Clinical Approaches to Non-Ordinary Experiences (NOEs): scoping review and bibliometric analysis

A scoping review and bibliometric analysis of 174 studies found that psychodynamic and transpersonal approaches dominate the clinical literature on non-ordinary experiences (NOEs), such as feelings of cosmic unity or sensing the deceased. Intervention techniques more frequently aimed to induce altered states (e.g., holotropic breathwork, meditation, psychedelic-assisted therapy) than to manage NOEs after they occurred. Bibliometric analysis revealed four research traditions: transpersonal/spiritual, psychiatric/psychopathological, psychedelic/meditative, and ethno-dissociative. The field relies heavily on case studies and qualitative reports, with limited experimental evidence, highlighting methodological and ethical challenges for future research.

Study at a glance

Abstract

Non-Ordinary Experiences (NOEs), encompassing phenomena such as feelings of cosmic or divine unity and sensing the presence of deceased persons, are common in the general population of different countries. Despite a recent increase in the number of studies investigating the implications of these experiences for mental health and well-being, no review comprehensively synthesizing existing psychotherapeutic, psychiatric, and counseling approaches to NOEs has been conducted, lacking further empirical guidance regarding their clinical management. To address this critical gap, the present study pursued four primary objectives: 1) to identify existing psychotherapeutic, psychiatric, and/or counseling approaches to NOEs within the mental health literature, 2) to examine interventions currently employed by mental health professionals to clinically manage NOEs, 3) to identify chief authors and countries where research in this area is being developed, and 4) to assess current research trends and provide recommendations for future research. A scoping review and a bibliometric analysis were carried out through a comprehensive search on PsycInfo and Web of Science databases, yielding 5,418 references, of which 174 met the eligibility criteria. Our results evidenced a predominance of psychodynamic and transpersonal approaches in this field, reflecting both historical traditions and contemporary emphases on the therapeutic potential of NOEs. Significantly, intervention techniques were more frequently oriented towards the induction of altered states (e.g., holotropic breathwork, meditation, psychedelic-assisted therapy). The bibliometric analysis pointed to four main paradigms that represent specific research traditions: transpersonal/spiritual, psychiatric/psychopathological, psychedelic/meditative, and ethno-dissociative. Despite this diversity, the field currently exhibits important methodological limitations, being largely characterized by a reliance on case studies and qualitative reports, with limited experimental evidence. Based on these findings, we critically discuss the methodological and ethical challenges involved and propose guidelines for future research. Keywords: anomalous experiences; non-ordinary experiences; mental health; psychotherapy; counseling; spirituality