Emotional Pattern Questionnaire

Your Name (required)


First Name

Last Name

This is optional. If you wish, please tell us a bit more about yourself. The more information you give me, the more relevant your report will be.

What is your occupation/ vocation/ passion?

In what area do you feel stuck in your life?

What was the topic that you were looking into before finding Eggshell Therapy?

What kind of resources are the most engaging for you?

I avoid speaking my mind or asking for what I want, in order to avoid conflicts.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I struggle to express my anger without 'blowing up.'

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


Sometimes I don't even realise I am angry until it reaches a boiling point.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


After I speak my mind or disagree with someone, I worry that they will like me less.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I often imagine that others think negatively about me – at work, amongst friends, or in a social group.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I always consider other people's needs and preferences before my own.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I try to avoid conflicts, even if that means I don't voice out my needs and wants.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I feel that there is constant pressure for me to achieve and to get the next thing done.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I find it hard to let go if I have made a mistake.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


‘Good enough’ is not good enough for me, even when others say otherwise.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I don't let myself off the hook when I make mistakes.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I often feel that there is something fundamentally wrong with me that makes me so different to others.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I am hypersensitive to criticism and react very strongly, either by collapsing on the inside, becoming very sad, or getting angry.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I sometimes denigrate myself before others have the chance to do so.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I feel that no one will want to be with me if they get to know the real me.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


Even if I achieve outward success, some part of me feels like a fraud on the inside.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I don’t allow myself to truly fall in love; I am always preparing for the day when the other person will leave me.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I am so sensitive in relationships that I end up doing things that push people away – e.g., by becoming clingy, jealous, or erratic.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I spend a lot of time worrying that someone will go when they find out who I truly am.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I am constantly worried that people I care about will leave me in one way or another: cheat on me, betray me, or die in an accident.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


(Almost there!)

I believe that the world is a hostile place, and that people will always do things to get what they want at the expense of others.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I am always sceptical of another person’s motive when they are nice to me.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I have been badly betrayed before and I have learned a painful lesson.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I cannot let my guard down or I will be used or abused.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I can trust no one but myself.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I fantasize about a strong person taking over my life and making it work.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I don’t feel that I can take proper care of myself.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I cannot rely on my own judgement when it comes to decision-making.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


It’s easier if I let others decide for me- most of the time I don’t know what I want.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I often feel helpless, that I am unable to cope with challenges in life.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I have difficulties disciplining myself to complete things, I easily become frustrated and give up on goals.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


It almost seems that the more I try to control myself the more I lose control.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I indulge in behaviours that are against my true values (over-consuming, over-indulging, procrastinating), and then feel extremely disgusted and ashamed of myself afterwards.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I keep making the same mistake again and again and I really hate myself for that.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


I often become consumed by my impulses and cannot focus on what I am supposed to do.

Strongly DisagreeDisagreeNeutralAgreeStrongly Agree


Copyright @Eggshell Therapy All Rights Reserved.

I have read and agreed to the Terms and Conditions

Email *