Divorce Recovery Self-Assessment I am comfortable telling people I am separated from my love partner Almost Always Usually Sometimes Seldom Almost Never I am physically and emotionally exhausted from morning until night Almost Always Usually Sometimes Seldom Almost Never I am constantly thinking of my former love partner Almost Always Usually Sometimes Seldom Almost Never I feel rejected by many of the friends I had when I was in the love relationship Almost Always Usually Sometimes Seldom Almost Never I become upset when I think about my former love partner Almost Always Usually Sometimes Seldom Almost Never I like being the person I am Almost Always Usually Sometimes Seldom Almost Never I feel like crying because I feel so sad Almost Always Usually Sometimes Seldom Almost Never I can communicate with my former love partner in a calm and rational manner Almost Always Usually Sometimes Seldom Almost Never There are many things about my personality I would like to change Almost Always Usually Sometimes Seldom Almost Never It is easy for me to accept my becoming a single person Almost Always Usually Sometimes Seldom Almost Never I feel depressed Almost Always Usually Sometimes Seldom Almost Never I feel emotionally separated from my former love partner Almost Always Usually Sometimes Seldom Almost Never People would not like me if they got to know me Almost Always Usually Sometimes Seldom Almost Never I feel comfortable seeing and talking to my former love partner Almost Always Usually Sometimes Seldom Almost Never I feel like I am an attractive person Almost Always Usually Sometimes Seldom Almost Never I feel as though I am in a daze and the world doesn't seem real Almost Always Usually Sometimes Seldom Almost Never I find myself doing things just to please my former love partner Almost Always Usually Sometimes Seldom Almost Never I feel lonely Almost Always Usually Sometimes Seldom Almost Never There are many things about my body I would like to change Almost Always Usually Sometimes Seldom Almost Never I have many plans and goals for the future Almost Always Usually Sometimes Seldom Almost Never I feel I don't have much sex appeal Almost Always Usually Sometimes Seldom Almost Never I am relating and interacting in many new ways with people since my separation Almost Always Usually Sometimes Seldom Almost Never Joining a singles group would make me feel I was a loser like them Almost Always Usually Sometimes Seldom Almost Never It is easy for me to organize my daily routine of living Almost Always Usually Sometimes Seldom Almost Never I find myself making excuses to see and talk to my former love partner Almost Always Usually Sometimes Seldom Almost Never Because my love relationship failed, I must be a failure Almost Always Usually Sometimes Seldom Almost Never I feel like unloading my feelings of anger and hurt upon my former love partner Almost Always Usually Sometimes Seldom Almost Never I feel comfortable being with people Almost Always Usually Sometimes Seldom Almost Never I have trouble concentrating Almost Always Usually Sometimes Seldom Almost Never I think of my former love partner as related to me rather than as a separate person Almost Always Usually Sometimes Seldom Almost Never I feel like an okay person Almost Always Usually Sometimes Seldom Almost Never I hope my former love partner is feeling as much or more emotional pain than I am Almost Always Usually Sometimes Seldom Almost Never I have close friends who know and understand me Almost Always Usually Sometimes Seldom Almost Never I am unable to control my emotions Almost Always Usually Sometimes Seldom Almost Never I feel capable of building a deep and meaningful love relationship Almost Always Usually Sometimes Seldom Almost Never I have trouble sleeping Almost Always Usually Sometimes Seldom Almost Never I easily become angry at my former love partner Almost Always Usually Sometimes Seldom Almost Never I am afraid to trust people who might become love partners Almost Always Usually Sometimes Seldom Almost Never Because my love relationship ended, I feel there must be something wrong with me Almost Always Usually Sometimes Seldom Almost Never I either have no appetite or eat continuously which is unusual for me Almost Always Usually Sometimes Seldom Almost Never I don't want to accept the fact that our love relationship is ending Almost Always Usually Sometimes Seldom Almost Never I force myself to eat even though I'm not hungry Almost Always Usually Sometimes Seldom Almost Never I have given up on my former love partner and getting back together Almost Always Usually Sometimes Seldom Almost Never I feel very frightened inside Almost Always Usually Sometimes Seldom Almost Never It is important that my family, friends, and associates be on my side rather than on my former love partner's side Almost Always Usually Sometimes Seldom Almost Never I feel uncomfortable even thinking about dating Almost Always Usually Sometimes Seldom Almost Never I feel capable of living the kind of life I would like to live Almost Always Usually Sometimes Seldom Almost Never I have noticed my body weight is changing a great deal Almost Always Usually Sometimes Seldom Almost Never I believe if we try, my love partner and I can save our love relationship Almost Always Usually Sometimes Seldom Almost Never My abdomen feels empty and hollow Almost Always Usually Sometimes Seldom Almost Never I have feelings of romantic love for my former love partner Almost Always Usually Sometimes Seldom Almost Never I can make the decisions I need to because I know and trust my feelings Almost Always Usually Sometimes Seldom Almost Never I would like to get even with my former love partner for hurting me Almost Always Usually Sometimes Seldom Almost Never I avoid people even though I want and need friends Almost Always Usually Sometimes Seldom Almost Never I have really made a mess of my life Almost Always Usually Sometimes Seldom Almost Never I sigh a lot Almost Always Usually Sometimes Seldom Almost Never I believe it is best for all concerned to have our love relationship end