Dream Survey Form
Thank you for taking this survey. Please answer the following questions in as much detail as you can. All responses will be kept confidential,and any published references will preserve your anonymity. Talking about dreams can give rise to surprising emotions and personal memories, so you are free to stop the survey at any time.
To contact professional psychotherapists who are trained in working with dreams, you may visit the website of the International Association for the Study of Dreams (www.asdreams.org)
1. How old are you?
2. Male or female?
Male
Female
3. What is your state of residence, or country if outside the US?
For the following questions, please describe when the dream occurred, the characters (their ages and relations to you), settings (whether familiar or unfamiliar), any colors in the dream, and any emotions you felt. Please include as much detail as you can.
4. Please describe the most memorable dream you’ve ever had, whether
5. What makes this dream so memorable? Did it have any impact on your waking life?
6. What was the very first dream you remember?
7. How old were you at the time of that dream?
8. What’s the worst nightmare you can remember?
9. Do you have any recurrent dreams? If yes, please describe them, and say how often they occur.
10. Do your dreams ever have animals in them? If yes, which ones appear most frequently?
11. Have you ever had a dream about your work or occupation? If yes, please describe it.
12. Have you ever had a dream of falling? If yes, please describe it.
13. Have you ever had a dream of flying? If yes, please describe it.
14. Have you ever had a dream of someone or something chasing you? If yes, please describe it.
15. Have you ever had a dream of someone who’s dead coming back to life? If yes, please describe it.
16. Have you ever had a dream in which you knew you were dreaming andnwere able to control the dream? If yes, please describe it.
17. Have you ever had a dream that was like being in a movie or hadnscenes and characters from a movie? If yes, please describe it.
18. Have you ever had a dream that predicted something that later happened in waking life? If yes, please describe it.
19. Have you ever had a dream that felt like a mystical or religious experience? If yes, please describe it.
20. Have you ever had a dream in which you felt an evil or demonic presence? If yes, please describe it.
21. Have you ever had a dream with sexual or romantic feelings? If yes, please describe it.
22. Have you ever had a dream that resulted in an actual sexual climax (e.g. for guys, a “wet dream”)? yes or no
Yes
No
23. How many hours on average do you sleep each night?
24. How would you describe the quality of your sleep?
excellent
good
fair
poor
terrible
25. How often do you wake up remembering a dream?
Almost every morning
once or twice a week
once or twice a month
once every few months
almost never
26. How often do you wake up remembering a nightmare?
Almost every morning
once or twice a week
once or twice a month
once every few months
almost never
Finally, some demographic questions:
27. Are you primarily right-handed or left-handed?
Right Handed
Left Handed
28. What was the last school you attended?
Grade school
high school
college
graduate/professional
29. What is your occupation?
30. Are you married or single?
Married
Single
If married, for how long?
If divorced, for how long?
31. Do you have children?
Yes
No
If yes, how many?
32. Were you raised in a religious tradition? If yes, which one?
33. Do you now belong to a religious tradition?
34. How often do you attend religious worship services?
more than once a week
once a week
once or twice a month
once or twice a year
seldom or never
If yes, which one?
35. Have you ever had what you would call a mystical experience? If yes, please describe it.
36. Do you have any comments about this survey, or suggestions of other questions to ask?
Thank you very much for your answers. Most people find it an unusual experience to bring to mind so many dreams all at once, so I suggest you take some time to reflect on whatever thoughts and feelings may have arisen. Also, you might try paying extra attention to the next few dreams you have, just to see if they react in any way to your answers on the survey. If you would like more information on the types of dreams covered here, go to the Research section and you’ll find articles on different aspects of dream phenomenology.
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