Inner Peace Evaluation - Forms - Dr. Daniel Zeiss

Clarity to do what is right - Mentoring

Inner Peace Questionnaire

Step 1 of 3

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Introduction
Please answer the questions below as truthfully as possible. Please don't think TOO MUCH about the answer, just answer it rapidly. Thinking might influence accuracy.

There is a difference between remembering a scene in a way that you are putting yourself in it or thinking about the memory from today. Please do not put yourself into this memory. Just think about it from today's point of view.

Please find 5 different situations that still make you react emotionally to this day just by thinking about them. Write down the intensity of your reactions using a scale of 0 - 10 with 0 being equal to "not at all", and 10 being "the maximum you can imagine". Please do not use any situation with an intensity below 2.

The situations are usually the ones you see yourself in from the outside, so as if you are in an observer role. It should feel like you see the situation and yourself in an image.
Situation 1 of 5*
Please briefly describe the situation you are thinking about.
How strong do you feel your emotional reaction in situation 1 (see above)?*
Situation 2 of 5*
Please briefly describe the situation you are thinking about.
How strong do you feel your emotional reaction in situation 2 (see above)?*
Situation 3 of 5*
Please briefly describe the situation you are thinking about.
How strong do you feel your emotional reaction in situation 3 (see above)?*
Situation 4 of 5*
Please briefly describe the situation you are thinking about.
How strong do you feel your emotional reaction in situation 4 (see above)?*
Situation 5 of 5*
Please briefly describe the situation you are thinking about.
How strong do you feel your emotional reaction in situation 5 (see above)?*
Hidden
Points