1. Introduction: Recipe for Emotional Wellness & Positivity I.Q. Scale

This Confidential Positive-Mind I.Q. Wellness Survey has 10 main questions, each with sub-questions. Please answer every question. At the end, you will have a chance to edit your survey. Your scores indicate the intensity of your response. The survey cannot be printed by you, but automatically sends a copy, when completed, to The HEAL Center when you press, "Done." To receive your analysis and where you rank on the Positive-Mind I.Q. Scale, please type your name, phone and email address in the box below Question 1.

* 1. *Question 1: I get emotionally overwhelmed. Either I over-react to circumstances, or I totally ignore my feelings. It is difficult for me to stay “present” in the present moment.

  No, I never feel this way. Yes rarely, but not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Get overwhelmed.
Over-react.
Ignore my feelings.
Hard to stay "present."

* 2. I am extremely uncomfortable with uncertainty. I worry about the future. I worry about how things that have happened in the past will happen again. In fact, I am just overwhelmed with all my thoughts. I easily get distracted, lose focus or have difficulty concentrating.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Uncertainty.
Worry about future.
Worry about past.
Overwhelmed all.
Lose focus.

* 3. I need things to stay the same in order to feel secure and safe. I try to control things, people and events in a way that seems unhealthy or inappropriate. It’s hard for me to keep an open mind, or allow other people to have differing views. I ignore my intuition.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Things to stay same.
Try to control.
Hard to stay open.
Ignore my intuition.

* 4. It bothers me when someone dislikes or disapproves of me. I feel defensive when someone disagrees with my opinions or beliefs. I hold back in my self-expression to avoid conflict. I avoid conflict at all costs.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Dislikes me.
Disagrees with me.
I avoid conflict.
I avoid at all costs.

* 5. I look outside of myself to get a sense of who I am. I overly identify with my stories of events. I am overly identified my past stories about myself.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Look outside for me.
Stories of events.
My past stories.

* 6. I tend to judge others or myself. I tend to look at things from a negative or pessimistic point of view. I don’t fully accept myself, or certain parts of myself. I feel like I don’t deserve to have what I want in life.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Judging You-Me
Pessimistic
Don't Accept Me
Don't Deserve

* 7. My feelings get hurt easily. I easily lose my temper, get angry. I feel like “my way” is always the best way. I am having recurring problems in key relationships.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Feelings hurt.
Lose temper.
My way best.
Recurring problems.

* 8. I sabotage my intentions and desires. I fear failure. I fear success. I am my own worst enemy.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
I sabotage me.
Fear failure.
Fear success.
Worst enemy.

* 9. I feel disconnected, alone or separate. I feel like some important piece of myself is missing and I don’t know where to find it. I have a hard time even knowing what I want in certain areas of my life. I have habits that I know are not serving me that I want to change.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Disconnected.
Me is missing.
Don't know.
Want to Change.

* 10. I procrastinate, or have difficulty making decisions. I doubt or second-guess myself. I doubt what others tell me. I doubt almost everything to the point of being totally stuck, and I cannot help myself.

  No, I never feel this way. Yes rarely, not a problem. Yes at times, I live with it. Yes true, this needs work. Yes, this truly must change. Yes, this truly must stop now.
Procrastinate.
Second guess.
Doubt others.
Totally stuck.
Page1 / 1
 
100% of survey complete.

T