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1. When I feel close to someone,

this person becomes an
important part of who I am
2. If someone close to me is hurt,
I feel personally hurt as well
3. My sense of pride comes from
my relationships
4. I like to emulate those who are
important to me
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5. A main consideration in
choosing a romantic partner is
how he/she would reflect on my
family
6. I like having my partner
physically near me while out in
public
7. It does not bother me when my
partner has his/her own set of
friends
8. It upsets me when I do not
know all of my partners
coworkers
9. I do not like my partner going
out socially with friends without
me
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10. Having frequent periods away

from my partner is important to
me
11. I am afraid that once I make a
commitment to a partner, I will
lose my freedom or identity.
12. It would bother me if I got
attached to people very easily.
13. I am comfortable without
close emotional relationships.
14. It is difficult for me to depend
on others.
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15. I believe that what my

partner does not know about me
will not hurt him/her.
16. I often worry that my partner
does not really love me.
17. I worry that romantic partners
will not care about me as much as
I care about them.
18. I often wish that my partner's
feelings for me were as strong as
my feelings for him or her.
19. When I show my feelings for
romantic partners, I am afraid
they will not feel the same about
me.
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20. I usually discuss my problems
and concerns with my partner.
21. I know my own strengths and
weaknesses.
22. I can usually achieve my
goals if I work hard enough.
23. If I really want it, almost
anything is possible for me.
24. What happens in my life is
mostly beyond my own control.
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25. When trying to smooth over

disagreements, I sometimes
make things worse.
26. I find it pointless to continue
working on things that are too
difficult for me.
27. All in all, I admit to feeling
that I am a failure.

28. I think highly of myself.

29. There are many things about

myself I would change if I could.
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30. I often feel upset with my life.

31. I am living the life that I want.

32. My physical, mental or

emotional health does not
interfere with having the life and
relationship that I want.

33. My financial and legal

business is handled.
34. I have effective relationship
skills.
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35. I have a good sense of where

I am headed in my life.

36. I feel lonely.

37. I feel I have people I can trust

and rely on if I need them.
38. When I am with other people,
I feel connected to them.
39. Important relationships have
ended or become weaker.
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40. I feel hopeless about having a

romantic relationship.
41. I am comfortable with pauses
when others are experiencing
emotion.
42. I sense when someone feels
troubled before being told.
43. I am comfortable with my
feelings of sadness, joy, anger
and fear.
44. I stay focused (not lost in
unimportant details or
procrastination) in getting a job
done.
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45. I freely admit to making

mistakes.
46. I can pull myself together
quickly after a set back.
47. I like tasks that challenge me
even if I make mistakes, as long
as I learn something valuable.
48. I always pay attention to
peoples body language when
talking to them.
49. I am able to confront
someone who has hurt my
feelings.
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50. I pause for a moment to

reflect on what a person has said
before reacting or responding.
51. When my first efforts to solve
a problem fail, I do not become
discouraged in my ability to
resolve the situation.
52. When I have a problem, I
think of as many possible ways to
address it until I can not come up
with any more ideas.
53. When confused about a
problem, I typically clarify vague
ideas or feelings by thinking of
them in concrete terms

54. To me, problems are learning

opportunities.
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55. I generally act on the first

idea that comes to mind in
solving a problem.
56. I feel that conflict is a
negative experience.
57. I state my true feelings when
dealing with conflict.
58. In conflict my reactions are
based on how I think the other
party perceives me.

59. I bargain to resolve conflict.

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60. I express anger

constructively.
61. One of my goals is to be a
"perfect" sexual partner.
62. As a sexual partner, I try to
be neat
63. I wait until I am in love with a
person before having sex with
him/her
64. I am shy about talking to my
partner about my own sexual
fantasies
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65. I believe any expression of

sexuality is healthy and
acceptable between two
consenting adults
66. For me, one of the most
important aspects of a romantic
relationship is sex
67. I have a clear sense of the
types of sexual activities I prefer
68. I like sex to be planned to
some extent rather than
completely spontaneous
69 I tend to be submissive to the
sexual desires of my partner
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70. I am actively experimenting

with sexual activities that are new
to me
71. I find it easy to ignore my
partners faults
72. I feel very possessive toward
my partner
73. When you are separated from
the love partner, the rest of the
world seems dull and unsatisfying
74. When you are in love, your
judgment is usually not too clear
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75. Love comes but once in a

lifetime
76. I find that my past partners
and I usually shared the same
mood
77. I am attracted to people who
quickly win respect from others
78. My partner is the sort of
person whom I myself would like
to be
79. It is hard for me to say
exactly when friendship turns into
love
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80. A couple does not need a

passionate sex life to be happy
81. What my partner does affects
me more than what s/he says
82. I know my partner loves me
when s/he does things for me that
s/he does not enjoy doing
83. I feel loved when my partner
helps me out with my chores
84. I feel loved when my partner
enthusiastically does a task I
have requested
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85. I feel loved when my partner
is touching me
86. I like for my partner to touch
me when s/he walks by
87. I feel secure when my partner
is touching me
88. I need to be touched every
day
89. I like taking long walks with
my partner
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90. I like to go to places with my

partner
91. I feel close when we are
talking or doing something
together
92. I enjoy extended trips with
my partner
93. I like to receive notes of
affirmation from my partner
94. I value my partners praise
and try to avoid his/her criticism
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95. I like my partner to

compliment my achievements
96. I need my partners words of
affirmation daily
97. I feel loved when I receive a
gift from my partner
 98. Visible symbols of love (gifts)
are very important to me
99. I like receiving gifts that my
partner makes
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100. I feel loved when my

partner celebrates my birthday
with a gift

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