Circle yes or no in response to each question. Please note that yes and no are not always in the same position. | ||
Column 1
|
Column 2
|
|
Yes
|
No
|
Is there anyone who knows and cares about all or almost all the significant events in your life? |
No
|
Yes
|
Do you feel as though you’re living life behind an invisible screen, unable to truly connect with anyone or anything? |
Yes
|
No
|
Is there at least one person you talk to at least once a week who really understands or almost understands all your feelings? |
No
|
Yes
|
Is there anything you feel you can’t or mustn’t tell anyone? |
Yes
|
No
|
Do you feel comfortable crying in front of the person or people you love the most? |
No
|
Yes
|
Have you recently suffered any kind of serious emotional wound, such as the loss of a job or a loved one? |
No
|
Yes
|
Have you benefited from therapy in the past and recently felt wistful about it, missing that kind of reliable support? |
No
|
Yes
|
Do you have unexpected negative emotional reactions or others’ behavior toward you, such as feeling shame when you are praised or anxiety when you are loved? |
No
|
Yes
|
Does your fear of others’ disapproval dominate your choices? |
Yes
|
No
|
Are you able to freely express love to your family and friends? |
No
|
Yes
|
Are you lonely even if-or especially when – you’re with a group of people? |
No
|
Yes
|
Do you have to be under the influence of alcohol or drugs in order to be open about your thoughts and emotions? |
If your answers are all in column 1 you can probably live a long happy life without ever seeing a professional counselor. If one or more of your answers falls in column 2 – that’s right, even one – you could benefit by visiting a good therapist. |