Advanced Ritual Healing Training - Soul Part Retrieval Questionnaire

About Soul Part Retrieval

Soul part retrieval is a process that helps people reconnect with their authentic selves. Over the course of life, due to various life circumstances, we can become dissociated from aspects of our authentic nature (called soul parts). Sometimes this happens just as the result of adapting to the households and cultures we grow up in. For example a joyful child living in a home with depressed adults may suppress their exuberance in order to fit in better with the household dynamic. An artistic child may be encouraged to give up their art, or may give it up in response to life circumstances. We can also lose aspects of our authentic selves through traumatic events and circumstances, the loss of a loved one, relationship dynamics, and accidents. Essentially whenever we feel like a part of us is diminished or missing, soul retrieval work can help us re-associate with those aspects of ourselves.

Indications of soul part loss include:

– lack of vitality and creativity
– chronic depression and/or anxiety
– lack of presence in your life, tendencies to check out
– feeling like you don’t have access to the full spectrum of human experience
– lack of a sense of core self, poor boundaries
– lack of personal strength, sense of personal power
– suicidal ideation/intent or fixation on death
– addictions and the regular use of substances to avoid life
– lack of resolution from past relationships
– you just feel drawn to the process

In the soul part retrieval process, the practitioner works with your healing intention and retrieves the relevant soul parts, making that energy available in the present. They will tell you what ages of soul parts have returned, information about the situation that led to their dissociation when available, and what if anything is needed for integration of that aspect of self into your current life. The soul retrieval process will also include clearing of energy that is not yours, or no longer useful to you, out of your energy field.

For the soul part retrieval process to be successful, recipients must be willing to receive their soul parts and do any integration work indicated. Soul retrieval work is not generally recommended for those with unstable mental health conditions or those with substantial active trauma which can hinder the process of receiving and integrating the work. In some cases concurrent work with a therapist may be required.

The integration process after a soul part retrieval can vary. In some cases follow-up work may be recommended though usually after a period of integration. Soul part retrievals are usually limited to about four soul parts per year to allow time for integration into your current life. Integration can include working with other modalities such as counseling and body work, though not all cases require professional support. Sometimes integration is just being mindful of the aspects of yourself that returned and tending to your personal growth over a period of time.

Apply to be a Client

Thank you for your interest in being a client for the Advanced Ritual Healing Training!

In exchange for receiving healing session work, practicum clients are willing to share their personal information and process with the training group. Practicum clients will be assigned to a practitioner-in-training, and their session may be observed and supported by other trainees and Maris. If you know a trainee, and were referred to this site through them, you may only be paired with that trainee as practitioner if you are NOT a friend or family member. Friends and family members will be assigned to other trainees, though your friend/family member can be present as a support person for your session at your discretion.

Please fill out the form below. Skip any questions that do not pertain to your personal history. Please note that your information will be shared within the training group and potentially for the benefit of future trainings in the form of an anonymous case study. If you don’t want to include certain information in the form please reply with “will discuss in session”. However, we will not have time for a full verbal intake in session, so please provide as much information as possible in the questionnaire. I recommend copying and pasting to a saved document any long responses in case the form doesn’t go through, which is rare but does happen on occasion.

Once Maris has received your form she will send you a confirmation of receipt and after reviewing your information will provide scheduling options if taking your case works for the training at this time. Practicums happen on some Friday afternoons Pacific Time between 1:00 and 5:00pm.

Feel free to email Maris with any questions you have in advance.

First Name *

Last Name *

Email Address *

Phone Number (if US) *

Who referred you? *

That person is...

a friend or family membera personal acquaintancesomeone you see for healing workother

If that person is a personal acquaintance, friend, or family member do you want them to be a support person for your session?

YesNoEither way

What is the full name given to you at birth? Please note any nicknames you have had over the years (that you would have regularly gone by) and your full current name if different. This information helps the practitioner identify soul parts as that aspect of you will respond to the name it was familiar with at that age.

What is your healing intention for yourself and your life? What would you/your life be like on the other side of this transformation?

