Asking the Unaskable: Clinicians, Near-Death Experiences, and the Fear of Inviting Suicidality
By Dr Lily Amorous
The NDE Connexion
Working with clients who have had—or who may have had—a near-death experience (NDE) presents profound opportunities for healing, connection, and spiritual growth. It also stirs deep concerns in many clinicians, particularly when the experience is unspoken, alluded to, or hidden just beneath the surface.
One of the most pressing and unspoken fears clinicians hold is this: If I ask about the NDE, will I push them closer to suicide?
It’s a delicate tension. On one hand, NDEs are known to be transformative and spiritually expansive. On the other, they can provoke intense longing, existential grief, and even a desire to return to “the other side.” This inner split can be misunderstood or missed entirely—unless someone dares to ask.
In this introductory article, we explore the psychology behind this clinical hesitation, unpack the nuanced relationship between NDEs and suicidal ideation, and offer trauma-informed, spiritually sensitive strategies for safely navigating these complex therapeutic conversations. We invite you to use this article as a launch pad to then further explore the complex interplay of NDEs and suicide.
Why Clinicians May Avoid the Topic of NDEs
Fear of “Opening a Can of Worms”
Many clinicians are trained to assess suicide risk in a structured, risk-management-oriented way. The language of the sacred, the mystical, or the ineffable may feel destabilising to this framework. Asking about NDEs may feel like veering into dangerous terrain.
Fear of Awakening Longing for Death
There’s a deeply human fear: What if bringing up the NDE reignites the client’s desire to go back? This fear isn’t unfounded—many NDErs do report post-experience feelings of homesickness for the place they glimpsed. But avoidance only reinforces silence.
Lack of Training
Most clinicians have little or no training in spiritually transformative experiences. Without a clear model for how to hold these stories safely, practitioners may worry they’ll say the wrong thing—or that they won’t know how to respond to what’s shared.
Legal and Ethical Anxiety
Some practitioners feel that asking about an NDE is “out of scope” or might cross boundaries into spiritual guidance. Others may fear that triggering a disclosure will increase liability if the client becomes suicidal.
These concerns are not irrational—but they can also get in the way of connection, integration, and healing.
Understanding the Link Between NDEs and Suicidal Longing
Contrary to common assumptions, most research shows that NDEs do not cause suicidality. In fact, many individuals report that the experience helped them recover from depression, addiction, or chronic suicidality. However, what often emerges post-NDE is a spiritual homesickness—a grief for the light, the love, the union, the freedom from pain (existential grief).
This longing can be misunderstood by clinicians as suicidal ideation, however it’s important to acknowledge that BOTH can be present at once, as clinicians may also find that they disregard signs of suicide intent by interpreting it as grief. Briefly, to distinguish:
Suicide Ideation
Desire to escape suffering
Often includes intent or planning
Difficulties in daily functioning often present
Includes hopelessness
Existential Grief / Longing
Desire to return to the realm of the NDE
No intention to act—just yearning
Often occurs in otherwise functional individuals
Includes hope—but in another realm
In reality, asking about the NDE does not increase suicidality—it decreases isolation. It validates a sacred and often buried experience. It helps clients feel seen, not judged. And when clinicians name the longing, they open the door to integration.
What NDErs Commonly Feel But Rarely Say
Because NDEs are so difficult to describe, many clients carry the following silently:
“I wish I had died—it felt better than this.”
“I’m not suicidal, but I don’t want to be here.”
“No one would understand what I saw.”
“I feel guilt and shame for wanting to go back when others are fighting to stay alive.”
“I think about dying all the time—but not in the way people think.”
If these sentiments are not invited, named, or normalised, they fester in shame and isolation. The clinician becomes someone to manage—not someone safe enough to explore meaning with.
Why It’s Clinically Safe (and Necessary) to Ask
Asking about NDEs does not implant suicidal thoughts. People who have had such experiences are already grappling with their own sense of meaning, purpose, and presence. When we avoid the conversation, we subtly reinforce that the experience is taboo.
Here’s what asking can do:
Validate and normalise an experience that the client may have buried
Differentiate between existential longing and suicidal intent
Allow for open conversation about integration and adjustment
Build a strong therapeutic alliance based on deep listening
Prevent actual suicidality by addressing root spiritual distress
Silence breeds shame. Questions, when asked gently and respectfully, create space.
How to Safely Inquire About an NDE
The key is to ask in a way that is open, non-pathologising, and spiritually inclusive.
Try language such as:
“Sometimes when people have had a close brush with death, they have experiences that feel profound, confusing, or hard to describe. Has anything like that happened for you?”
