Self-Discovery AssessmentΔSELF-DISCOVERY ASSESSMENTFirst NameLast NameGender Female MaleDate of Birth (mm/dd)Year of Birth EmailPhoneProfessionBirth Order (E.g 1st out of Five, 2/5, 3/5, 5/5...)State briefly why you are marrying your partner.Instructions There are no wrong or right answers to the statements in this assessment. Ensure you are in a calm and unhurried state before taking this assessment. The assessment requires you to HONESTLY give responses that reflect your authentic self. Answer truthfully for the most accurate reflection of your personality and your desires. Section 1 - ATTACHMENT DYNAMICSChoose the response that best describes you from the following scale: Strongly Agree Agree Neutral Disagree Strongly Disagree1. I find it relatively easy to get emotionally close to others. Strongly Agree Agree Neutral Disagree Strongly Disagree2. I often worry about being abandoned or not loved by my partner. Strongly Agree Agree Neutral Disagree Strongly Disagree3. I find it difficult to fully trust others, even my partner. Strongly Agree Agree Neutral Disagree Strongly Disagree4. I feel conflicted about being close to others—I want connection but also fear it. Strongly Agree Agree Neutral Disagree Strongly Disagree5. I feel comfortable depending on others and having others depend on me. Strongly Agree Agree Neutral Disagree Strongly Disagree6. I feel insecure if my partner doesn’t immediately respond to me. Strongly Agree Agree Neutral Disagree Strongly Disagree7. I prefer not to rely on others and feel uncomfortable when they depend on me. Strongly Agree Agree Neutral Disagree Strongly Disagree8. I sometimes push people away even though I deeply want their attention. Strongly Agree Agree Neutral Disagree Strongly Disagree9. I am comfortable sharing my thoughts and feelings with my partner. Strongly Agree Agree Neutral Disagree Strongly Disagree10. I tend to crave a lot of reassurance and affection in my relationships. Strongly Agree Agree Neutral Disagree Strongly Disagree11. I often feel the need to keep emotional distance from others to feel safe. Strongly Agree Agree Neutral Disagree Strongly Disagree12. I experience sudden mood changes in relationships, going from feeling secure to scared or confused. Strongly Agree Agree Neutral Disagree Strongly Disagree13. I feel confident that my partner will support me when I need them. Strongly Agree Agree Neutral Disagree Strongly Disagree14. I sometimes feel that I am more invested in the relationship than my partner. Strongly Agree Agree Neutral Disagree Strongly Disagree15. I am uncomfortable with too much closeness and often push people away. Strongly Agree Agree Neutral Disagree Strongly Disagree16. I have difficulty trusting people and fear they will hurt or abandon me. Strongly Agree Agree Neutral Disagree Strongly Disagree17. I trust my relationships to be stable and secure, even when there’s temporary distance. Strongly Agree Agree Neutral Disagree Strongly Disagree18. I often feel anxious when my partner is not available, even for short periods. Strongly Agree Agree Neutral Disagree Strongly Disagree19. I value my independence and sometimes avoid sharing my feelings with my partner. Strongly Agree Agree Neutral Disagree Strongly Disagree20. I often feel overwhelmed by emotions and struggle to express them clearly in relationships. Strongly Agree Agree Neutral Disagree Strongly Disagree21. I am generally satisfied with the level of closeness in my relationships Strongly Agree Agree Neutral Disagree Strongly Disagree22. I fear that my partner might not care about me as much as I care about them. Strongly Agree Agree Neutral Disagree Strongly Disagree23. I find it challenging to be emotionally vulnerable, even with people I care about. Strongly Agree Agree Neutral Disagree Strongly Disagree24. I tend to experience intense emotional reactions when I feel rejected or ignored. Strongly Agree Agree Neutral Disagree Strongly DisagreeSection 2 - SELF-EMOTIONAL MAPPINGChoose the response that best describes you from the following scale: Rarely Sometimes Often Usually Always1. I am able to recognize when my emotions change, even subtly. Rarely Sometimes Often Usually Always2. I notice when my mood shifts, even if it’s for a small reason. Rarely Sometimes Often Usually Always3. When I feel overwhelmed, I can usually tell which specific emotion is causing it. Rarely Sometimes Often Usually Always4. I take a moment to identify my emotions before reacting. Rarely Sometimes Often Usually Always5. I am aware of my physical reactions (like heart rate or tension) as signals of my emotions. Rarely Sometimes Often Usually Always6. I understand how past experiences shape my emotional reactions. Rarely Sometimes Often Usually Always7. I am aware of specific situations or interactions that trigger strong emotions in me. Rarely Sometimes Often Usually Always8. I notice when I start feeling emotional tension before it escalates Rarely Sometimes Often Usually Always9. I recognize when a particular person or event triggers recurring emotional patterns. Rarely Sometimes Often Usually Always10. I can pinpoint situations that make me feel emotionally vulnerable or sensitive. Rarely Sometimes Often Usually Always11. I can calm myself down when I feel intense emotions. Rarely Sometimes Often Usually Always12. I avoid