Insight and mindfulness




















 

 

PO Box 200161
Houston, Texas 77025
713-662-2743
mary@citta101.org

 

 

 

 

 

© 2006 Mary Rees

 
Application for Spiritual Direction

Please provide some basic information through the form below.

To read more about Spiritual Direction see Spiritual Direction on this website. For the current policy statement which you need to mail in before your first session is scheduled see the Policy Statement

Provide some basic information on this form.
Name
Street Address or P. O. Box
(Apartment Number)
City/State-Province/Zip
Country
E-mail Address
Web Site URL (if any)
Telephone # (include area code)
Place of Employment
Occupation
Birthday
I am :
Single Married Divorced Separated Widowed Clergy Religious
Religious body/church affiliation:
I am interested in working with Mary: one on one
with a group
both one on one and as part of a group
How much time do you give (on the average) to your inner life (e.g., prayer, meditation, journaling, silence, study, dream work, etc.)? Explain briefly below:
What is your previous experience with spiritual direction, counseling, or therapy? Describe below.
Do you have a physical or psychological health problem Mary should know about? If so, please explain below:
What is your motivation for seeking spiritual direction at this time? Please explain below:
Listed below are some approaches to spiritual growth which many have found helpful. Please check those you are familiar with and/or your desire to become familiar:

Topic
Am Familiar
Want to Learn

Dreamwork

Inner Child

Centering prayer

Focusing

Contemplative sitting

Scripture meditation

Guided Imagery

Eastern Spirituality

Mindfulness Meditation

Insight Meditation

Vipassana Meditation

Metta Meditation

Brahma Vihara Practices

Paramis

Contemplative reading

Insight Dialogue
(practice in interaction)

Creation Spirituality

12 Step Spirituality

Feminine Spirituality

Enneagram

Spirituality of the mystics
Other area(s) of familiarity
I understand that Mary Rees is a Spiritual Director and a Meditation Teacher - not a therapist. She will support me in my personal process of unfoldment; however, it is my process that guides our work. I am free to accept or reject any suggestions she makes. I will be open to the process and trust my own heart to know what is true.
Citta101.Org ~ Being Prayer ~ Nutshell Publications™