Near-death experiences (NDEs) are usually associated with clinical death, although this association remains controversial. A look back to the early understanding of these experiences, since the end of the 19th century, reveals a different picture than presented in contemporary descriptions. Indeed, the more historical accounts linked NDEs with various forms of intellectual and physical achievements which, in some cases, helped to produce rescue actions for the individual when facing life-threatening situations. This “energy of despair” seems to occur in a subset of NDEs, in which the experiencer becomes suddenly afraid by the prospect of his or her own death. First, we have provided a selective literature review on this topic, ranging from Albert Heim’s (1892) personal testimony to contemporary research. We next developed a theoretical psychodynamic approach to understanding NDEs, by which we attempted to integrate their psychological and evolutionary functions. We discuss possible distinctions among “fear-death” experiences, acute dying experiences, and “true” NDEs, and conclude that these experiences may reside on the same continuum. We consider that some, but not all, of these experiences have a common trigger of subjective agony, which can sometimes coincide with a real danger. The phenomenological differences among these experiences may reside in opportunities for rescue actions as perceived by the experiencer.