Induced After-Death Communication (IADC) Experience and Near-Death Experience (NDE): Two Variations of a Single Phenomenon

Abstract

Background: Induced after-death communication (IADC) experiences have been reported to share many phenomenological features with Near-Death Experiences (NDEs). This study aimed to empirically test the hypothesis that the majority of IADC experiences manifest a phenomenology that largely overlaps with that of NDEs. Methods: A cross-sectional observational design with retrospective data collection was employed. Fifty-nine participants (M = 56.25 years, SD = 10.18) who had previously undergone IADC therapy completed the Italian version of the Near-Death Experience (NDE) Scale. Descriptive analyses and repeated measures ANOVA were conducted to examine total scores and differences across subscales. Results: A total of 51 participants (86%) exceeded the established NDE threshold (≥7), with a mean total score of 14.69. The highest scores were observed on the Transcendental and Affective subscales, whereas the Paranormal subscale showed the lowest average scores. The Cognitive subscale exhibited intermediate values. Item-level analyses confirmed the high intensity of core NDE features, such as perceiving otherworldly environments, encountering deceased loved ones, and experiencing profound peace. Conclusions: This study provides the first empirical evidence of phenomenological overlap between IADC experiences and NDEs. These results shed light on the processes underlying the effectiveness of IADC therapy.

1. Introduction

Grief may be considered as a combination of cognitive and emotional processes, both conscious and unconscious, that are activated by the loss of a loved one (Freud, 1917; Parkes, 1970; Bowlby, 1980). The dominant model of the twentieth century, according to which the function of grief is to sever bonds with the deceased, has fallen into crisis and has increasingly been replaced by the understanding that healthy resolution of grief involves maintaining a continuing bond with the deceased. In this perspective, the affective and emotional bond with the loved one does not come to an end but rather is transformed into a new form (Klass et al., 1996; Brennan, 2014; Klass & Steffen, 2018; Worden, 2018). There are various ways in which bonds with the deceased may be expressed and nurtured: mental conversations, maintaining shared interests, adopting values or behaviors that were important to the deceased, sharing memories with others, taking on roles or responsibilities that the deceased held, engaging in rituals such as visiting a grave or observing an anniversary, and having experiences of after death communication. On this last point, Klass et al. (1996) note, for example, that parents regularly report sensing their child’s presence and hearing their child’s voice. After-death communications (ADCs) are a phenomenon that has received increasing scholarly attention (Bowlby, 1980; Sormanti & August, 1997; St. Germain-Sehr & Maxey, 2019). ADCs refer to experiences of contact and communication with someone who is no longer living in earthly life (Guggenheim & Guggenheim, 1996; Fenwick & Fenwick, 2008; Elsaesser, 2023). These experiences typically occur spontaneously in the waking state but can also manifest during REM sleep, with a level of clarity and coherence that is uncommon in ordinary dreams (LaGrand, 1997; Holden, 2017). Guggenheim and Guggenheim (1996), who coined the term “after-death communications” (ADCs), collected firsthand accounts from over 2000 individuals and described various types of ADCs.

They listed 12 primary types of after-death communication; however, only the following are relevant to our study: feeling the presence of the deceased, auditory ADCs, tactile ADCs, olfactory ADCs, and visual ADCs (Guggenheim & Guggenheim, 1996). Epidemiological data indicate that approximately 30–35% of the general population reports having experienced at least one after-death communication (ADC) in their lifetime, regardless of religious affiliation or cultural background (Streit-Horne, 2011; Pait et al., 2023). Prevalence is substantially higher among bereaved individuals, with 70–80% reporting at least one ADC within the first year following the loss (Streit-Horne, 2011). Empirical evidence suggests that ADCs are often experienced as comforting, meaningful, and beneficial, contributing positively to the grieving process (Streit-Horne, 2011; Holden, 2017; Penberthy et al., 2023).

Induced after-death communication (IADC) therapy is a form of grief therapy that was originally developed by Allan Botkin (Botkin & Hogan, 2005) based on multiple modifications to the EMDR protocol (Shapiro, 1989a, 1989b). It is considered a naturalistic and experiential form of therapy as it allows grieving individuals to intentionally reach a state of mind that permits a corrective emotional experience of an after-death communication (ADC) with deceased loved ones. It is important to distinguish between the subjective experience of communication—which can hold significant therapeutic value for the patient—and the ontological judgment (i.e., whether the communication actually “exists” or is merely a product of the mind). Although the ontological question is intriguing, it is not necessary to formulate or endorse any specific conclusion in order to facilitate a corrective emotional experience that may be highly effective in treating Prolonged Grief Disorder. This new procedure has been subjected to efficacy studies (Botkin & Hannah, 2013; Hannah et al., 2013; Holden et al., 2019; D’Antoni et al., 2025). IADC therapy has begun to receive increasing recognition within the peer-reviewed clinical literature, as evidenced by its inclusion in the second edition of New Techniques of Grief Therapy: Bereavement and Beyond (Neimeyer, 2023), reflecting a growing interest in its therapeutic relevance.

