For Professionals

For clinicians and practitioners

Experiencers are better served by professionals who understand them. Here you can learn the principles of experiencer-aware care, work through a practical guide to telling experience from disorder, draw on established peer-support training, and join the practitioner directory we refer experiencers to.

Understanding

What experiencer-aware care is, and how to tell experience from disorder

Experiencer-aware care

Most people who disclose an anomalous experience are well. Across the populations that have been studied, experiencers as a group do not show higher rates of mental illness on standard measures than the general population. You can read the evidence on the Research page. When distress is present, it usually comes from the experience itself and from being disbelieved, rather than from an underlying disorder. We take no position on the cause of these experiences. Our concern is the person and their wellbeing.

What experiencer-aware care looks like

  • Listen first, with respect and genuine curiosity, and let the person set the pace.
  • Stay neutral on whether the event was literally real, and keep the focus on the person in front of you.
  • Normalize. Treat an unusual experience as part of the range of human experience, and screen for suicidality, psychosis, and trauma exactly as you would with anyone.
  • Work trauma-informed, ease the distress of "ontological shock," and help the person integrate the experience into a life they can live well.
  • When a spiritual or anomalous experience is the focus of care and no disorder is present, the DSM-5 code "Religious or Spiritual Problem" (V62.89, ICD-10-CM Z65.8) lets the chart reflect the person accurately. It sits among the "Other Conditions That May Be a Focus of Clinical Attention," it is a Z-code rather than a disorder, and it is retained in DSM-5-TR.

A map of the experiences

These experiences are not one thing. They differ in how they present, in what tends to cause distress, and in how you support the person. A shared vocabulary helps.

  • Experiencer. A general term for someone who reports a direct anomalous or non-ordinary experience, who may or may not seek any explanation for it.
  • Near-death experience (NDE). A lucid experience reported during a close brush with death, often with features that recur across cultures.
  • Contact experience. A reported encounter with a presence or intelligence perceived as other than human.
  • Spiritually transformative experience (STE). An experience that durably reorganizes a person's sense of meaning, identity, or place in the world.
  • After-death communication (ADC). A sensed contact with someone who has died. Common in grief and, on its own, not a sign of illness.
  • Ontological shock. The disorientation that follows when an experience does not fit the person's prior sense of what is possible.
  • Spiritual emergence and spiritual emergency. Emergence is a gradual, manageable opening into new meaning. Emergency is when that process overwhelms the person's ability to function and calls for active support. The line runs between growth and crisis, not between health and disorder.

Distinguishing experience from disorder

The clinical task is to avoid two errors at once. The first is pathologizing a well person because their experience is unusual. The second is missing genuine illness because every symptom gets attributed to the experience. Screen as thoroughly as you would with anyone, then let the findings, rather than the content of the story, guide you.

Signs that point toward a well person

  • The experience is bounded in time rather than ongoing and escalating.
  • Reality-testing outside the experience is intact.
  • Distress is proportionate and eases as the person feels heard.
  • Functioning at work, in relationships, and in self-care holds.
  • The person can sit with uncertainty about what happened.

Signs that warrant fuller assessment or a higher level of care

  • Functional decline, self-neglect, or withdrawal that is getting worse.
  • Disorganized thinking, or beliefs that are fixed, systematized, and expanding.
  • Command experiences, or content that directs the person toward harm.
  • Suicidal or homicidal ideation, intent, or plan.
  • First onset of marked change in mid or later life, or a sudden shift in personality.
  • Heavy substance use, or a medical or neurological picture that fits the timeline.

If risk is present, act on it. Crisis resources are on the Get help now page.

Conditions worth ruling in or out

  • Sleep-related phenomena. Sleep paralysis with hypnopompic or hypnagogic imagery accounts for many nighttime "presence in the room" reports, including a felt weight on the chest, fear, and an inability to move. Ask about timing, sleep debt, and shift work.
  • Psychotic and prodromal presentations. Look for formal thought disorder, negative symptoms, functional decline, and expanding delusional elaboration, rather than a single coherent experience the person can step back from and reflect on.
  • Dissociative phenomena. Depersonalization, derealization, and absorption overlap with reports of altered or "missing" time.
  • Substance and medication effects. Include hypnotics, anticholinergics, stimulants, and psychedelics, along with periods of withdrawal.
  • Neurological contributors. Temporal-lobe activity, migraine aura, and other organic causes deserve referral when the picture suggests them.
  • Bereavement and after-death communication. A sensed presence of someone who has died is common and normative in grief, and is not by itself a sign of illness.

