Evaluation: (answer Often, Sometimes, Seldom, Never)
- My spouse calls me names, such as stupid or worthless, or uses sexually degrading terms. SELDOM
- My spouse mocks of belittles me. OFTEN
- My spouse tells me no one else would ever want me as a partner. NEVER
- My spouse pressures me to do things I do not want to do. SELDOM
- My spouse threatens to leave me. SOMETIMES
- My spouse uses the Bible to criticize me or to get me to do something he wants me to do. OFTEN
- My spouse tells me who I may have as friends. SOMETIMES
- My spouse dictates how often I can see/talk with my family of origin. SELDOM
- My spouse undermines me with our children. HIS CHILDREN, SOMETIMES
- My spouse speaks poorly of me to our children. HIS CHILDREN, SOMETIMES
- My spouse speaks poorly about me to others (his family, friends, neighbors, church people.) HIS FAMILY AND FRIENDS: OFTEN
- I don’t feel free to challenge my husband or disagree with him. OFTEN
- If I don’t agree with my husband or do what he wants, I have a price to pay. OFTEN
- My spouse breaks things around the house when he is angry or upset.NEVER
- My spouse screams and curses me. NEVER
- When I tell my husband my deepest feelings, he laughs at me, ignores me, or uses them against me. OFTEN
- My spouse disregards my needs. ALWAYS OFTEN
- My spouse tells me I can’t live without him. SELDOM
- My spouse badgers me until I give in to his demands. SOMETIMES
- My spouse calls me or texts me frequently wanting to know where I am, what I am doing, and who I am with. NEVER, HE DOESN’T CARE ENOUGH TO DO IT EVER
- My spouse monitors my e-mails, social media, and Internet use. NEVER
- My souse accuses me of things I did not do. SOMETIMES – I DID NOT HAVE AN AFFAIR BEFORE WE WERE MARRIED, I AM NOT NIT PICKING OR BADGERING HIM
- My spouse demands my attention when I am busy with something or someone else. SELDOM
- My spouse does not like it when I get positive attention or affirmation from other people – friends, family, church, work. NEVER
- My spouse tells me I cannot tell anyone what happens between us. SOMETIMES, HE IS GONG NUTS OVER ME BEING IN COUNSELLING
- My spouse uses sarcasm and ridicule to get me to stop talking or to change my mind about something. SOMETIMES
- My spouse refuses to listen to my point of view. OFTEN
- My spouse blows up when I ask questions about why he did something. OFTEN
- My spouse physically restrains me to keep me from leaving a volatile situation. NEVER
- My spouse has threatened to harm me. NEVER
- My spouse uses physical force to get me to do something he wants me to do or to stop doing something he doesn’t want me to do. NEVER
- My spouse has injured me. NEVER PHYSICALLY
- My spouse threatens to harm thins that are important to me (children, pets, property, and reputation.) NEVER
- My spouse uses physical force to coerce me sexually. NEVER
- My spouse withdraws from me if I don’t do what he wants. OFTEN
- My spouse refuses to respond when I ask him questions. OFTEN
- My spouse changes the subject when I try to bring up something that’s bothering me. OFTEN
- My spouse ignores me for long periods of time. OFTEN
- My spouse refuses to engage or participate in everyday family life. SOMETIMES
- My spouse plays mind games with me. OFTEN
- My spouse tells me that he’s the one who is being mistreated by me. OFTEN
- My spouse says the problems in our marriage are all my fault. OFTEN “MARRIAGE SHOULDN’T BE THIS HARD.” “I TOOK THE MARRIAGE COURSE I KNOW ALREADY”
- My spouse acts one way in public and another way at home. SOMETIMES
- There is a double standard around what’s acceptable behavior. he gives himself more leeway that he gives me. OFTEN
- My spouse refuses to tell me how much money he earns. OFTEN – HOW MUCH WE REALLY HAVE
- I have no voice regarding how our finances are saved or spent. SOMETIMES
- I have no idea what my husband does with our money even though I’ve asked. SELDOM, ALTHOUGH I DO NOT GET A REAL PICTURE, HE WILL ONLY SHOW ME WHAT IS ENTERED INTO THE CHECK BOOK, HE TELLS ME ABOUT THE PETTY CASH, BUT IT DOESN’T ALWAYS ADD UP.
