Can I Be Hypnotized?
Mistress Clarice
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Date
How old are you today?
1. When the television is on, can you "switch off" and lose track of what you are watching?
A. Frequently; What was the name of that program?
B. Sometimes
C. Rarely
2. When you go to the movie theater, can you feel emotional when you see something sad?
A. Frequently; "I am tearful now!"
B. Sometimes
C. Hardly ever
3. When you close your eyes, how quickly can you fall asleep?
A. Within 10 minutes
B. Within 30 minutes
C. When the alarm goes off
4. When reading a good book, can you "close off" to any external distractions?
A. Regularly; "noise, what noise?"
B. Occasionally
C. Never
5. When chatting with a close friend, do you lose track of time?
A. Nearly always
B. On occasion
C. Can't stop looking at my watch!
6. When you see someone else yawn, does it become contagious?
A. Repeatedly, I am yawning right now!
B. Now and again
C. Rarely
7. Do you salivate when you think about sucking or sinking your teeth into a sour, juicy lemon? (Think about it now)
A. Most of the time!!!
B. Sometimes
C. Hardly ever
8. When you like a new song, does it keep going round and round in your mind at the most inconvenient moments?
A. Regularly, "La-la-la..."
B. Occasionally
C. Not very often
9. If you close your eyes, can you visualize a journey form your house to the nearest shop?
A. Images are clear & detailed
B. Can visualize some details of the journey
C. Vague details; "Is there a shop near me?"
10. Would you (or others) consider you as a creative person?
A. Yes, I use my creative skills almost every day
B. Sometimes
C. Rarely
11. When you drive to a familiar place e.g. work, does your mind switch to auto pilot?
A. Nearly every day
B. Sometimes
C. Hardly ever
12. If you see a crowd of people looking at something, do you tend to look at the same direction out of curiosity?
A. Most of the time
B. Some of the time
C. Rarely
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