IADC experiences include ADC experiences but are not limited to them. In fact, in most cases, their phenomenology is broader. During IADC experiences, individuals often report encountering their deceased loved ones, who appear happy and generally younger, engaged in leisure activities, caring for others, and acquiring knowledge. The deceased frequently express that they remain by the survivor’s side—albeit invisibly—to continue caring for them (Botkin & Hogan, 2005). Furthermore, IADC experiences are not merely experiences of communication with loved ones; they encompass more. They are not only communicative but also environmental experiences, as they introduce the experiencer to rich, complex otherworldly environments, often characterized by beautiful landscapes, vivid saturated colors, and a light that shines upon them. (Botkin, 2000; Botkin & Hogan, 2005). Another aspect of IADC experiences that goes beyond simple communication with the deceased is their ability to make the past subjectively present (Botkin & Hogan, 2005, 2005; Lalla, 2021). Finally, in a minority of cases, the percipient experiences a mystical encounter with a loving light (Lalla, 2021).

This phenomenology of IADC experiences tends to overlap with that of near-death experiences (NDEs), which constitute the collective narrative of many individuals who have returned from clinical death (Moody, 1975; Ring, 1984; Sabom, 1998; van Lommel et al., 2001; van Lommel, 2007; Fenwick & Fenwick, 2008; Belanti et al., 2008; Holden et al., 2009; Long & Perry, 2010; Parnia et al., 2022). NDEs are typically reported as including distinct narrative sequence, such as: perceived death and separation from the body; visual and auditory awareness—including the ability to recall specific details of resuscitation during cardiac arrest; encounters with deceased loved ones; traveling toward a destination; visions of a natural environment of great beauty; additional encounters with loved ones; meeting a being of light; feelings of profound peace and serenity; a life review that is purposeful, meaningful, and educational; a sense of being “back home”; and ultimately, returning to earthly life. At present, at least 50 common thematic elements have been identified in the literature (Parnia et al., 2022).

National sample surveys of the general population have shown that approximately 4–8% of people report having had an NDE (Knoblauch et al., 2001; Perera et al., 2005). These individuals have described a distinct set of experiences that appear to be universal and independent of cultural, societal, or religious background (Long & Perry, 2010). Among cardiac arrest survivors, approximately 10–23% report having had an NDE (van Lommel et al., 2001; Greyson, 2003; Schwaninger et al., 2002).

In summary, the development of research has given rise to a series of intersecting trajectories:

• The phenomenon of natural after-death communication (ADC)—communication that occurs outside a therapeutic context—has been the subject of extensive research and documentation due to its potentially beneficial impact on the grieving process.
• The development of induced after-death communication (IADC) therapy has enabled the facilitation of such spontaneous experiences in individuals diagnosed with Prolonged Grief Disorder.
• Advances in resuscitation techniques since the late 1960s have made it possible to revive a greater number of individuals whose hearts had ceased functioning. This development has led to a rise in first-person reports of near-death experiences (NDEs), giving rise to a new line of scientific inquiry.
• Concurrently, clinical observations have highlighted notable phenomenological similarities between IADC experiences (as distinct from natural ADC) and NDEs, despite the differing conditions under which they occur. However, no empirical study has yet systematically investigated whether IADC experiences meet the phenomenological criteria commonly recognized for identifying NDEs.

The present study aims to address this gap by assessing the phenomenological characteristics of IADC experiences through a quantitative, empirical methodology, as detailed in the Section 2. The objective is to evaluate whether the IADC experience can be conceptualized as a variant of the NDE phenomenon and, consequently, whether its phenomenological profile can more comprehensively elucidate its function as a corrective emotional experience for individuals who are grieving.

2. Materials and Methods

2.1. Research Design

The present study adopts a cross-sectional observational design with retrospective data collection to empirically assess the hypothesized phenomenological similarity between near-death experiences (NDEs) and induced after-death communication (IADC) experiences. To this end, the Near-Death Experience Scale (NDES) was administered to a sample of 59 Italian participants who had previously undergone IADC therapy with C.L., the first author of this study.

2.2. Participants

The sample consisted of 59 participants (M = 56.25 years, SD = 10.18), with an average time since their last IADC session of 37.09 months (SD = 32.27). The majority of participants were female (90%), while 10% were male. Most participants were employed (76%) and highly educated, with 47% holding a master’s degree. The majority of participants identified as Catholic (58%), while 37% described themselves as spiritual but not religious. Only 8% reported having had a previous NDE, while 59% reported previous natural after-death communication (ADC) experiences, occurring outside any therapeutic context. During the IADC session, the primary contact was most frequently a parent (36%), followed by a partner (29%) and offspring (24%). See

Table 1. Sociodemographic and clinical characteristics of the sample (N = 59).

