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Instructions: Looking back on the entirety of your psychedelic session, please rate the degree to which at any time during that session you experienced the following phenomena. Answer each question according to your feelings, thoughts, and experiences at the time of the psychedelic session. In making each of your ratings, use the following scale: 0 none/not at all; 1 so slight cannot decide; 2 slight; 3 moderate; 4 strong (equivalent in degree to any other strong experience); 5 extreme (more than any other time in my life and stronger than 4). Feel free to use ‘half-point in-between scores’ if these are applicable.
1. Loss of your usual sense of time (T)
2. Experience of amazement (P)
3. Sense that the experience cannot be described adequately in words (I)
4. Gain of insightful knowledge experienced at an intuitive level
5. Feeling that you experienced eternity or infinity
6. Experience of oneness or unity with the objects and/or persons perceived in your surroundings
7. Loss of your usual sense of space (T)
8. Feelings of tenderness and gentleness (P)
9. Certainty of encounter with ultimate reality (in the sense of being able to ‘know’ and ‘see’ what is really real at some point during your experience)
10. Feeling that you could not do justice to your experience by describing it in words (I)
11. Loss of your usual sense of where you were (T)
12. Feelings of peace and tranquillity (P)
13. Sense of being ‘outside of’ time, beyond past and future (T)
14. Freedom from the limitations of your personal self and feeling of unity or bond with what was felt to be greater than your personal self
15. Sense of being at a spiritual height
16. Experience of pure being and pure awareness (beyond the world of sense impressions)
17. Experience of ecstasy (P)
18. Experience of the insight that “all is One”
19. Being in a realm with no space boundaries (T)
20. Experience of oneness in relation to an “inner world” within
21. Sense of reverence
22. Experience of timelessness (T)
23. You are convinced now, as you look back on your experience, that in it you encountered ultimate reality (that you ‘knew’ and ‘saw’ what was really real)
24. Feeling that you experienced something profoundly sacred and holy
25. Awareness of the life or living presence in all things
26. Experience of the fusion of your personal self into a larger whole
27. Sense of awe or awesomeness (P)
28. Experience of unity with ultimate reality
29. Feeling that it would be difficult to communicate your own experience to others who have not had similar experiences (I)
30. Feelings of joy (P)
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