Priorities and
Commitment: I feel
important enough with you, often enough, vs.:
50) your child/ren
(+ / o / - )
51) your prior partner/s (if any
(+ / o / -
)
52) your
_ family and _ friends (+ / o / -
)
53) your
_ work, _ school, _ hobbies,
_ church, _ _________________ (+ / o / -
)
(other)
___________________________________________________________ (+ / o / -
)
54) My
commitment to nurturing and protecting our
relationship is consistently among my top
three priorities - mainly from genuine desire,
vs. anxiety or duty (+ / o / -
)
55) Im consistently satisfied with
your demonstrated
(vs. stated) commitment to nurturing and
protecting our relationship (+ / o / -
)
Respect
56) I generally respect
your
_ values, _ goals, and _
actions highly
(+ / o / -
)
57) I usually feel respected enough
(+ / o /
- )
58) Im comfortable enough with
my level of
(+ / o / -
)
59) Im comfortable enough with
your level of self
respect (+ / o / -
)
(other)
_______________________________________________________
(+ / o / -
)
Our Time Together
60) We usually have
enough time alone together
61) The quality of our times alone
usually feels good enough
to me
62)
Your
about our alone-time is
usually high
enough for me
(other)
_______________________________________________________
(+ / o / -
)
Our Trust and
Honesty
63) I consistently trust that
you mean what you say to me (+ / o / -
)
64) I steadily trust that
you don't withhold
important things from me (+ / o / -
)
65) You don't use what I share against me
(+ / o / -
)
66) I can rely on you to not tell others what I wish to
keep private between us (+ / o / -
)
67) I completely trust that you won't
cheat sexually on me (+ / o / -
)
(other)
________________________________________________________
(+ / o / -
)
Our Values:
We usually
well enough on:
68) (Step)child
adoption
(+ / o / -
)
69) (Step)child
custody (+ / o / -
)
70) (Step)child
financial support
(+ / o / -
)
71) (Step)child
visitations (+ / o / -
)
72)
(Step)child _ guidance and _ discipline
(+ / o / -
)
73) Personal
health, medications, diet,
and exercise (+ / o / -
)
74) Home
choice, furnishing, decorating, and maintaining
(+ / o / -
)
75) Household
chores and responsibilities (+ / o / -
)
76) Leisure, play, holidays, and vacations
(+ / o / -
)
77) Money
_ provision, _ allocation, _ saving, _ investing,
_ managing, and _ estate planning
(+ / o / -
)
78)
church, and worship
(+ / o / -
)
79) Focusing enough on the present, vs.
the past or the future (+ / o / -
)
80)
Balancing our time between working, playing,
resting, and being
alone (+ / o / -
)
81)
Drug use (including food and prescription
chemicals) by
you, me, and the kids
(+ / o / -
)
82) Conceiving an "ours" child,
and/or adopting one
(+ / o / -
)
83) Planning enough for our lives vs. letting life happen
to us (+ / o / -
)
84) Our responsibilities to, and
limits with, bio,
step, (and "ex") relatives
(+ / o / -
)
85) Our responsibilities to,
and limits with, the kids other co-parent/s
(+ / o / -
)
86) Asking for and accepting help from appropriate others
when we need it (+ / o / -
)
87) Risking new experiences, ideas, and relationships from
time to time, vs. staying safely with the old ones
(+ / o / -
)
(other)
__________________________________________________________
(+ / o / -
)
(other)
_________________________________________________________
(+ / o / -
)
Other Relationship Strengths and
Stressors
(other)
__________________________________________________________
(+ / o / -
)
(other)
__________________________________________________________
(+ / o / -
)
(other)
__________________________________________________________
(+ / o / -
)