Fear of death is cited by some psychotherapists as a major factor inhibiting the process of personal change. At the same time there is evidence from many different sources that awareness of one's mortality can lead to positive changes in attitude and behaviour. In the current study eight subjects who have come close to death are interviewed and a detailed examination is made of their life-threatening experience (LTE) and their prior and subsequent attitudes towards life and death in an attempt to understand the factors involved in the personal change resulting from their experience. All the subjects describe significant changes in their attitudes following their LTE. Some report both positive and negative changes, whereas others see the changes as predominantly or wholely positive. The main finding is that the one factor which all these subjects have in common is the integration into their perception of themselves and of their world of an awareness of their personal mortality. Some implications of the results are discussed and directions for future research are outlined.