By completing the following survey, we can identify some impairments and traits that may be keeping us from living the life we want to live. We can give our-self a score between 1 and 10, with 1 being “no problem” and 10 being “a major problem that is making my life difficult”. We can then make a note of those items where the score is five or higher. These are areas you may want to work on over the next few weeks as we look at ways to turn these negative problems into positive solutions.
- Markedly impoverished, poorly developed, or unstable self-image, ______
- Excessive self-criticism; ______
- Chronic feelings of emptiness; ______
- Dissociative states under stress ______
- Instability in goals, aspirations, value, or career plans ______
- Compromised ability to recognize the feelings and needs of others ______
- interpersonal hypersensitivity (i.e., prone to feel slighted or insulted); ______
- Perceptions of others selectively biased toward negative attributes or vulnerabilities _____
- Intense, unstable, and conflicted close relationships; ______
- Marked by mistrust, neediness; ______
- Anxious preoccupation with real or imagined abandonment; ______
- Close relationships often viewed in extremes of idealization and devaluation; ______
- Alternating between over involvement and withdrawal. ______
- Unstable emotional experiences and frequent mood changes; ______
- Emotions that are easily aroused, intense, and/or out of proportion to events and circumstances. ______
- Intense feelings of nervousness, tenseness, or panic, often in reaction to interpersonal stresses; ______
- Worry about the negative effects of past unpleasant experience and future negative possibilities; _____
- Feeling fearful, apprehensive, or threatened by uncertainty; ______
- Fears of falling apart or losing control; ______
- Pathological personality traits in negative affectivity; ______
- Fears of rejection by – and/or separation from – significant others; ______
- Fears of excessive dependency and complete loss of autonomy; ______
- Frequent feelings of being down, miserable, and/or hopeless; ______
- Difficulty recovering from such moods; ______
- Pessimism about the future; ______
- Pervasive shame; ______
- Feeling of inferior self-worth; ______
- Thoughts of suicide and suicidal behaviour; ______
- Acting on the spur of the moment in response to immediate stimuli; ______
- Acting on a momentary basis without a plan or consideration of outcomes; ______
- Difficulty establishing or following plans; ______
- A sense of urgency and self-harming behavior under emotional distress;______
- Engagement in dangerous, activities, unnecessarily and without regard to consequences; ______
- Lack of concern for one’s limitations; ______
- Denial of the reality of personal danger. ______
- Persistent or frequent angry feelings; ______
- Anger or irritability in response to minor slights and insults. ______
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