Selftest: Relationship crisis/on separation

1 = strongly agree, 3 = strongly disagree

  1. 1. Physical signals: 1 2 3
    • Uncommon sweating, e.g. when the partner is nearby, when receiving messages from the partner.
    • Queasy feeling in the stomach / mild nausea / irregular digestion
    • Feeling of constriction, or pressure around the heart
    • Feeling of not being able to breathe properly
    • Feeling of wanting to stretch or straighten muscles because I feel as if something is weighing me down.
  2. 2. Unconscious body reactions 1 2 3
    • I unconsciously bite my fingernails, pick at or scratch my skin and lips.
    • Muscle twitching; facial tics, e.g. eyelids, mouth.
    • Feeling of uneasiness when breathing, change in the tone of voice.
    • I wake up in the night, think about things, and then can’t get back to sleep.
    • I’m sweating, but I don’t feel cold. I keep getting chills.
    • I feel feverish, and I’ve probably got a temperature.
  3. 3. Well-being 1 2 3
    • I feel exhausted, empty, down. Rest does not help.
    • I don’t feel happy with my life at the moment.
    • I don’t feel or behave like my ‘normal’ self.
    • I feel as if things are going totally wrong, think about it, but don’t know why.
    • My head feels heavy and ‘full’. I can’t think clearly.
    • I don’t feel like sex. This would be just too much for me at the moment.
    • I worry very much about my future and how I am going to manage.
  4. 4. Self organisation 1 2 3
    • I currently find it difficult to start work. I just don’t have the energy.
    • I find it difficult at the moment to speedily complete tasks.
    • I work more than usual. I'm looking for jobs because it distracts me.
    • I mean to socialize more – but I prefer to be on my own just now.
    • I’m not keeping up doing sport. I lack energy and enthusiasm.
    • I escape by doing an extreme amount of sport (self-chastisement). I don’t want to feel anything.
    • I control my eating habits, mealtimes, types of food more than usual.
    • I can’t control my eating habits. I eat way too much which makes me feel bad afterwards.
    • I seem to make more mistakes at the moment: clumsiness, accidents, forgotten appointments.
    • Maybe a glass of wine/cigarette will get rid of my tension.
  5. 5. Cognitive signals 1 2 3
    • My head won’t take anything in. Our discussions sap my strength.
    • I am able to do my jobs, but my thoughts are blocked by worries.
    • Bad memory: I forget so much. Other people notice this.
    • I feel very tense. I’m always 'on guard ' in case history repeats itself.
  6. 6. Mutuality/ honesty/ trust 1 2 3
    • In order to avoid an argument, I cannot speak openly and freely about things.
    • I unintentionally snap at my partner and other people in an aggressive way.
    • I often think about separation, as I believe I would be better off on my own.
    • My partner often makes fun of me in a snide way: my appearance, behaviour, work…
    • My partner does not take my concerns and interests seriously. I am unable to discuss this.
  7. 7. Dealing with other people 1 2 3
    • I cannot follow conversations properly. I am unable to concentrate.
    • I have the feeling that on holidays and at family gatherings the crisis situation will escalate.
    • I am often in a bad mood. Others can tell that I’m stressed and jumpy.
    • Because of my partner, I have neglected friends and family.