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Ten years ago our research on out-of-body experiences suggested that the elements of the near-death experience (NDE) were not necessarily limited to situations in which survival was threatened. A decade of continued study has confirmed that the perception of being near death, independent of the actual real i ty of the situation, is the key determinant of the classical NDE. From early in life, the infant's dread of catastrophe leads to the elaboration of extensive psychological defenses against the possibility of extinction. The NDE is simultaneously a manifestation of faith and a catalyst for the development of faith. On the occasion of the 10th anniversary of this journal, it is perhaps timely to reconsider a question we first posed in print 10 years ago (Gabbard, Twemlow, and Jones, 1981). The essence of that question is whether the classic features of the near-death experience (NDE) are associated exclusively with actual brushes with death. The answer then, as it is now, is clearly "'no." However, the extensive collection of anecdotal reports and scientific studies in the last decade warrants a Glen O. Gabbard, M.D., is Director of the C.F. Menninger Memorial Hospital, and Training and Supervising Analyst at the Topeka Institute for Psychoanalysis. Stuart W. Twemlow, M.D., is Clinical Professor of Psychiatry at the University of Kansas School of Medicine-Wichita, and Instructor at the Topeka Institute for Psychoanalysis. Reprint requests should be addressed to Dr. Gabbard at The Menninger Clinic, Box 829, Topeka, KS 66609-0829. Journal of Near-Death Studies, 10(1) Fall 1991 9 1991 Human Sciences Press, Inc. 41 42 JOURNAL OF NEAR-DEATH STUDIES reconsideration of the meaning and significance of the answer to the

Do "near-death experiences" occur only near-death?—revisited.