Six Month Progress Survey

Circle the option which you feel describes you. Please answer each question as honestly as possible. 


I find it easy to relax.

Never — Rarely —  Occasionally — Frequently — Always


I am open-minded.

Never — Rarely —  Occasionally — Frequently — Always


I find it easy to visualize things.

Never — Rarely —  Occasionally — Frequently — Always

I find it easy to visualize things that other people describe to me (e.g. a springtime meadow).

Never — Rarely —  Occasionally — Frequently — Always


I am happy with myself.

Never — Rarely —  Occasionally — Frequently — Always

Other people’s perception of me defines who I am.

True — False


It’s easier to work when given clear directions from an authority.

Never — Rarely —  Occasionally — Frequently — Always

I’m able to make decisions for myself.

Never — Rarely —  Occasionally — Frequently — Always

I need to be protected and guided.

Never — Rarely —  Occasionally — Frequently — Always


Service is it’s own reward.
True - False


I experience compulsions or desires without being able to explain their cause.

Never — Rarely —  Occasionally — Frequently — Always

I act on these compulsions or desires.

Never — Rarely —  Occasionally — Frequently — Always


I have difficulty remembering important things (e.g. current date and location).

Never — Rarely —  Occasionally — Frequently — Always

It is __________ difficult to remember.

Not at All — Somewhat — Very — Extremely — Impossibly

I can usually remember with concentration.

True — False


I feel in control of myself.

Never — Rarely —  Occasionally — Frequently — Always


My long-term habits and behaviors have changed recently.

True — False

I can explain these changes.

True — False

These changes are related to sex.

True — False

In my opinion, these changes are __________.

Positive — Negative

In the space below, please describe these changes, if any.





[Read the following quotation aloud.]


“I will do as I am told.”


I read the quotation aloud.

True — False


I want someone else to have control of my life.

True — False

I enjoy being forced to do things that I strongly dislike. 

Never — Rarely —  Occasionally — Frequently — Always