| *** 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. |
okay |
| *** You may choose more than one in each category *** |
| 2. but answer as simply as possible. |
I will |
| 3. If you would like to write an explanation for your answers, you may. |
lol |
| 4. All responses will be kept confidential. |
I hope so!!! |
| *** Self-Image: *** |
| 5. I am a Hottie |
don't think so |
| 6. I am Eye Candy |
I don't know |
| 7. I am Beautiful |
I think so |
| 8. I am Good Looking |
I think so but I'm not conceited at all |
| 9. I am Okay |
yes |
| 10. I am Not Attractive |
i don't think so |
| 11. I am Fat |
no i am not |
| 12. I am a MILF |
what? |
| 13. Other:___________ |
lol this is kinda funny |
| *** I Dress the Way I Do, Because: *** |
| 14. I feel like it |
i want to be in 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 |
yes |
| 20. Other:___________ |
i love stylish clothing |
| *** I Like It When: *** |
| 21. Men look at my Pictures on MySpace |
no i don't |
| 22. Men get "excited" over my pictures on MySpace |
no i don't |
| 23. Men relate to me as a desirable female |
yes |
| 24. Men leave me messages about how "Hot" I am |
mmm, when im not engaged, maybe |
| 25. Men pay any attention at all to me |
what? |
| 26. Men leave me alone |
no |
| 27. Other:___________ |
i am engaged, but seperated at the moment so i don't know how to answer those right now |
| *** It Bothers Me When: *** |
| 28. I am posing in a way to illicit a response from men in pictures |
yes |
|
|
| 29. I men judge me as an object |
yes |
| 30. I am treated as less than special |
no |
| 31. People don't seem to see the "real me" |
yes |
| 32. Other:___________ |
No Answer |
| *** I am Happiest When: *** |
| 33. I am appreciated |
yes |
| 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 |
yes |
| 39. I am successful |
yes |
| 40. Other:___________ |
No Answer |
| *** What I Need Most in Life to Feel Fulfilled is: *** |
| 41. Love |
very much so |
| 42. Respect |
same as above |
| 43. Happiness |
yes, im so depressed |
| 44. Sex |
not really, right in this moment |
| 45. Money |
yes |
| 46. Clothes |
yes |
| 47. A Hug |
yes |
| 48. Other:___________ |
No Answer |
| *** The Biggest "Pain" I Deal With is Because I was/Have Been *** |
| 49. Lied to |
yes, over and over again |
| 50. Hurt |
yes |
| 51. Abandoned |
no |
| 52. Injured |
no |
| 53. Raped |
no |
| 54. Victimized as a Child |
yes |
| 55. Heartbroken |
yes |
| 56. Other:___________ |
No Answer |
|
|
| *** I deal with the Following: *** |
| 57. Addiction to medications/drugs (prescription or otherwise) |
no |
| 58. Alcohol |
no |
| 59. Over-eating |
no |
| 60. Temper/Anger |
no |
| 61. Depression |
yes |
| 62. Other:___________ |
No Answer |
| *** My Biggest Fear Is: *** |
| 63. I won’t be a success |
no it's not |
| 64. I won’t be taken seriously |
yes |
| 65. I’ll go unnoticed |
yes |
| 66. I won't be a good wife |
no it's not |
| 67. I won't be a good mother |
no it's not, i will be a great mother |
| 68. I will never find a partner in life |
im wondering now after being with him 5 1/2 years!!!!!!!!! and we seperated |
| 69. I made a mistake getting together with the one I'm with (married or not) |
i don't know |
| 70. I will never get married |
i want to so bad |
| 71. I will never find a partner who is "worthy of me" |
i hope i do |
| 72. I am not worthy of being loved by someone |
im very worthy if u really love me |
| 73. My children will not be well adjusted |
yes they will |
| 74. I am going to hurt my children |
no i wont |
| 75. I am going to hurt myself (or hurt myself again) |
no |
| 76. I am a powerful person |
yes |
| 77. I will be successful |
yes |
| 78. I will not know how to handle success when it comes |
no i will be able |
| 79. I am afraid of people |
no |
| 80. I am afraid of going outside |
no |
| 81. I am afraid of speaking in public |
no |
| 82. I am afraid of being raped (or raped again) |
no |
| 83. Other:___________ (see this list for some examples: http://www.phobialist.com/reverse.html) |
No Answer |
| *** I Prefer the Company of: *** |
| 84. Men |
yes |
|
|
| 85. Women |
yes |
| 86. Teens |
no |
| 87. Children |
yes |
| 88. Girls |
no |
| 89. Boys |
no |
| 90. Elderly |
yes |
| 91. Other:___________ |
i love being around people |
| *** I My Perfect World I Would Be: *** |
| 92. A Model |
no |
| 93. A Singer/Musician |
no |
| 94. An Actor |
yes |
| 95. A Director |
yes |
| 96. A Manager |
yes |
| 97. A Mother |
yes |
| 98. A Bride |
yes |
| 99. Loved by Anyone |
no |
| 100. Loved by Someone |
yes |
| 101. Find love that was real and lasting |
yes |
| 102. Other:___________ |
No Answer |
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