Short Questionnaire For People Who Do Spiritual Healing.

Your answer to these questions will be used in a database to help in understanding aspects of the self and states of consciousness. Your identity will never be revealed to anyone. At no point in answering these questions will you asked to make medical claims of any kind.

Your name:

(If you don't put in your name, your form will be disqualified)

Your email address: (like: you@aol.com)


WHAT KIND OF SPIRITUAL HEALING DO YOU DO?

(You can choose more than one)

If you selected "Other" or "A technique I developed myself" (above), please describe the kind of healing you do.

HOW OFTEN DO YOU DO SPIRITUAL HEALING?

HOW LONG ARE YOUR SPIRITUAL HEALING SESSIONS?

HOW LONG HAVE YOU BEEN DOING SPIRITUAL HEALING?


What kind(s) of spiritual practice(s) are you doing now besides Spiritual Healing?

Please describe it/them as best as you can.

(I know these things are hard to put into words sometimes.)



How Often do you experience Deja Vu?



How Often do you get the feeling that everything is strange, dreamlike, just 'wrong', or somewhat alien?



How often do you get the feeling that someone or something is in the room with you, but when you turn to look, you don't find anyone there?

-or-

How often do you get the feeling that you are 'not alone' or that you are 'being watched' when you know you are by yourself?



How often do you get the feeling that your body is moving when you know its actually being still?

(This one is most common while falling to sleep)




How Often do you experience 'tingley' feelings, like pins-and needles, electric-like 'buzzes', or chills running up your spine? (DON'T count chills due to cold or your foot falling asleep.)


(Be sure to indicate BOTH your gender and age- yes, it matters): 

I am a male.

I am a female.


I am younger than 15 years old.

I am between 15 and 20 years old.

I am between 20 and 30 years old.

I am between 30 and 40 years old.

I am between 40 and 50 years old.

I am between 50 and 60 years old.

I am between 60 and 70 years old.

I am over 70.


PLEASE ANSWER ALL THE QUESTIONS EVEN IF YOU'RE NOT COMPLETELY COMFORTABLE WITH THEM OR THE EXACT WORDS USED HERE. WHEN YOU SKIP A QUESTION DELIBERATELY, YOU INFLUENCE THE RESULTS.

Please check the buttons next to the following items if they are true for you


I have seen an infinite space in my mind.

I write poetry.

I keep a diary or journal.

Sometimes my emotions appear so strongly that I am shocked at their intensity.

I have had a Near-Death Experience in which I experienced things I can never really describe.

It seems like I can never stop thinking about sex.

I almost never think about sex unless something happens to make me think about it.

Although I'm glad to be alive, I sometimes look forward to death, and an end to living in the physical reality.

Sometimes I think that there are rules to life that everyone understands except me.

When I lose an argument, I then spend some time thinking about what I should have said.

When I start talking in a setting I enjoy, I can have a hard time stopping.

I get angry easily, but it never lasts long, and I feel terrible afterward.

I have felt the presence of a spirit or power that I have prayed to.

I have been visited by a spirit or a power that wanted to do me harm.

At least once in my life, I have left my body, and I knew it wasn't a dream.

I have heard voices in my head so strongly that I wasn't sure if they were from outside or not.

Sometimes I smell things that aren't there.

I have a spirit familiar.

I am left-handed

I often think about suicide.

I almost never remember my dreams.

Sometimes my vision sharpens so that I can see with incredible clarity.

My spirituality is the most important thing in my life.

When I fall in love, it takes me over completely.

Sometimes I'm overwhelmed with a terrible fear of dying.

I have had an epileptic seizure.

I often find myself with words on the tip of my tongue that I just can't get out.

I make little altars around my house.

I own at least two sacred objects.

I was regularly physically or sexually abused as a child.

I have anxiety attacks.

I'm gay.

Sometimes I have sensations moving around inside my body.

I have experienced 'love at first sight'.

I have dyslexia.

I can see auras.

I remember my dreams often

My hands tingle when I do spiritual healing

My hands get warm or hot when I do spiritual healing

When I do spiritual healing, I feel that I'm not doing the healing work. Another being is actually doing it.


How often is your healing work effective?

Never

About 10% of the time

About 20% of the time

About 30% of the time

About 40% of the time

About 50% of the time

About 60% of the time

About 70% of the time

About 80% of the time

About 90% of the time

100% of the time



Can you think of a question that belongs in this questionnaire?

Please, put it here: Be creative.


Have you ever been addicted to any drug? Which one(s)?

(All identities and answers to this question are kept completely Confidential)



Is there anything you think I should know?

If you have had a Near-death Experience or any kind of powerful spiritual experience, and you're willing to tell me about it, please do it here. Any Comments are welcome.

You may also tell stories of your more interesting cases

Can we contact you?

Yes

No

Where are you located?
 
(USA ONLY)

Other countries
 
If yes, put your email address here:

Your email address:
 

 


Note: Your identity will be kept completely Confidential.