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A "caregiver" refers to anyone in whom a near-death
experiencer (NDEr) confides about their NDE. The first
caregiver to whom most NDErs turn is a medical professional who is
nearby within moments, hours, or days of the NDE. Other
caregivers include family, friends, and anyone else to whom the
NDEr discloses their experience. Usually, the first
discussion of an NDE plays an important role in the course of the
NDEr's integration process—a process that research 1 has shown can take years. The
following suggestions are offered to help caregivers provide NDErs
with the chance to discuss the experience as soon as they are ready
and to set out on a constructive course of integration.
To be most helpful to NDErs, caregivers need accurate
information, a helpful attitude, and specific skills.
Research conclusions 2 indicate that
- As many as 5% of the adult U.S. population have had an
- NDEs occur to people in a variety of situations, including
actual clinical death or situations involving medical procedure,
severe illness, injury, accident, or suicide attempt in which death
is occurring, is imminent, or is possible, or in which the person
believes they are about to die or are dying.
- The content of most NDEs ranges from pleasant to blissful,
including such common elements as an out-of-body experience,
movement through a tunnel or void, encountering deceased loved ones
and supernatural beings, and a life review.
- The content of some NDEs ranges from mildly to extremely
distressing, involving such content as feelings of guilt, remorse,
fear, confusion, or resistance; profound isolation; or, most
rarely, hellish settings.
- In the aftermath of a near-death situation, it is not currently
known why many people report no NDE, others report a pleasant NDE,
and a much smaller number report a distressing NDE.
- Immediate reactions to NDEs can range from "no big deal" to
- Long-term effects of NDEs typically involve mild to extreme
changes in personal beliefs, attitudes, values, goals, and sense of
The most helpful caregiver fosters a safe psychological
environment. In this environment, the NDEr can express and
explore the NDE itself and his or her evolving response to
it. The caregiver creates this environment through an
- Openness to listen to as little or as much as the NDEr wants to
- Acceptance of the NDEr's experience as their subjective
- Interest in the NDE as a valid human experience,
- Inquiry into any meaning that the NDEr attributes to the
- Support for the NDEr's ongoing process of integration.
Establishing and keeping this attitude often calls for the
caregiver to put aside personal beliefs and values in order to
honor and foster the NDEr's development of his or her own beliefs
The most helpful caregiver draws on a set of specific
skills. These include:
- Prior to any known situation in which an NDE might occur, such
as a medical procedure, the caregiver volunteers the reassurance
that, "At any time around your procedure, I'm interested to know
anything you're experiencing. You can feel free to tell me
anything you want to."
- After any situation in which an NDE might have occurred, the
caregiver volunteers the information that, "Sometimes when people
have been through [the situation the person has been through], they
describe unusual—or sometimes even weird—memories or
experiences. I wonder whether you have a memory or had an
experience like that."
- If the person looks quizzical or uncertain, the caregiver
reflects, "It looks like you don't have any memory of anything
unusual," and then moves on to a topic of relevance to the
- If the person responds with any level of recognition, the
caregiver reflects, "I'm interested to hear about anything you want
to tell me from what you remember."
- If the person reports an unusual memory or experience, whether
or not it seems to be an NDE, the caregiver uses primarily two
- Reflection: restating the emotions and content the person is
describing ("So you found yourself in a beautiful, intensely
colored sort-of garden scene where things seemed to be lit up from
the inside"), and
- Open-ended questioning: questions that cannot be answered by
"yes" or "no" and that encourage the person to go into more detail
("And what happened next?").
- When the person has described the actual experience as much as
they seem to want to, the caregiver asks, "What does the experience
mean to you?" or "What do you make of all that?" and reflects the
- The caregiver evaluates the person's level of need for further
- If the person seems satisfied to have discussed their
experience to this extent, the caregiver offers, "If you would like
to talk more about this again, or if you'd like information about
others who've had experiences similar to yours, let me know."
- If the person wants more information, the caregiver refers them
to the IANDS website where you currently are http://www.iands.org.
Resources such as contact information for the over 50 local Friends of IANDS
support groups that meet usually on a monthly basis, and
IANDS' internet message boards, as well as media support
such as brief articles on various NDE-related topics, an Introductory Bibliography of Near-Death
Experiences that lists recommended readings, and a list of audiotapes of presentations from past IANDS
conferences that can be purchased.
- If the person seems distressed—preoccupied, emotionally
upset, etc.—the caregiver refers the person to a mental
health professional who is equipped to provide the person with more
intensive and ongoing assistance. In Canada, caregivers can
contact, or can refer the NDEr to, the Spiritual Emergence Service (604-687-4655).
NDErs who want information about how to choose a psychotherapist
can consult the Experiencers' Guide to Psychotherapy.
For suggestions about appropriate mental health interventions,
the interested reader can consult these resources:
- Greyson, B. "The near-death experience as transpersonal
crisis." pp. 302-315 in Scotton, B. W., Chinen, A., & Barrista,
J. R. (Eds.) (1996). Textbook of transpersonal
psychiatry and psychology. New York: Basic Books.
- Greyson, B. (1997). "The near-death experience as a focus
of clinical attention." Journal of Nervous and Mental
Disease 185, pp. 327-334.
- Greyson, B. & Harris, B. (1987). "Clinical approaches
to the near-death experience." Anabiosis 6, pp.
The caregiver who would like to do in-depth reading on specific
NDE-related topics may purchase
the Near-Death Experiences Research
Bibliography. This bibliography enables the user
to generate a citations list of every Anabiosis and
Journal of Near-Death Studies article published
through 2001 that addressed a particular topic related to NDEs,
and, if desired, purchase reprints of the listed citations from the
IANDS office. Caregivers with other questions not answered in
this brochure may also contact the IANDS office.
- van Lommel, P., van Wees,
R., Meyers, V., & Elfferich, I. (2001). "Near-Death
Experience in Survivors of Cardiac Arrest: A Prospective Study in
the Netherlands". The Lancet 358, pp.
This study is available for free on-line
viewing. Also, see our summary and
commentary on this study
- Greyson, B. "Near-death
experiences" in Cardeña,
E., Lynn, S. J., & Krippner, S. (Eds.) (2000).
Varieties of Anomalous Experience: Examining the
Scientific Evidence. Washington, DC: American