him. Plato claims something utterly alien to the modern mentality; he says that only after death, when we are free of bodily influence, shall we know the whole crux of being. Plato feels that freeing the psyche from the body is an essential condition for the philosophic journey to ultimate wisdom. As indicated by Grosso,36,37 monistic materialism has collapsed the architecture of being to a one-level affair, the really real world of sense experience. The middle kingdom, the unreal domain of dreams, the flimsiest form of epiphenomena, perhaps the collective asylum of artists and the mad, may teach us to be less dogmatic in the way we toss about epithets like “real.” It may help us to open up to more multilevel ontologies.