| *** 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 |
that's something a 14 year old girl would probably say, not me |
| 6. I am Eye Candy |
never understood what that means! but no. |
| 7. I am Beautiful |
yes, i think of myself as classy |
| 8. I am Good Looking |
yes |
| 9. I am Okay |
more like when i haven't got any makeup on |
| 10. I am Not Attractive |
no |
| 11. I am Fat |
not fat, however i feel like i need to loose a few pounds |
| 12. I am a MILF |
haha, i don't think so |
| 13. Other:___________ |
n/a |
| *** I Dress the Way I Do, Because: *** |
| 14. I feel like it |
yes, my own sense of style |
| 15. I want to |
yes |
| 16. I need to |
no |
| 17. I feel powerful when I do |
no |
| 18. I love what I wear |
yes |
| 19. I like the response I get, even if it's not the response I want |
no |
| 20. Other:___________ |
i wear what i want for me and no one else |
| *** I Like It When: *** |
| 21. Men look at my Pictures on MySpace |
probably |
| 22. Men get "excited" over my pictures on MySpace |
not that i know of, ew |
| 23. Men relate to me as a desirable female |
i would hope so |
| 24. Men leave me messages about how "Hot" I am |
no |
| 25. Men pay any attention at all to me |
sometimes |
| 26. Men leave me alone |
i don't act interested because i'm not, i am engaged so i think they look elsewhere |
| 27. Other:___________ |
n/a |
| *** It Bothers Me When: *** |
| 28. I am posing in a way to illicit a response from men in pictures |
i don't do that |
|
|
| 29. I men judge me as an object |
i think men can be pigs so some probably do however i'm not some "easy girl" |
| 30. I am treated as less than special |
never |
| 31. People don't seem to see the "real me" |
sometimes |
| 32. Other:___________ |
n/a |
| *** I am Happiest When: *** |
| 33. I am appreciated |
definetely |
| 34. I am treated with respect |
yes |
| 35. I am acknowledged |
yes |
| 36. I am loved |
yes |
| 37. I am sexy |
yes |
| 38. I am shopping |
money doesn't buy happiness |
| 39. I am successful |
yes |
| 40. Other:___________ |
n/a |
| *** What I Need Most in Life to Feel Fulfilled is: *** |
| 41. Love |
most of all! |
| 42. Respect |
yes |
| 43. Happiness |
yes |
| 44. Sex |
yes |
| 45. Money |
well money helps so i'm not stressed out, so i guess so |
| 46. Clothes |
no |
| 47. A Hug |
depends on who from |
| 48. Other:___________ |
n/a |
| *** The Biggest "Pain" I Deal With is Because I was/Have Been *** |
| 49. Lied to |
yes i have a hard time trusting anyone new and unframiliar |
| 50. Hurt |
yes |
| 51. Abandoned |
no |
| 52. Injured |
no |
| 53. Raped |
no |
| 54. Victimized as a Child |
no |
| 55. Heartbroken |
yes |
| 56. Other:___________ |
n/a |
|
|
| *** I deal with the Following: *** |
| 57. Addiction to medications/drugs (prescription or otherwise) |
no |
| 58. Alcohol |
no |
| 59. Over-eating |
sometimes bad habbit |
| 60. Temper/Anger |
i say things i don't mean but i am honestly trying to work on that |
| 61. Depression |
no, just normal saddness sometimes |
| 62. Other:___________ |
n/a |
| *** My Biggest Fear Is: *** |
| 63. I won’t be a success |
yes |
| 64. I won’t be taken seriously |
no |
| 65. I’ll go unnoticed |
no |
| 66. I won't be a good wife |
yes |
| 67. I won't be a good mother |
yes, i try to be superhuman and don't allow myself room to make mistakes |
| 68. I will never find a partner in life |
n/a |
| 69. I made a mistake getting together with the one I'm with (married or not) |
just worry because he is going to be a police officer and that is a hard lifestyle i hope getting married won't be a mistake |
| 70. I will never get married |
no |
| 71. I will never find a partner who is "worthy of me" |
no |
| 72. I am not worthy of being loved by someone |
sometimes i feel like i'm not good enough |
| 73. My children will not be well adjusted |
no |
| 74. I am going to hurt my children |
never intentionally maybe if i accidently yell at them or something |
| 75. I am going to hurt myself (or hurt myself again) |
no |
| 76. I am a powerful person |
no |
| 77. I will be successful |
no |
| 78. I will not know how to handle success when it comes |
no |
| 79. I am afraid of people |
no |
| 80. I am afraid of going outside |
no |
| 81. I am afraid of speaking in public |
just nervous but can handle it |
| 82. I am afraid of being raped (or raped again) |
with my fiance gone all the time now, yes i worry doing things alone, we live in a world full of creeps! |
| 83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) |
n/a |
| *** I Prefer the Company of: *** |
| 84. Men |
not necessarily |
|
|
| 85. Women |
not neccessarily like above just anyone who is a good listener and a good friend and caring |
| 86. Teens |
no |
| 87. Children |
no |
| 88. Girls |
no |
| 89. Boys |
no |
| 90. Elderly |
no but they are quite wise i love learning from their wisdom |
| 91. Other:___________ |
n/a |
| *** I My Perfect World I Would Be: *** |
| 92. A Model |
not a model just have a model perfect body |
| 93. A Singer/Musician |
no |
| 94. An Actor |
no |
| 95. A Director |
no |
| 96. A Manager |
yes |
| 97. A Mother |
n/a |
| 98. A Bride |
no |
| 99. Loved by Anyone |
no |
| 100. Loved by Someone |
someone special not just anyone, someone who i love too |
| 101. Find love that was real and lasting |
yes |
| 102. Other:___________ |
n/a |