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MoonDragon's Alternative Health Information
WELL-BEING QUESTIONNAIRE - Page 3
THE MIND
EMOTIONS
A = Usually
B = Sometimes
C = Rarely
1. Are you unaffected by worry and girls? A B C 2. Do you find it easy to laugh? A B C 3. Do you express your feelings rather than bottle them up? A B C 4. Can you recall childhood memories without feeling bad? A B C 5. Can you openly share intimate thoughts and feelings? A B C 6. Can you be sensitive to other people's feelings? A B C 7. Are you unaffected by feeling rushed or irritable? A B C 8. Do you avoid undermining yourself with self-criticism? A B C TOTAL A_______ B_______ C_______
GENERAL GUIDANCE
A sense of humor, the ability to express yourself and share your feelings, empathy with others, and tolerance of their opinions indicate a strong sense of self-worth and high self-esteem.
YOUR SCORE
- A - Many A's mean you have a clear idea of your strength and weaknesses, are at ease with yourself, and are able to take criticism.
- B - If your score is mostly B's, use your answers to pinpoint areas that you need to develop.
- C - If you scored highly in C's, examine your difficulties in communication and your negative opinion of yourself: they could be jeopardizing your well-being.
RELATIONSHIPS
A = Usually
B = Sometimes
C = Never
1. Do you have someone with whom you can discuss personal worries or problems? A B C 2. Do you listen to people without interrupting them? A B C 3. Can you accept and deal with conflict in your relations with others? A B C 4. Do you feel no compulsion to seek approval from others? A B C 5. Can you express what you feel or believe without feeling anxious? A B C 6. Are you satisfied with your level of sexual activity? A B C 7. Are you happy with your level of sexual intimacy? A B C 8. Are you satisfied with your use (or nonuse) of contraception and/or practice of safer sex? A B C TOTAL A_______ B_______ C_______
GENERAL GUIDANCE
Those who have partners with whom to share problems are less likely to get sick and recover faster than those without. If you feel good about yourself it's easier to have close relationships. Sexual activity concerns satisfaction in a purely physical sense, while sexual intimacy concerns the mental aspect of an emotional involvement. Thus it is possible to score A in one and C in the other.
YOUR SCORE
- A - Congratulations if you scored mostly A's!
- B - If you scored many B's, examine the aspects of your relationships that may need attention.
- C - With mostly C's you could explore ways to improve your self-esteem, ability to relax, and communication skills. Seek out information about emotions and stress.
LIFE MANAGEMENT
A = Yes
B = Sometimes
C = Never
1. Do you include your relaxation time in you daily routine? A B C 2. Do you set yourself realistic goals? A B C 3. Do you organize your time to do things that are important to you? A B C 4. Do you plan ahead for events that may be potentially stressful? A B C 5. Do you feel you can rise to realistic challenges? A B C 6. Do you accept your and others' limitations? A B C 7. Can you make decisions without undue anxiety? A B C 8. Do you decide what you want or feel and say so specifically and directly? A B C 9. Do you allow others to share tasks and responsibilities? A B C 10. Do you get the balance between work and recreation about right? A B C TOTAL A_______ B_______ C_______
GENERAL GUIDANCE
Managing your life to achieve balance and control involves self-confidence, self-esteem, a sense of priorities, assertiveness, the ability to say "no", and planning ahead. It also means making time for things that maintain inner harmony and help you cope with challenge.
YOUR SCORE
- A - A majority of A's shows your attitude toward life is positive.
- B - High in B's, use these questions to examine which areas you could manage better.
- C - A high C score means you may feel that life is out of control, others take advantage, and you cannot cope with everyday problems. The following may help stress: Relaxation & Breathing, and Psychotherapy & Counseling.
YOUR OVERALL WELL-BEING
The color wheel is designed to help you identify at a glance which areas of your life might need improvement. Use dots to mark the total number of A's, B's, and C's you scored in each section of the questionnaire on the relevant segments of the color wheel. The inner, middle, and the outer zones of the wheel are color-coded to match your scores for A, B, and C respectively.
INTERPRETING YOUR RESULT
Together the two halves of the wheel - Body and Mind - make up an overall picture of your health. By looking at the number of dots in each circle you can quickly assess your overall well-being, and see whether there is an imbalance in the health of your body and mind.
INNER CIRCLE A
The inner circle (A) represents optimum well-being. The more scores you have in this area, the stronger and better equipped you are to deal with stress and illness.MIDDLE CIRCLE B
Scores in the middle zone (B) mean that while things could be worse, they could be better. Examine these areas in your life for ways of making improvements.OUTER CIRCLE C
Any score in the outer zone (C) is cause for concern. A high number of dots in a particular outer zone (C) indicates an area of your life that requires specific attention.
Well-Being Questionnaire...Page 2
Well-Being Questionnaire...Page 1
MoonDragon's Alternative Health Index
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