The near-death experience (NDE) most generally refers to a state of altered consciousness with various features that can occur during real or presumed near-death circumstances and/or life-threatening incidents. Some NDEs are associated with a nonfatal suicide attempt. This paper discusses how a belief by suicide attempters that their NDEs are a true portrayal of objective spiritual reality can at least in some cases be positively associated with a persistence or increase of suicidal ideation and on occasion lead to further suicide attempts, while also exploring why at other times such a belief may reduce the risk of suicide. The formulation of suicidal ideation associated with NDEs among some of those who did not initially try to kill themselves is also explored. Various examples related to NDEs and suicidal ideation are provided and discussed. Furthermore, this paper also offers some theoretical insights related to this matter and points out some specific therapeutic concerns based on this discussion.

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When people experience a near-death or life-threatening incident, they sometimes report an altered state of consciousness in which they have the perception of being out of or away from their physical body. During such an experience these individuals at times have the impression of encountering a spiritual personage who offers them a choice to stay or return to their physical life and/or attempts to motivate them to willingly do so, sometimes conflicting with a simultaneous desire to stay in that altered state of consciousness they perceive as the afterlife. This paper discusses how self-determination theory (SDT) is relevant to this process by meeting the experient’s three basic psychological needs for relatedness, competence, and autonomy, resulting in various degrees of effectiveness. It concludes with a postulation that by doing so it may foster a continuing intrinsic motivation to live life well, resulting in a greater overall condition of psychological wellbeing.