- My spouse tells me things that I know are not true. OFTEN, I AM JUST STARTING TO NOTICE
- My spouse omits information that keeps me from knowing the whole story about something. OFTEN
- My spouse lies to other people (children, work colleagues, friends, church, family, IRS, police.) SOMETIMES
- I feel crazy in my marriage. OFTEN
- I feel trapped in my marriage.SOMETIMES
- I don’t feel I can be myself in my marriage. OFTEN, HE HAS ME CHANGE: ‘I KNOW WHAT IS BEST FOR YOU.” “STOP BEING SO SILLY WITH THE KIDS.”
- I feel like a child in my marriage. SOMETIMES
- I feel like his mother in my marriage. NEVER
- I feel tense around my spouse. SOMETIMES
- I feel angry around my spouse. OFTEN
- I feel afraid around my spouse. SELDOM
- My children are afraid of my spouse, NEVER, THEY JUST DO NOT LIKE HIM, DO NOT TRUST HIM
- I feel physically ill around my spouse. ULCER COUNT? OFTEN
- I am using medications, excess food, and/or alcohol to cope with my marriage. ULCER MEDS, DIET
- OFTEN= 25
- SOMETIMES= 17
- SELDOM= 6
- NEVER= 13
- 1-28 describe various characteristics of emotionally abusive relationship: belittling, humiliating, badgering, controlling, undermining, and threatening. O=9, SO=9, SE=4, N=6
- 20-24 indicate jealousy and inappropriate dependency, which leads to being destructive O=0, SO=2, SE=1, N=2
- 29-34 describe physically abusive tactics used to express displeasure or force O=0, SO=0, SE=0, N=6
- 35-39 looks for more covert indicators of emotional abuse, not so obvious, very effective, indicate gross indifference to the feelings and needs of spouse, destructive to marriage. O=4, SO=1, SE=0, N=0
- 40-44 vague area of crazy making where you can’t define what is abusive, mind games, refusal to engage, and blaming me leaving me confused and uncertain. O=4, SO=1, SE=0, N=0
- 45-47 describe coercive control with respect to family finances O=1, SO=1, SE=1, N=0
- 48-50 describe deceit, which breaks trust and destroys the very foundation of marriage O=2, SO=1, SE=0, N=0
- 51-61 my response to what is happening in my marriage. Some are more resilient
- SELDOM
- OFTEN
- NEVER
- SELDOM
- SOMETIMES
- OFTEN
- SOMETIMES
- SELDOM
- SOMETIMES
- SOMETIMES
- OFTEN
- OFTEN
- OFTEN
- NEVER
- NEVER
- OFTEN
- OFTEN
- SOMETIMES
- NEVER
- NEVER
- SOMETIMES
- SELDOM
- NEVER
- SOMETIMES
- SOMETIMES
- SOMETIMES
- OFTEN
- OFTEN *
- NEVER
- NEVER
- NEVER
- NEVER
- NEVER
- NEVER *
- OFTEN *
- OFTEN
- OFTEN
- OFTEN
- SOMETIMES *
- OFTEN*
- OFTEN
- OFTEN
- SOMETIMES
- OFTEN*
- OFTEN*
- SOMETIMES
- SELDOM*
- OFTEN*
- OFTEN
- SOMETIMES*
- OFTEN*
- SOMETIMES
- OFTEN
- SOMETIMES
- SOMETIMES
- SOMETIMES
- OFTEN
- SELDOM
- NEVER
- OFTEN
- OFTEN