Survey on Personal Boundaries
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Check the word that most applies to how you truly feel
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1. I can't make up my mind.	Never Seldom Occasionally Often Usually
2.I have difficulty saying "no" to people.	Never Seldom Occasionally Often Usually
3.I feel like my happiness depends on other people.	Never Seldom Occasionally Often Usually
4. It's hard for me to look a person in the eyes.	Never Seldom Occasionally Often Usually
5. I find myself getting involved with people who end up hurting me.	Never Seldom Occasionally Often Usually
6. I trust others.	Never Seldom Occasionally Often Usually
7. I would rather attend to others than attend to myself.	Never Seldom Occasionally Often Usually
8. Others' opinions are more important than mine.	Never Seldom Occasionally Often Usually
9. People take or use my things without asking me.	Never Seldom Occasionally Often Usually
10. I have difficulty asking for what I want or what I need.	Never Seldom Occasionally Often Usually
11. I lend people money and don't seem to get it back on time.	Never Seldom Occasionally Often Usually
12. Some people who I lend money don't ever pay me back.	Never Seldom Occasionally Often Usually
13. I feel ashamed.	Never Seldom Occasionally Often Usually
14. I would rather go along with another person or other people than express what I'd really like to do.	Never Seldom Occasionally Often Usually
15. I feel bad for being so "different" from other people.	Never Seldom Occasionally Often Usually
16. I feel fear, anxious, scared or afraid.	Never Seldom Occasionally Often Usually
17. I spend my time and energy helping other so much that I neglect my own wants and needs.	Never Seldom Occasionally Often Usually
18. It's hard for me to know what I believe and what I think.	Never Seldom Occasionally Often Usually
19. I feel like my happiness depends on circumstances outside of me.	Never Seldom Occasionally Often Usually
20. I feel good.	Never Seldom Occasionally Often Usually
21. I have a hard time knowing what I really feel.	Never Seldom Occasionally Often Usually
22. I find myself getting involved with other people who end up being bad for me.	Never Seldom Occasionally Often Usually
23. It's hard for me to make decisions.	Never Seldom Occasionally Often Usually
24. I get angry.	Never Seldom Occasionally Often Usually
25. I don't get to spend much time alone.	Never Seldom Occasionally Often Usually
26. I tend to take on the moods of people close to me.	Never Seldom Occasionally Often Usually
27. Have a hard time keeping a confidence or secret.	Never Seldom Occasionally Often Usually
28. I am overly sensitive to criticism.	Never Seldom Occasionally Often Usually
29. I feel hurt.	Never Seldom Occasionally Often Usually
30. I tend to stay in relationships that are hurting me.	Never Seldom Occasionally Often Usually
31. I feel an emptiness, like something is missing in my life.	Never Seldom Occasionally Often Usually
32. I tend to get caught up "in the middle" of other people's problems.	Never Seldom Occasionally Often Usually
33. When someone I'm with acts up in public, I tend to feel embarrassed.	Never Seldom Occasionally Often Usually
34. I feel sad.	Never Seldom Occasionally Often Usually
35. It's not easy for me to really know in my heart about my relationship with a Higher Power or God.	Never Seldom Occasionally Often Usually
36. I prefer to rely on what others say about what I should believe and do about religious or spiritual matters.	Never Seldom Occasionally Often Usually
37. I tend to take on or feel what others are feeling.	Never Seldom Occasionally Often Usually
38. I put more into relationships than I get out of them.	Never Seldom Occasionally Often Usually
39. I feel responsible for other people's feelings.	Never Seldom Occasionally Often Usually
40. My friends or acquaintances have a hard time keeping secrets or confidences which I tell them.	Never Seldom Occasionally Often Usually

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Assessing and scoring this survey
Assessing and scoring this survey is similar to that of the Recovery Potential Survey, also found on this website. The more "Usuallys" and "Oftens" tend to indicate more boundary issues. They may also indicate some confusion over boundaries and limits, often called "blurred" boundaries. A person who answered all or mostly "Nevers" may not be aware of their boundaries. A person who has healed their Child Within would tend to answer many "Seldoms" and some "Occasionallys."

Rare items, like number 20, would be scored in the reverse.

If you have questions about any of these areas and dimensions of boundaries and limits, ask your therapist, counsellor, therapy group or other appropriate person -- including your Child Within.

I describe this scoring in more detail in my book on Boundaries and Relationships.

Adapted from the book, A Gift to Myself

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