Questionnaire – Clarifying Emotions

CLARIFYING EMOTIONS

You have an emotion which is limiting your peace, happiness or love. You want to understand where it is coming from and how to deal with. We methodically ask you the appropriate questions which guide you into a deeper understanding of how that emotion is created and how you might deal with it and free your self from it.

QUESTIONS CONCERNING YOUR PRESENT GOAL OF EMOTIONAL CLARITY
You may want to read or download the text: HOW OUR EMOTIONS ARE CREATED from the Life Clarification Capsules, so as to be able to answer these questions more effectively.

1. MY EMOTIONS

I would like to understand and deal with the following emotions. (You can check them off on the list and add your own.)

FEAR
GUILT
HURT
PAIN
ANGER
ABUSED
WORRY
DISILLUSIONMENT
DISCOURAGEMENT
REJECTION
ANXIETY
DEMEANED
INSECURITY
HATE
DEPRESSION
FRUSTRATION
LONELINESS
BITTERNESS
JEALOUSY
ENVY
UNWORTHY
RAGE
SELF REJECTION
SELF DOUBT
SHAME
INJUSTICE
MISUNDERSTOOD
ABANDONMENT
OTHERS

2. CHOOSING AN EMOTION

Which emotion would you like to work with first? (Suggestion: anger, hate and rage are usually second level emotions, which we feel because we are already feeling fear, pain or guilt. We suggest that you start out with emotions concerning pain or guilt and move on to those which encompass anger. It is, however, your choice).

I would like to start out with the emotion:

3. THE STIMULI:

Make a list of the “stimuli”; moments, events, behaviors and situations where you have felt this chosen emotion in the past. You may find that you have felt differently towards the same event, behavior or situation depending on various factors (ie. the persons, place, your own inner state). We will investigate those factors in the future. For the time being, include in your list all moments in which at least once you have felt the above emotion. You can select from the following list and also add your own:

1. When others do not agree with me.
2. When they do not understand me.
3. When they obstruct me from satisfying my needs.
(A need could be physical, practical, psychological, or even spiritual)
a. For physical needs such as sleep, food, sex, rest
b. Practical and safety needs such as a home, money, professional success
c. For emotional needs such as love, acceptance, approval, self affirmation, attention
d. Mental and spiritual needs such as to study, meditate, worship in my own way
4. When they do not respect me.
5. When they think they are superior.
6. When they try to control me or suppress me.
7. When they criticize me.
8. When they tell lies or gossip about me.
9. When they harm me or someone close to me.
10. When they have evil intentions or ulterior motives.
11. When they are negative, complaining, whining, criticizing etc.
12. When they think they know it all.
13. When they give me advice I have not asked for.
14. When they play the role of the victim, the poor me and want attention.
15. When they do not take care of themselves or do not carry their load.
16. When they make mistakes
17. When they do not keep their word or appointments.
18. When they are weak and dependent
19. When they act in an egotistical and selfish way, disregarding our or others’ needs
20. When they use me or others.
21. When they are cold and insensitive
22. When they are not responsible to their word or responsibilities
23. When they are lazy
24. When they ignore my needs
25. When they reject me.
26. When I make mistakes or do not succeed at some endeavor
27. When I do not live up to my conscience.
28. When I think of the past
29. When I think of the future
My future
My loved ones’ future

Other reasons:

4. My greatest source of tension / emotional disturbance is:

Family
Work
Health
Money
Friends
Love Relationship
A specific event which I am dealing with. Explain in no. 5

5. Other information which you would like to briefly share with us: (We will have an opportunity to go into more detail in future communications)

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