Variable	Category	N	%
Age (years)	M = 56.25, SD = 10.18
Time since last IADC session (months)	M = 37.09, SD = 32.27
Gender
	Male	6	10%
	Female	53	90%
Marital Status
	Married	19	32%
	Single	8	14%
	Widowed	13	22%
	Divorced	5	8%
	Separated	5	8%
	Cohabiting	9	15%
Educational Attainment
	Lower Secondary School	4	7%
	High School Diploma	12	20%
	Bachelor’s Degree	6	10%
	Master’s Degree	28	47%
	Postgraduate Specialization	6	10%
	Doctorate	3	5%
Occupational Status
	Employed	45	76%
	Unemployed	2	3%
	Retired	10	17%
	Homemaker	2	3%
Religious Belief
	Catholic/Other Religions	34	58%
	Spiritual but not Religious	22	37%
	Agnostic	2	3%
	Atheist	1	2%
Previous NDE
	Yes	5	8%
	No	54	92%
Previous Spontaneous ADC Experience
	Yes	35	59%
	No	24	41%
Primary Contact During IADC Session	Parent	21	36%
	Partner	17	29%
	Offspring	14	24%
	Extended Family	3	5%
	Sibling	2	3%
	Friend	1	2%
	Pet	1	2%

for detailed participant characteristics.

2.3. Procedure

Data collection took place between March and April 2025. Participants were approached via email by the IADC therapist who had previously conducted their IADC therapy sessions. The message included a brief explanation of the study’s aims, an invitation to participate voluntarily, and a link to the informed consent form and questionnaire. After providing informed consent, participants were asked to retrospectively complete the Italian version of the Near-Death Experience Scale (Greyson, 1983; Pistoia et al., 2018). Although the time elapsed since the death of the loved one was not systematically recorded in the present study, all participants had experienced the loss at least six months prior to undergoing IADC therapy, in accordance with standard clinical practice. No significant association was identified between time since loss and the occurrence of IADC experiences in previous research by the authors (D’Antoni et al., 2025). Participants were instructed to respond to the questionnaire exclusively on the basis of their personal IADC experience. Of course, the NDE Scale was not originally designed to assess IADC experiences. However, it was selected for our study because, as the most effective tool for recognizing and describing NDEs, it enables us to test our hypothesis that the phenomenology of IADC experiences substantially overlaps with that of NDEs. Participation in the study was completely anonymous, and no financial compensation was provided. As stated in the informed consent form, participants retained the right to withdraw from the study at any time without consequence. Individuals with a diagnosis of psychotic disorder were excluded from both IADC therapy and participation in the study.

2.4. Measures

Data collection was conducted using two instruments: a demographic and clinical questionnaire, and the Near-Death Experience Scale (Greyson, 1983), administered in its validated Italian version (Pistoia et al., 2018). The first section of the questionnaire included a concise set of items designed to collect sociodemographic and clinical data. Participants were asked to provide their age, gender, marital status, educational level, and occupational status. Additional information was collected, including details about their religious or spiritual orientation, any prior experience of spontaneous after-death communication (ADC), and any previous near-death experience (NDE). Participants were also asked to indicate the time elapsed since their most recent IADC session and to identify the primary figure with whom contact was perceived during that session (e.g., a parent, partner, child, sibling, friend, or pet). This information was used to describe the sample and to contextualize the IADC experiences.

The second instrument employed was the Near-Death Experience Scale (NDE Scale), a 16-item measure developed by Greyson (1983) to distinguish individuals who unequivocally claim to have had a near-death experience (NDE) from those with more questionable claims. For this reason, the NDE Scale is commonly used as a screening tool to identify genuine NDEs within a population. The scale comprises four subscales: Cognitive, Affective, Paranormal, and Transcendental, each of which captures a distinct dimension of the experience. For research purposes, a score of 7 or higher (1 SD below the mean) is used as the valid cut-off point to establish the presence of an NDE (Greyson, 1983). Each of the four subscales yields a score ranging from 0 to 8 points (0, 1, or 2 points for each of the four items). The Cognitive subscale consists of items 1–4; the Affective subscale of items 5–8; the Paranormal subscale of items 9–12; and the Transcendental subscale of items 13–16.

A newer version of Greyson’s scale has been proposed (Martial et al., 2020). However, we chose to use the original version for three main reasons: the new scale has not yet been validated in Italian; the original version is more appropriate for an initial application in the IADC context, given its long-standing use in NDE research over the past 40 years; the revised version introduces elements—such as feeling of non-existence or fear, a passage or tunnel, and a feeling of dying and/or being dead—that are less relevant to IADC experiences.

