Remembering Your Past Lives

Self Analysis Form: Fears and Distastes

For each item, check off the description that best describes your response,
plus any comments you may want to note:

1 -- Causes me great fear, distress/discomfort
2 -- Gives me some anxiety/discomfort
3 -- I have a neutral response
4 -- I find rather pleasant or comfortable
5 -- I greatly enjoy/feel totally comfortable

Condition
1 2 3 4 5 Comments
1. Being in water
2. Being in high places
3. Being in small, enclosed places
4. Being in wide open places
5. Snakes
6. Darkness
7. Heat
8. Cold
9. Sunlight
10. Wearing heavy clothing
11. Birds
12. Crowds
13. Solitude
14. Loud noises
15. Silence
16. Wearing high collars
17. Wearing hats
18. Mice
19. Arid climates
20. Humid climates
21. Certain nationalities or ethnic groups (list specific nationality or ethnic groups in "comment" space)
22. Certain foreign or regional accents (list specific accents in "comment" space)
23. People who are late
24. People who are early
25. Certain physical traits in others (i.e., hair color, body type, noses) List specifics in "comment" space.
26. The opposite sex
27. Authority figures
28. Fire
29. Wind
30. Lightening
31. Being abandoned
32. Hunger
33. Death
34. Tunnels
35. Bridges
36. High speed
37. Flying
38. Guns
39. Knives
40. Pregnancy/childbirth
41. Stairs

The items above are things that often come up when people list their
fears and distastes. You probably have your own. List them below and
mark your responses to them as you have for the others.

__________________________________________________________

__________________________________________________________

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Attractions to People and Places

Notes on Childhood Interests, Abilities, Memories

Things that stand out from my very early childhood memory.

Body Clues

Part One: Physical Strengths

1. Consider your childhood as well as the present. Did you, and/or do you, have any special body skills and characteristics that are a physical strength? For example, a strong, broad hand that enables you to play the piano; finger dexterity that enables you to do precision work, such as model building, etc. If so, list them:

2. Again, considering your childhood as well as the present, are any of your five sense particularly sharp? If so, describe:

3. Have you ever had any special athletic ability, either now or in the past? List specific abilities, as well as the body strengths necessary for these abilities. For example, you might list cross country skiing, which would require great stamina and strong legs. Maybe as a child you were the champion at some game. This would show great eye hand coordination.

Part Two: Physical Weaknesses

1. List any body "trouble spots" where you often experience illness or discomfort. Include any chronic health problems (ie., bad back, sinusitis) as well as areas where illness tends to re-occur for you (i.e., periodic stomach trouble, respiratory infections).

2. List any of the five senses that are especially weak or nonfunctional.

Part Three

1. List any birthmarks you may have, as well as where they are located. If you have feelings about any of these marks, be sure to note these as well.

2. Do you have particular features that others often notice, or that you are particularly aware of? For example, maybe others frequently comment on your small feet. Or maybe you have always been very aware of your long neck. Note any such features here, as well as whether you consider each feature to be an asset or a problem.

Note: The above survey is from a spiritual teacher and
healer who is no longer on earth.

This page is in memory of G. Peterson.


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