“Some people report feeling like they left their body, saw a light, or were surrounded by love. Have you ever had anything like that?”
“Many people don’t feel they can talk about these experiences. If that’s ever been true for you, I want you to know this is a safe space.”
If you suspect the client is carrying a post-NDE longing to return, you might say:
“I wonder if part of you misses the peace or connection you felt there?”
“It’s not uncommon to feel a kind of homesickness. If that’s part of your experience, we can talk about it.”
“Are there times when the longing and grief is so great that you think about how to return?”
“It sounds like experiencing that grief must be so exhausting. I also hear that since the NDE, that life has been so very challenging, in ways that have been hard for you to articulate. I see the toll that this is taking on you. Do you ever become so tired and overwhelmed that you find yourself in a dark place of thinking how to end things? It would be very understandable if you did” “If you ever do, please know that you can talk with me”
Having these discussions is very important. Not only could it intercept a suicide attempt, alongside ensuring that you have not disregarded clinical depression or psychological disorders, but it also ensures that you continue to establish a safe, therapeutic rapport and space for the client. Having open honest communications is key.
If Suicidal Ideation Is Present
Sometimes, your gentle inquiry will reveal suicidal thoughts, feelings, and plans. This does not mean you should have stayed silent. In fact, you’ve likely just uncovered something that has been hidden and carried heavily for some time.
If the client says something like:
“Yes, I’ve thought about ending my life to get back there.”
“This world feels unbearable after what I saw.”
Then you can gently shift into your clinical training:
Ask about current intent, plans, or means
Explore risk and protective factors
Use your established safety planning tools
Consider involving supports or crisis care as needed
Stay grounded and receptive. Keep the conversation open and don’t assume anything either way.
If a client responds that they have felt suicidal but feel strongly that they wouldn’t act on it, then this is an ideal opportunity to further explore the NDE, and if there were learnings from the NDE that act as a protective factor for the client upon their re-entry and future difficulties.
Likewise, if the client states they have had attempts, or ideation, then this is also an ideal time to talk about how/if their NDE impacted the outcome, or how it might in future.
Connect with the client often about their level of desire to return “to the other side.” Do not use suicide as the entry ticket to talk about NDEs, in other words, do not wait until a client is suicidal in order to give space and permission for them to talk about their NDE.
Supporting Clients Who Long to Return “There”
What these clients need is not fixing. Not reframing. Not spiritual bypassing. What they need is presence. Space. Respect.
Support them by:
Naming the Grief
“It makes sense that you would feel a longing for what you experienced. That connection, that love—it’s no small thing to lose.”
Normalising the Story
“You’re not alone in this. Many people who have had NDEs feel similarly. You’re not strange or broken.”
Exploring the Meaning
“What do you think this longing is asking of you? What parts of that experience are still alive in you?”
Using Creative Integration
Encourage journaling, art, dreamwork, or storytelling. Help the client express their experience in non-linear ways.
Helping the Sacred Take Root Here
Instead of framing their longing as pathology, help them find ways to embody what they felt “there” in their life “here.”
Your Role as Clinician
You don’t need to be a spiritual guide. You don’t need to know the answers. Your role is to be the person who isn’t afraid of the mystery. Who listens without judgment. Who can hold paradox without trying to resolve it.
That, in itself, is medicine.
Supervision and Self-Care
These conversations are intense. Clinicians may find themselves deeply moved, confused, or spiritually rattled. This is normal—and it’s a sign that the work matters.
If you're doing this kind of work:
Seek supervision that honours the spiritual dimension
Debrief with trusted peers or mentors
Reflect on your own beliefs, fears, and longings
Stay grounded in your values and ethical framework
Protect time for your own spiritual and emotional wellbeing
You are not immune to the impact of sacred stories. Care for yourself accordingly.
Final Reflections
Raising the topic of a near-death experience won’t cause a client to become suicidal. But not raising it may leave them alone in the most sacred and painful experience of their life.
As clinicians, we often fear asking the “unaskable.” But these are precisely the questions that can save lives—not always from death, but from despair. From loneliness. From fragmentation.
So ask gently. Listen deeply. Stay present.
You don’t need to lead the client to answers. But by walking with them, you become part of the healing.
Further Reading for Suicide and NDEs
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1943-278X.1981.tb00995.x
https://journals.sagepub.com/doi/abs/10.2190/5KBP-82F9-UDX8-NEY9
https://psycnet.apa.org/record/2025-01806-001
Dr Lily Amorous
The NDE Connexion | www.thendeconnexion.com.au
