| *** These question are serious and will help in writing several articles and a book I am preparing. *** |
| 1. Please rate the following statements by how you would apply them to yourself, and as honestly as possible. |
no answer |
| *** You may choose more than one in each category *** |
| 2. but answer as simply as possible. |
no answer |
| 3. If you would like to write an explanation for your answers, you may. |
no answer |
| 4. All responses will be kept confidential. |
no answer |
| *** Self-Image: *** |
| 5. I am a Hottie |
I'm confident of myself |
| 6. I am Eye Candy |
So sweet |
| 7. I am Beautiful |
More then you know |
| 8. I am Good Looking |
So true |
| 9. I am Okay |
More then Okay |
| 10. I am Not Attractive |
Oh but I am |
| 11. I am Fat |
Sometimes I feel that way, because people judge other people and we do all have feelings, so when you point with that finger, you best turn it around and point it right back atcha |
| 12. I am a MILF |
What the world is MILF? |
| 13. Other:___________ |
No Answer |
| *** I Dress the Way I Do, Because: *** |
| 14. I feel like it |
And I can |
| 15. I want to |
Be married one more time before I leave this earth |
| 16. I need to |
Care more about myself |
| 17. I feel powerful when I do |
A great job at my work |
| 18. I love what I wear |
Because I think I look good |
| 19. I like the response I get, even if it's not the response I want |
true |
| 20. Other:___________ |
No Answer |
| *** I Like It When: *** |
| 21. Men look at my Pictures on MySpace |
Yep |
| 22. Men get "excited" over my pictures on MySpace |
Gosh I don't know, don't really care |
| 23. Men relate to me as a desirable female |
Some do |
| 24. Men leave me messages about how "Hot" I am |
Yes and kinda makes me feel good |
| 25. Men pay any attention at all to me |
not true |
| 26. Men leave me alone |
not true |
| 27. Other:___________ |
No Answer |
| *** It Bothers Me When: *** |
| 28. I am posing in a way to illicit a response from men in pictures |
Yep |
|
|
| 29. I men judge me as an object |
Yep, begining to think all men are alike |
| 30. I am treated as less than special |
Sometimes |
| 31. People don't seem to see the "real me" |
No men tend to not see the real me |
| 32. Other:___________ |
No Answer |
| *** I am Happiest When: *** |
| 33. I am appreciated |
Very |
| 34. I am treated with respect |
Very much so, also at my job working in a jail |
| 35. I am acknowledged |
Yes |
| 36. I am loved |
Very much |
| 37. I am sexy |
Yes |
| 38. I am shopping |
Nope |
| 39. I am successful |
Yes |
| 40. Other:___________ |
No Answer |
| *** What I Need Most in Life to Feel Fulfilled is: *** |
| 41. Love |
Yes |
| 42. Respect |
Yes |
| 43. Happiness |
Yes |
| 44. Sex |
Sometimes |
| 45. Money |
Nope |
| 46. Clothes |
Nope |
| 47. A Hug |
Yes |
| 48. Other:___________ |
No Answer |
| *** The Biggest "Pain" I Deal With is Because I was/Have Been *** |
| 49. Lied to |
Alot |
| 50. Hurt |
Alot |
| 51. Abandoned |
Nope |
| 52. Injured |
Nope |
| 53. Raped |
Nope |
| 54. Victimized as a Child |
Nope |
| 55. Heartbroken |
Many times |
| 56. Other:___________ |
No Answer |
|
|
| *** I deal with the Following: *** |
| 57. Addiction to medications/drugs (prescription or otherwise) |
No way |
| 58. Alcohol |
Nope |
| 59. Over-eating |
Nope |
| 60. Temper/Anger |
Some what, I feel that my ex has made me a bitter woman and not be able to trust men around my teenage daughter for he sexually molested my oldest daughter who was her step father. |
| 61. Depression |
Yes |
| 62. Other:___________ |
No Answer |
| *** My Biggest Fear Is: *** |
| 63. I won’t be a success |
Sometimes |
| 64. I won’t be taken seriously |
Yes |
| 65. I’ll go unnoticed |
Nope |
| 66. I won't be a good wife |
Nope |
| 67. I won't be a good mother |
Sometimes |
| 68. I will never find a partner in life |
Sometimes |
| 69. I made a mistake getting together with the one I'm with (married or not) |
Nope, not with anyone |
| 70. I will never get married |
Sometimes I think that, trust is a very hard thing to do for me |
| 71. I will never find a partner who is "worthy of me" |
True |
| 72. I am not worthy of being loved by someone |
No |
| 73. My children will not be well adjusted |
Don't know |
| 74. I am going to hurt my children |
Nope |
| 75. I am going to hurt myself (or hurt myself again) |
No way |
| 76. I am a powerful person |
Nope |
| 77. I will be successful |
Nope |
| 78. I will not know how to handle success when it comes |
Maybe |
| 79. I am afraid of people |
Some |
| 80. I am afraid of going outside |
Naa |
| 81. I am afraid of speaking in public |
Nope |
| 82. I am afraid of being raped (or raped again) |
Nope |
| 83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) |
No Answer |
| *** I Prefer the Company of: *** |
| 84. Men |
Oh yeah |
|
|
| 85. Women |
just my best friends |
| 86. Teens |
Some |
| 87. Children |
Yes |
| 88. Girls |
No Answer |
| 89. Boys |
No Answer |
| 90. Elderly |
Love senior citizens |
| 91. Other:___________ |
No Answer |
| *** I My Perfect World I Would Be: *** |
| 92. A Model |
No Answer |
| 93. A Singer/Musician |
No Answer |
| 94. An Actor |
No Answer |
| 95. A Director |
No Answer |
| 96. A Manager |
No Answer |
| 97. A Mother |
Yes |
| 98. A Bride |
No Answer |
| 99. Loved by Anyone |
Yes |
| 100. Loved by Someone |
Yes |
| 101. Find love that was real and lasting |
Yes |
| 102. Other:___________ |
No Answer |