Marieta Pehlivanova is a researcher at the Division of Perceptual Studies (DOPS), University of Virginia, with interests relating to near-death and related experiences.
Contents
Career
Pehlivanova is a research sssistant professor of psychiatry and neurobehavioral sciences at the Division of Perceptual Studies (DOPS), University of Virginia School of Medicine. Her PhD in experimental psychology (cognitive neuroscience) from the University of Pennsylvania was awarded in 2017. An MA in experimental psychology from the same institution was received in 2016. A BS in statistics (mathematical statistics track) summa cum laude from American University was earned in 2007.
Pehlivanova worked as a biostatistician at MedStar Health Research Institute from 2007 to 2011 prior to joining DOPS. Her research interests encompass near-death experiences, children reporting past-life memories, after-death communications, and personality and cognitive correlates of psi beliefs and experiences.
Fear of Death (Thanatophobia)
In a 2022 publication, Pehlivanova and colleagues discuss the widespread existential fear of death, noting that this has been found in numerous studies to decline dramatically following a near-death experience, and seeking to uncover which of its features is mainly responsible. The strongest predictor was found to be the encounter with mystical beings and a life review. However, contrary to predictions, the sense of disembodiment often reported by experiencers was not associated with changes in death attitudes. The authors discuss these findings in the context of Terror Management Theory, concluding that they have implications for clinical interventions to help people at the end of life.1Pehlivanova et al (2022).
Pehlivanova and colleagues separately examined such interventions for thanatophobia, analysing 15 studies carried out between 2009 and 2019 in four categories: psychotherapy, mindfulness, psychedelic drugs and virtual reality. Psychotherapy approaches, including meaning-centred and life review therapies that strengthened belief in an afterlife, were shown to reduce death anxiety, although these findings were weakened by small samples and absence of control groups. Mindfulness exercises were found to reduce anxiety but typically without altering afterlife beliefs.
Psychedelic drugs (LSD and psilocybin) showed promise in dissociating mind from body and reducing death anxiety, although access to these is limited by government regulations. Virtual reality simulations of out-of-body experiences appeared effective, possibly by strengthening afterlife beliefs.
The authors found benefits in all four approaches and recommended that future research explore their mechanisms in larger, more diverse populations.2Blomstrom et al (2020).
Support Needs after Near-Death Experiences
Pehlivanova and colleagues conducted an exploratory investigation examining support needs amongst 167 near-death experiencers. Participants completed online questionnaires assessing the kind of professional help sought, perceived helpfulness of support, and barriers to accessing assistance. Sixty-four percent of participants reported seeking support to process their NDE. Seventy-eight percent found such support helpful.
Greater NDE intensity and prior psychological difficulties significantly increased the likelihood of an experiencer seeking support. Positive initial reactions when disclosing the NDE and support from NDE-friendly organizations was found to significantly enhanc perceived helpfulness of support received. Participants frequently cited fear of being labelled mentally ill or misunderstood as barriers to disclosure.
The authors emphasized a notable ‘gap of care’, with mental health professionals often seen as less helpful due to insufficient specialized training. The study underscored the importance of validation and psychological safety in post-NDE integration.3Pehlivanova et al (2025a).
Meditation, Mindfulness and Paranormal Experiences
Pehlivanova and colleagues investigated the relation between meditation, mindfulness and paranormal experience, comparing 98 individuals enrolled in intensive meditation retreats with 40 control participants over a two-week period. The meditation group demonstrated significantly higher baseline levels of paranormal beliefs and experiences and attributed greater meaning to these (p = 0.002). Performance on psi tasks (precognition, psychokinesis, and intuition) did not improve in either group over time, contrary to expectation. Meditation history was associated with more accurate intuition performance (p = 0.023).fn]Penberthy et al (2020).[/fn]
Spirituality in Psychiatry
In an article in Psychiatric Times, Pehlivanova and colleagues explored the extent to which spirituality, as opposed to religiosity, is integrated into psychiatric practice, highlighting its relevance across several DSM-5 diagnoses (including persistent depressive disorders, prolonged grief disorder, and post-traumatic stress disorder). The article discussed terror management theory alongside an alternative approach-oriented framework for addressing mortality awareness. The authors emphasized how direct confrontation with death fostered personal growth and existential well-being. Neuroimaging research revealed involvement of the default mode network and salience network in spiritual experiences.
The authors recommended structured spiritual assessments such as the FICA tool to enhance holistic psychiatric care, along with therapeutic modalities including meaning-centred psychotherapy, acceptance and commitment therapy, and mindfulness-based interventions.4Pehlivanova et al (2025b).`
Michael Duggan
Literature
Penberthy, J.K., Hodge, A.S., Hook, J.N., Delorme, A., Pehlivanova, M., Vieten, C. (2020). Meditators and nonmeditators: A descriptive analysis over time with a focus on unusual and extraordinary experiences. Journal of Yoga and Physiotherapy 8/3, 555744.
Pehlivanova, M., Carroll, A., Greyson, B. (2022). Which near-death experience features are associated with reduced fear of death? Mortality 28/3, 493-509.
Pehlivanova, M., McNally, K.C., Funk, S., Greyson, B. (2025a). Support needs after a near-death experience: A quantitative study with experiencers. Psychology of Consciousness: Theory, Research, and Practice. Advance online publication.
Pehlivanova, M., Weiler, M., Penberthy, J.K., Cozzolino, P.J. (2025b). Psychiatry and Spirituality: Exploring the Intersections of Meaning and Mental Health. Psychiatric Times, August 2025.