impulsive reactions when I’m experiencing strong emotions. Rarely Sometimes Often Usually Always13. I can manage my emotions in challenging situations without getting overwhelmed. Rarely Sometimes Often Usually Always14. I know when to take a break or step back to manage my emotions effectively. Rarely Sometimes Often Usually Always15. I can shift from negative emotions to more positive states with conscious effort. Rarely Sometimes Often Usually Always16. I recognize how my emotional state affects the way I behave with others. Rarely Sometimes Often Usually Always17. I understand how my emotions can affect my partner’s or friend’s mood. Rarely Sometimes Often Usually Always18. I am aware of how my emotional reactions might impact those around me. Rarely Sometimes Often Usually Always19. I can change my behavior if I realize my emotions are affecting others negatively. Rarely Sometimes Often Usually Always20. I consider how my emotions influence my decision-making. Rarely Sometimes Often Usually Always21. I reflect on my emotions to understand myself better. Rarely Sometimes Often Usually Always22. I recognize patterns in my emotional responses over time. Rarely Sometimes Often Usually Always23. I take responsibility for managing my emotions in relationships. Rarely Sometimes Often Usually Always24. I actively work on understanding the reasons behind my emotional triggers. Rarely Sometimes Often Usually Always25. I am committed to improving my emotional awareness and regulation skills. Rarely Sometimes Often Usually AlwaysSection 3 - PERSONALITY PROFILERead the list of statements and rate yourself from 0 - 10, with zero being the statement that least describes you and ten being the statement that most describes you.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 9 102. 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 9 103. 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 9 104. 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 9 105. I am very opinionated, and I can make decisions for others easily. 0 1 2 3 4 5 6 7 8 9 106. I love people and always want to make them happy. 0 1 2 3 4 5 6 7 8 9 107. 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 9 108. 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 9 109. I can motivate people to get things done. 0 1 2 3 4 5 6 7 8 9 1010. 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 1011. 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 1012. 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 1013. I love to work from the background without making noise about my accomplishment 0 1 2 3 4 5 6 7 8 9 1014. I withdraw from aggressive situations, would rather allow peace reign than be confrontational 0 1 2 3 4 5 6 7 8 9 1015. I am ambitious but I take my time and work at my pace 0 1 2 3 4 5 6 7 8 9 1016. I am a perfectionist to the core, I can’t stand disorganized people. 0 1 2 3 4 5 6 7 8 9 1017. I love to work based on rules and regulations and predetermined standards. 0 1 2 3 4 5 6 7 8 9 1018. 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 1019. 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 1020. 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 10Section 4 - STRENGTH & GROWTH TRACKERChoose the response that best describes you using the following scale: 1 - Rarely 2 - Sometimes 3 - Often 4 - Usually 5 - Always1. I feel confident in the qualities I bring to my relationship. Rarely Sometimes Often Usually Always2. I am comfortable supporting my partner without expecting anything in return. Rarely Sometimes Often Usually Always3. I am a good listener, making others feel heard and understood. Rarely Sometimes Often Usually Always4. I manage to keep a positive attitude even during challenging times. Rarely Sometimes Often Usually Always5. I value honesty and transparency in my relationship. Rarely Sometimes Often Usually Always6. I actively seek feedback to understand how I can improve. Rarely Sometimes Often Usually Always7. I regularly reflect on my behaviors and how they impact my relationship. Rarely Sometimes Often Usually Always8. I am open to learning about myself, even if it reveals areas I need to work on. Rarely Sometimes Often Usually Always9. I recognize when I need to adjust my behaviors or attitudes. Rarely Sometimes Often Usually Always10. I am aware of both my strengths and weaknesses in my relationship. Rarely Sometimes Often Usually Always11. I communicate openly and clearly in my relationship. Rarely Sometimes Often Usually Always12. I stay calm and patient when conflicts arise. Rarely Sometimes Often Usually Always13. I am willing to compromise to reach a mutual understanding. Rarely Sometimes Often Usually Always14. I make an effort to resolve conflicts constructively. Rarely Sometimes Often Usually Always15. I am open to discussing difficult topics without becoming defensive. Rarely Sometimes Often Usually Always16. I can handle my emotions well, even in difficult situations. Rarely Sometimes Often Usually Always17. I recover quickly from setbacks and learn from challenges. Rarely Sometimes Often Usually Always18. I stay focused and calm under pressure. Rarely Sometimes Often Usually Always19. I avoid taking out my frustrations on my partner. Rarely Sometimes Often Usually Always20. I work on improving my emotional stability for my