Catching Kismet Break Through to Forever Love Assessment v2.0

Section 1. Please answer the following questions about your experience of dating. Even if you have decided to approach things differently in the future, please answer based upon how you felt and behaved when you were most recently dating.

I have had a hard time finding someone who is the total package, and there is no way I would settle for anything less.

I am hung up on a guy that I would love to date, but he either doesn’t know how I feel or doesn't feel the same way.

I oftentimes find it hard to get out of the friend zone with men.

I don't seem to be able to get past the first or second date with guys.

I tend to attract:

I am good at flirting and know how to signal a man that I am interested.

It is common for men to get the wrong idea and think that I'm interested even when I'm not.

When searching for the right guy, I tend to date:

I have taken enough time to heal my heart from my last relationship.

I would love to be in a successful romantic relationship right now.

Having a successful romantic relationship is an important part of having a full life.

The way I feel about getting out there and dating is:

Dating is full of more disappointment than enjoyment.

I can find something positive in just about every first date I have.

I embrace dating as an opportunity to meet new people, and make new friends.

I feel crushed when a guy doesn’t contact me again after a first date I thought went well.

I feel very anxious about the process of meeting new men to date.

I feel very anxious even when I am in a committed relationship with a guy.

I feel very anxious when I am dating someone before we are in a committed relationship.

I feel very anxious when waiting for a guy I’m interested in to call or text me.

I feel very awkward on a first date.

I feel very depressed that I only seem to attract men who are not right for me.

I feel very disappointed after a first date with a guy who is not someone I could see myself actually dating.

I feel very disappointed when a man whose profile I really like does not write back to me online.

I feel very disappointed when not enough men contact me online.

I feel very frustrated that few men that I meet or go on first dates with are men I could ever see myself dating long-term.

My relationships tend to last 6 months or less.

Sometimes dating sucks so much that I stop dating for awhile.

Section 2. Through the following questions, we are analyzing patterns in your most significant relationships. Please answer the questions in the affirmative if you have noticed the following feelings, attitudes, and experiences in your most significant relationships. If multiple answers are true, pick the answer you feel is most common or most significant for you. In situations where one answer may have been true in the past, while another is true of your more recent relationships, answer according to what is true for you now.

It is common for me to feel jealous or fearful that my guy might be interested in another woman.

All men struggle with being faithful, but the good ones will overcome it.

I don't want to fully commit because I believe someone better might come along and I will be stuck.

If you could have only one of the following three qualities in a partner, which would you choose?

I tend to lose my own identity and/or spend a lot less time with friends when I am in a relationship.

I tend to give more than I receive.

I thrive on being needed by my guy. I have a strong desire to take care of my man.

It is important to me that I show my guy no one will ever love him like I can.

In the beginning of my relationships, I usually feel:

I typically feel comfortable having sex in a new relationship:

When I find someone I like, I typically:

I can't help it - the type of men I typically attract are: (Please select all that apply.)

In a relationship, my feelings about my guy:

How much time do you typically spend with your romantic partner?

When you spend time together, your guy usually finds a time that works for:

I am not my guy's top priority. He has other people or situations in his life that he prioritizes over our relationship.

Who typically ends your relationships?

Section 3. In the following questions, we are examining some of your core beliefs about relationships. Some responses will resonate with you more than others. For each question, please select all responses that you feel strongly represent an attitude that you have. If you are having difficulty choosing, try to discern which ones "feel" like a match.

Please take your time to select all of the following relationship beliefs that reflect attitudes that you hold about relationships. (Please select at least 1.)

Please take your time to select all of the following core beliefs that reflect attitudes that you hold. (Please select at least 1.)

Please take your time to select all of the following that reflect common negative ways that you view your romantic partners. (Please select at least 1.)

Please take your time to select all of the following common frustrations that you have when you are in a relationship. (Please select at least 1.)

Section 4. Please answer the following questions:

I get excited before all first dates because my date could be THE ONE.

I believe in being proactive about looking for love.

As I look back, I find that I typically ignore my friends’ advice about the men that I date, and go with my feelings instead.

If I meet a great guy but there is no chemistry, I typically wouldn't go out with him again.

I desire total emotional closeness with my romantic partners.

Each day I devote time to fulfilling my life’s purpose.

Every week, I engage in activities that bring me joy and make me feel alive.

My romantic partners typically don't desire as much emotional closeness I do.

I am able to say “no” to people without guilt, even those with whom I am close.

There have been times that my romantic partners have been scared away by the level of emotional closeness I desire.

I am compassionate towards myself.

Most men don’t meet my standards, so I don’t give them a chance.

I am still crazy about my ex, and it keeps me from moving forward with other relationships.

I am concerned about being as good as other people, and there are times I don't think I am.

I believe that I have limiting beliefs about love, dating, relationships, or myself that are keeping me from attracting my soulmate.

I can quickly name 5 activities that bring me joy and make me feel energized and happy to be alive.

I am typically worried that my romantic partners don't care about me as much as I care about them.

I can recognize red flags.

I feel comfortable ending a relationship if I see red flags.

I worry that my romantic partners don't really love me.

I feel completely lovable just as I am.

I have 4 or more dates a month.

