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) Healing by laying on hands in person Long Distance healing Prayers to heal others Working with photos of sick people Psychic surgery in person Remote Psychic surgery Healing people's energy, not their bodies Massage with subtle energy work Reiki (Classical Japanese) Reiki (Modern) A technique I developed myself Other 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? TWICE A DAY EVERY DAY MOST DAYS ABOUT 4-5 TIMES A WEEK ABOUT 2-3 TIMES A WEEK ABOUT ONCE A WEEK HOW LONG ARE YOUR SPIRITUAL HEALING SESSIONS? MORE THAN AN HOUR ABOUT AN HOUR ABOUT 45 MINUTES ABOUT 30 MINUTES ABOUT 20 MINUTES ABOUT 15 MINUTES ABOUT 10 MINUTES HOW LONG HAVE YOU BEEN DOING SPIRITUAL HEALING? MORE THAN TEN YEARS MORE THAN 5 YEARS MORE THAN 3 YEARS MORE THAN 2 YEARS MORE THAN 1 YEAR MORE THAN 6 MONTHS MORE THAN 3 MONTHS MORE THAN 1 MONTH LESS THAN ONE MONTH 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? Never Between once a month and once a year. About Once a month. About Once per week. More than once a week. About once a day on most days. More than once a day. Almost constantly. How Often do you get the feeling that everything is strange, dreamlike, just 'wrong', or somewhat alien? Never Between once a month and once a year. About Once a month. About Once per week. More than once a week. About once a day on most days. More than once a day. Almost constantly. 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? Never Between once a month and once a year. About Once a month. About Once per week. More than once a week. About once a day on most days. More than once a day. Almost constantly. 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) Never Between once a month and once a year. About Once a month. About Once per week. More than once a week. About once a day on most days. More than once a day. Almost constantly. 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.) Never Between once a month and once a year. About Once a month. About Once per week. More than once a week. About once a day on most days. More than once a day. Almost constantly. (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) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Other countries   If yes, put your email address here: Your email address:

Note: Your identity will be kept completely Confidential.