Practice

Assessing, holding your stance, and approaches that help

Assessment

Use the instruments you already trust, and add a few that fit this work.

  • Risk and trauma. Screen with your standard tools, such as the Columbia Suicide Severity Rating Scale (C-SSRS) and the PTSD Checklist for DSM-5 (PCL-5). The Dissociative Experiences Scale (DES-II) helps where dissociation is in question.
  • Experience-specific measures. The Greyson Near-Death Experience Scale, the Mystical Experience Questionnaire (MEQ-30), and the anomalous-experience inventories used in the research literature let you describe what the person reports without judging it.
  • Culture. The DSM-5 Cultural Formulation Interview (CFI) is free and structured, and it matters here because what counts as anomalous is shaped by culture. Communicating with deceased relatives, for example, is expected and ordinary in many communities.

Holding your own stance

Notice your own reaction. These accounts can pull a clinician toward quiet skepticism on one side or fascination and over-identification on the other. Either pull leaks into the room. Your work is not to convert the person and not to correct them. Hold a steady, curious neutrality, keep your attention on the person's wellbeing, and bring strong reactions to supervision or consultation.

Approaches that help

No single model owns this work. Clinicians draw on approaches that support integration and ease distress, adapted from their usual evidence base rather than tested as cures for anomalous experience. Match the approach to the presenting need, the same way you would with any client.

  • Trauma-focused care, including EMDR, where a frightening experience carries a traumatic charge.
  • Internal Family Systems and other parts-based work for the conflicting reactions an experience can stir.
  • Acceptance and Commitment Therapy for living well alongside unresolved uncertainty about what happened.
  • Narrative and meaning-centered approaches for rebuilding a coherent story after ontological shock.
  • Existential and somatic work for the bodily and meaning dimensions the experience touches.

Memory and client safety

Many caring practitioners use hypnosis, often with people who feel they have nowhere else to turn, and the relief and validation that can bring is real. At the same time, the research on memory is consistent: hypnosis and guided "memory recovery" can produce recollections that feel vivid and certain yet are not reliable as a record of what literally happened. That matters especially here, because an experiencer is often trying to understand a real and disorienting event, and material surfaced this way can take on a life of its own. We'd encourage treating anything recovered under hypnosis as the person's meaningful experience rather than as established fact, favoring non-leading methods, and seeking independent corroboration before drawing factual conclusions. Where hypnosis eases distress, supports relaxation, or aids integration, it can be genuinely valuable. The caution is specifically about reconstructing events, not about the practitioners who do this work.

How it looks in practice

Three short composites, drawn from common presentations rather than real people, show the differential at work.

A widow hears her late husband's voice. Six weeks after his death she hears him call her name and feels him sit on the edge of the bed. She sleeps and eats well, keeps her routines, and finds the experience comforting more than frightening. The read: a common, normative feature of grief. Support the mourning. No diagnosis is needed.

A student wakes pinned, certain a figure is in the room. It happens as he falls asleep or wakes, lasts seconds to a minute, brings fear and an inability to move, and has worsened during exam weeks of short sleep. The read: sleep paralysis with hypnopompic imagery. A sleep history, sleep hygiene, and reassurance do more here than interpretation.

A man in his early twenties describes a presence directing his actions. Over months his thinking has grown harder to follow, he has stopped seeing friends, his work has fallen away, and the belief is fixed and expanding. The read: this is not a bounded experience to normalize. Screen for a psychotic process and arrange prompt assessment.

At a glance

  • Listen first. Let the person set the pace. Stay neutral on what literally happened.
  • Screen for risk, psychosis, trauma, sleep, substances, and medical causes, the same as with anyone.
  • Reassure when the findings are reassuring. Refer or escalate when the cautionary signs are present.
  • When a spiritual or anomalous experience is the focus and no disorder is present, the chart can use the DSM-5 code Religious or Spiritual Problem (V62.89, ICD-10-CM Z65.8), which is not a diagnosis.
  • A useful opening: "Tell me about the experience in your own words, and what it has been like to live with."

Download the one-page clinician quick reference (PDF)

An invitation you can add to your intake

Some clinicians add a single line to intake forms so clients know the door is open:

"You are welcome to talk about unusual, spiritual, or anomalous experiences here. They will be met with respect."

Clinician questions

Answers to questions that come up often

  • A client reports something I find hard to believe. What is my role?

