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INURTURE MARITAL HEALTH CHECK
INURTURE MARITAL HEALTH CHECK
By
juwonodutayo
July 1, 2023
776
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Name
*
First
Last
Email Address
*
Age
*
Gender
*
Male
Female
How long have you been married?
*
Birth Order (E.g. 1/5; or 2/5; or 5/5; etc)
*
State briefly why you married your spouse.
*
Your Intention for this exercise
*
1. I find it relatively easy to get emotionally close to others.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
2. I often worry about being abandoned or not loved by my partner.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
3. I find it difficult to fully trust others, even my partner.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
4. I feel conflicted about being close to others—I want connection but also fear it.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
5. I feel comfortable depending on others and having others depend on me.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
6. I feel insecure if my partner doesn’t immediately respond to me.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
7. I prefer not to rely on others and feel uncomfortable when they depend on me.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
8. I sometimes push people away even though I deeply want their attention.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
9. I am comfortable sharing my thoughts and feelings with my partner.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
10. I tend to crave a lot of reassurance and affection in my relationships.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
11. I often feel the need to keep emotional distance from others to feel safe.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
12. I experience sudden mood changes in relationships, going from feeling secure to scared or confused.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
13. I feel confident that my partner will support me when I need them.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
14. I sometimes feel that I am more invested in the relationship than my partner.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
15. I am uncomfortable with too much closeness and often push people away.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
16. I have difficulty trusting people and fear they will hurt or abandon me.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
17. I trust my relationships to be stable and secure, even when there’s temporary distance.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
18. I often feel anxious when my partner is not available, even for short periods.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
19. I value my independence and sometimes avoid sharing my feelings with my partner.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
20. I often feel overwhelmed by emotions and struggle to express them clearly in relationships.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
21. I am generally satisfied with the level of closeness in my relationships
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
22. I fear that my partner might not care about me as much as I care about them.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
23. I find it challenging to be emotionally vulnerable, even with people I care about.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
24. I tend to experience intense emotional reactions when I feel rejected or ignored.
*
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
1. My partner is my first dial when I experience a great moment of joy or an unexpected moment of sadness
*
Never True
Rarely True
Occasionally True
Usually True
Always True
2. We are able to apologize and forgive when one of us has hurt the other
*
Never True
Rarely True
Occasionally True
Usually True
Always True
3. My partner is good at meeting my emotional needs
*
Never True
Rarely True
Occasionally True
Usually True
Always True
4. My partner considers and respects me in their choices and actions
*
Never True
Rarely True
Occasionally True
Usually True
Always True
5. We make it a priority to go out together at least once a fortnight
*
Never True
Rarely True
Occasionally True
Usually True
Always True
6. My partner and I share same beliefs and values
*
Never True
Rarely True
Occasionally True
Usually True
Always True
7. My partner encourages me in all I do and my spiritual growth
*
Never True
Rarely True
Occasionally True
Usually True
Always True
8. I am able to talk to my partner about my hopes for the future without fear
*
Never True
Rarely True
Occasionally True
Usually True
Always True
9. We support each other in the goals we have for our family life
*
Never True
Rarely True
Occasionally True
Usually True
Always True
10. We share and create beautiful memories together as a couple
*
(Never True)
Rarely True
Occasionally True
Usually True
Always True
11. My partner listens to my point of view even when we disagree
*
Never True
Rarely True
Occasionally True
Usually True
Always True
12. My partner listens to my opinions without interrupting or criticizing me
*
Never True
Rarely True
Occasionally True
Usually True
Always True
13. My partner constantly gives me their full and undivided attention when I feel like expressing myself.
*
(Never True)
