SPIRITUAL WELLNESS SELF-ASSESSMENT QUESTIONNAIRE
Using 1 as low and 10 as high, indicate to what degree you presently receive nurture, energy, support, or fulfillment from the following. But remember, it is not a contest and the scores are not cumulative. Each question stands alone and is informative for its own sake. When complete, ask, “What have I learned about myself here?”
- A satisfying. long term romantic love relationship?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - At least one mutually supportive, sometimes challenging, enduring friendship?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - A parenting relationship with at least one of your own offspring or another child for whom you have been a primary “parenting one”?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - A consistently nurtured sense of wonder at the beauty, rhythms and miracles of nature?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - A relationship with a personal God as a life partner, who is “on your side”, likes you, cares about your feelings / experiences, is fairly consistently close to you?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Harmony with non-personal forces of the universe, e.g. through meditation, scientific exploration, philosophy?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - A productive relationship with a personal helper, e.g. a spiritual director, therapist, clinical supervisor, counselor, addiction sponsor?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Success in an art of giving help to others, e.g. as a therapist, minister, health care practitioner, counselor?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - An individuated, mutually supportive and understanding relationship with at least one of your parents?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Effective physical self care, including maintaining healthy weight, moderate if any drinking, no smoking, adequate rest, sound diet?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Habitual, effective emotional self care, including affective awareness, assertiveness, and sharing or otherwise dealing with your own feelings?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Success in your primary chosen way of dealing with the urges of sexual expression, e.g. through regular enough sexual activity, satisfying celibacy, etc.?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Finding your best work satisfying and appreciated by key others?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Athletic accomplishment satisfying to you?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Regular, active involvement in a hobby that delights you?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Consistent, enriching involvement in a faith community including regular use of religious writings, symbols, traditions, and practices?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Making a (to you) satisfying contribution to the human community as a whole, through e.g. political activity to improve world living conditions, involvement in social action causes, writing for others’ benefit, etc.?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Integrating losses into your life, e.g. deaths of close people, your own disability, divorce?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Confronting your mortality, facing your own death with wisdom rather than heavy denial, bitterness, depression?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Accomplishment in or appreciation of creative endeavors, i.e. the arts, e.g. in music, theater, painting, literature?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Encountering “the new” in educational partnership with teachers / learners e.g. delight in your own learning, teaching, being a mentor?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Adjusting for and appreciating the limitations or your own aging e.g. diminished health, vigor and appearance along with increased wisdom, magnanimity, and insight?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Cultural background enrichment?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Feeling validated and mentored by the elder men / women?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Communing with your family of origin as a whole?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Patriotic activity for the good of your homeland?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Neighboring with people who live near you?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Tuning in to your treasuring of your own person?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Nesting, i.e. arranging, maintaining, and enjoying the ambiance of your own living space?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Viewing your earning, having, and spending of money as personally enriching and “enough”?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Fellowship or sisterhood with your gender peers?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Connectedness with any siblings who shared the same family of origin?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10 - Acceptance, respect and validation from your chronological, employment, professional or athletic peers?
1 * * * * 2 * * * * 3 * * * * 4 * * * * 5 * * * * 6 * * * * 7 * * * * 8 * * * * 9 * * * * 10