1. I feel dirty, like there's something wrong with me- Rarely
2. Sometimes I think I'm crazy- Sometimes
3. I feel ashamed- Of the incident? Never (though I used to)
4. I'm different from other people- Usually
5. I feel powerless- Sometimes
6. If people really knew me, they'd leave- Rarely
7. I want to die- Sometimes
8. I want to kill myself- Sometimes
9. I hate myself- Sometimes
10. I have a hard time taking care of myself- Rarely
11. I don't deserve to be happy- Rarely
12. I don't trust my intuition or my feelings- When it comes to people. I basically don't trust anyone that I trust. It's very confusing.
13. I'm often confused- Often
14. I don't know how to set goals and follow through on them- Sometimes
15. I'm scared of success- Sometimes
16. I'm a failure. I don't feel capable of doing a good job- Sometimes
17. I use work to make up for empty feelings inside- Rarely
18. I'm a perfectionist- Sometimes
19. I've made up a lot of stories about my life- Rarely
20. I've done a lot of shoplifting- Never
1. I don't think feelings are very important- Just mine sometimes, but I'm working on that
2. I usually don't know what I'm feeling- Sometimes
3. I can't tell one feeling from another- Sometimes
4. I only experience one or two emotions- Never
5. I have a hard time expressing my feelings- Rarely
6. I have a hard time crying freely- Often
7. I cry all the time- Rarely
8. I get uncomfortable when I feel too happy- When it involves other people, yes.
9. I get nervous when things are relaxed and calm- Rarely
10. I feel enraged a lot of the time- Sometimes
11. I'm rarely angry. Anger scares me- sometimes
12. I get depressed a lot- Sometimes
13. I have a lot of nightmares- Sometimes
14. I have panic attacks- Rarely
15. If I really let myself go, my feelings would be out of control- Often
16. I've been violent- Never
17. I haven't been violent yet, but I'm worried I might be- Only in self defense.
1. I'm not "in my body" a lot of the time- Sometimes
2. I frequently space out- Often
3. My body often feels numb- Rarely
4. I feel as if my body is separate from the rest of me- Rarely
5. I don't pay too much attention to my body's signals (hunger, tiredness, pain)- Rarely (yoga helps with that)
6. I think my body is ugly- Never
7. I hide my body- Rarely
8. I'm dyslexic. I had learning disabilities when I was growing up- Never
9. I use drugs or alcohol more than I think I should- Never
10. I often eat compulsively- Never (I am hypoglycemic and very careful about what I eat and how much)
11. I keep myself from eating, or eat and throw up- Never, though under stress I sometimes neglect to eat.
12. I hurt myself on purpose (cut, burn or injure myself)- Never anymore, though I did a few times the year of the incident.
13. I have illnesses I think are related to my abuse- Sometimes (mainly fevers and malaise)
14. I've worked out to make my body strong so I wouldn't feel like a victim- I do exercise, but usually not with that motivation.
15. I've had flashbacks of the abuse during surgery or other medical procedures- Never
16. I'm scared to go to the dentist. I hate the feeling of things in my mouth- Never (I spent much of my pre-teens having mouth surgery, so I'm pretty jaded)
17. (For women) I'm scared to go to the gynecologist- Never
1. I often feel alienated from other people, as if I'm from another planet- Usually
2. Most of my relationships just don't work- Usually
3. I don't have many friends- Always (though I'd like to change that)
4. I'm okay with my friends, but I just can't work things out with a lover- Rarely
5. I think I'm really meant to be alone- Sometimes
6. I'm not sure I deserve to be loved- Rarely
7. I don't know what love is- Rarely
8. I find it hard to trust people- Usually
9. I think people are going to leave me- What people?
10. I test people a lot- Often
11. It's hard for me to be nurtured or to nurture someone else- It is my nature to be nurturing, but I am wary of people (esp. men) who seem to want to nurture me.
12. I'm clingy with people I'm close to. I'm afraid to be alone- Rarely
13. I'm scared of making commitment. When people get too close, I panic- Usually
14. I have a hard time saying no- Rarely
15. People take advantage of me in relationships- Often
16. I get involved with people who are inappropriate or inaccessible- Rarely
17. I've had relationships with people who remind me of my abuser- Never, though they sometimes end up reminding me later
18. I'm struggling a lot with my partner- Often
19. Sometimes I think my partner is my abuser- Never
20. Sexual abuse is really creating problems in my relationship- If this question refers to sexual abuse in one's present relationship, then no.
1. I avoid sex. Deep down, I wish I never had to deal with sex again- Rarely
2. I am celibate. I haven't had sex in years- Never
3. I really think sex is disgusting- Never (as long as it is consensual)
4. I don't feel sexual desire. I think there's something basically wrong with it- Never
5. Sex isn't pleasurable for me. I usually have sex to make the other person happy- Rarely
6. I try to use sex to meet most of my needs- Never
7. It really feels like I'm "oversexed."- Rarely
8. Sex and aggression are really connected for me- Rarely
9. I find it hard to be close in nonsexual ways. It just isn't satisfying- Rarely
10. I frequently go after sex I really don't want- Never
11. Sex is the thing I'm best at- Rarely
12. I've sold myself for sex- Never
13. I've had sex with people who don't respect me- Rarely
14. I need to control everything about sex- Rarely
15. I have a hard time staying present when I make love- Rarely
16. When I am sexual, I have terrifying, scary feelings I don't understand- Rarely
17. I often have flashbacks of my abuse while making love- Not in a long time.
18. I get sexually aroused when I read or talk about sexual abuse- Never
19. Violent, sadistic fantasies turn me on- Never (unless you count light BDSM)
20. I'm ashamed of my sexuality- Never
21. I've sexually abused others- Never
CHILDREN AND PARENTING
1. I feel awkward and uncomfortable around children- Rarely
2. I have a hard time being affectionate with kids- Rarely
3. I have a hard time setting boundaries with kids- n/a
4. I have a hard time balancing children's needs with my own- I don't have kids
5. (For parents) I feel inadequate as a parent- n/a
6. I have trouble protecting children I take care of- Never
7. I tend to be overprotective- Sometimes
8. I've successfully protected children- Yes
9. I'm scared I'll be abusive- Never
10. I have abused children- Never
11. My kids have been abused (by someone else)- n/a
MY FAMILY OF ORIGIN
1. I have strained relationships with my family- Always
2. Members of my family have rejected me (or vice versa)- n/a
3. I have a hard time setting limits with my family- Always
4. People in my family invalidate my feelings and experiences- Often
5. I feel crazy when I'm around my family- Sometimes
6. I can't be honest with the people in my family- Usually
7. My abuse is still a secret in my family- They don't know.
8. I'm waiting for people in my family to come around and support me- I would like that someday.
1. When I look over my responses, I feel... lucky that I do not seem to harbor shame over my body and sexuality, but sad about my inability to trust and connect with people.
2. I've been most strongly affected in the areas of... Intimacy, Feelings.
3. I was least affected in the areas of... Body, Family
4. The hardest statements for me to acknowledge were... Intimacy.
5. I feel the most hopeful about making changes in... Self esteem
6. I already made major strides in the following areas... Self esteem, sexuality
7. I feel the most hopeless about changing... I don't really want to admit hopelessness about anything right now. I'm trying very hard to be hopeful.
8. I was surprised by... Well, pleasantly surprised at how separate sex and sexual abuse are in my mind, and that I actually seem to be taking good care of myself overall.
9. I learned... that I have healed and grown in almost every way, but am seriously deteriorating as a social creature and hope I can turn it around, because I still have a lot of love to give.