The NDE is a subjective event experienced by persons who come close to death, who are believed dead and unexpectedly recover, or who confront a potentially fatal situation and escape uninjured. It usually includes dissociation from the physical body, strong positive affect, and transcendental experiences. Phenomenologically, there is a characteristic temporal sequence of stages: peace and contentment; detachment from physical body; entering a transitional region of darkness; seeing a brilliant light; and passing through the light into another realm of existence) (Greyson, 1983) . While only 1/3 of persons who survive an encounter with death have this type of NDE (Ring, 1990) , modern medical technology has resulted in many persons experiencing NDEs. In 1982, Gallup estimated that approximately 8 million American adults have had a NDE with at least some of the features described above.
Although positive personality transformations frequently follow a NDE, significant intrapsychic and interpersonal difficulties may also arise (Greyson & Harris, 1987). Many individuals report that they doubted their mental stability, and therefore did not discuss the NDE with friends or professionals for fear of being rejected, ridiculed, or regarded as psychotic or hysterical. One person reported, "I've lived with this thing [NDE] for three years and I haven't told anyone because I don't want them to put the straightjacket on me" (Sabom & Kreutziger, 1978, p. 2). A hospitalized patient recounted that, "I tried to tell my nurses what had happened when I woke up, but they told me not to talk about it, that I was just imagining things" (Moody, 1975, p. 87). Even religious professionals have not always been sensitive to the spiritual dimensions of such experiences: "I tried to tell my minister, but he told me I had been hallucinating, so I shut up" (Moody, 1975, p. 86).
Fortunately, the many published scientific articles and first person accounts have resulted in greater sensitivity to these experiences (Basford, 1990; Kason & Degler, 1994) . NDEs are recognized as fairly common occurrences in modern ICUs, as is the need to differentiate between ICU psychoses and NDEs, and the importance of not "treating" NDEs with antipsychotic medication (Greyson & Harris, 1987) . In a recent publication, Greyson (1997) described the distress associated with NDEs as a Religious or Spiritual Problem and noted that, "The inclusion of this new diagnostic category in the DSM-IV permits differentiation of NDEs and similar experiences from mental disorders and may lead to research into more effective treatment strategies" (p. 327).