personal growth. Rarely Sometimes Often Usually Always21. I am willing to try new things that might improve my relationship. Rarely Sometimes Often Usually Always22. I view challenges as opportunities to grow and learn. Rarely Sometimes Often Usually Always23. I adapt my behaviors based on feedback from my partner. Rarely Sometimes Often Usually Always24. I actively seek ways to improve myself and my relationship. Rarely Sometimes Often Usually Always25. I am committed to ongoing personal development and growth. Rarely Sometimes Often Usually AlwaysSection 5 - TRAUMA IMPACT Answer each statement honestly based on your feelings and experiences. • Use the scale provided to indicate how strongly you agree or disagree with each statement. Strongly Disagree Disagree Neutral Agree Strongly Agree 1. I have experienced physical abuse in my life. Strongly Disagree Disagree Neutral Agree Strongly Agree2. I have experienced emotional or psychological abuse in my life. Strongly Disagree Disagree Neutral Agree Strongly Agree3. I have experienced sexual abuse or assault. Strongly Disagree Disagree Neutral Agree Strongly Agree4. I have experienced neglect or abandonment. Strongly Disagree Disagree Neutral Agree Strongly Agree5. I have experienced a significant loss (e.g., death of a loved one). Strongly Disagree Disagree Neutral Agree Strongly Agree6. I have experienced a traumatic accident or injury. Strongly Disagree Disagree Neutral Agree Strongly Agree7. I have witnessed violence or traumatic events. Strongly Disagree Disagree Neutral Agree Strongly Agree8. I have experienced a natural disaster (e.g., earthquake, flood). Strongly Disagree Disagree Neutral Agree Strongly Agree9. I have experienced chronic illness or severe health issues. Strongly Disagree Disagree Neutral Agree Strongly Agree10. I have experienced other forms of trauma not listed above. Strongly Disagree Disagree Neutral Agree Strongly Agree11. I often feel anxious or fearful without a clear reason. Strongly Disagree Disagree Neutral Agree Strongly Agree12. I have frequent nightmares or flashbacks about past events. Strongly Disagree Disagree Neutral Agree Strongly Agree13. I find it difficult to trust others. Strongly Disagree Disagree Neutral Agree Strongly Agree14. I often feel emotionally numb or detached. Strongly Disagree Disagree Neutral Agree Strongly Agree15. I have difficulty managing my anger or emotions. Strongly Disagree Disagree Neutral Agree Strongly Agree16. I experience feelings of shame or guilt related to past events. Strongly Disagree Disagree Neutral Agree Strongly Agree17. I often feel overwhelmed or unable to cope with stress. Strongly Disagree Disagree Neutral Agree Strongly Agree18. I avoid people, places, or activities that remind me of past trauma. Strongly Disagree Disagree Neutral Agree Strongly Agree19. I have difficulty forming or maintaining relationships. Strongly Disagree Disagree Neutral Agree Strongly Agree20. I struggle with feelings of depression or hopelessness. Strongly Disagree Disagree Neutral Agree Strongly Agree21. I experience frequent headaches or migraines. Strongly Disagree Disagree Neutral Agree Strongly Agree22. I have chronic pain or physical discomfort. Strongly Disagree Disagree Neutral Agree Strongly Agree23. I have trouble sleeping or experience insomnia. Strongly Disagree Disagree Neutral Agree Strongly Agree24. I often feel fatigued or lacking in energy. Strongly Disagree Disagree Neutral Agree Strongly Agree25. I experience gastrointestinal issues (e.g., stomach aches, nausea). Strongly Disagree Disagree Neutral Agree Strongly Agree26. I have difficulty breathing or experience shortness of breath. Strongly Disagree Disagree Neutral Agree Strongly Agree27. I have a weakened immune system or frequent illnesses Strongly Disagree Disagree Neutral Agree Strongly Agree28. I engage in self-destructive behaviors (e.g., substance abuse, self-harm). Strongly Disagree Disagree Neutral Agree Strongly Agree29. I have an eating disorder or disordered eating patterns. Strongly Disagree Disagree Neutral Agree Strongly Agree30. I experience other physical symptoms not listed above that may be related to stress or trauma. Strongly Disagree Disagree Neutral Agree Strongly Agree31. I have trouble concentrating or staying focused. Strongly Disagree Disagree Neutral Agree Strongly Agree32. I experience memory problems or difficulty recalling information. Strongly Disagree Disagree Neutral Agree Strongly Agree33. I often feel confused or disoriented. Strongly Disagree Disagree Neutral Agree Strongly Agree34. I have negative thoughts or beliefs about myself. Strongly Disagree Disagree Neutral Agree Strongly Agree35. I struggle with decision-making or problem-solving. Strongly Disagree Disagree Neutral Agree Strongly Agree36. I feel easily overwhelmed by everyday tasks. Strongly Disagree Disagree Neutral Agree Strongly Agree37. I have intrusive thoughts about past traumatic events. Strongly Disagree Disagree Neutral Agree Strongly Agree38. I have a negative outlook on the future. Strongly Disagree Disagree Neutral Agree Strongly Agree39. I often feel disconnected from reality. Strongly Disagree Disagree Neutral Agree Strongly Agree40. I experience other cognitive difficulties not listed above. Strongly Disagree Disagree Neutral Agree Strongly AgreeSubmit Form