2.5. Statistical Analyses

Descriptive statistics were used to summarize the sample’s sociodemographic and clinical characteristics and to examine the distribution of scores on the Near-Death Experience Scale (NDE Scale). Although individual Likert-type items are ordinal in nature, the NDE Scale aggregates multiple items to assess a broader latent construct. According to Carifio and Perla (2008), such composite scales can be treated as interval-level, supporting the computation of means and standard deviations. Norman (2010) further demonstrated that parametric tests are robust even when applied to ordinal data, particularly in large samples. Based on these considerations, descriptive and inferential analyses were conducted using parametric methods. To assess the intensity of IADC experiences, an item-level analysis was performed on the 51 participants whose NDE Scale scores met or exceeded the cut-off (≥7). Each of the 16 items was evaluated using two complementary indicators: (1) the mean score (range: 0–2) and (2) the response distribution across 0 = not present, 1 = mild, and 2 = strong. Classification thresholds were introduced in the Section 3 based on observed patterns.

3. Results

The following results detail the phenomenological features of induced after-death communication (IADC) experiences as assessed by the Near-Death Experience (NDE) Scale. The analysis includes the proportion of participants who met the established NDE cut-off, comparative evaluations across the four subscales of the NDE Scale, post hoc pairwise comparisons to identify significant differences between subscales, and an item-level analysis of the 16 individual items of the NDE Scale.

3.1. Comparative Analysis of NDE Subscales

We examined the distribution of NDE Scale scores in the sample using the established cut-off score of ≥7, which indicates the presence of a Near-Death Experience. A total of 51 participants (86%) scored at or above this threshold.

Conversely, approximately 14% of participants scored below the cut-off point of 7. These individuals’ experiences did not exhibit the core phenomenological features typically associated with NDEs. Rather, the phenomenology of these non–NDE-like IADC experiences appeared to more closely overlap with that of after-death communications (ADCs) than with near-death experiences (NDEs).

Descriptive statistics for the total NDE score and its subscales (Cognitive, Affective, Paranormal, and Transcendental) are presented in

Table 2. Descriptive statistics of NDE scale total score and subscales in participants scoring above and below the cut-off value.

NDE Scale	Above Cut-Off (≥7) M (SD)	Below Cut-Off (<7) M (SD)
Total Score	14.69 (5.16)	4.00 (1.51)
Subscales
Cognitive	3.53 (1.71)	0.63 (0.74)
Affective	3.92 (2.28)	1.38 (0.92)
Paranormal	2.92 (1.73)	0.63 (0.74)
Transcendental	4.31 (1.63)	1.38 (0.92)

, separately for the Above Cut-off group (≥7) and the Below Cut-off group (<7).

3.2. Post Hoc Pairwise Comparisons

A repeated-measures ANOVA was conducted on the subgroup of 51 participants who scored above the NDE cut-off (≥7) to compare scores across the four NDE subscales. Mauchly’s test indicated that the assumption of sphericity had been violated, W = 0.725, χ²(5) = 15.70, p = 0.008. Therefore, degrees of freedom were corrected using the Greenhouse-Geisser estimate of sphericity.

The repeated measures ANOVA revealed a significant effect of Subscale on scores, F(2.57, 128.46) = 7.58, p < 0.001, Greenhouse-Geisser ε = 0.856, partial η² = 0.132, ω² = 0.062, indicating that average scores differed significantly across the four subscales.

Post hoc pairwise comparisons with Holm correction revealed that Affective scores were significantly higher than Paranormal scores (pHolm = 0.016, d = 0.539), and Transcendental scores were significantly higher than Paranormal scores (pHolm < 0.001, d = 0.750). No other pairwise comparisons reached statistical significance after correction (all pHolm > 0.05). Detailed post hoc test results are reported in

Table 3. Post hoc pairwise comparisons for the NDE subscales with Holm correction (pHolm) and effect sizes (Cohen’s d).

		Mean Difference	SE	Cohen’s d	pHolm
Cognitive	Affective	−0.39	0.32	−0.21	0.46
	Paranormal	0.61	0.30	0.33	0.14
	Transcendental	−0.78	0.33	−0.42	0.08
Affective	Paranormal	1.00	0.32	0.54	0.02
	Transcendental	−0.39	0.34	−0.21	0.46
Paranormal	Transcendental	−1.39	0.21	−0.75	<0.001

Note. p-values are adjusted using the Holm correction method to account for multiple comparisons.

.

Overall, these findings suggest that the Transcendental and Affective subscales contributed most to the total NDE score, whereas the Paranormal subscale exhibited the lowest mean scores across participants. The Cognitive subscale displayed intermediate values, higher than the Paranormal scores but lower than the Affective scores. This phenomenological profile is illustrated in Figure 1, which presents the mean scores and standard errors for each NDE subscale.

In the present study, the profile of IADC experiences with NDE-like phenomenology shows the Transcendental subscale occupying the highest mean score, closely followed by the Affective subscale, while the Cognitive subscale occupies an intermediate position, between these two and the Paranormal subscale, which showed the lowest average score. It is noteworthy that this profile differs from the pattern typically observed in classical near-death experiences, in which the Affective subscale generally scores highest, followed by the Transcendental, Paranormal, and, finally, Cognitive subscales (Greyson, 1983).

