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Dissertation - World Federation of Music Therapy

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Listen to the music in a relaxed state, with eyes closed, focusing on the imagery, the<br />

music may evoke in you. After listening report your experience using this form:<br />

Did the music evoke or stimulate imagery? (mark with an X)<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

If the music evoked or stimulated imagery, what kind <strong>of</strong> imagery:<br />

(please give a mark on all <strong>of</strong> the following image modalities)<br />

Visual imagery<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Auditory imagery<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Sensory-kinaesthetic imagery<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Olfactory/gustatory imagery<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Feelings/emotions (Which:_____________________)<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Memories/recollections<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Transpersonal imagery<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Other reactions (Which:__________________)<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Was the a narrative? (Which/cues:__________________________<br />

I__________I__________I__________I__________I__________I<br />

Not at all-------------------- to some extent -----------------Very much<br />

Other Comments:_____________________________________________<br />

560

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