Rarely True
Occasionally True
Usually True
Always True
14. We discuss new ideas with each other and make decisions together
*
Never True
Rarely True
Occasionally True
Usually True
Always True
15. We are able to talk about strong emotions such as excitement, hope, grief and anxiety
*
Never True
Rarely True
Occasionally True
Usually True
Always True
16. Growing up my parents/guardians respected my uniqueness and encouraged me in my developments
*
Never True
Rarely True
Occasionally True
Usually True
Always True
17. My parents/guardians have/had a strong loving relationship
*
Never True
Rarely True
Occasionally True
Usually True
Always True
18. Growing up my parents/guardians spent ample time with me (play with me, talk with me)
*
Never True
Rarely True
Occasionally True
Usually True
Always True
19. I was raised with increasing freedom and boundaries appropriate for my age
*
Never True
Rarely True
Occasionally True
Usually True
Always True
20. My parents/guardians remain/remained faithful to each other through thick and thin
*
Never True
Rarely True
Occasionally True
Usually True
Always True
21. My partner is sensitive towards my sexual needs and makes effort to meet them
*
Never True
Rarely True
Occasionally True
Usually True
Always True
22. We agree on our sexual practices
*
Never True
Rarely True
Occasionally True
Usually True
Always True
23. My partner shows me care and comfort through regular non-sexual touching
*
Never True
Rarely True
Occasionally True
Usually True
Always True
24. I am happy about the frequency of our love-making
*
Never True
Rarely True
Occasionally True
Usually True
Always True
25. I am able to talk to my partner about my sexual hopes and desires
*
Never True
Rarely True
Occasionally True
Usually True
Always True
26. We have a marital coach we both respect and always listen to
*
Never True
Rarely True
Occasionally True
Usually True
Always True
27. Our home has a clear vision & values that is both known to us and everyone in the home
*
Never True
Rarely True
Occasionally True
Usually True
Always True
28. We have joint goals, interests and vision that we pursue together
*
Never True
Rarely True
Occasionally True
Usually True
Always True
29. We have a family constitution that guides our conduct which we both respect
*
Never True
Rarely True
Occasionally True
Usually True
Always True
30. Our marriage has a purpose.
*
Never True
Rarely True
Occasionally True
Usually True
Always True
1. Many people think I am unemotional and blunt in relating with people and handling issues.
*
0
1
2
3.
4
5
6
7
8
9
10
2. My work rate is high, able to work under pressure, taking risks or projects others think can’t be done.
*
0
1
2
3.
4
5
6
7
8
9
10
3. I easily take the lead wherever I find myself and could get upset when goals are not met.
*
0
1
2
3.
4
5
6
7
8
9
10
4. I usually ignore how people feel when I am chasing a goal or trying to get results.
*
0
1
2
3.
4
5
6
7
8
9
10
5. I am very opinionated, and I can make decisions for others easily.
*
0
1
2
3.
4
5
6
7
8
9
10
6. I love people and always want to make them happy.
*
0
1
2
3.
4
5
6
7
8
9
10
7. I encourage people to work together and easily let go offences so we can move on
*
0
1
2
3.
4
5
6
7
8
9
10
8. People notice me easily and love me because I am the life of the party wherever I find myself
*
0
1
2
3.
4
5
6
7
8
9
10
9. I can motivate people to get things done.
*
0
1
2
3.
4
5
6
7
8
9
10
10. I dislike rules and regulations that promotes dogma & tradition because I know there are other ways to get the job done
*
0
1
2
3.
4
5
6
7
8
9
10
11. I naturally hate to offend people so I may be slow to confront issues because I am waiting for the right time to do it.
*
0
1
2
3.
4
5
6
7
8
9
10
12. People see me as a slow starter and they think I don’t like change but I am steady, dependable, controlled
*
0
1
2
3.
4
5
6
7
8
9
10
13. I love to work from the background without making noise about my accomplishment
*
0
1
2
3.
4
5
6
7
8
9
10
14. I withdraw from aggressive situations, would rather allow peace reign than be confrontational
*
0
1
2
3.
4
5
6
7
8
9
10
15. I am ambitious but I take my time and work at my pace
*
0
1
2
3.
4
5
6
7
8
9
10
16. I am a perfectionist to the core, I can’t stand disorganized people.
*
0
1
2
3.
4
5
6
7
8
9
10
17. I love to work based on rules and regulations and predetermined standards.
*
0
1
2
3.
4
5
6
7
8
9
10
18. I need time to think and plan before embarking on any project of journey. I rarely would jump on a trip or any venture without a proper plan and reflection
*
0
1
2
3.
4
5
6
7
8
9
10
19. I could be suspicious and critical of people, always weighing the intentions or motives behind whatever they do.
*
0
1
2
3.
4
5
6
7
8
9
10
20. I am very detailed and thorough in whatever I do, always trying to do things right leaving no room for error
*
0
1
2
3.
4
5
6
7
8
9
10
1. I feel more loved, cared for and elated when
*
my partner sends me a loving note/text for no particular reason
my partner and I hold hands/hug.
2. I feel more loved, cared for and elated when
*
my partner and I get to spend time together alone with no distractions or interruptions
my partner does something practical to help me out..
3. I feel more loved, cared for and elated when
*
my partner shows they love me by giving me a gift, no matter how little
my partner and i hang out together - just the two of us
4. I feel more loved, cared for and elated when
*
my partner pleasantly surprises me by doing something for me they know I am supposed to do
my partner and I randomly touch each other or lock eyes together
5. I feel more loved, cared for and elated when
*
my partner puts their arm around me when we're at a function or an event
my partner surprises me with a gift.
6. I feel more loved, cared for and elated when
*
I'm around my partner, even if we're not really doing anything
I hold hands with my partner.
7. I feel more loved, cared for and elated when
*
my partner buys or gets me a gift.
my partner tells me "I love you"
8. I feel more loved, cared for and elated when
*
I sit close to my partner or stand beside them
I am complimented by my loved one for no apparent reason
9. I feel more loved, cared for and elated when
*
I get the chance to just "hang out" with my partner.
I unexpectedly get small gifts from my partner.
10. I feel more loved, cared for and elated when
*
I hear my partner tell me, "I'm proud of you."
my partner helps me with a task and takes the burden off me
11. I feel more loved, cared for and elated when
*
I get to do things with my partner.
I hear encouraging words from my partner.
