Healing Feelings...
Questionnaire

First Look — Self Evaluation

The following questions are intended to guide you as you begin evaluating your feelings and the impact feelings have in your life. Becoming aware of your feelings is a necessary step to changing negative feelings to positive feelings.

You may choose to print a copy of your answers and compare them with how you feel in a few weeks or months. You might also consider starting a Feelings Journal, as a journal can be an important tool in assisting you to identify your feelings and where and when they are triggered. May you be blessed as you begin your Journey of discovery—of "Self" discovery!

Note: There are two steps to the evaluation. Step 1: Answer each question. Step 2: Click the Show Discussion link after each question for helpful information on each question and how your answers relate to the Healing Feelings books. Answers are not saved. If you leave this web page before completing and printing it, you will need to retake the evaluation.


1. In communicating the language of feelings with others, my current ability to do this efficiently is:

Lousy Not So Good Pretty Good Great

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2. If I stop to think about it, I can usually identify my feelings accurately.

Never Rarely Sometimes Frequently Always

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3. If I were to characterize the underlying negative feelings that motivate my actions and attitudes, they would be:

Anger/Resentment
No Sense of Direction
Guilt/Shame
Fearful/Anxious
Bitterness/Hate
Overwhelmed/Burdened
Rejection/Abandonment
I just don't Understand
Need for Approval
Not Enough/Not Good Enough
Need to Control
Resistant/Hostile
Lost/Alone
Hopeless/Helpless
Sad/Depressed

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4. If I could change anything in my life, it would be:

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5. If I were to describe my relationship with my __________ it would be:

Spouse:Lousy Not So Good Pretty Good Great
Children:Lousy Not So Good Pretty Good Great
Extended Family:Lousy Not So Good Pretty Good Great
Friends:Lousy Not So Good Pretty Good Great
Co-workers:Lousy Not So Good Pretty Good Great

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6. When I enter a room full of people I don't know, I feel:

Uncomfortable
Apprehensive
Quiet
Shy
Calm
Outgoing
Center of Attention
Out of Control
Wish I Wasn't There

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7. When I get angry, the thing I would most likely to do is:

Scream
Spout off with words
Punch someone or something
Go spend money on myself
Go eat
Destroy whatever is nearest to me
Cry
Start throwing things
Go be by myself
Kick something
Retreat
Confront the source

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8. When something goes "wrong" I usually:

Want to blame something or someone else for it.
Am willing to accept and "own" my responsibility in the matter.
Just "blow if off" or ignore the situation.
Say, "It doesn't matter."
Often feel very sorry about it.

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9. Every time I think I'm going to move forward in my life, I seem to hit a brick wall called:

Restricted Area
Inadequate
Unworthy
Powerless
Impossible
Over Anxious
Deficient
Fear of the Future
Fear of Success
Fear of Failure
Unrealistic
I'm not enough
Hopeless or Helpless
Victim or Martyr

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10. The area of my life in which I'd most like to see improvement is:

Note: Rank the importance of each for you with 1 being most important
 
Relationships 1 2 3 4 5 6
Physical Health 1 2 3 4 5 6
Financial Matters 1 2 3 4 5 6
Feelings of Self-worth 1 2 3 4 5 6
Spiritual Development 1 2 3 4 5 6
Understanding Who I Am 1 2 3 4 5 6

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11. If one word could describe how I would most like to feel on an on-going basis, it would be:

Peaceful
Joyful
Loving/Loved
Truly Forgiving
Happy
Powerful
Grateful
Allowing
Connected

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12. Evaluate your current lifestyle in these areas:

Note: 1=Never, 2=Sometimes, 3=Half the time, 4=Usually, 5=Always
 
It is easy for me to share my feelings with others 1 2 3 4 5
I meet people easily 1 2 3 4 5
I am surrounded by people who care 1 2 3 4 5
I always have enough time 1 2 3 4 5
I seem to jump from crisis to crisis 1 2 3 4 5
I schedule time for myself 1 2 3 4 5
I schedule time to enjoy my family 1 2 3 4 5
I love the way I look 1 2 3 4 5
I feel energized and ready for each day 1 2 3 4 5
My body, mind and spirit are healthy and balanced 1 2 3 4 5
I give myself time to exercise 1 2 3 4 5
I don't worry about if I can pay my bills 1 2 3 4 5
I always have enough business or sales 1 2 3 4 5
I live in my dream home 1 2 3 4 5
I have abundance in my life 1 2 3 4 5

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13. If I were to list one word each for my 7 greatest weaknesses, those words are:

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14. If I were to list one word each for my 7 greatest strengths, those words are:

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15a. If I only had 6 months to live I would enjoy:

15b. If I only had 6 months to live I would stop doing:

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16. I hope to gain/understand the following, on my Journey to discovering my true Self.

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The purpose of this Self Evaluation is not to cause you to over analyze your life. The purpose is to guide you on your individual Journey to the understanding that you are perfect just by Be-ing you.

We trust that you have enjoyed taking this questionnaire as a first step on your Journey to discovering your True Self.