Self Care Assessment

Self Care Assessment

Consider the following 40 statements below, filling in the blanks that follow with the number that best corresponds with your life at this time.

Responses: 1 = Very True 2 = Somewhat True 3 = Rarely True

1. When people get upset, I try to smooth things out. ____
2. I am able to listen to others problems without trying to “fix” them and/or take away their pain. ____
3. My self-worth is determined by how others perceive me. ____
4. When I am exposed to conflict, I feel it is my fault. ____
5. I feel guilty when others are disappointed by my actions. ____
6. When I make a mistake, I tend to be extremely critical of myself: I have difficulty forgiving myself. ____
7. I usually know how I want other people to treat me. ____
8. I tell people how I prefer to be treated. ____
9. My achievements define my self-worth. ____
10. I feel anxious in most situations involving confrontation. ____
11. In relationships, it is easier for me to “give” than to “receive”.____
12. I can be so focused on someone I am helping that I lose sight of my own perceptions, interests and desires. ____
13. It is hard for me to express sadness. ____
14. To make mistakes means that I am weak. ____
15. It is best to not “rock the boat” or “make waves”. ____
16. It is important to put people at ease. ____
17. It is best not to need others. ____
18. If I cannot solve a problem, I feel like a failure. ____
19. I often feel “used up” at the end of the day. ____
20. I take work home frequently. ____
21. I can ask for help but only if the situation is serious. ____
22. I am willing to sacrifice my needs in order to please others. ____
23. When faced with uncertainty, I feel that things will get totally out of control. ____
24. I am uncomfortable when others do not see me as being strong and self-sufficient. ____
25. In intimate relationships, I am drawn to people who are needy or need me. ____
26. I have difficulty expressing my differing opinion in the face of an opposing viewpoint. ____
27. When I say “no”, I feel guilty. ____
28. When others distance from me, I feel anxious. ____
29. When listening to someone’s problems, I am more aware of their feelings than I am of my own feelings. ____
30. I find it difficult to stand up for myself and express my feelings when someone treats me in an insensitive manner. ____
31. I feel anxious when I am not busy. ____
32. I believe that expressing resentments is wrong. ____
33. I am more comfortable giving than receiving. ____
34. I become anxious when I think I’ve disappointed someone. ____
35. Work dominates much of my life. ____
36. I seem to be working harder and accomplishing less. ____
37. I feel most worthwhile and alive in crisis situations. ____
38. I have difficulty saying “no” and setting limits. ____
39. My interests and values reflect what others expect of me rather, than my own interests and values. ____
40. People rely on me for support. ____

It is important for you to periodically review your self-care, along with your needs and action plans to meet those needs.

If you find that your responded with a 1 (Very True) to more than 15 of these items, it’s definitely time to take a close and careful look at self-care issues.