Welcome to the Divorce Self-Assessment.

This divorce self-assessment allows you to get a reliable score of the state of your mental health. As you move through your recovery process you will see your score rise.

The following statements are feelings and attitudes that people frequently experience after a love relationship has ended. Read each statement. Decide how frequently the statement applies to your present feelings and attitudes. Mark your response on your answer sheet. Do not leave any statements blank. If the statement is not appropriate for you in your present situation, answer the way you feel you might if that statement were appropriate.

After taking the self-assessment, your results will be immediately be sent to you. Please allow 15-20 minutes to take the self-assessment and should you need to leave the assessment, you may need to re-start again.

1. I am comfortable telling people I am separated from my love partner
2. I am physically and emotionally exhausted from morning until night
3. I am constantly thinking of my former love partner
4. I feel rejected by many of the friends I had when I was in the love relationship
5. I become upset when I think about my former love partner
6. I like being the person I am
7. I feel like crying because I feel so sad
8. I can communicate with my former love partner in a calm and rational manner
9. There are many things about my personality I would like to change
10. It is easy for me to accept my becoming a single person
11. I feel depressed
12. I feel emotionally separated from my former love partner
13. People would not like me if they got to know me
14. I feel comfortable seeing and talking to my former love partner
15. I feel like I am an attractive person
16. I feel as though I am in a daze and the world doesn't seem real
17. I find myself doing things just to please my former love partner
18. I feel lonely
19. There are many things about my body I would like to change
20. I have many plans and goals for the future
21. I feel I don't have much sex appeal
22. I am relating and interacting in many new ways with people since my separation
23. Joining a singles group would make me feel I was a loser like them
24. It is easy for me to organize my daily routine of living
25. I find myself making excuses to see and talk to my former love partner
26. Because my love relationship failed, I must be a failure
27. I feel like unloading my feelings of anger and hurt upon my former love partner
28. I feel comfortable being with people
29. I have trouble concentrating
30. I think of my former love partner as related to me rather than as a separate person
31. I feel like an okay person
32. I hope my former love partner is feeling as much or more emotional pain than I am
33. I have close friends who know and understand me
34. I am unable to control my emotions
35. I feel capable of building a deep and meaningful love relationship
36. I have trouble sleeping
37. I easily become angry at my former love partner
38. I am afraid to trust people who might become love partners
39. Because my love relationship ended, I feel there must be something wrong with me
40. I either have no appetite or eat continuously which is unusual for me
41. I don't want to accept the fact that our love relationship is ending
42. I force myself to eat even though I'm not hungry
43. I have given up on my former love partner and getting back together
44. I feel very frightened inside
45. It is important that my family, friends, and associates be on my side rather than on my former love partner's side
46. I feel uncomfortable even thinking about dating
47. I feel capable of living the kind of life I would like to live
48. I have noticed my body weight is changing a great deal
49. I believe if we try, my love partner and I can save our love relationship
50. My abdomen feels empty and hollow
51. I have feelings of romantic love for my former love partner
52. I can make the decisions I need to because I know and trust my feelings
53. I would like to get even with my former love partner for hurting me
54. I avoid people even though I want and need friends
55. I have really made a mess of my life
56. I sigh a lot
57. I believe it is best for all concerned to have our love relationship end
58. I perform my daily activities in a mechanical and unfeeling manner
59. I become upset when I think about my love partner having a love relationship with someone else
60. I feel capable of facing and dealing with my problems
61. I blame my former love partner for the failure of our love relationship
62. I am afraid of becoming sexually involved with another person
63. I feel adequate as a fe/male love partner
64. It will only be a matter of time until my love partner and I get back together
65. I feel detached and removed from activities around me as though I were watching them on a movie screen
66. I would like to continue having a sexual relationship with my former love partner
67. Life is somehow passing me by
68. I feel comfortable going by myself to a public place such as a movie
69. It is good to feel alive again after having felt numb and emotionally dead
70. I feel I know and understand myself
71. I feel emotionally committed to my former love partner
72. I want to be with people but I feel emotionally distant from them
73. I am the type of person I would like to have for a friend
74. I am afraid of becoming emotionally close to another love partner
75. Even on the days when I am feeling good, I may suddenly become sad and start crying
76. I can't believe our love relationship is ending
77. I become upset when I think about my love partner dating someone
78. I have a normal amount of self-confidence
79. People seem to enjoy being with me
80. Morally and spiritually, I believe it is wrong for our love relationship to end
81. I wake up in the morning feeling there is no good reason to get out of bed
82. I find myself daydreaming about all the good times I had with my love partner
83. People want to have a love relationship with me because I feel like a lovable person
84. I want to hurt my former love partner by letting him/her know how much I hurt emotionally
85. I feel comfortable going to social events even though I am single
86. I feel guilty about my love relationship ending
87. I feel emotionally insecure
88. I feel uncomfortable even thinking about having a sexual relationship
89. I feel emotionally weak and helpless
90. I think about ending my life with suicide
91. I understand the reasons why our love relationship did not work out
92. I feel comfortable having my friends know our love relationship is ending
93. I am angry about the things my former love partner has been doing
94. I feel like I am going crazy
95. I am unable to perform sexually
96. I feel as though I am the only single person in a couples-only society
97. I feel like a single person rather than a married person
98. I feel my friends look at me as unstable now that I'm separated
99. I daydream about being with and talking to my former love partner
100. I need to improve my feelings of self-worth about being a wo/man
101. What is your gender?
102. >Do you have kids?
103. >What do you do during normal work hours?
104. > Where are you in the divorce process?
105. Did you initiate the divorce?
106. How long were you or have you been married?
107. How long ago did you get divorce or when do you expect to be divorced?
108. Please tell us a little bit about your story (optional)
109. Did you/do you have many friends or family to talk to and support you during your divorce and soon after? (optional but very helpful)
110. Is there anything else you would like to share with us that might be helpful?

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