3.3. Item-Level Analysis of Experiential Intensity

Table 4. Frequencies, percentages, means, and standard deviations for each NDE scale item.

Item	0		1		2		Mean	SD
	Freq.	%	Freq.	%	Freq.	%
NDE01	21	41%	17	33%	13	25%	0.843	0.809
NDE02	9	18%	31	61%	11	22%	1.039	0.631
NDE03	20	39%	19	37%	12	24%	0.843	0.784
NDE04	22	43%	17	33%	12	24%	0.804	0.8
NDE05	5	10%	35	69%	11	22%	1.118	0.553
NDE06	19	37%	15	29%	17	33%	0.961	0.848
NDE07	21	41%	14	27%	16	31%	0.902	0.855
NDE08	19	37%	16	31%	16	31%	0.941	0.835
NDE09	8	16%	31	61%	12	24%	1.078	0.627
NDE10	19	37%	13	25%	19	37%	1.0	0.872
NDE11	44	86%	3	6%	4	8%	0.216	0.577
NDE12	27	53%	16	31%	8	16%	0.627	0.747
NDE13	7	14%	18	35%	26	51%	1.373	0.72
NDE14	22	43%	7	14%	22	43%	1.0	0.938
NDE15	6	12%	15	29%	30	59%	1.471	0.703
NDE16	37	73%	4	8%	10	20%	0.471	0.809

reports descriptive statistics for each individual item of the NDE Scale, including frequencies, percentages, means, and standard deviations.

To classify experiential intensity, each item was examined according to its mean score and response distribution. A threshold of ≥1.26 was used to define “very high” intensity, based on the empirical observation that only two items (NDE13 and NDE15) clearly exceeded this value and were predominantly rated “2”. Thus, 1.25 was considered a natural boundary separating “high” from “very high” intensity. The remaining levels were defined in regular intervals of 0.25, proportionally dividing the theoretical range (0–2), in line with conventional scale interpretation methods (see

Table 5. Definition of experiential intensity based on mean scores and response distributions. Response distributions refer to the percentage of participants scoring each item at levels 0 (not present), 1 (mild), and 2 (strong). Intensity levels were assigned based on a combination of mean scores and the specific distribution patterns observed across response categories.

Experience Intensity Level	Mean Score Range	Response Distributions
Very High	≥1.26	Predominance of responses scoring 2 (distribution: 2 > 1 > 0).
High	1.00–1.25	Either: (a) predominance of responses scoring 1, followed by 2 (distribution: 1 > 2 > 0), or (b) a bimodal distribution in which responses scoring 0 and 2 exceed those scoring 1 with responses scoring 1 and 2 jointly exceeding 50% of total responses (distribution: 0 ≈ 2 > 1, with 1 + 2 > 50%).
Medium	0.76–0.99	Prevalence (but not predominance) of responses scoring 0, with responses scoring 1 and 2 jointly exceeding 50% of total responses (distribution: 0 > 2 > 1 or 0 > 1 > 2, with 1 + 2 > 50%).
Low	0.50–0.75	Predominance of responses scoring 0, followed by responses scoring 1 and few scoring 2 (distribution: 0 > 1 > 2).
Very Low	<0.50	Predominance of responses scoring 0, with few responses scoring 1 and 2 (distribution: 0 ≫ 1 > 2 or 0 ≫ 2 > 1).

).

This framework allows for a more nuanced classification by combining a central tendency measure (mean) with the internal structure of subjective perception. For instance, a mean score of 1.00 could result from a uniform response pattern (e.g., 100% scoring “1”) or a bimodal distribution (e.g., 50% scoring “0” and 50% scoring “2”), each suggesting a different experiential profile. The inclusion of response distributions thus enhances the interpretive validity of the intensity classification.

Based on the criteria outlined above, a very high intensity of experience was observed for items NDE13 and NDE15. High intensity, though slightly lower, was noted for items NDE02, NDE05, NDE09, NDE10, and NDE14. Items classified as medium intensity included NDE01, NDE03, NDE04, NDE06, NDE07, and NDE08. A low intensity was found for NDE12, while very low intensity was observed for NDE11 and NDE16.

4. Discussion

The present study explored the phenomenological overlap between induced after-death communication (IADC) experiences and near-death experiences (NDEs). The empirical hypothesis tested was that patients who had undergone an IADC experience would reach or exceed a score of 7 on the Near-Death Experience Scale (Greyson, 1983), the established cut-off for identifying an experience as an NDE. This hypothesis was based on clinical observations suggesting that IADC experiences often manifest as a variant of near-death experiences.

To empirically test this hypothesis, the NDE Scale was administered as a standardized instrument. It was predicted that the majority of participants would exceed the established cut-off score (≥7) that indicates the presence of an NDE.

4.1. Phenomenological Overlap Between IADC and NDEs

To the best of our knowledge, this is the first study in which the Near-Death Experience Scale (Greyson, 1983) has been used to investigate the similarity between induced after-death communication (IADC) experiences and near-death experiences (NDEs).

