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Self Test

[[ note: we’ll have an intro page before this one that tells the benefits of why they want to take the self-test and what they’ll receive in return. The intro page will link to the self-test page. ]]

How Are You Adjusting To The Ending Of A Love Relationship?

Complete The Fisher Divorce Adjustment Scale Below

Complete the questionnaire & you will receive an email with your results.

20 Minute Complimentary Interpretive Phone Consult Available – Once you have received your results, contact 720-524-3664 to schedule your consultation.

Answer each of the following questions below:

The following statements are feelings and attitudes that people frequently experience while they are ending a love relationship. Keeping in mind one specific relationship you have ended or are ending, read each statement and decide how frequently the statement applies to your present feelings and attitudes. You must answer every question. If the statement is not appropriate for you in your present situation, answer the way you feel you might if that statement were appropriate.

1. I am comfortable telling people I am separated from my love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

2. I am physically and emotionally exhausted from morning until night.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

3. I am constantly thinking of my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

4. I feel rejected by many of the friends I had when I was in the love relationship.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

5. I become upset when I think about my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

6. I like being the person I am.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

7. I feel like crying because I feel so sad.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

8. I can communicate with my former love partner in a calm and rational manner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

9. There are many things about my personaIity I would like to change.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

10. It is easy for me to accept my becoming a single person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

11. I feel depressed.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

12. I feel emotionally separated from my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

13. People would not like me if they got to know me.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

14. I feel comfortable seeing and talking to my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

15. I feel like I am an attractive person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

16. I feel as though I am in a daze and the world doesn’t seem real.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

17. I find myself doing things just to please my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

18. I feel lonely.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

19. There are many things about my body I would like to change.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

20. I have many plans and goals for the future.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

21. I feel I don’t have much sex appeal.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

22. I am relating and interacting in many new ways with people since my separation.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

23. Joining a singles’ group would make me feel I was a loser like them.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

24. It is easy for me to organize my daily routine of living.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

25. I find myself making excuses to see and talk to my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

26. Because my love relationship failed, I must be a failure.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

27. I feel like unloading my feelings of anger and hurt upon my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

28. I feel comfortable being with people.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

29. I have trouble concentrating.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

30. I think of my former love partner as related to me rather than as a separate person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

31. I feel like an okay person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

32. I hope my former love partner is feeling as much or more emotional pain than I am.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

33. I have close friends who know and understand me.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

34. I am unable to control my emotions.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

35. I feel capable of building a deep and meaningful love relationship.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

36. I have trouble sleeping.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

37. I easily become angry at my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

38. I am afraid to trust people who might become love partners.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

39. Because my love relationship ended, I feel there must be something wrong with me.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

40. I either have no appetite or eat continuously which is unusual for me.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

41. I don’t want to accept the fact that our love relationship is ending.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

42. I force myself to eat even though I’m not hungry.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

43. I have given up on my former love partner and getting back together.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

44. I feel very frightened inside.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

45. 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

46. I feel uncomfortable even thinking about dating.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

47. I feel capable of living the kind of life I would like to live.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

48. I have noticed my body weight is changing a great deal.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

49. I believe if we try, my love partner and I can save our love relationship.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

50. My abdomen feels empty and hollow.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

51. I have feelings of romantic love for my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

52. I can make the decisions I need to because I know and trust my feelings.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

53. I would like to get even with my former love partner for hurting me.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

54. I avoid people even though I want and need friends.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

55. I have really made a mess of my life.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

56. I sigh a lot.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

57. I believe it is best for all concerned to have our love relationship end.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

58. I perform my daily activities in a mechanical and unfeeling manner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

59. I become upset when I think about my love partner having a love relationship with someone else.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

60. I feel capable of facing and dealing with my problems.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

61. I blame my former love partner for the failure of our love relationship.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

62. I am afraid of becoming sexually involved with another person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

63. I feel adequate as a fe/male love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

64. It will only be a matter of time until my love partner and I get back together.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

65. 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

66. I would like to continue having a sexual relationship with my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

67. Life is somehow passing me by.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

68. I feel comfortable going by myself to a public place such as a movie.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

69. It is good to feel alive again after having felt numb and emotionally dead.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

70. I feel I know and understand myself.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

71. I feel emotionally committed to my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

72. I want to be with people but I feel emotionally distant from them.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

73. I am the type of person I would like to have for a friend.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

74. I am afraid of becoming emotionally close to another love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

75. Even on the days when I am feeling good, I may suddenly become sad and start crying.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

76. I can’t believe our love relationship is ending.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

77. I become upset when I think about my love partner dating someone.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

78. I have a normal amount of self-confidence.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

79. People seem to enjoy being with me.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

80. Morally and spiritually, I believe it is wrong for our love relationship to end.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

81. I wake up in the morning feeling there is no good reason to get out of bed.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

82. I find myself daydreaming about all the good times I had with my love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

83. People want to have a love relationship with me because I feel like a lovable person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

84. 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

85. I feel comfortable going to social events even though I am single.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

86. I feel guilty about my love relationship ending.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

87. I feel emotionally insecure.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

88. I feel uncomfortable even thinking about having a sexual relationship.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

89. I feel emotionally weak and helpless.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

90. I think about ending my life with suicide.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

91. I understand the reasons why our love relationship did not work out.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

92. I feel comfortable having my friends know our love relationship is ending.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

93. I am angry about the things my former love partner has been doing.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

94. I feel like I am going crazy.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

95. I am unable to perform sexually.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

96. I feel as though I am the only single person in a couples-only society.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

97. I feel like a single person rather than a married person.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

98. I feel my friends look at me as unstable now that I’m separated.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

99. I daydream about being with and talking to my former love partner.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

100. I need to improve my feelings of self-worth about being a wo/man.

—
Almost Always
Usually
Sometimes
Seldom
Almost Never

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