    The same as always: understand the person, assess risk and functioning, and support wellbeing. You do not have to decide whether the event was literally real to do good work.

  • How do I document this without pathologizing?

    Describe the experience in the person's own words, record your risk and diagnostic screening, and, where a disorder is absent, use the Religious or Spiritual Problem code rather than a diagnostic label.

  • When should I refer out or up?

    When the cautionary signs above are present, when risk is active, or when a medical, neurological, or substance cause needs evaluation beyond your scope.

  • Do I need to share my client's beliefs?

    No. You need genuine respect and steady neutrality. Neither agreement nor correction is part of the job.

Train and join

Programs to join, train through, and be listed in

Practitioner directory

The practitioner directory helps experiencers find a clinician or practitioner who understands them. It is the public list on the Get Support page.

If you offer experiencer-aware care, we'd love to have you in our directory. A listing connects you with experiencers searching specifically for clinicians who understand their reality.

Join the directory. To be listed, a practitioner:

  • confirms verified credentials and a clear scope of practice;
  • commits to experiencer-aware, non-pathologizing, trauma-informed care and a published code of ethics;
  • discloses modality, fees, insurance, telehealth, and jurisdictions, along with any conflicts of interest;
  • re-attests annually.

Training in experiencer-aware care

  • Experiencer-aware clinical training

    An evidence-informed course on phenomenology, distinguishing distress from disorder, sound memory practice, trauma-informed and somatic approaches, and cultural and religious framings. Planned

  • First-responder and primary-care modules

    Short, practical guidance for emergency departments, EMS, primary care, and chaplains on receiving a disclosure with care, built on trauma-informed practice. Planned

  • Peer-supporter training

    An openly published curriculum for peer volunteers, drawing on the established materials in the field. Underway

  • Continuing education credit

    Accreditation of the clinical training for CE and CME hours, so the learning counts toward licensure and certification. Planned

Peer support

Peer-support training

Sign up for the next Peer-Support Training class here:

For reference, some of the resources used in our Peer-supporter training classes are listed below.

Standards and competencies

Training models and curricula

Trauma-informed care and crisis basics

Supporting experiencers specifically

References

Reading and allied organizations

Selected reading

A short, credible starting point for clinicians new to this work, with sources on both the experience and its conventional explanations.

  • Cardena, E., Lynn, S. J., and Krippner, S. (eds.). Varieties of Anomalous Experience: Examining the Scientific Evidence, 2nd ed. American Psychological Association, 2014.
  • Rabeyron, T. (2022). "When the Truth Is Out There: Counseling People Who Report Anomalous Experiences." Frontiers in Psychology. doi.org/10.3389/fpsyg.2021.693707
  • Fach, W., et al. (2013). "A Comparative Study of Exceptional Experiences of Clients Seeking Advice and of Subjects in an Ordinary Population." Frontiers in Psychology. pmc.ncbi.nlm.nih.gov/articles/PMC3575056
  • Spanos, N. P., et al. (1993). "Close Encounters: An Examination of UFO Experiences." Journal of Abnormal Psychology, 102(4), 624-632.
  • Lukoff, D., Lu, F., and Turner, R. (1998). "From Spiritual Emergency to Spiritual Problem." Journal of Humanistic Psychology. journals.sagepub.com
  • Greyson, B. (2021). After: A Doctor Explores What Near-Death Experiences Reveal About Life and Beyond. St. Martin's Press.
  • Grof, S., and Grof, C. (eds.) (1989). Spiritual Emergency: When Personal Transformation Becomes a Crisis. Tarcher.
  • Simmonds-Moore, C. (ed.) (2012). Exceptional Experience and Health: Essays on Mind, Body and Human Potential. McFarland.
  • French, C. C., and Stone, A. (2014). Anomalistic Psychology: Exploring Paranormal Belief and Experience. Palgrave Macmillan. A grounding in the conventional and cognitive explanations.

Allied organizations

  • ACISTE, the American Center for the Integration of Spiritually Transformative Experiences: professional certification and a provider directory.
  • IANDS, the International Association for Near-Death Studies: clinician training resources and a provider list.
  • Spiritual Emergence Network: a referral directory for spiritual-emergence support.
  • John E. Mack Institute: experiencer dialogues and clinician referrals.
  • UVA Division of Perceptual Studies: an academic research unit studying experiences that challenge current scientific understanding.

To be listed in the directory, or to help shape the training and resources here, write to us.

↑