The hypothesis—that individuals who had undergone an IADC experience would reach or exceed the established cut-off for NDEs—was based on prior clinical observations suggesting that IADC experiences often replicate the phenomenology of near-death experiences (NDEs).

The finding that 86% of the participants obtained a score above the established threshold of 7 on the NDE Scale supports the initial hypothesis that IADC experiences show substantial phenomenological overlap with NDEs. It is noteworthy that the mean total score among this 86% of the sample was 14.69, which is more than double the cut-off score of 7 used to identify NDEs. This finding further corroborates the validity of the hypothesis. Moreover, the mean score of 14.69 is remarkably close to the average score of 15.01 reported in the original validation study of the NDE Scale (Greyson, 1983).

As previously noted, the phenomenology of non–NDE-like IADC experiences more closely aligns with that of after-death communications (ADCs) than with that of near-death experiences (NDEs). Nevertheless, their greater length and richer content—compared to classical ADCs—render them a meaningful form of corrective emotional experience. Conversely, given their more complex and emotionally significant phenomenological profile, it is plausible that NDE-like IADC experiences exert a stronger therapeutic impact than non–NDE-like IADC experiences on individuals suffering from Prolonged Grief Disorder.

In the subgroup of patients who reported NDE-like IADC experiences, the distribution of average scores across the four subscales differs from that commonly observed in individuals who have experienced near-death experiences (NDEs) in life-threatening contexts. Specifically, the Transcendental and Affective subscales exhibit the highest scores, as in classic NDEs, but in reverse order. Among individuals who have reported classic NDEs, the highest average scores are generally found on the Affective subscale, followed by the Transcendental subscale (Greyson, 1983), while in IADC experiences, the opposite pattern emerges. Additionally, the Paranormal and Cognitive subscales reverse their typical order of prominence. The Paranormal subscale typically scores lower than the Affective and Transcendental subscales but higher than the Cognitive subscale (Greyson, 1983). By contrast, in IADC experiences, the average Cognitive subscale score exceeds that of the Paranormal subscale. This overall pattern indicates a distinct variation in the experiential profile of IADC experiences, distinguishing them from classical NDEs. The Transcendental subscale of the Greyson Near-Death Experience Scale measures the extent to which an individual’s experience includes elements of encountering a realm or reality perceived as beyond ordinary existence. This subscale specifically captures experiences related to a perceived connection with an otherworldly and numinous dimension. The Affective subscale assesses feelings of peace, joy, a sense of harmony with the universe, and the perception of a brilliant light. The Cognitive subscale assesses alterations in thought processes, perceptions of temporal distortion, reliving experiences from one’s past, and an extraordinary sense of understanding or insight that transcends ordinary cognition. The Paranormal subscale is characterized by heightened sensory perception, extrasensory experiences, the perception of future events, and the sensation of being separated from one’s physical body (Greyson, 1983).

The respective contribution of each NDE Scale component to IADC experiences with NDE-like phenomenology outlines the distinctive phenomenological profile of these experiences. The item-level analysis of these IADC experiences further clarifies this phenomenological profile and enhances our understanding of the therapeutic potential of IADC therapy (Botkin & Hannah, 2013; Hannah et al., 2013; Holden et al., 2019; D’Antoni et al., 2025).

4.2. Item-Level Intensity on the NDE Scale in IADC Experiences

We can now explore the findings more deeply by reflecting on the item-level analysis. As previously discussed, the highest average score was observed in the Transcendental subscale. Three of the four items comprising this subscale were characterized by very high or high levels of intensity: NDE13 (“Did you seem to enter some other, unearthly world?”; very high level of intensity), NDE14 (“Did you seem to encounter a mystical being or presence?”; high level of intensity), and NDE15 (“Did you see deceased spirits or religious figures?”; very high level of intensity).

The fourth item, NDE16 (“Did you come to a border or point of no return?”), showed a very low level of intensity. Yet, how can it be explained that 28% of NDE-like IADC experiencers reported reaching a limit or point of no return? Clinical understanding of IADC experiences can help clarify the significance of these responses. Among these participants, 8% selected response 1, indicating that they made a conscious decision to ‘return’ to life. This response likely reflects a deliberate choice to end the IADC experience. In fact, once initiated, such experiences typically continue to unfold until the percipient decides—at least temporarily—to bring them to a close. Additionally, 20% of patients selected response 2 (“A barrier that I was not allowed to cross; or ‘sent back’ to life involuntarily”). This may be interpreted as follows: first, patients may feel frustrated by the impossibility, during the IADC experience, of remaining permanently with their deceased loved ones, and by being compelled to return to their everyday lives; second, patients often express to their deceased loved ones a desire for permanent reunion. They may, for example, disclose suicidal ideation or ask their loved ones to intervene to hasten the end of their earthly existence. In such cases, the message they receive is consistently that their time in earthly life should not be shortened, as they still have existential tasks to fulfill. In other words, they are told that while they can voluntarily obtain a temporary reunion, a permanent reunion must not be requested and cannot be obtained. There is a boundary or point of no return that should not be crossed. In near-death experiences, this boundary cannot be crossed during the experience itself; in IADC experiences, it must not be crossed either during the experience or after it has taken place.