What forms of healing work have you engaged in the past and what forms are you currently engaged in?

Were there any turning points or phases in your life when you feel like you lost a part of yourself or a part of you became significantly diminished? For example you were easily creative before the age of 10 and then X happened and you had trouble with creativity after that. Please indicate the ages of turning points and what you felt was lost.

Do any significant past relationships feel unresolved? If so in what way?

Are there any emotions you don't experience or experience rarely? If yes please indicate which ones.

Did you experience any physical and/or emotional traumas that still impact you today?

Have there been times when you have been rendered unconscious (including but not limited to surgeries, blackouts from drug or alcohol use, accidents)?

Do you have a history of psychological disorders (including depression and anxiety)? What was the age of onset? What treatments have you received and for how long?

Are you currently on psychotropic medication (antidepressants, anti-anxiety meds etc.)?

Do you have a history of suicide attempts or suicidal ideation (regular thoughts of death with no intention to commit suicide)? Please indicate ages of any attempts.

Are you currently experiencing suicidal ideation or persistent thoughts of death?

Were there any deaths of anyone close to you that resulted in your feeling like a part of you went with them or your feeling that you lost something due to their death?

Have you had any near death experiences?

Do you have a history of using psychadelics?

Do you have any addictions? If so to what?

Have you used recreational drugs for long periods of time in the past? What age did you start?

Have you done any spiritual explorations that involve leaving your body?

Is there anything about you, your body, your response to healing processes that would be useful for us to know?

Is there anything else you want us to know?

Type your name in the box below to sign the Informed Consent and Hold Harmless Agreement (text below) *

Informed Consent and Hold Harmless Agreement

I, the electronic signer above, hereby authorize Maris Bergrune (legal name Melissa Rosenberger, hereafter referred to as Maris) and students in her Advanced Ritual Healing training to engage in soul retrieval and energy clearing work on your behalf.

By participating in the training I affirm that I have read the following statements indicating understanding and consent of the conditions presented:

I understand that the Advanced Ritual Healing trainees who will be doing the work are learning and are not experienced practitioners. Due to the limitations of the online format, Maris will not necessarily be directly supervising my session. These sessions are functionally appointments with the trainees with the potential for additional support provided by the group format and Maris if needed.

The information I provide in the questionnaire and what happens in the training will be shared with Maris and the trainees. This information may also be used as a case study for future trainings, in which event my identity will be anonymous.

I understand that Maris and her trainees are not therapists or medical providers, and that this work is not a substitute for therapy or medical treatment. I understand that this work does not intend to diagnose, treat, or cure disease or mental illness. I understand that this work is not for people experiencing unstable mental health conditions, those who are in crisis, or those with substantive active trauma. I understand that this work is transformative/catalytic and that I am responsible for acquiring the mental health support, aftercare, or integration work needed to process this work, as recommended by Maris and the trainees or according to my own self-assessment and judgment.

I will not hold Maris, the trainees, or The Golden Lyre LCC legally responsible for any physical, emotional, mental, circumstantial, or energetic effects that may occur in connection with my participation in sessions. I recognize and agree that I am fully responsible for my well-being during my session, which includes disclosing any concerns and/or questions I may have before, during, or following my session.

I understand that there is no guarantee of any specific result from session work and that the outcome is not predictable or controllable. In receiving session work I am willing to assume the risk of this uncertainty.

I understand that during a course of session work some symptoms or circumstances may be activated or exacerbated: I may experience new symptoms as layers of work come up for processing, and I may experience an exacerbation of existing symptoms as the work progresses. I understand that usually these states are temporary and resolve with a completion of the work, but that no guarantees can be given about their resolution.

I understand that what can be done in a single session is potentially limited and complex conditions often require multiple sessions and/or a longer-term approach to the healing process.

With this knowledge, I voluntarily consent to participate in the Advanced Ritual Healing training, realizing that no guarantees have been given to me by Maris regarding the cure or improvement of my conditions. Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Maris and The Golden Lyre LCC and all its agents from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with the above mentioned procedures and services.

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