LOVE SURVEY

 

4-MOST OF THE TIME  3-MUCH OF THE TIME    2-SOME OF THE TIME  1-ALMOST NONE OF THE TIME

 

  1. My parents modeled healthy patterns of love._____________
  2. I have a fear of losing others' love.__________________
  3. When I experience hurt or frustration in love, I find it more difficult to trust and love again.______                                                                                                              
  4. I make myself known in significant ways to those I love._______________
  5. I find it difficult to express loving feelings toward members of the same sex._______
  6. I am as afraid of being accepted by those I Love as I am of being rejected.___________
  7. I have to take some risks if I am to open myself to loving.____________
  8. In my loving relationships there is complete trust and an absence of fear.___________
  9. I accept those whom I love as they are, without expecting them to be different.________
  10. I need constant closeness and intimacy with those I love.___________-

 

 

Free Reflections:

 

  1. What did you learn about love in your family of origin?

 

 

  1. How do you express your love to others?

 

 

  1. How do you let another person know your own need to receive love, affection, and caring?

 

 

  1. List some specific fears you have concerning loving others.

 

 

  1. What barriers within yourself prevent others from loving you or prevent you from fully receiving their love?

 

 

  1.  List some qualities that you think are lovable.

 

 

 

  1. What are some specific ways in which you might become a more lovable person?