Instructions
Answer the following questions as honestly as possible based on your typical feelings and behaviors in close relationships. Use the following scale to rate each statement:
- 1 - Strongly Disagree
- 2 - Disagree
- 3 - Neutral
- 4 - Agree
- 5 - Strongly Agree
mark your answer by changing the style of the bullet point(s) that resonates with you and a number where the (🪷) is
Questions
- Comfort with Intimacy (🪷)
- I feel comfortable depending on others and having them depend on me.
- I find it easy to get emotionally close to others.
- I am comfortable expressing my needs and desires to my partner.
- Fear of Abandonment (🪷)
- I often worry that my partner does not love me or will leave me.
- I need a lot of reassurance from my partner that they care about me.
- I find myself feeling anxious when I am not in contact with my partner.
- Avoidance of Closeness (🪷)
- I find it difficult to trust others completely.
- I prefer not to rely on others or have others rely on me.
- I feel uncomfortable when others get too close to me emotionally.
- Relationship Satisfaction (🪷)
- I am generally satisfied with my relationships.
- My relationships tend to be stable and long-lasting.
- I feel that my partner understands and values me.
- Conflict Management (🪷)
- I handle conflicts with my partner constructively.
- I feel comfortable discussing problems and resolving conflicts in my relationships.
- I tend to stay calm and composed during disagreements.
- Independence vs. Dependency (🪷)
- I am comfortable being independent and also being close to others.
- I don’t feel a strong need to be constantly reassured by my partner.
- I can enjoy activities and time away from my partner without feeling distressed.
- Self-Worth (🪷)
- I generally have a positive view of myself.
- I believe I am worthy of love and respect.
- I feel confident in my ability to form and maintain healthy relationships.