Immediately following the Transcendental subscale, the Affective subscale yielded the next highest average scores. The items and their average scores are as follows: NDE05 (“Did you have a feeling of peace or pleasantness?”; high level of intensity), NDE06 (“Did you have a feeling of joy?”; medium level of intensity), NDE07 (“Did you feel a sense of harmony or unity with the universe?”; medium level of intensity), and NDE08 (“Did you see or feel surrounded by a brilliant light?”; medium level of intensity).

The Affective subscale refers to characteristic aspects of IADC experiences. The encounter with a deceased loved one, the otherworldly natural environment in which it takes place, and the warm, affective light that illuminates it tend to evoke feelings of peace, pleasantness, and joy, along with a sense of harmony and unity with the universe.

Scores on the Cognitive subscale are slightly lower than those on the Affective subscale. Items from the Cognitive subscale also capture relevant aspects of the IADC experience. Item NDE01 (“Did time seem to speed up?”; medium level of intensity) reflects participants’ reports of a sense that time was passing more quickly. During an IADC experience, time can indeed be perceived differently from ordinary consciousness (Botkin & Hogan, 2005). Item NDE02 (“Were your thoughts speeded up?”; high level of intensity) can be associated with the experience of rapidly arriving thoughts that appear to originate from deceased loved ones. Often, patients report that they do not even have time to ask a question before receiving a response. Another characteristic of IADC experiences is that communication from deceased loved ones sometimes seems to arrive instantaneously, conveying a multitude of messages that subsequently require considerable time to be translated and articulated in words. Item NDE03 (“Did scenes from your past come back to you?”; medium level of intensity) corresponds to the IADC experience of seeing or reliving specific scenes from one’s past. Item NDE04 (“Did you suddenly think you understood everything?”; medium level of intensity) reflects the new insights and shifts in meaning that often emerge during IADC sessions—for example, the realization that the deceased loved one is still alive and well, remains present in the patient’s everyday life, and that one day a permanent reunion with him or her will be possible. Additionally, NDE04 reflects a new awareness that life continues after death, holds intrinsic meaning, and should be guided by transcendent values.

Scores on the Paranormal subscale are generally lower than those on the other subscales. This is because, although two items on this subscale reached a high level of intensity, the other two appear less relevant to typical IADC experiences. For instance, item NDE09 (“Were your senses more vivid than usual?”; high intensity) effectively captures the heightened sensory perception often reported during IADC sessions. Similarly, item NDE10 (“Did you seem to be aware of things happening elsewhere, as if by extrasensory perception?”; high intensity) aligns with accounts of information perceived during IADC sessions that was later externally corroborated. In contrast, item NDE11 (“Did you have visions of the future?”; very low intensity) and item NDE12 (“Did you feel separated from your physical body?”; low intensity) received markedly lower scores, likely because they reflect phenomenological elements more typical of classical NDEs.

Regarding item NDE11, although visions of future events are acknowledged as a possible component of near-death experiences (NDEs), empirical research indicates that such phenomena are relatively uncommon. Greyson (1983) reported that only 16% of NDErs gave a clearly positive response to the item “Visions of the future” on the Preliminary Questionnaire, from which the NDE Scale was developed. Likewise, Schwaninger et al. (2002); van Lommel (2007), and Parnia et al. (2022) did not highlight future visions as a frequent or salient feature in their respective studies.

In the preliminary questionnaire, which served as the basis for the development of the NDE Scale, clearly positive responses to the item “out-of-body experience” (later designated as item NDE12: “Did you feel separated from your physical body?”) accounted for 53% of responses (Greyson, 1983). Given their intrinsic characteristics, IADC experiences—unlike NDEs—do not typically involve separation from the physical body. The lower intensity of responses to item NDE12 among NDE-like IADC experiencers may be attributed to the absence of the life-threatening conditions commonly associated with classical near-death experiences.

Following the item-level analysis, the phenomenology of the IADC experience emerged with greater clarity and definition. By first identifying the items that reached a high or very high intensity level and then rephrasing the corresponding questions as affirmative statements, a distinctive experiential profile begins to take shape. The IADC experience can thus be characterized by the following elements: “I seemed to enter some other, unearthly world”; “My senses were more vivid than usual”; “My thoughts speeded up”; “I seemed to be aware of things happening elsewhere as if by extrasensory perception”; “I saw deceased spirits or religious figures”; “I seemed to encounter a mystical being or presence”; and “I had a feeling of peace or pleasantness.” These features clearly indicate that the IADC experience shares substantial phenomenological overlap with the near-death experience (NDE).