12. I feel more loved, cared for and elated when
*
my partner does things for me instead of just talking about doing nice things.
I feel connected to my partner through a hug
13. I feel more loved, cared for and elated when
*
I hear commendations from my partner.
my partner gives me something that shows they were really thinking about me.
14. I feel more loved, cared for and elated when
*
I'm able to just be around my partner.
I get a back rub or massage from my partner.
15. I feel more loved, cared for and elated when
*
my partner reacts positively to something I've accomplished
my partner does something for me that I know they don't particularly enjoy.
16. I feel more loved, cared for and elated when
*
my partner and I kiss frequently,
my partner shows interest in the things I care about.
17. I feel more loved, cared for and elated when
*
my partner works on special projects with me that I have to complete.
my partner gives me an exciting gift.
18. I feel more loved, cared for and elated when
*
I'm complimented by my partner on my appearance
my partner takes the time to listen to me and really understand my feelings.
19. I feel more loved, cared for and elated when
*
my partner and I share non-sexual touch in public.
my partner offers to run errands for me.
20. I feel more loved, cared for and elated when
*
my partner does a bit more than their normal share of the responsibilities we share (around the house, work-related, etc).
I get a gift that I know my partner put thought into choosing
21. I feel more loved, cared for and elated when
*
my partner doesn't check their phone while we're talking
my partner goes out of their way to do something that relieves pressure on me.
22. I feel more loved, cared for and elated when
*
I can look forward to a holiday because of a gift I anticipate receiving
I hear the words, "I appreciate you" from my partner.
23. I feel more loved, cared for and elated when
*
my partner brings me a little gift after they've been traveling without me.
my partner takes care of something I'm responsible to do but I feel too stressed to do at the time.
24. I feel more loved, cared for and elated when
*
my partner doesn't interrupt me while I'm talking.
gift giving is an important part of our relationship.
25. I feel more loved, cared for and elated when
*
my partner helps me out when they know I'm already tired.
I get to go somewhere while spending time with my partner.
26. I feel more loved, cared for and elated when
*
my partner and I are physically intimate.
my partner gives me a little gift that they picked up in the course of their normal day
27. I feel more loved, cared for and elated when
*
my partner says something encouraging to me.
I get to spend time in a shared activity or hobby with my partner
28. I feel more loved, cared for and elated when
*
my partner surprises me with a small token of their appreciation
my partner and I touch a lot during the normal course of the day.
29. I feel more loved, cared for and elated when
*
my partner helps me out- especially if I know they're already busy.
I hear my partner specifically tell me, "I appreciate you."
30. I feel more loved, cared for and elated when
*
my partner and I embrace after we've been apart for a while.
I hear my partner say how much I mean to them
1. A man is superior to a woman and every woman must submit to a man.
*
Agree
Disagree
2. I believe a husband is superior to his wife.
*
Agree
Disagree
3. I believe it is the duty of a woman to raise and nurture the children.
*
Agree
Disagree
4. I believe a real man must be the breadwinner and must provide for his family.
*
Agree
Disagree
5. The man should have the final say in every matter that concerns the family.
*
Agree
Disagree
6. I believe a man and a woman are the same and none is superior & both man and woman must submit.
*
Agree
Disagree
7. I believe a husband and his wife are teammates where the husband takes the lead by serving his family.
*
Agree
Disagree
8. I believe who cooks is a means to an end and anyone should be able to cook for the family or we delegate it.
*
Agree
Disagree
9. I believe everyone should work & whatever we bring in should collectively serve the interest of the family.
*
Agree
Disagree
10. The man needs to consult his wife about her dreams and align with his to create a strategic direction for the family.
*
Agree
Disagree
11. I believe the final say in every matter should be based on our expertise in those areas of concern
*
Agree
Disagree
12. I believe in making compromises for the sake of the marriage.
*
Agree
Disagree
13. A man doesn’t have to disclose what he earns to his wife.
*
Agree
Disagree
14. A wife who questions what her husband does is not submissive.
*
Agree
Disagree
15. A wife who earns more than her husband will be proud and disrespectful.
*
Agree
Disagree
16. A husband who does not allow his wife to work is caring.
*
Agree
Disagree
17. A husband who does not allow his wife to work or develop herself is controlling.
*
Agree
Disagree
18. Husband and wife must be willing to make sacrifices when necessary for the marriage to work.
*
Agree
Disagree
19. Family members need to pre-inform us before they show up at our door.
*
Agree
Disagree
20. Whatever couples earn must be open to everyone in the family & no one owns anything privately
*
Agree
Disagree
21. A good wife should hold her husband accountable and must be able to question his actions and decisions.
*
Agree
Disagree
22. Marital conflict is sometimes unavoidable but no conflict is unresolvable.
*
Agree
Disagree
23. A couple should stay in the marriage because of the children even if either of them feels disatisfied.
*
Agree
Disagree
24. A couple can find a resolution that satisfies all stakeholders in the marriage when there's conflict.
*
Agree
Disagree
25. When a marriage fails, both partners are responsible.
*
Agree
Disagree
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