Almost Always Usually Sometimes Seldom Almost Never I perform my daily activities in a mechanical and unfeeling manner Almost Always Usually Sometimes Seldom Almost Never I become upset when I think about my love partner having a love relationship with someone else Almost Always Usually Sometimes Seldom Almost Never I feel capable of facing and dealing with my problems Almost Always Usually Sometimes Seldom Almost Never I blame my former love partner for the failure of our love relationship Almost Always Usually Sometimes Seldom Almost Never I am afraid of becoming sexually involved with another person Almost Always Usually Sometimes Seldom Almost Never I feel adequate as a fe/male love partner Almost Always Usually Sometimes Seldom Almost Never It will only be a matter of time until my love partner and I get back together Almost Always Usually Sometimes Seldom Almost Never I feel detached and removed from activities around me as though I were watching them on a movie screen Almost Always Usually Sometimes Seldom Almost Never I would like to continue having a sexual relationship with my former love partner Almost Always Usually Sometimes Seldom Almost Never Life is somehow passing me by Almost Always Usually Sometimes Seldom Almost Never I feel comfortable going by myself to a public place such as a movie Almost Always Usually Sometimes Seldom Almost Never It is good to feel alive again after having felt numb and emotionally dead Almost Always Usually Sometimes Seldom Almost Never I feel I know and understand myself Almost Always Usually Sometimes Seldom Almost Never I feel emotionally committed to my former love partner Almost Always Usually Sometimes Seldom Almost Never I want to be with people but I feel emotionally distant from them Almost Always Usually Sometimes Seldom Almost Never I am the type of person I would like to have for a friend Almost Always Usually Sometimes Seldom Almost Never I am afraid of becoming emotionally close to another love partner Almost Always Usually Sometimes Seldom Almost Never Even on the days when I am feeling good, I may suddenly become sad and start crying Almost Always Usually Sometimes Seldom Almost Never I can't believe our love relationship is ending Almost Always Usually Sometimes Seldom Almost Never I become upset when I think about my love partner dating someone Almost Always Usually Sometimes Seldom Almost Never I have a normal amount of self-confidence Almost Always Usually Sometimes Seldom Almost Never People seem to enjoy being with me Almost Always Usually Sometimes Seldom Almost Never Morally and spiritually, I believe it is wrong for our love relationship to end Almost Always Usually Sometimes Seldom Almost Never I wake up in the morning feeling there is no good reason to get out of bed Almost Always Usually Sometimes Seldom Almost Never I find myself daydreaming about all the good times I had with my love partner Almost Always Usually Sometimes Seldom Almost Never People want to have a love relationship with me because I feel like a lovable person Almost Always Usually Sometimes Seldom Almost Never I want to hurt my former love partner by letting him/her know how much I hurt emotionally Almost Always Usually Sometimes Seldom Almost Never I feel comfortable going to social events even though I am single Almost Always Usually Sometimes Seldom Almost Never I feel guilty about my love relationship ending Almost Always Usually Sometimes Seldom Almost Never I feel emotionally insecure Almost Always Usually Sometimes Seldom Almost Never I feel uncomfortable even thinking about having a sexual relationship Almost Always Usually Sometimes Seldom Almost Never I feel emotionally weak and helpless Almost Always Usually Sometimes Seldom Almost Never I think about ending my life with suicide Almost Always Usually Sometimes Seldom Almost Never I understand the reasons why our love relationship did not work out Almost Always Usually Sometimes Seldom Almost Never I feel comfortable having my friends know our love relationship is ending Almost Always Usually Sometimes Seldom Almost Never I am angry about the things my former love partner has been doing Almost Always Usually Sometimes Seldom Almost Never I feel like I am going crazy Almost Always Usually Sometimes Seldom Almost Never I am unable to perform sexually Almost Always Usually Sometimes Seldom Almost Never I feel as though I am the only single person in a couples-only society Almost Always Usually Sometimes Seldom Almost Never I feel like a single person rather than a married person Almost Always Usually Sometimes Seldom Almost Never I feel my friends look at me as unstable now that I'm separated Almost Always Usually Sometimes Seldom Almost Never I daydream about being with and talking to my former love partner Almost Always Usually Sometimes Seldom Almost Never I need to improve my feelings of self-worth about being a wo/man Almost Always Usually Sometimes Seldom Almost Never What is your gender? Female Male Prefer not to say >Do you have kids? None 0-5 years old 6-12 years old 13-18 years old 19 or older >What do you do during normal work hours? Stay at home parent Physical/Active type of job Managerial job Desk Job Not currently working/Other > Where are you in the divorce process? Please select your answer Considering divorce In the divorce process Divorced Did you initiate the divorce? Please select your answer Yes No It was mutual How long were you or have you been married? Please select your answer 0 to 5 years 6 to 10 years 11 to 15 years 16 to 20 years 21 years or more How long ago did you get divorce or when do you expect to be divorced? Please select your answer 0 to 1 year ago 1 -2 years ago 2-5 years ago 6 or more years ago In the next month Sometime this year Not sure Please tell us a little bit about your story (optional) Did you/do you have many friends or family to talk to and support you during your divorce and soon after? (optional but very helpful) Please select your answer Yes No Is there anything else you would like to share with us that might be helpful? Email address Name Phone Number Time's up