The experiential profile becomes even more nuanced when items of medium intensity are included: “Time seemed to speed up,” “Scenes from my past came back to me,” “I saw or felt surrounded by a brilliant light,” “I felt a sense of harmony or unity with the universe,” “I suddenly seemed to understand everything,” and “I had a feeling of joy.”

4.3. Study Limitations and Future Directions

This study empirically tested, for the first time, the hypothesis that IADC experiences and near-death experiences (NDEs) share a common phenomenology. To this end, the NDE Scale was administered, as it has been the most widely used investigative tool over the past forty years for identifying NDEs and distinguishing them from other types of experiences (Greyson, 1983). The findings obtained support the notion that the two types of experience—though arising in radically different contexts (near-death conditions vs. grief therapy)—represent two variations of a single phenomenon. Importantly, these findings do not address the ontological status of IADC experiences.

Despite the valuable insights provided, several limitations should be acknowledged. Firstly, as is typically the case when using the NDE Scale, participants completed the scale several months or even years after their IADC sessions. As a result, recall bias may have influenced the accuracy of their phenomenological reporting. Therefore, future studies should aim to administer the NDE Scale closer in time to the IADC experience in order to minimize this bias. However, it is important to note that all participants had access to a verbatim transcript of their IADC experience.

Second, the sample consisted exclusively of individuals who had previously completed IADC therapy with the same therapist, potentially limiting the generalizability of the findings due to therapist- or setting-specific influences. To enhance generalizability and control for therapist-related effects, future studies should involve multiple therapists trained in the IADC procedure and assess inter-therapist variability.

Third, although the sample size was adequate for preliminary analyses, it remained relatively small, thereby reducing statistical power and limiting the ability to detect more subtle phenomenological patterns.

Fourth, self-selection bias may have occurred, as participation was voluntary and may have attracted individuals with particularly rich and vivid experiences.

Finally, although the use of the original NDE Scale was justified, it may not fully capture the nuances specific to IADC phenomena, as the scale was originally developed to assess NDEs reported by individuals in life-threatening conditions.

Future research should aim to address the current limitations by recruiting larger and more diverse samples, as well as by involving multiple therapists to improve generalizability. It would also be beneficial to complement the Near-Death Experience (NDE) Scale with instruments specifically designed to assess the IADC experience, alongside qualitative analyses of verbatim transcripts from patient-reported sessions. Furthermore, future studies should examine whether individual differences, such as personality traits, might influence the degree of success of IADC therapy and affect the extent to which IADC experiences overlap with NDEs. Exploring these factors could provide valuable insights into treatment variability and help identify potential predictors of clinical efficacy.

No differences were observed in the content of the experience among participants, regardless of whether they identified as Catholic or adherents of other religions, spiritual but not religious, agnostic, or atheist. Furthermore, as demonstrated in a previous study (D’Antoni et al., 2025), the phenomenology of IADC experiences was not shaped by expectations stemming from Catholic cultural tradition—neither theologically (which would not be possible in any case, given that Catholic theology does not provide a specific description of heaven), nor in literarily (e.g., IADC experiences contain no references to Dante’s Inferno and Purgatory), nor iconographically (e.g., they lack images of angels playing trumpets, saints, or other figures associated with that religious narrative). In essence, this phenomenology appeared to be independent of and inconsistent with expectations suggested by the cultural tradition of Catholicism. Nevertheless, future cross-cultural research is warranted to assess whether these findings can be generalized across different cultural contexts.

5. Conclusions

Despite the aforementioned limitations, the present study offers valuable preliminary evidence concerning the phenomenological similarities between induced after-death communication (IADC) experiences and near-death experiences (NDEs). By systematically applying a validated assessment tool to IADC experiences, results were obtained that describe the IADC experience as encompassing after-death communication (ADC) experiences while also extending beyond them. In summary, through the induction of a receptive mental state, IADC therapy facilitates the emergence of experiential phenomena comparable to those described in NDEs. As Botkin (2000) noted, “The more multisensory and elaborated ADCs are, the more similar they are to NDEs. That is why induced ADCs are actually more similar to NDEs than to spontaneous ADCs” (pp. 183–184).

The data collected may contribute to a deeper understanding of the non-ordinary states of consciousness associated with IADC therapy, as well as to offer greater insight into the factors underlying its demonstrated clinical efficacy, which has been supported by several empirical studies (Botkin & Hannah, 2013; Hannah et al., 2013; Holden et al., 2019; D’Antoni et al., 2025). Future research based on these preliminary findings could further refine the theoretical and clinical implications of IADC experiences. Moreover, the distinction between NDE-like and non–NDE-like IADC experiences underscores the importance of investigating how specific phenomenological characteristics may influence therapeutic outcomes. Psychotherapists might consider fostering conditions that facilitate the emergence of NDE-like experiences, given their potential clinical relevance. Future research is warranted to empirically assess the differential therapeutic impact associated with these two experiential profiles.