1. List a recent conflict or negative situation you've had with your mate-partner-something that really "pushed your buttons."

Be sure that you and your mate write down the same conflict for the purpose of this survey.

2. How did you feel in response to that conflict or situation? How did that conflict or negative situation make you feel?

Circle all that apply—but "star" the most important feelings:

• Indifferent
• Unsure
• Apathetic
• Puzzled
• Upset
• Reluctant
• Sullen
• Provoked
• Sad
• Hurt
• Bored
• Disappointed
• Wearied
• Torn up
• Shamed
• Uncomfortable
• Baffled
• Confused
• Nervous
• Worried
• Annoyed
• Disgusted
• Resentful
• Bitter
• Fed up
• Frustrated
• Miserable
• Painful
• Guilty
• Embarrassed
• Frightened
• Anxious
• Horrified
• Afraid or scared
• Disturbed
• Furious
• Mad
• Other: ________________
• Other: ________________

3. How did that conflict make you feel about yourself? How did you feel about yourself? What did the conflict say about you? What was the "self" message—the message that it sent to you?

"As a result of the conflict, I felt …" (Circle all that apply—but place a "star" by the most important feeling)

• Rejected (not wanted)
• Abandoned
• Alone (disconnected)
• Failed or felt like a failure
• Helpless, powerless or impotent
• Unloved
• Defective "Something is wrong with me …
I'm the problem")
• Invalidated
• Inadequate
• Inferior
• Cheated
• Dissatisfied
• Worthless
• Degraded
• Humiliated
• Other: _______________________

4. What do you do when you feel _____________________________________ [insert the most important answer from question #3]? How do you cope when you feel …? What are your strategies to deal with that feeling?

Circle all that apply—but "star" the most important coping behaviors:

• Verbally defend self
• Withdraw
• Escalate
• Belittle or use sarcasm
• Develop negative beliefs
• Blame others ("It's your fault …")
• Passive-aggressive behaviors
• Care-taking
• Act out (e.g., affair or other acting out behaviors)
• Eating disorders
• Over function (do what others should be doing)
• Feel responsible for others
• Go into a "solve it" or "fix i" mode
• Spend or shop
• Addictions (i.e., drugs, alcohol, etc.)
• Complain
• Aggression or abuse
• Manipulate
• Anger or rage
• Catastrophize
• Numb out
• Humor
• Minimize
• Rationalize
• Indifference (unconcern or coldness)
• Abdicate (give away responsibilities)
• Neutral posture (become Switzerland)
• Self-depreciation (run-down or degrade self)
• Other: _________________
• Other: _________________

List below each spouse's fears and coping behaviors to diagram your own relational fear dance.

Husband's Fears:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Husband's Coping:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Wife's Fears:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Wife's Coping:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

Now that you have identified your fear dance, you are ready to take the next step. For you to break these negative patterns in your marriage that keep you stuck, we recommend two options:

Call our phone counseling team to arrange an appointment, so you can be coached through the next steps. 1-866-875-2915

Get your hands on our video series, "Solving the Real Love in the Real World Puzzle." This material is a great resource for either an individual couple or a group of couples to use for turning their Dance of Fear into a Dance of Honor!

Cut and paste this link: http://store.dnaofrelationships.com

Please don't hesitate to contact us if you think we might assist you in any other way.

© Copyright 2003 Smalley Relationship Center

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