I worry that my romantic partners will stop loving me.

I have a strong network of close friends who love and support me unconditionally.

I have close friends who tell me the truth instead of just telling me what I want to hear.

I worry that my romantic partners will leave me.

I have good examples of people close to me who are in successful, happy marriages.

I have taken time to define the qualities I am looking for in a mate.

I worry that my romantic partners will find someone else.

I have trouble being my authentic self with men.

I know how to balance my drive for career success at work with femininity when I am with my man.

I am very independent and self-sufficient, even in a romantic relationship.

I know the characteristics of my perfect guy, and I won’t settle for anything less.

I know what my life’s purpose is.

It is not necessary for me to be in a close, committed relationship.

I listen to what a man says, but I only make decisions based upon what he does.

I love myself.

I prefer not to depend upon my romantic partners.

I prioritize my own needs.

I prioritize my own self-care.

I feel uncomfortable sharing deeply personal thoughts and feelings even with my romantic partners.

I recognize when I am not being treated with dignity and respect.

The number one need a man wants fulfilled in a relationship is:

I feel uncomfortable when my romantic partner depends upon me too much.

I turn to family and/or friends during challenging times in my life.

I use my thoughts and feelings to attract my life partner.

I feel uncomfortable when my romantic partners talk about their thoughts and feelings.

If someone does not treat me with dignity and respect, I have no problem communicating how I feel to that person or ending a relationship, if necessary.

It has been at least 6 months since I went out on a date.

I tend to keep my problems to myself and figure them out alone.

My friends give me advice about the men that I date.

My parents are happily married.

I want a romantic partner who knows how to figure out their own problems themselves.

On dates, I often find myself thinking about what is happening instead of being fully present with my date.

When I am having a difficult time, I have people I can turn to.

Section 5. Please answer the following questions about your most recent significant relationship (or your current relationship if you are in a significant committed relationship).

I know how to seek and grant forgiveness.

We share feelings and understand each other.

We are able to discuss and resolve differences.

We appreciate each other’s personality and habits.

We agree on budget and financial matters.

We have a good balance of activities together and apart.

We are comfortable discussing sexual issues and affection.

We feel good about our relationships with relatives and friends.

We agree on how to share decision-making and responsibilities.

We agree on issues related to having and raising children.

We are tolerant of each other's or share the same spiritual values and beliefs.

Section 6. Please answer the following questions about your expectations of your ideal future relationship.

My partner will meet all my needs for companionship.

Time will resolve our problems.

If I have to ask, it is not as meaningful.

We should live ‘happily ever after’ with no major problems.

Keeping secrets about my past or present is acceptable if it would only cause pain for my partner.

Less romance means we have less love for one another.

Our relationship will remain the same over time.

My partner’s interest in sex will be the same as mine.

Our relationship will be better when we have a baby.

We will do things just like my family did.

Nothing could cause us to question our love for one another.

I believe I will know everything there is to know about my partner.

Love is all you need for a great marriage.

It is better to keep silent about something bothering me than to cause unnecessary problems in our relationship.

Section 7. The questions below will provide an important dimension to your assessment results, so please try to answer them as candidly as possible.

Did a household member go to prison?

Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?

Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?

Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

Was a household member depressed or mentally ill, or did a household member attempt suicide?

Were your parents ever separated or divorced?

Section 8. Please answer the following questions:

As a youth, people noticed that I was capable and could get things done.

When I was young, I was independent and a go-getter.

When I was young, I believed that life is what you make it.

I believe that my father loved me when I was little.

I believe that my mother loved me when I was little.

I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too.

My family, neighbors and friends talked often about making our lives better.

Someone in my family cared about how I was doing in school.

We had rules in our house and were expected to keep them.

When I felt really bad, I could almost always find someone I trusted to talk to.

When I was a child, neighbors or my friends’ parents seemed to like me.

When I was a child, teachers, coaches, youth leaders or ministers were there to help me.

When I was a child, there were relatives in my family who made me feel better if I was sad or worried.

When I was little, other people helped my mother and father take care of me and they seemed to love me.

Section 9. Please answer the following questions with a rating between 0 and 10.

How in touch with your authentic painful emotions are you when you experience a challenging or difficult time in your life? 0 - Not in touch at all 10 - Totally in touch

How dedicated have you been over the course of your life to activities that will help you to understand yourself better and heal. (e.g. psychotherapy, hypnosis, EFT, etc.) 0 - Not dedicated, 10 - devote time each day.

How much of a connection have you been able to see between events that happened in your childhood, and events that happened/happen in your life as an adult? 0 - See no connections, 10 - Frequenly see connections.

How much do you believe that you are still impacted in your life today by the events that occurred in your childhood? 0 - Not impacted, 10 - Very impacted.

How much have you completely forgiven everyone who has hurt you in any way in your life? 0-Forgiven no one 10-Forgiven everyone

We typically have painful repeating patterns of events or situations that commonly occur in our lives - to what degree have you learned the lessons from those patterns and eliminated them from your life. 0-Eliminated NO Painful patterns 10-Eliminated ALL painful patterns

How painful are the patterns you experience in your life? 0-Not painful at all 10-Extremely painful