Place your answers to the questions below on the scale, using a percentage of the time your partner generally displays these behaviors in your relationship. Answer the questions again, assessing how you think your partner would answer the same question, and put the percentage on the scale in parenthesis ( ).
1. Attending
When we are talking, I tend to stay with you and maintain eye contact and, in general, give you my full attention.
Rarely Often
(0————————————————————————————————————-100)
2. Listening
I listen thoughtfully when you are talking and pay attention to your words and your feelings. I do not let my mind wander or think about a retort before you are done talking. I do not interrupt you when you are talking.
Rarely Often
(0————————————————————————————————————-100)
3. Empathy
I make it a point to understand where your thoughts and feelings are coming from. I am able to see and feel what you’re experiencing and feel with you. You can count on me to understand you.
Rarely Often
(0————————————————————————————————————-100)
4. Communicating Understanding
I communicate that I hear and understand you and that I know where you are coming from. I respond to what you say before I express my own thoughts or feelings. I check out when I am not sure I understand you accurately. I realize that my hearing you doesn’t help very much unless you know you are being heard.
Rarely Often
(0————————————————————————————————————-100)
5. Respect
I let you know that I value you as a person and I see you as a unique human being with the wisdom of your own experiences. I affirm your right to be in charge of your own life. I am on your side. I am for you. I let you know that I want you to be all that you can be and all that you choose to be.
Rarely Often
(0————————————————————————————————————-100)
6. Accepting
I accept you the way you are. I do not try to change you or your behavior. You have a right to your own thoughts, feelings and attitudes. I may disagree with you at times, but I don’t try to change your view point. When I disagree with you, I make it a point to understand you without putting you down. When you disagree with me, I am not defensive or argumentative.
Rarely Often
(0————————————————————————————————————-100)
7. Assertive Without Being Aggressive
I do not suffer in silence, but I am not a bully either. I care for you, but I put a high priority on taking care of myself as well. I do not expect you to always to agree with me, but I do expect you to value what I have to say. I don’t say yes when I mean no. I want you to assert yourself in the same way.
Rarely Often
(0————————————————————————————————————-100)
8. Self-Revealing
I am open. I express my thoughts, feelings, wants, and fantasies freely and spontaneously. I am willing to talk about my weaknesses as well as my strengths. I am even willing to tell you things that embarrass me. I let you know what is really going on with me.
Rarely Often
(0————————————————————————————————————-100)
9. Immediacy
I talk about how it is with us—you and me. When a conversation bogs down, I stop and talk about what is going on between you and me, “here and now,” that might be getting in the way. I tell you what I like and don’t like about the way we relate to each other. I want you to do the same.
Rarely Often
(0————————————————————————————————————-100)
10. Straight Talk
I don’t use “smoke screens” like sarcasm, teasing, long-winded lectures, withdrawing, or sulking. I let you know straight what is going on, even if it means conflict. I ask for what I want. I think we are both strong and mature enough to deal with reality. Yet I am sensitive enough not to hurt needlessly.
Rarely Often
(0————————————————————————————————————-100)
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