Priorities and
Commitment: I feel
important enough with you, often enough, vs.:
79) your prior partner/s (if any
(+ / o / -
)
80) your
_ family and _ friends (+ / o / -
)
81) your
_ work, _ school, _ hobbies,
_ church, _ _________________ (+ / o / -
)
82) (other)
___________________________________________________________ (+ / o / -
)
83) My
commitment to nurturing and protecting our
relationship is consistently among my top
three priorities - mainly from genuine desire,
vs. anxiety or duty (+ / o / -
)
84) Im consistently satisfied with
your demonstrated
(vs. stated) commitment to nurturing and
protecting our relationship (+ / o / -
)
Respect
85) I generally respect
your
_ values, _ goals, and _
actions highly
(+ / o / -
)
86) I usually feel respected enough
(+ / o /
- )
87) Im comfortable enough with
my level of
self respect
(+ / o / -
)
88) Im comfortable enough with
your level of self
respect (+ / o / -
)
89) (other)
_______________________________________________________
(+ / o / -
)
Our
Time Together
90) We usually have
enough time alone together
(+ / o / -
)
91) The quality of our times alone
usually feels good enough
to me
(+ / o / -
)
92)
Your
about our alone-time is
usually high
enough for me
(+ / o / -
)
93) (other)
_______________________________________________________
(+ / o / -
)
Our Trust and
Honesty
94) I consistently trust that
you mean what you say to me (+ / o / -
)
95) I steadily trust that
you don't withhold
important things from me (+ / o / -
)
96) You don't use what I share against me
(+ / o / -
)
97) I can rely on you to not tell others what I wish to
keep private between us (+ / o / -
)
98) I completely trust that you won't
cheat sexually on me (+ / o / -
)
99) (other)
________________________________________________________
(+ / o / -
)
Our Values:
We usually
well enough on:
100) Personal
health, medications, diet,
and exercise (+ / o / -
)
102) Home
choice, furnishing, decorating, and maintenance
(+ / o / -
)
103) Household
chores and responsibilities (+ / o / -
)
104) Leisure, play, holidays, and vacations
(+ / o / -
)
105) Money
_ provision, _ allocation, _ saving, _ investing,
_ managing, and _ estate planning
(+ / o / -
)
106)
church, and worship
(+ / o / -
)
107) Focusing enough on the present, vs.
the past or the future (+ / o / -
)
108)
Balancing our time between working, playing,
resting, and being
alone (+ / o / -
)
109)
Drug use (including food and prescription
chemicals) by
you, me, and other family members
(+ / o / -
)
110) Conceiving a child
and/or adopting one
(+ / o / -
)
111) Planning enough for our lives vs. letting life happen
to us (+ / o / -
)
112) Asking for and accepting help from appropriate others
when we need it (+ / o / -
)
113) Risking new experiences, ideas, and relationships from
time to time, vs. staying safely with the old
ones
(+ / o / -
)
114)
(other)
__________________________________________________________
(+ / o / -
)
115) (other)
__________________________________________________________
(+ / o / -
)
Other Relationship Strengths and
Stressors
116) _________________________________________________________________
(+ / o / -
)
117) _________________________________________________________________
(+ / o / -
)
118) _________________________________________________________________
(+ / o / -
)
119) _________________________________________________________________
(+ / o / -
)
120) _________________________________________________________________
(+ / o / -
)