Part One

About specific childhood memories and perceptions

It may be a good idea to print out this page so that when you are looking what your answers could mean, you can look back at the questions with ease.

1. I was often told as a child to be strong.
True____ False_____

2. I do not remember much affection being displayed in my family.
True____ False_____

3. Anger was the feeling most desplayed in my family.
True____ False_____

4. I rarely felt i could express my feeling to my family.
True____ False_____

5. As a child i remember my Mother and/or Father as overly intrusive.
True____ False_____

6. As a child i remember being sexualy abused.
True____ False_____

7. As a child i remember being physically abused.
True____ False_____

8. As a child i remember being emotionally abused.
True____ False_____

9. As a child i remember my Mother and/or Father being emotionally absent.
True____ False_____

10. I remember times when i was punished for strong feelings, such as when i was angry or upset and in tears about something.
True____ False_____

11. When i was upset or frightened, my mother and/or Father often ignored me.
True____ False_____

12. I grew up in a very religious household.
True____ False_____

13. I had a parent that couldn't raise me due to a physical illness or trauma.
True____ False_____

14. I grew up with a lot of double messages.
True____ False_____

To see what this could mean, go to
Part One B

Questionnaire Index

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